Subject: GYNECOLOGY

BENIGN AND MALIGNANT DISEASES

OF THE VULVA AND VAGINA
BENIGN DISEASES OF THE VAGINA AND
VULVA
Contents:
a.
b.
c.
d.
e.

Etiology
Screening
Diagnosis
Diagnostic Techniques
Management

Urethral Caruncle
-

Small fleshy outgrowth of the distal

edge of the urethra.
Soft, smooth, friable bright red
appears as an eversion of the urethra.
Generally, small maybe pedunculated
and grow 1-2 cms in diameter.
Arises from ectropion of the posterior
urethral wall associated with retraction
and atrophy of the vagina.

Signs and sympotms:

-

Many are asymptomatic

Dysuria, frequency, urgency
Point tenderness after contact
Ulcerative lesions: spotting on contact,
more than hematuria.

Differential Diagnosis:
1.
2.
-

Urethral carcinoma
bleeding, urinary frequency, dysuria
mass with tenderness and ulceration
Urethral Prolapse
Perimenopause
Most asymptomatic

Establish Diagnosis: BIOPSY

Management:

Transcriber: John Vincent Pagaddu & Harold Briosos

1.
2.
3.
4.
5.

Dr. Ellen Manzano

Topical estrogen and avoid irritation

Cryosurgery
Laser therapy
Fulguration
Operative excision

CYSTS
1.
-

Bartholins gland
Cystic dilation of duct
2% are asymptomatic
Treated when infected

2. Wolffian duct or Mesonephric

cysts
- RARE
- Thin walls with serous fluid near the
clitoris/hymenal ring
3.
-

Skenes duct
RARE
Found on examination
Arise from scarring of the small ducts
secondary to infection
Asymptomatic in premenopausal
women
Treatment:
o Excision careful to prevent
urethral injury
o Conservative

4. Vulvar
- Epithelial cyst
o Beneath epidermis, anterior half
of the labia majora
o Multiple, freely movable, round
slow growing
o Nontender
o White or yellow caseous like
thick cheese
o Local scarring when rupture
occurs,
o Inflammatory reaction in the
subcutaneous tissue.
5. Inclusion cyst
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If from vagina secondary to trauma,

OB like episiotomy
Vulva: histogenesis include embryonic
remnants and occlusion of
pilosebaceous ducts of sweat glands
Differential diagnosis:
o Fibroma

Transcriber: John Vincent Pagaddu & Harold Briosos

o Lipoma
o Hidradenomas
Treatment:
o Heat compression
o EXCISION

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