Challenges and Advances in Vulvovaginal Disorders_OnDemand-Challenges and Advances in Vulvovaginal Disorders

Video Transcription

Video Summary

In this comprehensive AUGS webinar, Dr. Hope Hafner, a leading expert in vulvovaginal disorders, discusses common and complex conditions affecting the vulva and vagina, focusing on therapeutic advances and best management practices. She begins by emphasizing the importance of thorough clinical evaluation and diagnostic testing, including the use of wet mounts and yeast cultures, highlighting recurrent and resistant yeast infections. New antifungal agents like ibrexifungin and oteseconazole are reviewed, along with their indications and limitations, especially in pregnancy.<br /><br />Dr. Hafner explores inflammatory conditions such as lichen simplex chronicus, lichen sclerosis, and erosive lichen planus. She details their clinical presentations, including symptoms like intense pruritus and vulvar scarring, and emphasizes tailored treatment strategies incorporating high-potency topical corticosteroids, oral medications, and lifestyle modifications. For refractory or severe cases, she describes advanced interventions such as intramuscular steroids, immunomodulators, nerve blocks, and surgical procedures, including vulvar and vaginal reconstructive surgeries with emphasis on postoperative dilation and maintenance therapy.<br /><br />Vulvodynia is addressed with an algorithmic approach, focusing on vulvar care, topical and systemic pain modulators (e.g., amitriptyline, gabapentin), physical therapy, and cognitive behavioral therapy. The webinar also covers rare but serious conditions like Stevens-Johnson syndrome and toxic epidermal necrolysis, stressing early recognition and aggressive management to prevent sequelae.<br /><br />The discussion concludes with practical counseling tips, addressing hormonal therapies, topical treatments, and conservative management of secondary irritants like urine leakage. Dr. Hafner underscores the necessity of multidisciplinary care involving dermatology, sexual counseling, and pain clinics. Resources such as ISSVD guidelines and educational apps are recommended for clinicians. The session also features audience Q&A on maintenance therapy, surgical candidacy, and emerging treatment modalities.

Keywords

vulvovaginal disorders

yeast infections

antifungal agents

lichen simplex chronicus

lichen sclerosis

erosive lichen planus

vulvodynia

Stevens-Johnson syndrome

toxic epidermal necrolysis

multidisciplinary care