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Latest Research Advances in Vulvar Disease
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Latest Research Advances in Vulvar Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 3914

Special Issue Editor

Dr. Julia Jückstock

E-Mail Website
Guest Editor
Assistant Professor of Gynecology and Obstetrics, RoMed Klinik Wasserburg am Inn, Wasserburg am Inn, Germany
Interests: vulvar diseases such as lichen sclerosus, vulvodynia, and vaginism, vulvar dysplasia and vulvar carcinoma; infectious diseases of the vulvar and vagina

Special Issue Information

Dear Colleagues,

Compared to other gynecologic conditions, vulvar diseases are rare. Additionally, many vulvar patients are elderly women who do not fit into “classical” study settings. Thus, experimental as well as clinical research in this area is scarce. Advances in understanding the pathomechanisms of vulvar diseases are, however, of crucial importance for those patients in order to be able to offer them efficient treatment options. Most symptomatic non-pregnant gynecologic patients seek consultation due to vulvar and/or vaginal problems. The majority can be cured with locally applied antibiotics, but some of them suffer from different conditions, and therefore have to be asked thoroughly about their anamnesis and treated differently: pruritus is the key symptom of both harmless problems and vulvar carcinoma, and even specialists sometimes do not know how to correctly diagnose and treat the underlying condition. Besides inspection, supplemented by vulvoscopy, biopsy samples are helpful in identifying the correct diagnosis. As the conditions are wide-ranging, treatment has to be many-sided: in non-malignant vulvar diseases, locally applied cremes, solutions, and tinctures are indicated, while in pre-malignant and malignant disease, surgery is the only promising cure. The radicality of the surgical procedures has recently been reduced. This is true both for groin lymph node dissection where, in some cases, sentinel lymph node excision is possible, and tumor-free margins where less healthy tissue is required in the surgical specimen than even a few years ago. Awareness of vulvar diseases has begun to grow among gynecologists, but it also has to increase in clinicians of other medical disciplines.

Dr. Julia Jückstock
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vulvar disease
  • Lichen sclerosus
  • Vulvodynia
  • Vulvar dysplasia
  • Vulvar carcinoma
  • Vulvar surgery

Published Papers (2 papers)

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Research

8 pages, 1319 KiB  
Article
Fractional Carbon Dioxide Laser Improves Vaginal Laxity via Remodeling of Vaginal Tissues in Asian Women
by Lin Gao, Wei Wen, Yuanli Wang, Zhaoyang Li, Erle Dang, Lei Yu, Chenxi Zhou, Meiheng Lu and Gang Wang
J. Clin. Med. 2022, 11(17), 5201; https://doi.org/10.3390/jcm11175201 - 2 Sep 2022
Cited by 6 | Viewed by 1396
Abstract
Background: Vaginal laxity (VL) is characterized by the relaxing of the vaginal wall that affects the quality of life and sexual function of patients. The current management of VL such as Kegel exercises and topical or systemic hormonal replacement results in unsatisfactory outcomes; [...] Read more.
Background: Vaginal laxity (VL) is characterized by the relaxing of the vaginal wall that affects the quality of life and sexual function of patients. The current management of VL such as Kegel exercises and topical or systemic hormonal replacement results in unsatisfactory outcomes; thus, novel modalities are needed to improve the efficacy. Vaginal fractional carbon dioxide (CO2) laser treatment has shown growing applications for the treatment of VL, but results show nonconformities due to the lack of objective evaluations. In this study, we aimed to validate the clinical efficacy and biophysical benefits of fractional CO2 laser treatment for VL patients with the incorporation of objective approaches. Methods: This is a descriptive study without controls. A total of 29 patients were enrolled and treated with two sessions of FemTouch vaginal fractional CO2 laser, with a one-month interval between sessions. Both subjective and objective measurements, including female sexual function index (FSFI), vaginal health index score (VHIS), vaginal tactile imaging (VTI), and histology were used to validate the clinical efficacy and biophysical benefits after treatment. Results: The overall FSFI scores and VHIS scores after the first and second treatment sessions were significantly higher than the baseline scores (p < 0.01, n = 29). VTI measurements showed a significant increase in maximal pressure resistance (kPa) of both the anterior and posterior vaginal walls at a 10–12-month post-treatment visit compared with pre-treatment controls (p < 0.001; n = 16). Histological examination showed that laser treatment led to increases in the thickness of the stratified squamous epithelium layer and density of connective tissues in the lamina propria. Conclusions: Fractional CO2 vaginal laser treatment can improve both vaginal health and sexual function and restore vaginal biomechanical properties by increasing vaginal tissue tightening and improving vaginal tissue integrity in Asian women. Our data support that fractional CO2 vaginal laser is a valid treatment modality for VL. Full article
(This article belongs to the Special Issue Latest Research Advances in Vulvar Disease)
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15 pages, 1976 KiB  
Article
Influence of Photodynamic Therapy on Lichen Sclerosus with Neoplastic Background
by Magdalena Bizoń, Danuta Maślińska and Włodzimierz Sawicki
J. Clin. Med. 2022, 11(4), 1100; https://doi.org/10.3390/jcm11041100 - 19 Feb 2022
Cited by 4 | Viewed by 1954
Abstract
Background: Lichen sclerosus is the most common nonmalignant vulvar disease with morbidity in postmenopausal age. The first line of treatment is corticosteroid therapy. In case of insufficiency, tacrolimus or pimecrolimus can be provided. Photodynamic therapy (PDT) can be used as alternative way of [...] Read more.
Background: Lichen sclerosus is the most common nonmalignant vulvar disease with morbidity in postmenopausal age. The first line of treatment is corticosteroid therapy. In case of insufficiency, tacrolimus or pimecrolimus can be provided. Photodynamic therapy (PDT) can be used as alternative way of treatment while symptoms recurrent despite other methods. Methods: the analyzed population of 182 women with diagnosis of lichen sclerosus treated using PDT was divided into three groups: patients with neoplastic disease or intraepithelial neoplasia; those with a positive family history of neoplastic disease; and a control group with no neoplastic disease and no familial history of neoplastic diseases. Results: Reduction of vulvar changes was assessed in the whole vulva in the groups as 21.9%, 21.2% and 21.8%, respectively. The most frequent symptom, itching, was reported to decrease in all groups, 39.3%, 35.5% and 42.5%, respectively. Improvement of quality of life was assessed in 91.3% of the whole group, stabilization of lichen sclerosus in 7.1% and progression in 1.6%. Conclusions: Photodynamic therapy gives positive results in most cases. Improvement after PDT is observed in objective vulvoscopic assessment and in subjective patients’ opinions. Neoplastic disease in the past can influence the effectiveness of PDT. Full article
(This article belongs to the Special Issue Latest Research Advances in Vulvar Disease)
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