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Mixed gonadal dysgenesis (MGD) is a disorder of sex development caused by mosaicism of the Y chromosome, represented by 45,X/46,XY. Prophylactic gonadectomy is recommended as soon as possible after its diagnosis, owing to a high risk of malignancy. In the present case, a 21-year-old woman presented with primary amenorrhea. Although the patient's external genitalia were female, the patient exhibited a hypoplastic uterus, wherein the ovaries were difficult to identify. The patient's height was 146 cm; they had cubitus valgus and webbing of the neck, leading to the consideration of a disorder of sex development. Chromosomal examination revealed 45,X/46,XY mosaicism. Thus, the patient was diagnosed with MGD. After thorough counseling, laparoscopic bilateral gonadectomy was performed. Pathological examination revealed a gonadoblastoma of the left gonad. Postoperatively, the patient had no recurrence and continued on Kaufmann therapy. In conclusion, prophylactic gonadectomy is recommended immediately following a diagnosis of MGD; however, the timing of the surgery should be carefully considered and adequate counseling should be conducted by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Nematodes of the Onchocercidae family, such as Pelecitus spp., are filarial parasites of medical and veterinary importance. Although infections are widely distributed among avian species, only 2 cases of human Pelecitus ocular infection, both in South America, have been reported. We describe a 61-year-old man in northeast Thailand diagnosed with an ocular infection. Morphologic characteristics suggested the causative agent was a female Pelecitus nematode: coiled body, rounded anterior and posterior extremities, a distinct preesophageal cuticular ring, lateral alae, a postdeirid, and a protuberant vulva. Sequences of the 12S rDNA gene indicated 95%–96% identity and cox1 gene 92%–96% identity with published P. copsychi sequences. P-distance for cox1 sequences between the causative agent and P. copsychi was 6.71%. Phylogenetic trees of 12S rDNA and cox1 genes indicated the species differed from but is closely associated with P. copsychi. Healthcare providers should be aware of the threat of ocular infection from Pelecitus spp. nematodes. [ABSTRACT FROM AUTHOR]

Context.--Noninvasive self-sampling is a convenient option that may be highly accepted by women for home- based detection, which could increase the screening rate for cervical cancer (CC) and reduce its incidence and mortality. Objective.--To compare the distribution of high-risk human papillomavirus (hr-HPV) between the vulva and cervix and to explore the clinical value of vulvar HPV detection in CC screening. Design.--The study was nested within a clinical trial on a recombinant HPV 9-valent vaccine for women ages 20 to 45 years. Women with paired vulvar and cervical specimens were included and underwent cytology and HPV detection. The consistency of HPV detection between vulvar and cervical specimens was evaluated using Cohen K statistics. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to evaluate the diagnostic accuracy of primary CC screening. The primary end points were cervical intraepithelial neoplasia (CIN) grade 2/3 or worse (CIN2+/3+). Results.--A total of 7999 women were enrolled, and 83/33 cases were diagnosed as CIN2+/CIN3+. The HPV- positive rate in vulvar specimens (1785 of 7999; 22.32%) was higher than that in cervical specimens (1390 of 7999; 17.38%), and there were no significant differences in the distribution of hr-HPV genotypes between the vulva and cervix in patients with CIN2+/CIN3+. Vulva-based HPV primary screening showed sensitivity, specificity, PPV, and NPV comparable to those for cervix-based HPV primary CC screening in the detection of CIN3+. Conclusions.--The distribution of vulvar and cervical HPV was similar in patients with CIN2+/CIN3+. Vulva-based HPV primary CC screening had acceptable diagnostic efficacy and might be used as a modality for primary CC screening. [ABSTRACT FROM AUTHOR]

Context.--There have been exceedingly few reports of epidermodysplasia verruciformis (EV) or EV-like lesions in the vulva. We describe the first observation of vulvar lesions displaying synchronous EV-like histology and conventional high-grade squamous intraepithelial lesion (HSIL), a finding hitherto unreported in medical literature. Objectives.--To describe this novel vulvar lesion with hybrid features of HSIL and EV, attempt to confirm the hypothesis of coinfection with a and b human papillomavirus (a-HPV and b-HPV) genotypes, and describe relevant underlying genetic mutations. Design.--Cases were retrospectively selected from our institutional archive. Detailed review of clinical information, histologic examination, and whole genome sequencing (WGS) were performed. Results.--Five samples from 4 different patients were included. Three of 4 patients had a history of either iatrogenic immune suppression or prior immune deficiency, and all 3 featured classic HSIL and EV changes within the same lesion. One patient had no history of immune disorders, presented with EV-like changes and multinucleated atypia of the vulva, and was the sole patient without conventional HSIL. By WGS, several uniquely mappable reads pointed toward infection with multiple HPV genotypes, including both a-HPVs and b-HPVs. Mutations in genes implicated in cell-mediated immunity, such as DOCK8, CARMIL2, MST1, and others, were also found. Conclusions.--We provide the first description of vulvar lesions harboring simultaneous HSIL and EV features in the English-language literature, a phenomenon explained by coinfection with a-HPV and b-HPV genotypes. The finding of EV-like changes in a vulvar specimen should prompt assessment of the patient's immune status. [ABSTRACT FROM AUTHOR]

Introduction: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) or 11-hydroxylase deficiency (11OHD) is characterized by underproduction of cortisol and overproduction of adrenal androgens. These androgens lead to a variable degree of virilization of the female external genitalia in 46,XX individuals. Especially in developing countries, diagnosis is often delayed and 46,XX patients might be assigned as males. This study aims to describe the clinical and biochemical characteristics of a unique cohort of untreated male-reared 46,XX classic CAH patients from Indonesia and discusses treatment challenges. Methods: Nine untreated classic CAH patients with 46,XX genotype and 21OHD (n=6) or 11OHD (n=3), aged 3-46 years old, were included. Biometrical parameters, clinical characteristics, and biochemical measurements including glucocorticoids, renin, androgens, and the pituitary-gonadal axis were evaluated. Results: All patients had low early morning serum cortisol concentrations (median 89 nmol/L) without significant increase after ACTH stimulation. Three patients with salt wasting 21OHD reported one or more periods with seizures and/or vomiting in their past until the age of 6, but not thereafter. The remaining patients reported no severe illness or hospitalization episodes, despite their decreased capacity to produce cortisol. In the 21OHD patients, plasma renin levels were elevated compared to the reference range, and in 11OHD patients renin levels were in the low-normal range. All adult patients had serum testosterone concentrations within the normal male reference range. In 21OHD patients, serum 11-oxygenated androgens comprised 41-60% of the total serum androgen concentrations. Glucocorticoid treatment was offered to all patients, but they refused after counseling as this would reduce their endogenous androgen production and they did not report complaints of their low cortisol levels. Discussion: We describe a unique cohort of untreated classic 46,XX male CAH patients without overt clinical signs of cortisol deficiency despite their cortisol underproduction and incapacity to increase cortisol levels after ACTH stimulation. The described adolescent and adult patients produce androgen levels within or above the normal male reference range. Glucocorticoid treatment will lower these adrenal androgen concentrations. Therefore, in 46,XX CAH patients reared as males an individual treatment approach with careful counseling and clear instructions is needed. [ABSTRACT FROM AUTHOR]

A new genus is proposed to accommodate an undescribed dorylaimid form collected in Iran. Persianema gen. n. is characterised by its three-layered cuticle, oral field appreciably sunken but its perioral area visibly protruding, odontostyle less than one-half of lip region diam. and with large aperture, guiding ring simple and always located in front of odontostyle, odontophore 4-5 times longer than odontostyle, dorsal gland nucleus (DN) very posteriorly located, female genital system di-ovarian with well-developed pars refringens vaginae, tail short and rounded in both sexes, spicules dorylaimid and 3-4 spaced ventromedian supplements with hiatus. Its type and only species, P. enigmaticum sp. n., is described and illustrated, including SEM observations. It is distiguished by its 1.45-2.03 mm long body, lip region offset by shallow depression and 15.5-17.5 μm wide, odontostyle 6-7 μm long with aperture occupying more than half of its length, neck 285-340 μm long, pharyngeal expansion 38-43% of the total neck length, three gland cells present at pharyngo-intestinal junction, simple uterus 81-113 μm or 1.7-3.1 body diam. long, transverse vulva (V = 50-54), tail 15-25 μm long (c = 69-106, c′ = 0.6-0.8) and spicules 38-48 μm long. Molecular analysis of D2-D3 28S rDNA sequences revealed its closest similarity with Pungentus sequences, and an integrative comparison supports its belonging to Pungentinae. [ABSTRACT FROM AUTHOR]

Introduction: The triangular recess (TR), also called triangular fossa or vulva cerebri, represents the anterior extension of the diencephalic ventricle, located between the anterior columns of the fornix and the anterior white commissure. Over time, this structure of the third cerebral ventricle generated many disputes. While some anatomists support its presence, others have opposite opinions, considering that it only becomes visible under certain conditions. The aim of the study is to demonstrate the tangible structure of the triangular recess. Secondly, the quantitative analysis allowed us to establish an anatomical morphometric standard, as well as the deviations from the standard. Materials and methods: Our study is both a quantitative and a qualitative evaluation of the triangular fossa. We dissected 100 non-neurological adult brains, which were fixed in 10% formaldehyde solution for 10 weeks. The samples are part of the collection of the Institute of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi. We highlighted the triangular fossa by performing dissections in two stages at the level of the roof of the III ventricle. Results: The qualitative analysis is a re-evaluation of the classical data concerning the anatomy of the fossa triangularis. We proposed an original 3D model of the triangular recess in which we described a superficial part called vestibule and a deep part called pars profunda. We measured the sides of the communication between the two proposed segments, as well as the communication with the III ventricle. By applying the Heron's formula, we calculated the area of the two communications. Statistical evaluations have shown that these communications are higher than they are wide. In addition, there is a statistical difference between the surfaces of the two communications: 34.07 mm² ± 7.01 vs. 271.43 mm² ± 46.36 (p = 0.001). Conclusion: The outcome of our study is both qualitative and quantitative. Firstly, we demonstrated the existence of the triangular fossa and we conceived a spatial division of this structure. Secondly, the measurements carried out establish an anatomo-morphometric norm of the triangular recess, which is useful in assessing the degree of hydrocephalus during the third endoscopic ventriculoscopy. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM/C) is the partial or total removal of external female genitalia for non-medical reasons and is recognized as a human rights violation. It is practiced in various ethnic groups around the world and is an expression of gender inequality. FGM/C is most prevalent in sub-Saharan Africa but has also spread to migrant communities in Europe, North America, and Australia. Spain has criminalized FGM/C and has implemented prevention measures in primary healthcare settings. However, there is a need to improve detection and address the physical and psychological consequences of FGM/C. An intersectional approach that considers the cultural, social, and structural factors influencing migrant women's choices is necessary to eliminate this harmful practice. [Extracted from the article]

Anogenital mammary‐like glands are normal structures of the anogenital region. Tumors originating from these glands often exhibit a striking resemblance to their mammary gland counterparts. Herein, we present a rare case of adenocarcinoma of mammary gland type in the vulva of a 69‐year‐old female. Histopathologic examination revealed a complex lesion, which included a large encapsulated papillary carcinoma (EPC) with associated invasive carcinoma of mammary gland type and ductal carcinoma in situ (DCIS). The invasive component consisted mostly of invasive ductal carcinoma of no special type, with a notable focus of invasive mucinous carcinoma. p40 immunostain demonstrated a lack of myoepithelial cells in both the EPC and invasive carcinoma, but such cells expressed p40 around the ducts involved by DCIS. The main component of this lesion, EPC, was characterized by a papillary proliferation within a cystic space surrounded by a fibrous capsule without a myoepithelial layer. The histopathologic features of anogenital EPC closely resemble cutaneous hidradenoma papilliferum. Indeed, there have been a few reports in the literature describing cases where in situ and invasive carcinoma arose from a preexisting hidradenoma papilliferum. As tumors of anogenital mammary‐like glands bear a closer resemblance to breast lesions than to skin tumors, we recommend that they be aligned with the classification of well‐established breast lesions rather than cutaneous adnexal tumors. [ABSTRACT FROM AUTHOR]

Mammary‐type tissue in the vulva was first described in 1872 but has been rarely reported in the literature. This tissue was previously considered as ectopic breast tissue that occurs as a result of incomplete regression of the milk line. Similar to native breast tissue, ectopic mammary tissue is hormone‐sensitive and can develop benign changes, such as fibroadenoma, as well as malignant changes. A more recent theory suggests that these benign and malignant mammary‐type entities arise from mammary‐like anogenital glands, which constitute normal vulvar components. We report a case of a 41‐year‐old woman who presented with a chronic asymptomatic cyst on the left vulva that eventually became uncomfortable, especially on standing. The cyst was located on the labium minus, measuring 1.0 × 0.5 cm, with no identified erythema or other skin abnormalities. Excision of the lesion and subsequent microscopic examination showed a circumscribed mass with a nodular overgrowth of epithelial and stromal components, resembling a mammary fibroadenoma with pseudoangiomatous stromal hyperplasia. We bring to attention this rare diagnosis and the importance of considering it in the presence of a vulvar lesion. The malignant and recurrence potential of mammary‐type tissue necessitates excision with clear margins and close monitoring of these patients. [ABSTRACT FROM AUTHOR]

Accurate oestrous detection is critical to optimise sows' reproductive performance. The conventional method of oestrous detection relies on the laborious back-pressure test. This study presents an automated oestrous detection method for sows housed in individual stalls using a robotic imaging system and neural networks. A robotic imaging system consisting of a LiDAR camera was used to monitor a group of stall-housed sows at a 10-min interval to capture their postures and vulva volume. Imagery data were analysed using a previously developed pipeline. Results showed that significant changes were observed in daily standing index, sternal lying index, lateral lying index, posture change frequency, and vulva volume before the onset of oestrous. A 1-D convolutional neural network model architecture for oestrous detection was developed using Days from Weaning (DFW), behaviour features, and vulva volume features as inputs. The oestrous detection models were evaluated using 10-fold cross validation. The training and testing accuracies of the oestrous detection model were 96.1 ± 2.0% and 92.3 ± 10.1% when using the DFW and behaviour features as input. The model's training and testing accuracies increased to 98.1 ± 2.4% and 98.0 ± 4.2% when vulva volume features were added to the input. While it is difficult to trace the behaviour of sows housed in group conditions, combining vulva volume features with DFW could be a suitable method to detect the onset of oestrous in these sows. The training and testing accuracies of this method of oestrous detection were 97.9 ± 1.4% and 95.2 ± 4.8%. However, further validation under real group house conditions is needed. • An automated estrus detection method for stall- and group-housed sows. • Combining vulva volume and behaviour features can improve detection accuracy. • Method showing potential for automated early pregnancy diagnosis for sows. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The diagnosis of chronic uterine inversion occurs after birth or secondary to pathologies of the pelvic region organs. Especially, the diagnosis and treatment of isolated chronic inversion rapidly under appropriate conditions seem to reduce maternal morbidity and mortality. Chronic uterine inversion is a rare clinical diagnosis and difficult to diagnose and treat. This is a 22‐year‐old patient with no particular history known for a month for uterine fibroid with a polyp, who gave birth through the cervix in the context of subfertility for a year. Non puerperal uterine inversion is a rare clinical condition, and it should be kept in mind that this may be uterine inversion when mass lesions causing clinical complaints are detected, especially in the vulva, vagina, and cervix uteri region. The quality of life of the patients is increased by reducing the morbidity and mortality rates by making a diagnosis with a good clinical and ultrasonographic evaluation. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to evaluate the reliability and quality of videos on YouTube about labiaplasty procedures. Material and Methods: A search was carried out on YouTube using the search terms 'labiaplasty' and 'labia minora reduction'. The first 100 videos for each keyword were evaluated and 42 videos were analyzed. The distribution of video types was examined. The videos were scored by a five-member committee using the global quality scale (GQS) and modified DISCERN (mDISCERN) scales. Videos uploaded by physicians and academicians were classified as professional, and patients, commercial entities, and allied health personnel were classified as non-professional groups. Results: The mean mDISCERN score of all videos was 2.29±0.65, while the mean GQS score was 2.75±0.67. When professional and non-professional groups were compared, the mDISCERN and GQS scores were significantly higher in the professional group (p=0.017 and p=0.010, respectively). When surgical technique videos and videos providing information about the disease or surgery were compared, there was a significant difference in video power index (VPI), viewing rate, and number of comments (p=0.001, p=0.001, and p=0.003, respectively), while there was no significant difference in terms of mDISCERN and GQS scores. Weak negative correlations were observed between the mDISCERN score and VPI (rs=-0.326, p=0.037), between the GQS score and viewing rate (rs=-0.392, p=0.010), and between the GQS score and VPI (rs=-0.382, p=0.014). Conclusion: YouTube is not a reliable source of information about labiaplasty. Low-quality videos receive more engagement. Obstetrics and gynecology associations should produce content on YouTube about this subject. [ABSTRACT FROM AUTHOR]

Background Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes. The aim of this study was to devise a system to standardize the classification and reporting of inguinal lymph node dissection perioperative complications by creating a worldwide collaborative, the complications and adverse events in lymphadenectomy of the inguinal area (CALI) group. Methods A modified 3-round Delphi consensus approach surveyed a worldwide group of experts in inguinal lymph node dissection for melanoma, penile and vulval cancer. The group of experts included general surgeons, urologists and oncologists (gynaecological and surgical). The survey assessed expert agreement on inguinal lymph node dissection perioperative complications. Panel interrater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. Results Forty-seven experienced consultants were enrolled: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons and 4 (8.5%) gynaecology oncologists. Based on their expertise, 31 (66%), 10 (21.3%) and 22 (46.8%) of the participants treat penile cancer, vulval cancer and melanoma using inguinal lymph node dissection respectively; 89.4% (42 of 47) agreed with the definitions and inclusion as part of the inguinal lymph node dissection intraoperative complication group, while 93.6% (44 of 47) agreed that postoperative complications should be subclassified into five macrocategories. Unanimous agreement (100%, 37 of 37) was achieved with the final standardized classification system for reporting inguinal lymph node dissection complications in melanoma, vulval cancer and penile cancer. Conclusion The complications and adverse events in lymphadenectomy of the inguinal area classification system has been developed as a tool to standardize the assessment and reporting of complications during inguinal lymph node dissection for the treatment of melanoma, vulval and penile cancer. [ABSTRACT FROM AUTHOR]

Lipomas are common benign adipose tissue tumors but are infrequently found in the labia majora, especially at a large size. We report a case of a giant lipoma of the labia majora in a 37-year-old woman diagnosed by imaging methods and successfully treated by surgery. This case highlights the importance of considering lipoma in the differential diagnosis of labial masses and underscores the role of imaging in diagnosis. They need to be differentiated from liposarcoma or omental herniation into Nuck's canal. It also demonstrates the effectiveness of surgical management for large lipomas in sensitive areas, with attention to both medical and aesthetic outcomes. [ABSTRACT FROM AUTHOR]

Context: In Australia, it is a common practice to dock sheep tails, to reduce breech soiling and flystrike. According to research, for docking to provide the optimal benefit, tails should be left at a length that covers the vulva in ewes and to an equivalent length in males. Docking tails shorter than recommended increases the risk of perineal cancers, arthritis and prolapse. Research indicates that some producers dock tails shorter than recommended, up to 57% in surveys and up to 86% in on-farm data. Aims: This study aimed to ascertain the current tail docking length, practices, knowledge and attitudes of Australian sheep producers. Methods: A national survey was conducted using online, hardcopy and computer-assisted telephone interview (CATI) modes of delivery (n = 547). Key results: Fifty-seven percent (205/360) of online and hardcopy survey participants chose short tail images to represent their practice, where the vulva was exposed. Although 88% (135/154) of CATI participants described their sheep tail lengths to be covering the vulva, participants equated the length to leaving two tail joints (40%, 54/134) and/or 50 mm (29%, 39/134), both of which have been previously found to be too short to cover the vulva. There was a high awareness of the recommended length (75.7%, 408/539) and 60% (234/390) of participants described it accurately. Significant associations were identified between choosing the short tail image and (1) describing the recommended length to be shorter than it is (P < 0.01), (2) being a producer in South Australia (P < 0.05), and (3) practicing mulesing (P < 0.01). Tail docking is important for producers to reduce flystrike, but docking at their chosen length held more importance than following the recommendation. Participants tended to agree that shearers preferred short tails. Docking tails with a hot knife or rubber rings were the most common methods used. Conclusions: These results indicated that short tail docking remains a sheep-welfare issue for Australian sheep, and that a knowledge–practice gap exists for some producers. Implications: Future research in the space of tail length could address the identified knowledge–practice gap, attitudes, and individual barriers to benefit sheep welfare and the industry. Most sheep in Australia have their tails docked and it is recommended that, after docking, the tail covers the vulva of ewes, with an equivalent length in males, because docking at a shorter length increases the risk of disease and compromises welfare. An Australia-wide survey of sheep producers was conducted and found that >50% indicated that they docked sheep tails shorter than recommended, and 20–25% were unaware of the recommendation. Short tail docking remains a sheep-welfare concern and requires further research and extension. [ABSTRACT FROM AUTHOR]

Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder–urethral regions related to menopause changes, negatively influencing woman's quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women. [ABSTRACT FROM AUTHOR]

Calcinosis cutis (CC) is characterized by the deposition of calcium salts in the skin and subcutaneous tissues. CC involving the vulva or foreskin (prepuce) is uncommon. We present a 9‐year‐old female with vulvar CC and a 15‐year‐old male with preputial CC. Microscopic review of excisional specimens revealed calcification associated with follicular cysts in the vulvar case and lichen sclerosus in the preputial case, suggesting a dystrophic origin to a subset of cases of genital CC that might otherwise be classified as idiopathic. The clinical implication of these findings is the need for close histopathologic scrutiny and ongoing clinical surveillance of patients with genital CC initially deemed idiopathic. [ABSTRACT FROM AUTHOR]

This article examines the short entry titled "Kjønnslepper" ("Labia") from the first volume of Karl Ove Knausgård's encyclopedia of the seasons series, Om høsten (Autumn) (2015). It wrestles with the entry's potential to scandalize and juxtaposes its anatomy with some ideas about shame from queer theory, developments in sex education, and feminist approaches to female genitalia. I argue that the primary anatomy of "Labia" is not labia as they are , but rather Knausgård's face-saving relationship to the vulva. After addressing my motivations for writing about and teaching Knausgård, I work through what I maintain are the three parts of "Labia" in order, showing how the entry expresses a longing for lost (paternal) innocence, places genitalia on a familiar path of heterosexualization, and replicates conventional ideas about sex. Along the way, I also interrupt Knausgård's monologue with alternative vulval inventories to demonstrate that the anatomy of "Labia" is a figuration among others, while resisting its trajectory away from the vulva in favor of the face. [ABSTRACT FROM AUTHOR]

The unknown male of Echemus escaleraiSimon, 1909 from Morocco is described for the first time, and the epigyne and vulva are illustrated for the first time. The position of the species in the genus EchemusSimon, 1878 is discussed. Cryptodrassus helvolus (O. Pickard-Cambridge, 1872), previously known from Cyprus, Russia (Northern Ciscaspia), and Israel, is reported for the first time in Morocco, Algeria, and Tunisia. [ABSTRACT FROM AUTHOR]

Aim: To analyze the different types of benign vulvar tumors that required surgery and to correlate with the histopathological findings postoperatively. Materials and methods: This retrospective study was conducted over a period of 1 year in a tertiary care hospital in Southern India. A total of 11 benign solid vulvar masses which were operated between July 2022 and June 2023 were included in the study. Demographic data, description of the mass, time taken to seek medical attention, surgical procedure and pictographic histopathological findings were studied. Results: The study population ranges from 26 to 45 years with a mean age of 35.8 ± 7.33 years. The mean time taken to seek medical care for the detected mass was 16.25 ± 17.23 months. The earliest presentation was noted 6 months after detection, while one patient presented 6 years after the appearance of the mass. The largest mass was 12 x 15 cm in size. All the masses underwent complete surgical excision with no postoperative complications. The most common pathological finding was fibroepithelial polyp, noted in four patients, followed by leiomyoma of the vulva and vulvar hemangioma. The other masses were reported as vulvar endocervicosis, epidermoid cyst, and lipoma, respectively. It is important to note that these tumors, though benign, can cause functional, sexual, and emotional impairment. These women were followed up 6 months postoperatively and did not show any recurrence. The quality of life assessment using the VR-12 validated scale indicated the improvement in all 11 women after surgery. Conclusion: Surgical excision of benign vulvar masses not only mitigates the risk of premalignant tumors of the vulva, but also greatly improves the quality of life. Clinical significance: • This study helps us understand benign vulvar masses and the importance of surgical removal of these masses to prevent risk of malignancy. • Surgical excision helps to greatly improve the quality of life in these women. [ABSTRACT FROM AUTHOR]

In this response to Hartman, this issue, I integrate anti-Blackness and Indigenous theories, to ponder the ways risk is projected onto Hartman's infant niece. The "dense temporalities" of the many objects used to surveil the infant are described, along with the ways Hartman's lovely meandering associations via autotheory contribute to shifting ontologies and epistemologies. Building on Hartman's considerations of the varieties of unconscious enigmatic forms his niece is bathed in, I explore the potentials of these transmissions emanating from the dense temporal histories of the surveillance objects themselves and the ways the "human" infant perpetually comes into being only momentarily, co-emergent with these more-than-human objects along with those humans tending to her. The racialized and misogynous histories of some of these objects and their transmitted risks, can only be enigmatic and too-much. Hartman's use of the term "snatch" is also examined along with its versatility based on its meanings referring to both vaginas, vulvas, and phallic "members." [ABSTRACT FROM AUTHOR]

Summary: Aphelenchoides yixingensis n. sp. found in Chinese red pine (Pinus massoniana) in Yixing city, Jiangsu Province, P.R. China, is described. It is characterised by a very slim body (a = 50.8 (41.3-63.8) and 49.3 (42.3-55.1) for males and females, respectively), three (occasionally five) lateral lines in the lateral field, a short stylet (9-12 μ m), the excretory pore located at the level of nerve ring, the vagina is not sclerotised and the vulva has slightly protruding lips and lacks a flap, the post-uterine sac is well developed and forms ca 29.0% (24.1-34.1%) of the vulva to anus distance. The spicules are smoothly arcuate, the apex and rostrum rounded and short, and the dorsal limb is 20.5 (16.9-22.2) μ m long, the distal end bluntly rounded. Spicule sheath-like structure is present, triangular and outstretched when heat-killed in some individuals. The male tail bears three pairs (2 + 2 + 2) of caudal papillae. The tail of both sexes is sub-cylindrical, the terminus bearing a bluntly pointed mucron with tiny nodular protuberances, mainly at the distal part. The new species belongs to the Group 2 category of Aphelenchoides species sensu Shahina and is defined as A2-B1-C1-D1-E2-F2 according to the categorisation codes of OEPP/EPPO. Phylogenetic analysis based on 18S and 28S D2-D3 of rDNA, along with ITS and mt COI , confirmed its status as a new species. A proposal for genus Ptychaphelenchus as a synonym of Aphelenchoides is also discussed. [ABSTRACT FROM AUTHOR]

Summary: A new species of the genus Skrjabinomermis , collected from two locations in north and northwest of Iran, is described and illustrated, including morphological data and D2-D3 rRNA LSU sequences. Skrjabinomermis pirnaimi sp. n. is characterised by its six cephalic papillae, two hypodermal pegs in the area of the cephalic papillae, adult's cuticle with very fine cross fibres, head rounded, mouth central, amphids cup-shaped, six hypodermal cords, vulva a transverse slit, located post-equatorially, cuticular protruding and vulval lips well developed, vagina pear- or barrel-shaped, with slightly bent lumen, tail similar in both sexes, bluntly rounded, spicules paired, medium sized, slightly curved, fused posteriorly for about 68-73% of their length, with pointed tip, male genital papillae arranged in three rows: the median ventral row having two pre- and two post-anal papillae, and the lateroventral rows with five papillae each. Molecular analyses using the D2-D3 expansion regions of the 28S rRNA gene sequences placed the genus Skrjabinomermis as a sister genus to Romanomermis with 93% Bayesian posterior probability based upon currently available data. [ABSTRACT FROM AUTHOR]

Aggressive angiomyxoma is a locally invasive, rarely diagnosed mesenchymal tumor that predominantly affects the perineal region of women in their reproductive years. It is typically found in areas such as the vagina, vulva, and other pelvic soft tissues, but its presentation can be highly variable. We describe a particularly unique case of aggressive angiomyxoma, presenting in an atypical manner within the vaginal region of a 31-year-old virgin woman. This case is noteworthy for the unusual growth pattern of the angiomyxoma—located strictly within the vaginal epithelium, showing no signs of invasion into surrounding tissues, which is not typical of the aggressive nature of this type of tumor. The patient presented with a mass that protruded through the hymen, an uncommon presentation that led to initial speculation about the nature of the mass. The definitive diagnosis of aggressive angiomyxoma was made by meticulous histopathological examination after surgical excision of the mass. This case emphasizes the critical importance of considering aggressive angiomyxoma in the differential diagnosis of vaginal masses, particularly those that do not exhibit invasive characteristics. The case also highlights the need for increased awareness among clinicians about the potential for atypical presentations of this rare tumor, to facilitate timely and accurate diagnosis, and to guide appropriate management strategies. This report contributes to the growing body of literature on aggressive angiomyxoma, highlighting the variability in its presentation and the need to heighten suspicion in atypical cases. [ABSTRACT FROM AUTHOR]

Although rare, vulvar melanoma is the second most common histological type of vulvar cancer, representing around 10% of all malignant tumors involving the vulva presenting typically in post-menopausal women. The data on vulvar melanoma consists almost entirely of case studies and small retrospective series. A standardized approach to the diagnosis and management of vulvar melanoma is not available. In this paper, a case of vulvar melanoma in remission is described and a review of the current literature is presented. A 73-year-old, G5P5 (5-0-0-5), complained of a 3-year history of intense vaginal pruritus. A biopsy was done at the site of the hyperpigmented patch revealing vulvar melanoma. CT scan was done before surgery and revealed negative lymph node invasion nor metastasis. The patient underwent a radical vulvectomy followed by adjuvant radiotherapy which offered remission of disease for 5 years. [ABSTRACT FROM AUTHOR]

Though they are commonly known as "universal tumors," lipomas are rarely found in the vulva. In this report, we discuss the case of a 15-year-old girl who presented with an enormous (26.5 × 21.5 × 6.5 cm) left labial swelling that had been progressively enlarging for a year and had led to extensive distortion of the vulvar anatomy. Following imaging, surgical excision with vulvar reconstruction was performed focusing on esthesis and function. Pathological examination confirmed the clinical and radiological diagnosis of a lipoma. The patient is doing clinically well at 1 year of follow-up with significant improvement in her academic performance and self-esteem. [ABSTRACT FROM AUTHOR]

Two populations of Aporcelaimellus obtusicaudatus were isolated from the soils of sugarcane and Paddy fields of district Dehradun (30° 19' N, 78°03' E and 960 meter above sea level), Uttarakhand, India. Based on morphological, morphometrical and molecular studies, the nematode was identified as Aporcelaimellus obtusicaudatus. Both isolates characterized by having body size 1.6-2.9 mm (SF5) and 1.8-3.1 mm (SF8) long, lip region offset by deep constriction, lips angular and 15.5-19.8 μm (SF5) and 14.5-18.8 μm (SF8) broad, odontostyle dorylemoides with wide lumen 19-22 μm long in (SF5) and 20-23 μm long in (SF8), odontostyle aperture half of its length, neck length 416-631 μm long (SF5) and 430-594 μm long (SF8), pharyngeal expansion 220.3-367 μm and 234-327.5 μm long or occupying 52-58% and 54-55% of the total neck length in both isolates, female genital system amphidelphic with transverse vulva and opaque pars refringens vaginae, tail short and rounded to conical with inner cuticle. Molecular analyses utilizing segments of the 28S rDNA and 18S rDNA placed Aporcelaimellus obtusicaudatus in a clade with other A. obtusicaudatus reported from different geography Ireland, South Africa, China and UK. A comparative study of species of genus Aporcelaimellus is also provided. [ABSTRACT FROM AUTHOR]

Background: lichen sclerosus (LS) is a chronic, inflammatory disease of the genital and extra genital skin, causing pruritus, soreness, pain and dyspareunia. The aim of this study was to investigate whether LOW level laser Therapy (LLLT) can improve the quality of life in women with lichen sclerosus (LS) and insufficient topical treatment. Methods: In a descriptive prospective observational study conducted between 02.01.2016 and 08.01.2018, we included 100 women with LS with insufficient topical treatment because of poor response of symptoms. Ah participants received ten LLLT treatments (808 nm and 500 mW) over a period of 8 weeks. The first four treatments were planned as two treatments per week. The remaining six treatments were planned as once a week. A Danish health-related quality of life tool (HRQoL test) monitored the effect. Results: A total of 94 patients completed the study, median age of 62 [InterQuartile Range 53-69]. There was a statistically significant improvement in seven of the eight domains of the HRQoL test after ten LLLT. We found the results of DoloTest to be statistically significant in all of the groups except for smoking (p < 0.094). Conclusions: LLLT treatment can improve the quality of life in women with LS. [ABSTRACT FROM AUTHOR]

The study analysed the case of a 74-year-old woman with a diagnosis of FIGO IVA vulvar carcinoma. The patient was also suffering from other diseases such as type 2 diabetes, hypertension, obesity, and permanent atrial fibrillation. Among the patient’s most significant nursing problems, self-care deficit, impaired mobility, impaired ability to perform hygiene and self-toileting, and lack of knowledge about disease were singled out. The aim of the work is to present knowledge and explain the subject of the therapeutic process and nursing problems of a patient with advanced vulvar cancer based on an individual case study. ICNP® reference terminology was used to develop care plans. The midwife’s care of a patient with advanced vulvar cancer requires special consideration of education, health promotion, and self-management activities, assisting with hygiene activities, and providing psychological support. The overarching goal in the patient’s care is to strive for the highest possible degree of self-care.

Background & aim: Schwannoma seldom occurs in female genitalia; with only a few cases being reported in the medical literature. This tumor can present on labia majora, labia minora, clitoris, and vagina. In this study, a case of vulvar schwannoma, which resembled a leiomyoma, is reported.Case report: A 44-year-old woman presented with a history of a small palpable mass located on the left labium. Ultrasonography showed a heterogeneous mass suggestive of a leiomyoma. Subsequently, the patient underwent surgical excision of the mass with clear margins. Histopathological examination confirmed the diagnosis of vulvar schwannoma. The patient was discharged in good condition following the excision.Conclusion: Schwannoma of the vulva represents a rare neoplasm that can be treated by surgical excision. The prognosis is excellent and recurrence is uncommon. Therefore, histopathological assessment is recommended for management of Schwannoma of the vulva.

We describe the hitherto unknown male of Centromerus fuerteventurensis Wunderlich, 1992 and present new illustrations of the epigyne and vulva. We also provide an update on the known distribution of this species on the Canary Islands. [ABSTRACT FROM AUTHOR]

The corona of the glans clitoris is a clinically important yet poorly understood anatomical structure. There has been longstanding confusion regarding the prevalence of the corona of the glans clitoris and, moreover, its very existence. Therefore, this anatomical study assesses the prevalence of the corona of the glans clitoris and the gross anatomy of the proximal glans clitoris. Anatomy was assessed in 104 female donor bodies ranging in age from 50 to 102 years with an average age-at-death of 78.1±10.9 years (mean±SD). All clitorises (100%; 104:104 dorsums and 100%; 208:208 sides) were found to have a well-defined clitoral corona. Three of 104 (2.9%) coronas possessed grossly visible, outward-projecting, bluntly rounded papillae. Some donors possessed a coronopreputial frenulum. Clitoropreputial adhesions were common and associated with clitoral pearls. Clitoral pearls were identified in 37.8% (14:37) of unembalmed donors and observed to create clitoral craters, structural deformations in the surface of the corona and glans. The results of this study suggest that the corona of the glans clitoris is a ubiquitous anatomical structure. The clitoral coronal papillae and coronopreputial frenulum are novel, previously undescribed, anatomical structures. This study identifies that the corona of the glans clitoris is prone to pathological processes such as clitoral pearl formation and clitoral deformation. In addition to novel anatomical findings, the results of this study call attention to the need for life-long clitoral examinations. Furthermore, the corona of the glans clitoris should be regularly included in anatomical texts and accurately depicted in anatomical illustrations. [ABSTRACT FROM AUTHOR]

Simple Summary: Cervical cancer is one of the most prevalent cancers among women. However, the clinically well-accepted cervical HPV 16/18 test was not sufficient to screen patients with high-grade cervical intraepithelial neoplasia (CIN 2+). The purpose of this study was to investigate the infection features of 15 high-risk (HR) HPVs in cervix, vagina, vulva, and anus, and evaluate their potential association with cervical lesions. In this study, HPV genotyping was performed on samples from the four anogenital sites of 499 Chinese women. Results showed that in addition to the well-recognized cervical-cancer-associated subtypes, e.g., HPV 16, 52, and 58, HPV 51, 53, and 56 had high prevalence and site-related infection consistency among the anogenital sites studied. In addition to cervical HPV 16/18, cervical HPV 33/35/52/53/56/58 were suggested as potential indicators that could improve the accuracy of HR-HPV screening in predicting CIN 2+. Background: Both cervical cancer and cervical intraepithelial neoplasia (CIN) are associated with human papillomavirus (HPV) infection at different anogenital sites, but the infection features of high-risk (HR) HPVs at these sites and their association with cervical lesions have not been well characterized. Given the limitation of cervical HPV 16/18 test in screening patients with high-grade CIN (CIN 2+), studies on whether non-16/18 HR-HPV subtype(s) have potential as additional indicator(s) to improve CIN 2+ screening are needed. Methods: The infection of 15 HR-HPVs in vulva, anus, vagina, and cervix of 499 Chinese women was analyzed, and CIN lesion-associated HR-HPV subtypes were revealed. Results: In addition to the well-known cervical-cancer-associated HPV 16, 52, and 58, HPV 51, 53, and 56 were also identified as high-frequency detected subtypes prevalently and consistently present at the anogenital sites studied, preferentially in multi-infection patterns. HPV 16, 52, 58, 56, and 53 were the top five prevalent subtypes in patients with CIN 2+. In addition, we found that cervical HPV 33/35/52/53/56/58 co-testing with HPV 16/18 might improve CIN 2+ screening performance. Conclusion: This study provided a new insight into HR-HPV screening strategy based on different subtype combinations, which might be used in risk stratification clinically. [ABSTRACT FROM AUTHOR]

Simple Summary: Vulvar lymphomas are uncommon diseases and account for less than 0.5% of gynecological cancers and 1.5% of all NHLs. The various types of lymphomas have recently been identified as separate diseases and not as morphological variations of the same disease, according to the World Health Organization classification. They often represent the secondary localization of systemic disease, and diffuse large B-cell lymphoma is the most common type. We also considered cases of vulvar T-cell lymphomas. The data analysis highlighted the difficulty of diagnosis and the need to resort to biopsy–histological examination, as well as molecular methods. The correctness of the diagnosis directly affects appropriate therapeutic management, which requires an adequate surgical approach that can be integrated with chemotherapy and radiotherapy. Since they are very rare tumors, lymphomas of the vulva are often not properly recognized. Patients with vulvar lymphoma are generally elderly and the classical manifestation of the disease is a vulvar mass. No significant age differences have been found between primary and secondary lymphoma. To make a correct diagnosis, it is therefore necessary to use not only histological examination but also the genetic and molecular profile in order to establish optimal therapeutic management. Literature analysis confirm the good prognosis of this disease. [ABSTRACT FROM AUTHOR]

A variety of skin lesions from benign to premalignant and malignant can present on the vulva. One of the most common presentation to the emergency department is bartholin gland issues, from simple cyst to bartholin gland abscess and malignancy. Symptomatic Bartholin abscesses and cysts account for about 2% of all gynecologic visits per year [1] . Variety of management options are available for symptomatic bartholin cysts or abscesses, depends on the patient’s symptoms and degree of inflammation and infection present. Treatment options include simple drainage, fistulization, marsupialization, and excision of the gland. These treatment options do not guarantee complete cure of the bartholin gland abscess and they might be associated with rare complications. [2]. [ABSTRACT FROM AUTHOR]

Summary: The present study describes two new Ditylenchus species, isolated from the growing medium of Rhododendron simsii imported from Japan, at the Ningbo plant quarantine laboratory, Ningbo, P.R. China. Ditylenchus parvicauda n. sp. is an amphimictic species. Females have six incisures in the lateral fields, a medium length slim body, a short delicate stylet with asymmetrical stylet knobs, the secretory-excretory (S-E) pore located posterior to the isthmus and in the anterior region of the basal pharyngeal bulb, a posteriorly located vulva (V = 80.9-83.0), post-uterine sac (PUS) tube-like, and the tail cylindrical, tapering gradually towards finely rounded terminus. Males are similar to females in general morphology and have 10.1-14.9 μ m long spicules. The second new species, D. gracicauda n. sp. is characterised by having a long and slender body, the presence of a vulval flap, four lines in the lateral field, a narrow and low lip region not offset, the S-E pore located posterior to the isthmus but not in the anterior region of the basal pharyngeal bulb, a posteriorly located vulva (V = 71.1-76.2), a short post-vulval uterine sac short (4.5-9.2 μ m), and the tail slender, tapering gradually towards finely rounded to wedge-shaped terminus. The two new species were also characterised molecularly using 18S, ITS and the D2-D3 expansion segments of 28S rRNA genes. Our phylogenetic analyses showed their independent place among available Ditylenchus species. Several Ditylenchus species are regulated pests, and the introduction of these species into a new environment may result in diseases among native plants or vegetation in the area. Therefore, careful attention must be directed towards newly discovered species, particularly those under quarantine observation. [ABSTRACT FROM AUTHOR]

Summary: Three populations of Pauronemoides siddiqii n. gen., n. sp. were recovered from three different locations in northwestern and northern Iran from bark and soil samples. The new genus was described and illustrated based upon morphological and molecular characteristics. Pauronemoides n. gen. belongs to the family Paurodontidae and is characterised by the medium-sized body, asymmetrical knobs in stylet base, stem-like extension into intestine, post-vulval uterine sac (PUS) absent or rudimentary, different tail tip shape between sexes, and bursa enveloping tail or reaching to the tail end. The type species, Pauronemoides siddiqii n. gen., n. sp., is mainly characterised by 752-1281 μ m body length in females and 660-1085 μ m in males, six equally-sized lips, stylet 9-11 μ m long with asymmetrical knobs, six incisures in lateral fields forming five bands, three of which (two outers and one central) are wider, and variably lengthened stem-like extension projecting into the intestine. Vulva situated posteriorly (V = 87.7-91.7%), PUS absent. Conical tail with widely rounded end, having a small mucron at tip in females, males with conical tail ending to a narrower tip and bursa enveloping tail completely. The type species of the new genus was compared with all known species of the genera Prothallonema , Paurodontus , Paurodontoides and Paurodontella. Pauronemoides siddiqii n. gen., n. sp. resembles Prothallonema macrocellum and P. mucronatum by having the bulb extension penetrating into the intestine, dimorphism in tail shape of both sexes and bursa enveloping tail, and Paurodontella iranica by tail shape dimorphism between sexes and bursa ending near tail tip. Therefore, the above-mentioned species are transferred to the new genus as Pauronemoides macrocellus n. gen., n. comb. (= Prothallonema macrocellum), P. mucronatus n. gen., n. comb. (= Prothallonema mucronatum) and P. iranicus n. gen., n. comb. (= Paurodontella iranica). In addition to morphological comparisons, molecular phylogenetic analyses were performed using two sequences of small subunit (SSU), and three partial sequences of D2-D3 expansion segments of the large subunit (LSU) rDNA, and the resulting topologies were discussed. [ABSTRACT FROM AUTHOR]

A nulliparous intact female Labrador Retriever, aged two years, was presented to the University Veterinary Hospital, Kokkalai with the complaint of a mass protruding from the vulva for the past two weeks. Histopathology of the protruded vaginal mass revealed keratinised and hyperplastic vaginal epithelium with focal areas of mild spongiosis. Subsequently, the condition was diagnosed as vaginal hyperplasia Type III and the condition was managed with surgical circumferential excision under general anaesthesia. No recurrence was observed on the succeeding oestrous cycle. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify clinicopathologic parameters associated with disease outcome in FIGO stage I vulvar squamous cell carcinoma (vSqCC). The cohort consisted of 126 patients diagnosed with vSqCC in the period 2006–2016 who underwent primary vulvar surgery and evaluation of groin lymph node status. Tumors were reviewed by an experienced gynecologic pathologist. p16 and p53 protein expression by immunohistochemistry and HPV status were analyzed in 116 tumors. Clinicopathologic parameters, protein expression and HPV status were analyzed for association with progression-free and overall survival (PFS, OS). p16 expression and aberrant p53 were found in 49 (42%) and 61 (53%) tumors, respectively. Sixty-six tumors were HPV-associated (57%). Relapse was diagnosed in 35/126 (28%) of patients, and 23 (18%) died of disease. Tumor diameter > 4 cm (p = 0.013), lymphovascular space invasion (LVSI; p < 0.001), the presence of lichen sclerosus (p = 0.019), p16 expression (p = 0.007), p53 expression (p = 0.012), HPV status (p = 0.021), lymph node metastasis (p < 0.001) and post-operative radiotherapy (p < 0.001) were significantly related to OS in univariate analysis. Tumor diameter > 4 cm (p = 0.038), LVSI (p = 0.003), the presence of lichen sclerosus (p = 0.004), p16 expression (p = 0.004), HPV status (p = 0.039), lymph node metastasis (p < 0.001) and post-operative treatment (p < 0.001), were significantly related to PFS in univariate analysis. Age, BMI and surgical resection involvement were not significantly associated with OS or PFS. In multivariate Cox analysis, LVSI and p16 expression were independent prognosticators of OS (p < 0.001 and p = 0.02, respectively) and PFS (p = 0.018, p = 0.037). In conclusion, LVSI and p16 expression are independent prognostic factors in stage I vSqCC. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) is defined as all procedures involving partial or total removal of the external female genitalia, or other injuries to them for non-medical reasons. Due to migration, healthcare providers in high-income countries need to better understand the consequences of FGM. The aim of this study was to elucidate women's experiences of FGM, with particular focus on perceived health consequences and experiences of healthcare received in Sweden. Methods: A qualitative study was performed through face-to-face, semi-structured interviews with eight women who had experienced FGM in childhood, prior to immigration to Sweden. The transcribed narratives were analyzed using content analysis. Results: Three main categories were identified : "Living with FGM", "Living with lifelong health consequences" and "Encounters with healthcare providers". The participants highlighted the motives behind FGM and their mothers' ambivalence in the decision process. Although the majority of participants had undergone FGM type 3, the most severe type of FGM, the lifelong health consequences were diverse. Poor knowledge about FGM, insulting attitude, and lack of sensitive care were experienced when seeking healthcare in Sweden. Conclusions: Our findings indicate that FGM is a complex matter causing a diversity in perceived health consequences in women affected. Increased knowledge and awareness about FGM among healthcare providers in Sweden is of utmost importance. Further, this subject needs to be addressed in the healthcare encounter in a professional way. [ABSTRACT FROM AUTHOR]

Aim: This cross‐sectional study evaluated vaginal health and hygiene practices among reproductive and perimenopausal women in Japan using an online‐based questionnaire. Methods: The questionnaire included 11 well‐structured questions concerning vulvovaginal symptoms and hygiene care practices. Participants' responses were anonymized and analyzed descriptively. The relationships of age, family income, occupation, and childbearing with women's concerns regarding vaginal or vulvar problems were analyzed by chi‐square tests. Results: About 80% of women in their 20s to 50s in Japan reported experiencing vulvovaginal symptoms. Women in their 40s had significantly fewer symptoms than women in their 20s (p = 0.04), and women in their 50s had significantly fewer symptoms than all other age groups (20s, 30s, and 40s) (p < 0.001). Among symptomatic women, 77.5% did not discuss their symptoms with anyone else and only 10% visited doctors. About 12.5% of women reported taking special care of their vagina or vulva regularly, whereas 38.2% expressed a desire to try some form of care but had not yet done so. Of the women who did not take special care of their vagina or vulva, 46.2% lacked knowledge about proper care, 42.2% did not want to spend money on care, 30.5% did not want to discuss care with others, and 21.3% were psychologically reluctant. Conclusion: Determination of the prevalence of vulvovaginal symptoms among Japanese women can enhance understanding of this prevalent condition and its impact on women's health. These findings may help formulate effective public health interventions and promote better hygienic practices, thus improving the well‐being of women in Japan. [ABSTRACT FROM AUTHOR]

Accurate and timely estrus detection is one of the critical factors for improving the conception rate of sows in swine reproduction. Estrus detection in the current industry relies on experienced breeding technicians using the back pressure test method, which is time-consuming, labor-intensive, and subjective. This study aimed to develop an image-processing pipeline that could predict the onset of estrus by monitoring the variation of the vulva volume of sows. A robotic imaging system consisting of a LiDAR camera was used to collect depth and infrared (IR) images of sows multiple times per hour. The developed image processing pipeline consisted of a deep learning model (MobileNet) to exclude images with defective postures (e.g., excreting posture, vulva region not showing) for vulva detection. The selected images were further processed to (1) segment sow vulva regions (3-dimensional surface) using a U-Net model, (2) exclude incorrectly segmented 3D vulva surfaces using a MobileNet model, and (3) calculate the vulva volume using the segmented 3D vulva surface. Results show that all three models achieved high test accuracy of 94.8% (MobileNet 1), 96.7% (U-Net), and 100% (MobileNet 2). The vulva volume was calculated using the developed pipeline for all the test sows. Daily average vulva volume showed a noticeable increase in all sows at 0-1 day prior to the onset of estrus. This study concluded that the developed image processing pipeline could automatically detect vulva swelling, which may be used as a biological sign indicating the onset of post-weaning estrus in sows. [ABSTRACT FROM AUTHOR]

Objective: This study examined the quality of life and burden of disease of vulvar lichen sclerosus (VLS) patients in three states of menstruation to better understand VLS. Methods: A total of 607 VLS patients were enrolled into this retrospective study. According to the ages of onset, menarche and menopause, the patients were divided into three groups: prepubertal group (n = 96), reproductive group (n = 400) and postmenopausal group (n = 111). Data were collected by direct interview and clinical examination. Results: A total of 93% of patients had itching, with a median numerical rating scale score of five. In the prepubertal group, the median score was three. Nocturnal itching occurred in 49.6% patients. Nearly half of the patients (45.9%) thought the itching affected their sleep. However, this ratio was very different in the prepubertal group (20.7%). Some patients (12.8%) cleaned their vulva more than seven times per week. Only 17.2% of patients experienced no effect on their sex life. The median dermatology life quality index score in all patients was six, but it was only three in the prepubertal group. The median number of hospital visits was two times, and the number of clinic visits was three times. Previous expenses, in median, were 2000 RMB. For 84.3% patients, the gynecologic clinic was their first choice. Conclusion: VLS places great physical, mental and economic burdens on patients. Patients in the prepubertal group had milder symptoms and dermatology life quality index score. VLS should arouse the attention of patients and specialists. Synopsis: Vulvar lichen sclerosus leads to a decrease in patient's quality of life and places great economic burdens on patients. [ABSTRACT FROM AUTHOR]

While histological diagnosis of Paget disease of vulva is mostly straightforward, identifying and confirming invasion can be challenging. Often invasion is accompanied by epidermal hyperplasia, marked inflammatory response and desmoplastic reaction. Diagnosis of invasion in Paget disease portends a poor outcome. We report findings from a recurrent primary vulvar Paget disease where overall histomorphology of possible invasive disease is unusual and raises a possibility of displacement of Paget cells in the dermis. We compare histology of the index case with known invasive vulvar Paget disease cases retrieved from our pathology archives. Unique histomorphology in the index case suggests a possibility of previous excision related dermal displacement of Paget cells. [ABSTRACT FROM AUTHOR]

Vulval fibroadenoma is a rare benign tumor arising from the ectopic breast tissue or mammary-like anal glandular tissue. Although it is a common breast neoplasm, its genital location makes it notable, with less than a hundred cases being reported in the literature so far. It is commonly known to present in the reproductive age group, similar to its breast counterpart, with its histogenesis being a frequent topic of discussion. Despite being benign and largely infrequent, these vulval neoplasms continue to be important reasons for medical consultation. We present one such case of vulval fibroadenoma presenting as an enlarged lymph node in a 37-year-old female. [ABSTRACT FROM AUTHOR]

This article discusses the challenges and reasons for the underdiagnosis of prenatal ambiguous or atypical genitalia. The authors highlight the impact of this condition on parents and healthcare professionals, as well as the importance of effective communication and sex assignment. They explore the definitions and prevalence of ambiguous/atypical genitalia and the associated genetic, hormonal, and developmental disorders. The article identifies three main factors contributing to the underdiagnosis: lack of knowledge, lack of strong evidence, and lack of recognition and support. The authors propose strategies to improve prenatal detection, including redefining criteria and implementing comprehensive qualitative and quantitative assessments during mid-pregnancy ultrasound examinations. [Extracted from the article]