Re: Is this vulvodynia?
From: Efrain Ramirez (eramirezt@coqui.net)
Fri Nov 28 20:28:05 2008
Or has had.. good question..
Ef
At Fri, 28 Nov 2008, R. Daniel Braun wrote:
>
>Does she have any oral lesions??
>Dan
>
>On Fri, Nov 28, 2008 at 5:26 PM, Marilyn Ringstaff <
>marilyn.ringstaff@obgyn.net> wrote:
>
>> I have a patient who has had dyspareunia (at introitus) & constant
>> irritation–symptoms for > a year, initially had erythema at 5 & 7
>> o'clock, now has very shallow ulcerative lesions ~ 2-3 mm-present for a
>> couple of mos. Monogomous/male partner with no symptoms, herpes culture
>> of lesions negative, no STD history, labs including Herpes Select are
>> negative, culture of the lesions pending. Urine culture is negative.
>> Wet Mount (-) except for small amt yeast and treated now twice w/o
>> relief of symptoms. She tried Nuvaring and s/s got worse, now using
>> only condoms for contraception- & tried diff kinds/non-latex, etc. We've
>> gone all through the vulvodynia 'self-help' checklist from the NVA
>> (http://www.nva.org/new_patient_guide/index.html) without any changes.
>> >From what I've read of vulvodynia, erythema can be present, but lesions
>> aren't typical, I colpo'd the area and there are no acetowhite areas- so
>> didn't biopsy/didn't want to make symptoms worse.
>>
>> Would you biopsy? Would yeast cultures be helpful? Other thoughts?
>>
>> Thanks, Marilyn
>>
>> --
>> Marilyn Ringstaff, CNM, JD
>> Rome, Georgia
>>
>--
>R. Daniel Braun, MD FACOG(L) ABMP CMTh
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>--
>R. Daniel Braun
>
> "Science without Religion is LAME; Religion without Science is BLIND"
> Einstein 1941
>
--
"I can accept failure, but I can't accept not trying." - Michael Jordan
