Abnormalities Of Female Genitalia ✅ Flashcards
(44 cards)
What can abnormalities of the female genitalia be split into?
- Internal or external
- Acquired or congenital
Give 3 examples of congenital abnormalities of the female external genitalia?
- Imperforate hymen
- Vaginal agenesis
- Congenital adrenal hyperplasia
What is the most common presentation of imperforate hymen?
Bulging introital mass as neonate
What are the lour common presentations of imperforate hymen?
Primary amennorhoea or urinary retention in post-pubertal girls
How may imperforate hymen be first identified?
On routine antenatal scans
How is imperforate hymen treated?
Surgical incision of the imperforate hymen
What is vaginal agenesis also known as?
Mayer-Rokitansky syndrome
Does vaginal agenesis occur alone or in conjunction with other abnormalities?
May occur alone but most commonly seen with other abnormalities
What does vaginal agenesis usually occur as part of?
A spectrum of abnormalities resulting from failure of organogenesis of the mesonephric and the paramesonephric duct structures
How much of the vagina is absent in vaginal agenesis?
Classically, upper 2/3 is absent bur may be completely absent or manifest as a dimple in the perineum
How common is vaginal agenesis as a cause of primary amennorhoea?
It is the most common cause
Give 2 acquired causes of abnormalities of female external genitalia?
- Labial adhesions
- Vaginal discharge
How do labial adhesions appear?
The labia minora becomes fused together to give a ‘blank’ appearance of the perineum
Who are labial adhesions most common in?
2-6 year olds
What causes labial adhesions?
Thought to be response to inflammation e.g. vulvovaginitis
What problems result from labial adhesions?
Rarely cause problems but can sometimes cause obstruction or deviation in normal urinary stream
What are the management options for labial adhesions?
- Conservative management
- Surgical management
- Treatment with oestrogen creams
Why is conservative management an option in labial adhesions?
The natural history of labial adhesions is that they’ll revolve spontaneously
What is the limitation of oestrogen creams in the management of labial adhesions?
In pre-pubertal girls the lack of circulating oestrogens means they often reform on stopping topical oestrogens
When might surgical management of labial adhesionbe indicated?
In severely symptomatic cases, eg severe disruption of urine flow
How severe can the disruption of urine flow be in labial adhesions?
Stream from urethra can be directed upwards by dense adhesions
What is the problem with severe disruption of urine flow in labial adhesions?
Can be difficult to keep flow of urine diverted to toilet or potty
Is vaginal discharge common in prepubertal girls?
No, is uncommon
Is vulvovaginitis common in prepubertal girls?
Yes
