SERVICES:
TREATMENT OF DISEASES OF THE VULVA

Dr Sassone has special training in the diagnosis and treatment of vulvar disease and is a member of the Americal Society for Colposcopy and Cervical Pathology nad the National Vulvodynia Association

The vulva is the set of a woman's external genital organs. This includes: the pubic mound (mons pubis), the outer or large lips (labia majora), the inner or small lips (labia minora) that also form the clitoral hood, the clitoris, the opening of the urethra and the glands around the urethra and the vaginal opening.

What are the symptoms if a vulvar disorder is present?
Itching, burning, skin thickening, small growths and ulcerations are the most frequent ones. Vulvar pain can be present without any apparent lesion or reason.

How are vulvar disorders evaluated?
Symptoms alone are not sufficient for diagnosis. Chronic infection and cancer might have the same symptoms and they might even look alike, at first examination. For recurrent or persistent symptoms, a very detailed examination of the vulva (vulvoscopy) the perineum (perineoscopy) and the vagina (colposcopy) is necessary. A magnifying instrument (colposcope) is utilized and enables the experienced examiner to detect what is not visible at naked eye exam. Small biopsies, performed with local anesthesia, are often necessary to reach the correct conclusion. Dr. Sassone  performs all exams in her office. The pathologists who interpret the biopsies are specialized in skin disorders (dermopathologists).

How are vulvar diseases treated?
Very often with a cream or an ointment that must be appropriate for the specific condition. Occasionally laser, or other forms of surgery are indicated. The majority of vulvar disorders are readily treated if they have been correctly diagnosed. Treatment is performed in the office or at home. If it is necessary to recur to laser ablation or very large excisions, these procedures would be done by Dr. Sassone in the operating room as ambulatory surgery.

What if I have cancer of the vulva?
Luckily, most cancers of this area develop slowly, and they will be diagnosed at a stage when they have not yet become cancers (precancerous lesions). Precancerous lesions are treatable with creams, ointments, resins and minimally invasive surgeries. It is important not to let a lesion develop to full blown cancer. Cancers are treated differently, depending on the type, the size and the location.

What is volvodynia (vulvar pain)?
This is a chronic condition of pain that can be diagnosed only by excluding all the other causes of pain. For years this condition was dismissed as "psycological", because no clear causes were identifiable. Vulvodynia is probably a complex disease with hormonal, viral, immunological and also psychological roots. Certain organisms, like yeasts, HSV or HPV, might trigger an autoimmune response that persists, or waxes and wanes, for years. Lifestyle factors can contribute, as well as disturbances in neurotransmitters. All the diagnostic procedures necessary to exclude other cause of pain are performed in the office. Treatment with classical and experimental modalities is available.

If you are unfamiliar with some of the terminology used in this page, please visit our glossary.