Disorders of Vulva, Vagina and Cervix

Cervical cancer, or invasive cervical carcinoma (ICC), is the 3rd most common cancer in women in the world, with > 50% of the cases being fatal. In the United States, ICC is the 13th most common cancer and the cause of < 3% of all cancer deaths due to the slow progression of precursor lesions and, more importantly, effective cancer screening. There are 2 major histologic types of ICC: squamous cell carcinoma (SCC) and adenocarcinoma. High-risk human papillomaviruses (hrHPVs) cause > 99% of SCCs and > 85% of adenocarcinomas. Early cervical neoplasia is asymptomatic, and diagnosis is made using routine screening methods, including the cervical Papanicolaou test with cytology, hrHPV testing, and biopsy. Treatment of precursor or dysplastic lesions depends on the severity of the dysplasia and the age of the patient. Management of ICCs depends on the stage and varies from excisional biopsy by cervical cone biopsy for microinvasive ICC to radical hysterectomy for more advanced cases. If there is extracervical spread, radiation and chemotherapy would be recommended.

A number of hormone-mediated processes take place in the female genitals. The follicle maturation in the uterus, formation of the mammary gland tissue and lactation are processes that are basic knowledge to medical students. In the following, the most important facts are listed. Afterwards you can use the three exam questions to control your knowledge.

Colpitis and bacterial vaginoses are diseases of the vagina. Apart from the symptoms themselves, there is always the risk of an ascending infection. Also inflammations of the outer genitals are an important clinical issue. For one thing, vulvitis is very frequent and ubiquitous. Furthermore, the outer genitals are so sensitive that diseases can cause great discomfort for the patient, even if they often are harmless. Here you can read all about pathogens, diagnostics and treatment.

Abnormal looking cervix can be seen commonly in gynecology in day to day practice. It becomes necessary to differentiate between normal physiological changes brought by normal menstrual cycle from the anatomical and pathological disorders. Colposcopic examination of cervix with a stereoscopic binocular magnifying glasses is extremely helpful for identification of the possible etiology behind and exclusion of any cancerous growth to establish the diagnosis. The etiologic reasons of abnormal cervix can be physiological, infectious, abnormal growth and iatrogenic. This article provides a step-by-step approach to differentiating them.