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Vulvovaginal complaints in the prepubertal child

Authors
Marc R Laufer, MD
S Jean Emans, MD
Section Editors
Jan E Drutz, MD
George A Woodward, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

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 [1]. 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.

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".)

NONSPECIFIC VULVOVAGINITIS

Nonspecific vulvovaginitis is responsible for 25 to 75 percent of vulvovaginitis in prepubertal girls [2]. There are a number of potential factors in children that increase their risk of vulvovaginitis: lack of labial development, unestrogenized thin mucosa, more alkaline pH (pH 7) than postmenarchal girls/women, poor hygiene, bubble baths, shampoos, deodorant soaps, obesity, foreign bodies, and choice of clothing (leotards, tights, and blue jeans).

Chronic masturbatory activity can lead to vulvar irritation with occasional thickening of the clitoral hood. Sexual abuse is another etiology of nonspecific vulvovaginitis. Some girls with nonspecific vulvovaginitis seem to experience recurrences at the time of upper respiratory infections.

Once a specific etiology (listed below) for the symptoms has been excluded, the following recommendation for parents may be of help:

                         

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Literature review current through: Nov 2016. | This topic last updated: Wed Nov 18 00:00:00 GMT+00:00 2015.
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