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Journal of Minimally Invasive Gynecology Sep 2021
Topics: Female; Humans; Pelvic Organ Prolapse; Surgical Mesh; Vulva
PubMed: 34273588
DOI: 10.1016/j.jmig.2021.07.007 -
G3 (Bethesda, Md.) May 2022Development of the Caenorhabditis elegans vulva is a classic model of organogenesis. This system, which starts with 6 equipotent cells, encompasses diverse types of...
Development of the Caenorhabditis elegans vulva is a classic model of organogenesis. This system, which starts with 6 equipotent cells, encompasses diverse types of developmental event, including developmental competence, multiple signaling events to control precise and faithful patterning of three cell fates, execution and proliferation of specific cell lineages, and a series of sophisticated morphogenetic events. Early events have been subjected to extensive mutational and genetic investigations and later events to cell biological analyses. We infer the existence of dramatically changing profiles of gene expression that accompanies the observed changes in development. Yet, except from serendipitous discovery of several transcription factors expressed in dynamic patterns in vulval lineages, our knowledge of the transcriptomic landscape during vulval development is minimal. This study describes the composition of a vulva-specific transcriptome. We used tissue-specific harvesting of mRNAs via immunoprecipitation of epitope-tagged poly(A) binding protein, PAB-1, heterologously expressed by a promoter known to express GFP in vulval cells throughout their development. The identified transcriptome was small but tightly interconnected. From this data set, we identified several genes with identified functions in development of the vulva and validated more with promoter-GFP reporters of expression. For one target, lag-1, promoter-GFP expression was limited but a fluorescent tag of the endogenous protein revealed extensive expression. Thus, we have identified a transcriptome of C. elegans vulval lineages as a launching pad for exploration of functions of these genes in organogenesis.
Topics: Animals; Caenorhabditis elegans; Caenorhabditis elegans Proteins; DNA-Binding Proteins; Female; Morphogenesis; Transcriptome; Vulva
PubMed: 35551383
DOI: 10.1093/g3journal/jkac091 -
Plastic and Reconstructive Surgery Oct 2020After studying this article, participants should be able to: (1) Identify the most appropriate type of anesthesia for the female genital plastic surgical patient and... (Review)
Review
LEARNING OBJECTIVES
After studying this article, participants should be able to: (1) Identify the most appropriate type of anesthesia for the female genital plastic surgical patient and minimize risks of nerve injury and thromboembolic event through proper preoperative evaluation and knowledge of positioning. (2) Define the vulvovaginal anatomy, including common variants, and assess vulvovaginal tissues after childbirth and menopause. (3) Apply surgical techniques to minimize complications in female genital plastic surgery. (4) Classify the types of female genital mutilation/cutting and design methods of reconstruction after female genital mutilation/cutting.
SUMMARY
Female genital plastic surgery is growing in popularity and in numbers performed. This CME article covers several aspects of safety in the performance of these procedures. In choosing the best candidates, the impact of patient motivation, body mass index, parity, menopause and estrogen therapy is discussed. Under anesthesia, consideration for the risks associated with the dorsal lithotomy position and avoidance of compartment syndrome, nerve injury, deep venous thromboses, and pulmonary embolus are covered. Anatomical variations are discussed, as is the impact of childbirth on tissues and muscles. Surgical safety, avoidance of complications, and postoperative care of a variety of vulvovaginal procedures are discussed. Videos showing anatomical variations and surgical techniques of the most common female genital procedures with recommendations to reduce the complication rate are included in the article. Finally, female genital mutilation/cutting is defined, and treatment, avoidance of complications, and postoperative care are discussed.
Topics: Female; Gynecologic Surgical Procedures; Humans; Plastic Surgery Procedures; Vagina; Vulva
PubMed: 32970012
DOI: 10.1097/PRS.0000000000007349 -
Obstetrical & Gynecological Survey Feb 2021Gynecologists are experts in providing care to women with vulvovaginal complaints. Cysts located in the vagina and vulva can cause pain and irritation and incite... (Review)
Review
IMPORTANCE
Gynecologists are experts in providing care to women with vulvovaginal complaints. Cysts located in the vagina and vulva can cause pain and irritation and incite concern. Given the relatively low prevalence of these cysts in the population, helpful diagnostic and management information for providers is scarce.
OBJECTIVE
This article will detail the epidemiology, embryology, presentation, and management of vulvovaginal cysts.
EVIDENCE ACQUISITION
We completed a comprehensive literature review for all available data and included case reports, case series, histological studies, and descriptive articles obtained from PubMed and relevant textbook chapters.
RESULTS
In general, cystic lesions of the vagina and vulva are typically benign and asymptomatic and do not require intervention. Special attention should be paid to cysts arising in women older than 40 years and those that are fixed or associated with pain or bleeding. Cysts that require management may require imaging, often either with transvaginal ultrasound or magnetic resonance imaging. Surgical excision, when necessary, has a high success rate.
CONCLUSIONS AND RELEVANCE
Vaginal and vulvar cysts have a myriad of presentations and etiologies. A thorough understanding of these is helpful to guide decisions about further testing and management options.
Topics: Adult; Cysts; Diagnosis, Differential; Disease Management; Female; Gynecology; Humans; Middle Aged; Vagina; Vaginal Diseases; Vulva; Vulvar Diseases
PubMed: 33625519
DOI: 10.1097/OGX.0000000000000858 -
Journal of Obstetrics and Gynaecology... Jul 2023
Topics: Female; Humans; Neoplasms, Fibroepithelial; Polyps; Vulva; Vulvar Neoplasms; Adolescent
PubMed: 35589521
DOI: 10.1016/j.jogc.2021.03.014 -
Seminars in Diagnostic Pathology Jan 2021Approximately half of adenocarcinomas that involve the vulva are secondary, either through direct extension or metastases from elsewhere. Primary vulvar adenocarcinomas... (Review)
Review
Approximately half of adenocarcinomas that involve the vulva are secondary, either through direct extension or metastases from elsewhere. Primary vulvar adenocarcinomas are rare and encompass a diverse array of neoplasms that are nominally classified based on the presumed tissue or organ of origin, the tumoral phenotype, or both. In this review, we summarize the clinicopathologic features of adenocarcinomas that originate from the vulva and related structures, including the terminal urethra. Adenocarcinomas of this region encompass lesions that are defined by their primary site (such as adenocarcinomas of the Bartholin gland, which by definition must be in the region of the Bartholin gland), histomorphology and immunophenotype (such as clear cell carcinoma and adenocarcinoma of intestinal [cloacogenic] type), or both (such as adenocarcinoma of skene gland origin, which is associated with that specific organ but which also displays a distinctive phenotype that is similar to the phenotype of high grade prostatic adenocarcinoma). Other types, such as mammary-type adenocarcinomas, are presumed to originate from the putative mammary-like glands of the vulva and display a spectrum of pathologic features that are similar to their mammary counterparts. Similarly, vulvar carcinomas of sweat gland origin are pathologically similar to their counterparts in the non-vulvar skin and include a variety of cutaneous adnexal-type malignancies such as apocrine adenocarcinoma and eccrine adenocarcinoma. Some tumors, such as adenoid cystic carcinoma, may represent a Bartholin gland adenocarcinoma, a carcinoma of sweat gland origin, or a carcinoma arising from extramammary Paget disease (EMPD), depending on the context. Invasive carcinomas of various types have been reported in 7-12.7% of EMPD, and these are likely the most common primary glandular malignancy of the vulva. Occasional vulvar adenocarcinomas have been reported to be HPV-associated, although this association has not been established for the broader group of vulvar adenocarcinomas. Rare adenocarcinomas are not classifiable by the aforementioned nosologic scheme, and are designated as vulvar adenocarcinoma NOS.
Topics: Adenocarcinoma; Bartholin's Glands; Female; Humans; Vulva; Vulvar Neoplasms
PubMed: 33032903
DOI: 10.1053/j.semdp.2020.09.011 -
Clinics in Plastic Surgery Oct 2022Consultation for female esthetic genital concerns is unique in that the topic is shrouded in secrecy. Few opportunities exist for the improvement of female sexual health... (Review)
Review
Consultation for female esthetic genital concerns is unique in that the topic is shrouded in secrecy. Few opportunities exist for the improvement of female sexual health and well-being when compared with male counterparts. Women concerned with the appearance of their genitalia seek help with improving their confidence and reducing mental and physical discomfort attributed to large labia minora. Validated questionnaires given to patients beforehand, a detailed sexual history, and a comprehensive vulvar examination help define the esthetic and functional issues. Providing informed consent and setting realistic expectations are the key final steps to a successful esthetic genital consultation.
Topics: Esthetics; Female; Genitalia, Female; Humans; Male; Plastic Surgery Procedures; Referral and Consultation; Vulva
PubMed: 36162938
DOI: 10.1016/j.cps.2022.06.006 -
Clinics in Plastic Surgery Oct 2022The two base techniques for labiaplasty surgery are the linear excision and the wedge excision. The modification of using radiofrequency in a curvilinear manner is... (Review)
Review
The two base techniques for labiaplasty surgery are the linear excision and the wedge excision. The modification of using radiofrequency in a curvilinear manner is exceptionally precise, safe, and can produce exceptionally beautiful results based on surgical skill and experience. We recommend using this curvilinear technique as the core skill to learn as a labial surgeon both for ease and safety. Presented are the steps to achieve safe and consistent results no matter the anatomy. The method to reduce the lateral clitoral hood to help balance the appearance of the vulvar structures is also presented.
Topics: Female; Humans; Plastic Surgery Procedures; Vulva
PubMed: 36162940
DOI: 10.1016/j.cps.2022.06.007 -
Clinics in Plastic Surgery Jan 2023Female genital cosmetic surgery consists of multiple procedures, usually including labiaplasty, clitoral prepuce reduction, labia majora augmentation, and vaginoplasty.... (Review)
Review
Female genital cosmetic surgery consists of multiple procedures, usually including labiaplasty, clitoral prepuce reduction, labia majora augmentation, and vaginoplasty. The reasons for women to undergo these surgeries can be categorized as functional and aesthetic ones. In this study, we introduced the modified vaginoplasty with acellular dermal matrix (ADM) and briefly reviewed our experience in the combination of multiple procedures to achieve the optimal effect.
Topics: Female; Humans; Rejuvenation; Acellular Dermis; Vagina; Vulva; Clitoris
PubMed: 36396257
DOI: 10.1016/j.cps.2022.07.007 -
Aesthetic Plastic Surgery Dec 2021This study was designed to evaluate utility of transferring autologous adipose-derived mesenchymal stem cells with high regenerative capacity and adipose tissue...
BACKGROUND
This study was designed to evaluate utility of transferring autologous adipose-derived mesenchymal stem cells with high regenerative capacity and adipose tissue derived-stromal vascular fraction, so-called 360 Vaginal Beautification technique, in labia majora augmentation and vaginal tightening operation.
METHODS
A total of 97 female patients who underwent labia majora augmentation and vaginal tightening operation with 360 Vaginal Beautification technique were included. Post-discharge early (3rd and 7th postoperative day) and late (1 and 3rd postoperative month) surgical complications were assessed , while the Female Genital Self-Image Scale (FGSIS) was applied before surgery and also during postoperative 6-12 months.
RESULTS
All complications noted on postoperative 3rd day (ecchymosis of labia majus, ecchymosis of clitoral hood, tenderness in the pubic area and pain at the vaginal entrance points) regressed on postoperative 7th day with no infection, edema, lipoma or granuloma formation in any patient. Total mean FGSIS score was 17.7 ± 1.6 in the pre-operative period, and increased significantly to 20.9 ± 1.4 and 22.2 ± 1.8 in the postoperative 6th month (p < 0.001) and 12th month (p = 0.013), respectively.
CONCLUSIONS
The use of autologous fat, called 360 vaginal beautification, in the labia majora augmentation and vaginal tightening appears to be a safe technique due to use of autologous tissue transfer and to be associated with high satisfaction rate and an advantage of being more minimally invasive than surgical labia majora augmentation and vaginal tightening.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
Topics: Aftercare; Female; Humans; Patient Discharge; Retrospective Studies; Stromal Vascular Fraction; Treatment Outcome; Vagina; Vulva
PubMed: 34373975
DOI: 10.1007/s00266-021-02488-w