The MUSC Department of Obstetrics and Gynecology has developed a program to address problem vulvar and vaginal diseases. This program provides the patient with expert diagnosis and treatment of problem vulvovaginal diseases such as vulvar dystrophies and dysplasia, vulvodynia, vestibulitis, and recurrent vaginitis. About Vulvar Disease:
Persistent vulvar symptoms such as itching and burning can be a sign of a more serious disease than routine vaginitis. Vulvar dystrophies are characterized by a change in the skin of the vulva. This skin can become either abnormally thick (squamous cell hyperplasia) or too thin like cigarette paper (lichen sclerosis). Moreover, precancerous changes (vulvar intraepithelial neoplasia or VIN) can also present in this way. Painful sexual intercourse is the hallmark symptom of women with vestibulitis. Accurate diagnosis and effective therapy can restore normal sexual function. Finally, many women experience a chronic burning sensation of the vulva with no obvious abnormality found during examination. These women require an experienced clinician’s approach to the diagnosis and treatment of vulvodynia. Care of Women with Recurrent Vaginitis:
Most women experience a least one episode of vaginitis during their lives. The most common diagnoses found in women with chronic, recurrent vaginitis are:
1) Bacterial vaginosis,
2) Vulvovaginal candidiasis
3) Inflammatory vaginitis
Trichomonas vaginitis rounds out the list of causes of recurrent vaginitis. Fortunately, only a small percentage of women will develop chronic, recurrent disease. These patients deserve the best in accurate diagnosis and up-to-date therapy that our Vulvovaginal Disease Program has to offer. Early diagnosis and medical therapy can forestall and even prevent the secondary detrimental effects of chronic infection on the lower genital tract. 
| Bacterial Vaginosis (BV) is the most common form of vaginitis in women of reproductive age. BV is associated with several reproductive sequelae including preterm labor and delivery, postoperative infections, and susceptibility to sexually transmitted infections. |
Our approach to diagnosis is dependent upon seeing the patient when she is symptomatic and performing the appropriate diagnostic testing including microscopy of the vaginal secretions and culture. Once the diagnosis is confirmed induction therapy to promote the remission of symptoms is instituted. Following this, patients are placed on suppressive therapy to prevent relapse of their symptoms. In difficult cases, antibiotic resistance can be found. Testing can be performed to determine the nature of this resistance and modern antimicrobials, some available only through a compassionate use program, can be made available. Why Choose MUSC for Women's Health?
MUSC is fortunate to have experienced physicians to both diagnose and treat persistent vulvovaginal symptoms and their causes. Dr. Soper is one of the few ob/gyn physicians in the country trained in Infectious Diseases and is a well respected researcher in this area. Moreover, clinical trials are always underway at Cannon Place allowing the patient an opportunity for participation in utilizing the most up-to-date therapies. In addition, both Drs. Soper and Underwood have advanced experience [more than 50 years of combined experience] in the surgical therapy of vulvar disease including vestibulectomy for vestibulitis. This highly curative operation, done in the outpatient setting, can restore normal sexual function in women who are candidates for this treatment. Finally, Dr. Underwood is particularly adept at managing the patient with dysfunction following previous surgical therapy involving the vulva and vagina. The Vulvovaginal Disease Program emphasizes the ideal patient encounter and physician-patient communication. Practitioners Involved:
Dr. David Soper , MUSC Women’s Health at Cannon Place
Dr. Paul Underwood , East Cooper Women’s Center MUSChealth.com Online Library Links:
What is vaginitis?
Sexually Transmitted Diseases
Other Online Resources:
Vulvar Anatomy- National Vulvodynia Association
Bacterial Vaginosis- American Academy of Family Physicians
Bacterial Vaginosis (BV)- Centers for Disease Control and Prevention
Genital Candidiasis (Vulvovaginal Candidiasis (VVC), Vaginal Yeast Infections)- National Center for Infectious Diseases
Candidiasis genital (candidiasis vulvovaginal (CVV) e infecciones vaginales por levaduras)- National Center for Infectious Diseases
Information to Live By: Vaginitis- American Social Health Association
Vulvar Problems- American College of Obstetricians and Gynecologists
Vulvodynia- American Academy of Family Physicians
Vulvodynia- Mayo Foundation for Medical Education and Research
General Information- National Vulvodynia Association
Genital Problems in Women: Self-Care Flowcharts -American Academy of Family Physicians
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