Journal of Lower Genital Tract Disease最新文献

{"title":"More Steps Forward for the Journal of Lower Genital Tract Disease.","authors":"Jacob Bornstein","doi":"10.1097/LGT.0000000000000774","DOIUrl":"10.1097/LGT.0000000000000774","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"1-2"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Lichen Sclerosus and Vulvodynia Content Across Social Media Platforms: What Is Trending Over Time.","authors":"Samantha Shiplo, Brintha Sivajohan, Amanda Selk","doi":"10.1097/LGT.0000000000000782","DOIUrl":"10.1097/LGT.0000000000000782","url":null,"abstract":"<p><strong>Objectives: </strong>Vulvovaginal diseases are common gynecologic complaints and patients often turn to social media (SM) for medical information. The objective of this study is to examine vulvovaginal content on SM and how it has changed over time.</p><p><strong>Materials and methods: </strong>Four SM platforms were searched (i.e., Facebook, Instagram, Twitter, and YouTube) at 2 time points from March 30 to May 7, 2021, and again from November 24 to December 10, 2022. Newer SM platforms became popular during this time interval and thus TikTok and Reddit were included in the search in 2022. This study focused on 2 common vulvovaginal conditions: lichen sclerosus and vulvodynia. The SM platforms were searched for content on these conditions and the type of content, language, and country of origin were assessed.</p><p><strong>Results: </strong>A total of 1228 SM accounts, posts, and pages were assessed. Lichen sclerosus content on SM was mostly informational (32.6%), whereas vulvodynia content was mostly personal experience (30.5%). Patient support groups were significantly more popular in 2021 compared with 2022 and professional groups were more common in 2022 compared with 2021 ( p < .001). Overall, Facebook and Instagram consisted mostly of patient support groups, YouTube had both informational and professional videos, TikTok had mostly personal experiences and healthcare professional videos, and Reddit was mostly discussions about patient personal experiences.</p><p><strong>Conclusions: </strong>The current study highlights the content and quantifies user engagement of lichen sclerosus and vulvodynia on SM.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"95-100"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aesthetic Outcome and Psychosexual Distress After Treatment for Vulvar High-Grade Squamous Intraepithelial Lesions.","authors":"Gerda Trutnovsky, Magdalena Holter, Daniela Gold, Daisy Kopera, Julia Deban, Dina Misut, Stefanie Aust, Karl Tamussino, Elfriede Greimel","doi":"10.1097/LGT.0000000000000785","DOIUrl":"10.1097/LGT.0000000000000785","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared aesthetic outcome, psychosexual distress, and treatment satisfaction between women receiving surgical treatment or medical treatment with imiquimod for vulvar high-grade squamous intraepithelial lesion.</p><p><strong>Materials and methods: </strong>This is an extended analysis of the multicenter, randomized noninferiority trial \"topical imiquimod versus surgery for vulvar intraepithelial neoplasia.\" Patients were randomized to primary topical treatment or surgery and stratified by unifocal or multifocal disease. Digital photos of vulvar appearance were subsequently assessed for aesthetic outcome by 3 investigators blinded to group allocation. Psychosexual distress and treatment satisfaction were assessed with the Cervical Dysplasia Distress Questionnaire, the Sexual Activity Questionnaire, and the Client Satisfaction Questionnaire at baseline and follow-up.</p><p><strong>Results: </strong>One hundred ten patients aged between 19 and 82 years were enrolled. Per-protocol analysis showed complete clinical response in 80% (37/46) using imiquimod, compared with 79% (41/52) after one surgical intervention. Photodocumentation at baseline and 6-month follow-up was available for 84 of these patients (44 imiquimod, 40 surgery). Blinded reviewer assessments of lesion size and lesion severity showed improvement from baseline to follow-up, with no differences between treatment groups. Sexual pleasure, discomfort, and distress remained stable from baseline to follow-up in both groups.</p><p><strong>Conclusions: </strong>Good aesthetic outcome of vulvar high-grade squamous intraepithelial lesion treatment can be achieved with imiquimod and surgery, consisting of ablation or local excision. Treatment satisfaction and stable psychosexual health may not be dependent on chosen treatment modality, but rather on counseling in accordance with patients' preferences.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"48-53"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the Longitudinal Risk of CIN 3+ for <CIN 2 Colposcopy for Patients Referred With High-Grade Cytology.","authors":"Sabrina Piedimonte, Kyle Tsang, Nathaniel Jembere, Joan Murphy, Tina Karapetian, Julia Gao, Bronwen McCurdy, Jocelyn Sacco, Rachel Kupets","doi":"10.1097/LGT.0000000000000765","DOIUrl":"10.1097/LGT.0000000000000765","url":null,"abstract":"<p><strong>Objective: </strong>To determine the baseline and cumulative risk of cervical intraepithelial neoplasia (CIN)3 and invasive cervical cancer in participants referred to colposcopy with high-grade cytology and <CIN2 histology, stratified by biopsy result.</p><p><strong>Methods: </strong>The authors linked administrative databases including cytology, pathology, cancer registries, and physician billing history to identify participants referred to colposcopy between January 2012 and December 2013 with high-grade cytology (atypical squamous cells [ASC]-H, high-grade squamous intraepithelial lesion [HSIL], invasive squamous cell carcinoma, adenocarcinoma, atypical glandular cells [AGC], adenocarcinoma in situ) and had <CIN2 (with and without biopsy confirmation) at colposcopy. Three- and 5-year risks of CIN3 and invasive cervical cancer were generated using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Among 4,168 women referred to colposcopy for ASC-H, HSIL, squamous cell carcinoma, or adenocarcinoma, the 3- and 5-year CIN3 incidence rates were 17.7%/20.0% no biopsy, 13.0%/15.1% negative biopsy, and 18.9%/20.0% low-grade squamous intraepithelial lesion (LSIL) biopsies. The 3- and 5-year incidences of invasive cancer were: 1.25%/1.68% no biopsy, 0.78%/1.04% negative biopsy, and 0%/0% LSIL biopsy. When the initial cytology was AGC/adenocarcinoma in situ (n = 944), the 3- and 5-year rates of CIN3 were 7.42%/8.39% no biopsy, 7.41%/9.26% negative biopsy, and 7.69%/7.69% LSIL biopsy. The invasive cancer rates were 1.12%/1.54% no biopsy, 0.46%/0.46% negative biopsy, and 0.0%/0.0% LSIL biopsy. By screening cytology, participants referred for HSIL had the highest 3- and 5-year rates of CIN3 (18.9% and 21%) compared with AGC (7.22%/8.28%) and ASC-H (15.5%/18%). The 3- and 5-year invasive cancer rates were 1.38%/1.75% HSIL, 0.85%/1.17% AGC, and 0.91%/1.36% ASC-H.</p><p><strong>Conclusions: </strong>In participants referred for high-grade cytology where colposcopy shows <CIN2, the subsequent risk of invasive cancer at 5 years is sufficiently elevated to warrant close surveillance in colposcopy.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"7-11"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement on Lesion Presence and Location at Colposcopy.","authors":"Kathrine Dyhr Lycke, Jayashree Kalpathy-Cramer, Jose Jeronimo, Silvia de Sanjose, Didem Egemen, Marta Del Pino, Jenna Marcus, Mark Schiffman, Anne Hammer","doi":"10.1097/LGT.0000000000000786","DOIUrl":"10.1097/LGT.0000000000000786","url":null,"abstract":"<p><strong>Objectives/purpose: </strong>The reproducibility and sensitivity of image-based colposcopy is low, but agreement on lesion presence and location remains to be explored. Here, we investigate the interobserver agreement on lesions on colposcopic images by evaluating and comparing marked lesions on digitized colposcopic images between colposcopists.</p><p><strong>Methods: </strong>Five colposcopists reviewed images from 268 colposcopic examinations. Cases were selected based on histologic diagnosis, i.e., normal/cervical intraepithelial neoplasia (CIN)1 ( n = 50), CIN2 ( n = 50), CIN3 ( n = 100), adenocarcinoma in situ ( n = 53), and cancer ( n = 15). We obtained digitized time-series images every 7-10 seconds from before acetic acid application to 2 minutes after application. Colposcopists were instructed to digitally annotate all areas with acetowhitening or suspect of lesions. To estimate the agreement on lesion presence and location, we assessed the proportion of images with annotations and the proportion of images with overlapping annotated area by at least 4 (4+) colposcopists, respectively.</p><p><strong>Results: </strong>We included images from 241 examinations (1 image from each) with adequate annotations. The proportion with a least 1 lesion annotated by 4+ colposcopists increased by severity of histologic diagnosis. Among the CIN3 cases, 84% had at least 1 lesion annotated by 4+ colposcopists, whereas 54% of normal/CIN1 cases had a lesion annotated. Notably, the proportion was 70% for adenocarcinoma in situ and 71% for cancer. Regarding lesion location, there was no linear association with severity of histologic diagnosis.</p><p><strong>Conclusion: </strong>Despite that 80% of the CIN2 and CIN3 cases were annotated by 4+ colposcopists, we did not find increasing agreement on lesion location with histology severity. This underlines the subjective nature of colposcopy.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"37-42"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Society for the Study of Vulvovaginal Disease (ISSVD) Vulvar Awareness Day Campaign: Knowledge of Vulvovaginal Diseases Among Italian Obstetrics and Gynecology Residents.","authors":"Federica Bevilacqua, Amanda Selk, Colleen Stockdale, Pedro Vieira-Baptista, Tolu Adedipe, Tanja Bohl, Luca Marozio, Fulvio Borella, Niccolò Gallio, Benedetta Pollano, Eleonora Robba, Ilaria Barbierato, Chiara Benedetto, Mario Preti","doi":"10.1097/LGT.0000000000000777","DOIUrl":"10.1097/LGT.0000000000000777","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to investigate vulvovaginal disease (VVD) awareness in Italian obstetrics and gynecology (Ob/Gyn) residents.</p><p><strong>Materials and methods: </strong>A 25-question survey on VVD basic knowledge (17 questions) and willingness to improve it (8 questions) was distributed through Ob/Gyn resident online group chats, from different Italian Universities in January 2023. A total number of 250 residents were invited to participate; 124 responses were obtained (response rate: 50%). Data were collected and analyzed using descriptive statistics through REDCap.</p><p><strong>Results: </strong>Overall, 87 of the 124 respondents (70%) fully completed the questionnaire and represented the study group. Residents were distributed among years of residency: 15% first year, 31% second year, 23% third year, 11% fourth year, and 20% fifth year. Most (60%) never attended a VVD clinic during residency, with an increasing percentage of attendance in later residency years (15% at first year vs 65% at fifth).Participants reported low knowledge of vulvar precancerous lesions and vulvoscopy but better knowledge of vaginitis, vulvar self-examination, and lichen sclerosus. Of the respondents, 50% were not satisfied with the education provided during residency, and more than 60% lacked confidence in managing VVD.All participants expressed a strong desire to improve their knowledge and skills, with 100% agreeing that every gynecologist should know the \"basics\" and 98% wanting to improve their knowledge through webinars (45%), lessons (34%), newsletters, and videos (19%).</p><p><strong>Conclusion: </strong>Our findings indicate a significant need to improve VVD knowledge among Italian Ob/Gyn residents. Further efforts are necessary to provide information about VVD and comprehensive training programs in Italian Universities.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"91-94"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colposcopy-A Valuable Diagnostic Tool for Pregnant Women With Unexplained Vaginal Bleeding.","authors":"Inshirah Sgayer, Maskit Shmueli, Lior Lowenstein, Maya Frank Wolf","doi":"10.1097/LGT.0000000000000783","DOIUrl":"10.1097/LGT.0000000000000783","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to examine the diagnostic value of colposcopy in a large cohort of pregnant women with unexplained vaginal bleeding during the second or third trimester.</p><p><strong>Materials and methods: </strong>This retrospective study included women who underwent colposcopy due to vaginal bleeding in the second and third trimesters during 2012-2022 at a tertiary care hospital. Demographics, obstetric data, bleeding characteristics, colposcopy results, cervical cytology testing, a sonogram directed at the placenta, and birth details were collected.</p><p><strong>Results: </strong>In total, 364 women were included. The mean maternal age was 29.7 years and the mean gestational age at examination was 30.7 weeks. Vaginal bleeding was mild in 80.8%, moderate in 14.6%, and severe in 4.7%. Only 3.3% had been vaccinated against human papilloma virus and 25.5% underwent a Pap smear study before pregnancy. Colposcopy diagnosed the bleeding source in 83 women (22.8%). The colposcopic examination revealed vaginal bleeding due to contact bleeding from ectropion in 46 (12.6%), a decidual/cervical polyp in 37 (10.2%), acetowhite epithelium in 12 (3.3%), herpes genetalis in 2 (0.5%), and bleeding from vaginal varices in 2 (0.5%). Of those who were recommended a follow-up examination after the postpartum period, only 49.1% completed such.Among women with compared to without postcoital bleeding ( N = 72), the risk of abnormal colposcopic findings was higher (24 [33.3%] vs 54 [19.7%], p = .017) and the rate of abnormal Pap smear was higher (7 [13.2%] vs 7 [3.2%], p = .008).</p><p><strong>Conclusions: </strong>Colposcopy can be a valuable diagnostic tool for women with unexplained vaginal bleeding in the second or third trimester.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"32-36"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Physiotherapy for Treating Vulvodynia: A Systematic Review.","authors":"Renata Polliana Nascimento, Megan L Falsetta, Tracey Maurer, Ayane Cristine Alves Sarmento, Ana Katherine Gonçalves","doi":"10.1097/LGT.0000000000000787","DOIUrl":"10.1097/LGT.0000000000000787","url":null,"abstract":"<p><strong>Objectives: </strong>We set out to assess the efficacy of physiotherapy for vulvodynia.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Scopus, Web of Science, SciELO, PEDro, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched in February 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Cochrane Risk of Bias tool (Rob 2). Because of the high heterogeneity presented between the studies, it was not possible to carry out qualitative analysis. The results were presented narratively. This systematic review was registered with the PROSPERO database.</p><p><strong>Results: </strong>A total of 2,274 articles were retrieved. Seven studies met the criteria and were included in a systematic review, which included a total of 477 patients. The interventions included were electromyography biofeedback ( n = 2), transcutaneous electrical nerve stimulation ( n = 1), transcranial direct current stimulation ( n = 1), low-intensity shockwave ( n = 1), physiotherapy treatment ( n = 1), and pelvic floor exercise with behavioral modification ( n = 1). All studies evaluated pain reduction, 5 evaluated sexual function, and 2 evaluated quality of life. All interventions were effective for the main outcomes; only the transcranial direct current stimulation intervention showed no significant difference when compared with the placebo or sham group. Three studies presented a high risk of bias due to the lack of blinding.</p><p><strong>Conclusions: </strong>The studied interventions (electromyography biofeedback, transcutaneous electrical nerve stimulation, shockwave, physiotherapy, and pelvic floor exercise) seem to improve pain, sexual function, and quality of life. However, the heterogeneity of the studies prevented meta-analysis. In addition, well-designed trials are needed to improve the certainty of this evidence.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"54-63"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Basaloid Differentiated Vulvar Intraepithelial Neoplasia.","authors":"Courtney L O'Keefe, Luisa Y A Watts, Jill I Allbritton","doi":"10.1097/LGT.0000000000000781","DOIUrl":"10.1097/LGT.0000000000000781","url":null,"abstract":"","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"110-112"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71434772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulvar Ulcers: An Algorithm to Assist With Diagnosis and Treatment.","authors":"Natalie A Saunders, Kathryn C Welch, Hope K Haefner, Cindy Rasmussen, Lynne Margesson","doi":"10.1097/LGT.0000000000000776","DOIUrl":"10.1097/LGT.0000000000000776","url":null,"abstract":"<p><strong>Objectives: </strong>Vulvar ulcers can be challenging to diagnose, manage, and treat. Ulcers can be nonspecific in appearance and have many etiologies. Description of the lesion is very important.</p><p><strong>Methods: </strong>An interactive vulvar ulcer algorithm was created to aid in the evaluation, diagnosis, and treatment of vulvar ulcers.</p><p><strong>Results: </strong>The algorithm flowchart begins with careful history and physical examination. Pending these, specific tests can be obtained to aid in diagnosis. The algorithm also links to appropriate treatments. The algorithm can be accessed on the International Society for the Study of Vulvovaginal Disease Web site ( issvd.org ). Each underlined word in the algorithm is a hyperlink that leads to a wealth of information on the topic that providers can use to direct testing and aid in diagnosis and treatment.</p><p><strong>Conclusions: </strong>The vulvar ulcer algorithm can help clinicians with diagnosis and treatment plans.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"73-75"},"PeriodicalIF":3.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}