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Characteristics and initial diagnoses in women presenting to a referral center for vulvovaginal disorders in 1996-2000.

OBJECTIVE
To describe the demographics, presenting symptoms, physical examination and laboratory findings, and initial diagnoses in a cohort of women referred for evaluation of vulvovaginal problems.


STUDY DESIGN
Descriptive review of medical records of new patients referred for evaluation of vulvar problems between January 1, 1996, and December 31, 1999. Electronic medical records and other documents were manually abstracted.


RESULTS
Three hundred twenty-two women met the study criteria. The majority were Caucasian (93.8%) and married (63.9%). The mean age was 41 years, with a range of 13-88. The majority reported at least one vaginal delivery (72.9%) or cesarean section (10.6%). The most common symptoms were vulvar pain (86.3%), dyspareunia (70.8%), itching (36.0%) and skin changes (18.0%). Most patients received a diagnosis in more than one evaluation category. Prevalent diagnoses included Bartholin fossa pain (12.1%), vulvar vestibulitis (19.9%), restriction and fissuring of the posterior labial commissure (20.1%), dysesthetic vulvodynia (32.3%), pelvic floor dysfunction (39.8%) and dermatologic conditions (47.5%).


CONCLUSION
Women presenting for evaluation of vulvar disorders represent a heterogeneous population. Among women with vulvar pain, abnormalities of the skin and pelvic floor are common and should be ruled out prior to making a diagnosis of vulvar vestibulitis or dysesthetic vulvodynia.