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F/U Question to Dr. Montgomery Re: Extreme Vaginal Discomfort - Need as many opinions as possibleFrom: Lisa (anonymous@obgyn.net)Thu, 10 Aug 2000 17:49:38 -0500 (CDT)
>At Wed, 9 Aug 2000, Lisa wrote: >> >>I have been suffering with severe discomfort in my vaginal area >>(particularly in the labia minora)for about 4 months. I have been >>experiencing burning, irritation, and rawness, but no itching or >>discharge. I am not sexually active and I have not changed soaps or >>anything like that. >> >>I have gone to my GYN several times and he seems to believe it is >>"vaginitis" and a yeast infection. He has given me many different >>creams which have provided some relief, but no cure, and today I feel >>like that area of my body is on fire. He also prescribed a vaginal >>suppository for the yeast, but it only gave me temporary relief as well. >> >>I am so frustrated and miserable. I would really appreciate some help. >>Thanks. > >Lisa, >I am going to make you an expert in vulvar problems right now. The >rules to treat vulvar symptoms are very straight forward. At the first >presentation, you listen to the symptoms and do the standard swab of the >vaginal/vulvar secretions and place them on a slide to look for the >common causes of symptoms, such as yeast, gardnerella, trichomonas and >you treat what you think you might see. The second presentation with >the same symptoms warrants formal cultures of the vulva/vagina that are >sent to the lab to see if anything grows that can be treated >specifically. At the third presentation for the same symptoms, you >don't have a diagnosis yet because the patient (you in this case)hasn't >gotten any relief with the things you have tried for infections. To get >the diagnosis, you now need to do a vulvar biopsy. This is a little >biopsy that allows the pathologist to tell you exactly what is going on >in the skin in the area that is causing the symptoms. There are a >plethora of vulvar problems that require specific treatment and aren't >infections. The only way to appropriately direct treatment is to get a >biopsy. That is where you are currently at-you need a biopsy of the >problem area. Now you are qualified to treat everybodies vulvar >problems on the Forum... >Lynn >-- >Lynn D. Montgomery, MD >Director, Maternal-Fetal Medicine >Rocky Mountain Perinatal Center >Missoula, Montana > Dr. Mongomery: Could you tell me exactly what the biopsy involves? Does it hurt? If so, how much? Is an effective anesthetic used? How long does the procedure last? Thanks.
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