Non-Specific Vulvovaginitis and Labial Agglutination

00:01 Let's now talk about non-specific causes of vulvovaginitis.

00:05 Sometimes you can see vulvovaginitis in young girls specifically because they are now starting to toilet on their own and do their own hygiene regimen.

00:16 This can sometimes lead to poor hygiene.

00:18 So it's important to emphasize good hygiene in these patients.

00:23 Also, you should encourage young girls to wear white cotton underpants as sometimes colored or dyed underwear can cause irritation.

00:32 Avoidance of bubble baths and shampooing in the bath or using harsh soaps is advised as this can irritate the vulva, which is sensitive.

00:42 Loose fitting underpants and pajamas are necessary.

00:46 If a young girl is in gymnastics, ballet or perhaps figure skating, those outfits and costumes can be very tight and cause chronic irritation.

00:55 And in addition girls can sit in plain water and it helps protect the vulva and perineum and also encourages good hygiene.

01:05 This is sometimes referred to as a sitz bath.

01:08 I also want to bring your attention to labial agglutination.

01:12 This is happens in a hypoestrogenic state and what happens is the labia actually stick together.

01:19 This can be very painful.

01:21 In the first picture here you'll see evidence of a labial agglutination.

01:27 However, after treatment you can see that the labia can be separated.

01:30 This is a cartoon representation of what labial agglutination looks like.

01:36 You can see here that maybe there is a clitoris and the labia are fused.

01:40 You can try to separate them gently with the q-tip.

01:44 If they don't separate naturally don't force it.

01:48 These patients require estrogen therapy and typically they'll get better and their labia will actually fall apart on their own.

01:56 Okay, let's review everything that we've discussed.

02:02 Don't forget that little girls are vulnerable to sexual abuse.

02:06 The most common foreign body in a young girl causing vaginitis is toilet tissue.

02:11 Young girls lack estrogen making their vulva prone to irritation.

02:17 All abused in young girls needs to be reported to the local authorities.

02:22 Good hygiene and appropriate clothing can prevent non-specific vulvovaginitis.

02:29 Thank you for listening and good luck on your exam.