Many women suffer silently from chronic vulvar itch, vulvar pain and sexual dysfunction due to fear of social stigma, anxiety, guilt, cultural taboos as well as heightened self-consciousness as the vulva is a sensitive region. This has resulted in a lack of awareness for common vulvar diseases and the vulva remains an enigma and mystery to many medical professionals and patients alike. Many vulvar conditions are commonly misdiagnosed and undertreated and patients remain resigned to their symptoms for a long period of time, leading to delay in diagnosis of vulva skin conditions.
We often come across advertisements selling special feminine washes, douches, hair remover wipes, and even products promoting vaginal tightening. Women commonly attempt to obtain information about these products from social media which often results in misinformation. This leads to insecurities about their bodies and can deter patients from seeking proper medical advice for their conditions.
In this day and age of technology at your fingertips, many young girls turn to the internet and social media for information regarding the vulva and its associated conditions. This often offers them an unbalanced view of the vulva due to the inherent bias of social media feeds and the presence of fake news. These young girls are therefore susceptible to low self-esteem, depression and body dysmorphic disorder due to the lack of medically accurate knowledge of normal anatomical variants of the vulva.
A myriad of vulvo-vaginal conditions can affect young women in the reproductive age group. These include infections, inflammatory dermatological conditions, pre-cancers and cancers. Various psycho-sexual illnesses, chronic pain syndromes and sexual dysfunction often result from these conditions. These women unfortunately suffer from poor quality of life due to the lack of knowledge and treatment for these conditions. Many women are traumatized by fear and stigma of sexually transmitted infections when it comes to diseases of the vulva. This includes the understanding of the Human Papilloma Virus (HPV), which is a leading cause of many cervical and vulvar conditions.
In the spectrum of elderly women, we often see conditions such as lichen sclerosus and Extra Mammary Paget’s disease (EMPD) presenting at a late stage with extensive perineal involvement due to the hesitancy of the patient in sharing her chronic vulvar itch symptoms with her family and caregivers. Early diagnosis and treatment of both conditions markedly reduce the incidences of keratinizing squamous cell carcinoma and adenocarcinoma of the vulva. Once detected in a timely manner, treatment of early stage vulvar cancers often assures good quality of life and overall survival.
Vulvar conditions are multifactorial and multi-disciplinary care is often required. It is a referral centre for patients with complex vulvar conditions. The clinic provides a comprehensive set of services to each patient and the treatment process is streamlined and individualised.
At each clinic visit, the patient will be reviewed by a consultant gynaecologist with a special interest in vulvar diseases, together with a consultant dermatologist. There are also close working relationships with other specialist clinics such as the sexual health clinic and the clinic for sexually transmitted infections. Other professionals involved in the care of the patients include the physiotherapist, psychologist, psychiatrist and medical social worker. This holistic team approach is employed to provide the best care and expertise to patients who have resistant and chronic vulvar problems.
We understand that the vulva is not an isolated organ and comprehensive assessment of the lower genital tract is required in treating all vulvar diseases, including screening for associated cervical and vaginal conditions. Our multi-disciplinary approach at KK Women’s and Children’s Hospital ensures that our patients receive comprehensive assessment, treatment, counselling and education of their conditions.
The vulva clinic has a close affiliation with the paediatricians in KK Women's and Children's Hospital and we take a special interest in the education of young adolescent girls who have concerns about the appearance of their vulva. In a special group of young women who have discomfort due to the abnormal size of the inner lips of their vulva, we offer vulvar labial reduction surgery, often in discussion and collaboration with a consultant plastic surgeon.
The vulva clinic offers a warm and friendly environment for patients to be assessed and examined, with the promise of strict patient confidentiality. The patients are also given adequate time during each clinic visit in order for all concerns and expectations to be explored and addressed. We focus on developing and providing the best services available and we seek constant improvement to provide expert advice and the latest evidence-based treatment for the large number of women who come through our doors each year. Our ultimate aim is to break the barrier of shyness and embarrassment associated with vulvar conditions and help women enjoy good quality of life with confidence.
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