Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker, School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
Curr Probl Pediatr Adolesc Health Care. 2020 Jul;50(7):100836. doi: 10.1016/j.cppeds.2020.100836. Epub 2020 Aug 8.
Vulvovaginitis, referring to inflammation of the vulva and vagina, is a commonly reported concern among adolescents and young women presenting for gynecologic care. Symptoms of vulvovaginitis may include vaginal discharge, odor, itching, pain, dysuria, skin irritation, burning, and dyspareunia. Vulvovaginitis may result from infectious or non-infectious causes. Bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis represent the three most common infectious causes of vulvovaginitis in adolescents and young adults. Additionally, non-infectious causes such as the presence of a foreign body in the vagina, chemical irritants, douching, and poor hygiene may also lead to symptoms of vulvovaginitis. A thorough history in combination with the appropriate physical examination and laboratory evaluation is necessary to identify the cause of a patient's symptoms. Importantly, adolescent patients should be given the opportunity to speak privately with the provider without a parent or guardian present in the room, particularly when gathering the sexual history. Appropriate anticipatory guidance and counseling should be provided once a diagnosis has been made, and prevention of future episodes of vulvovaginitis should be discussed.
外阴阴道炎是指外阴和阴道的炎症，是青少年和年轻女性在妇科就诊时常见的主诉。外阴阴道炎的症状可能包括阴道分泌物、异味、瘙痒、疼痛、尿痛、皮肤刺激、烧灼感和性交困难。外阴阴道炎可能由感染或非感染性原因引起。细菌性阴道病、外阴阴道假丝酵母菌病和滴虫性阴道炎是青少年和年轻女性外阴阴道炎最常见的三种感染性病因。此外，非感染性病因，如阴道内异物、化学刺激物、冲洗和卫生条件差，也可能导致外阴阴道炎症状。为了明确患者症状的病因，需要详细的病史，结合适当的体格检查和实验室评估。重要的是，应给予青少年患者与提供者私下交谈的机会，特别是在采集性史时，而无需父母或监护人在场。一旦做出诊断，应提供适当的预期指导和咨询，并讨论预防未来外阴阴道炎发作的问题。
