Overview of vulvovaginal complaints in the prepubertal child
- Marc R Laufer, MD
Marc R Laufer, MD
- Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
- S Jean Emans, MD
S Jean Emans, MD
- Mary Allen Avery Professor of Pediatrics
- Harvard Medical School
- Section Editors
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
- George A Woodward, MD
George A Woodward, MD
- Section Editor — Pediatric Signs and Symptoms
- Professor of Pediatrics
- University of Washington School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will discuss common vulvovaginal disorders in this population. The gynecological history and physical examination and techniques for obtaining cultures in these children are reviewed separately. (See "Gynecologic examination of the newborn and child".)
Vulvovaginal complaints in prepubertal children may be the result of infection, congenital abnormalities, trauma, or dermatologic conditions. Vaginitis may have a nonspecific etiology or may be due to known pathogens. It is the commonest gynecological problem in prepubertal girls . Symptoms include vaginal discharge, erythema, soreness, pruritus, dysuria, and bleeding. Occasionally, urinary tract or bowel symptoms may be interpreted by a child as vulvar or vaginal complaints.
Nonspecific vulvovaginitis is responsible for 25 to 75 percent of vulvovaginitis in prepubertal girls . There are a number of potential factors in children that increase their risk of vulvovaginitis:
●Lack of labial development
●Unestrogenized thin mucosa
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- NONSPECIFIC VULVOVAGINITIS
- SPECIFIC INFECTIONS
- Respiratory and enteric flora
- Gardnerella vaginalis
- Sexually transmitted diseases
- - Neisseria gonorrhoeae
- - Chlamydia trachomatis
- - Trichomonas vaginalis
- - Condylomata acuminata
- FOREIGN BODY
- POLYPS, SKIN TAGS, OR TUMORS
- SYSTEMIC ILLNESS
- VULVAR ULCERS
- URINARY TRACT PATHOLOGY
- Ectopic ureter
- Urethral prolapse
- CUTANEOUS VULVAR DISEASE
- Lichen sclerosus
- Labial adhesions
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS