Vulval disorders in paediatric and adolescent patients and their management

Abstract

Key content Vulval disorders are one of the commonest complaints in the paediatric and adolescent population. They present with acute‐on‐chronic symptoms such as pruritus, vaginal discharge and vulval soreness. History‐taking and examination of young patients requires a sensitive approach and age‐appropriate use of language. The hypoestrogenic, exposed and neutral pH of the vulva in the paediatric patient is more susceptible to nonspecific inflammation and injury. Adolescents are more likely to present with dermatoses, thrush and infection caused by common pathogens such as Escherichia coli, group A streptococcus and sexually transmitted infections. A conservative approach with reassurance and follow‐up is required in most vulval disorders. Learning objectives To appreciate the different gynaecological history and examination techniques required for paediatric and adolescent patients. To understand the common presentations and conditions of vulval pathology in these groups of patients. To gain confidence in managing common, non‐malignant vulval pathology in young patients. Ethical issues Reassurance of normal vulval anatomy should be provided for young patients requesting labial reduction surgery.