Cryosurgery in the treatment of lichen sclerosus et atrophicus of the vulva

Twelve patients with lichen sclerosus et atrophicus of the vulva were treated by a nitrous oxide cryoprobe. All had had severe itching which was relieved in the post-operative period in 75% and for 3 years in 50%. Eight had histologically proven leukoplakia which cleared post-operatively in five (62.5%) and remained clear at three years in four (50%). In one patient pruritus, leukoplakia and ultimately squamous carcinoma appeared.

Treatment of genital warts by cryosurgery--a follow-up study

This is a follow-up study involving 50 patients who were treated as outpatients for genital warts using cryosurgery. Single and multiple lesions involving the vulva, vagina and cervix were treated. A cryoprobe cooled to minus 70 degrees centigrade by liquid carbon dioxide and applied to the lesion for 2 1/2 to 3 minutes was used in the treatment. Nine pregnant patients in this study treated with cryosurgery did not experience any adverse effects on their pregnancies. There were no adverse side effects noted among the rest of the patients. All the patients with single wart were treated successfully with cryosurgery whereas those with multiple lesions were successfully treated in only 82 per cent of the patients. Four patients did not respond to treatment. Recurrence after cryosurgery within 3 months of therapy was noted in 2 patients. In conclusion, the treatment of genital warts by cryosurgery was found to be a safe and effect procedure.

[Bartholinitis--sepsis--pancreatitis (author's transl)]

The article describes an acute inflammation of Bartholin's gland named after the Danish anatomist Caspar Thoméson Bartholin, jr. (1655--1738), which eventually led to hospitalisation of a 47-year old woman for a period of two months involving many complications: truly a case of a small cause producing a great effect! Similar cases have not been found in the literature referred to by us, and hence publication of this unusual case appears justified.

Case report: Bartholin gland cyst in the cow

Images

Benign enlargement of the labia minora: report of two cases

2 cases of bilateral hypertrophy of the labia minora are recorded. The patients presented with vulvar discomfort and redundant labia and reduction vulvoplasty was carried out. The resected specimens showed marked hyperplasia of the non-hair-bearing sebaceous glands, acanthosis, keratosis, and hyperpigmentation of the epithelium and a variable degree of neoangiogenesis and fibrosis in the upper dermis. No cause was established clinically or pathologically. The etiology and pathogenesis of this condition are briefly discussed.

Urogenital sinus origin of mucinous and ciliated cysts of the vulva

The origin of mucinous and ciliated cells in the vulva and the pathogenesis of cysts lined by these epithelia were investigated. Small mucinous glands numbering from one to more than a hundred were encountered in 9 of 19 vulvas (53%) that were consecutively examined at autopsy. Eleven other cysts were encountered clinically. Six were lined by mucinous epithelium, three by pseudostratified cells with cilia plus small foci of mucinous epithelium, and two by ciliated epithelium only. Four of the cysts with ciliated epithelium were otherwise typical Bartholin's gland cysts. It is concluded that glands lined by either mucinous or ciliated epithelia are normal constituents of the vulvar vestibule, are derived from urogenital sinus, and develop into cysts when the neck leading to the vulvar surface becomes inflamed and obstructed.

Laser surgery in gynecology

More experience and time are required to determine the advantages of laser surgery in gynecology. For precision surgery through the colposcope, the carbon dioxide laser beam appears to be useful in the control of neoplastic lesions of the vaginal mucosa and possibly of the cervix uteri. Tumor volume reduction through laser vaporization, especially when a recurrent tumor is attached to the bony pelvis, is an outstanding advantage. Adhesiolysis during myomectomy and reconstructive surgery of the fallopian tubes might be facilitated by the laser beam. Laser surgery on the vulva, both colposcopically directed and grossly with the CO2 laser scalpel, might prove to be important for the treatment of various lesions. Detailed technical knowledge, rigid safety precautions, and judicious clinical considerations are essential for competent laser surgery.

Gynecologic surgery using the CO2 laser (light amplification by stimulated emission of radiation)

The laser is a new tool which can be a precise and accurate instrument for tissue removal under colposcopic direction in the areas of the cervix, vagina and vulva. Healing is rapid since the laser inflicts minimal tissue destruction. Postoperative pain is minimal and healing is without scar formation. The expense of the equipment and training of the operating surgeon are its only drawbacks.

Vulvar fusion-unusual cause of urinary obstruction

A case of urinary obstruction caused by vulvar fusion in an adult is reported. Anterograde micturition-urethrocystography revealed reflux of urine in the vagina and cavum uteri. Treatment consisted of sharp separation of the labia. Ointment dressing was applied to prevent reagglutination. After 1 year the patient has no urological complaints.

Mucocele-like changes in Bartholin's glands

Two cases are described in which changes identical to those of oral mucocele occurred in Bartholin's glands. The histopathology, histochemistry, and pathogenesis are discussed.

Hypertrophy of the labia minora

Gynecologic disorders during childhood and adolescence have received relatively little attention. Since earlier sexual activity among teenage girls is becoming more common, it is desirable that those interested in the diseases of women keep abreast of the current developments in adolescent gynecology. Two patients with congenital hypertrophy of the labia minora are presented and the treatment is discussed.

Crohn's disease of the vulva

Over the past 10 years, it has been well established that Crohn's disease may involve any segment of the gastrointestinal tract from the mouth to the anus and may also cause destructive extraintestinal lesions. Extensive cutaneous ulceration has recently been recognized as one of the rare extraintestinal complications. A case of chronic vulvar ulceration due to Crohn's disease is reported. The clinical manifestations and management of such a lesion are discussed.