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Developmental Abnormalities

Developmental abnormalities of the vulva and vagina are commonly manifest at birth but may also present during delayed puberty, sexual intercourse or during an obstructed labour. Divided into conditions where the gender of the genitalia is not in question, and those where there are various degrees of clitoral enlargement, labial fusion and where gonadal abnormalities show one or more facets of male genitalia, this chapter describes the conditions associated with each of these conditions in turn, and describes contemporary management options.

The first section- malformations that do not lead to sexual ambiguity- begins by describing the very rare phenomena of the double vulva and the more common condition of cysts of the canal of Nuck. Dermoid cysts are then discussed, followed by vascular malformations, dilatations and their treatment. The author then moves on to the topics of congenital lymphedema and the imperforate hymen, cautioning that complications of an imperforate hymen may become especially worrying with the onset of menstruation. Transverse, longitudinal and non-midline longitudinal and oblique vaginal septa are the next topic for consideration, and the author makes good use of medical imagery to illustrate his discussion. Double vaginas, vaginal hypoplasia, atresia and agenesis are then briefly outlined and the section concludes with the topics of DES associated abnormalities, Gartner’s duct cysts, epispadias, hypospadias and vaginal fistulas.

The second sectioned is concerned with malformations that are associated with ambiguous external sexual organs, where gender cannot be easily assigned by visual inspection. Topics covered include gonadal dysgenesis, ovarian dysgenesis, testicular dysgenesis and true hermaphroditism. The eChapter concludes with a brief discussion on the investigation and treatment of intersex.

This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vagina Manual is an invaluable resource especially suitable for:

  • Gynecologists
  • Dermatologists
  • General Practitioners
  • Obstetricians
  • Midwives
  • General nurses
  • Practice nurses
  • Nurse Practitioners

There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of the from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.

Contents include

  • Distinguishing vascular malformations from vascular neoplasms
  • Developmental abnormalities of the vagina, including septa and imperforate hymens
  • Abnormalities induced by synthetic estrogens
  • Ambiguous external sexual organs
  • Surgical treatment options
  • Milroy’s disease and Turner’s syndrome.
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Author / Editor Biographies

John Brenan is a dermatologist practicing in Melbourne. He is a past President of the Australian College of Dermatology, consultant dermatologist to the Mercy Hospital for Women and the original dermatologist for the Dermogynaecology Clinic.
David Allen is a certified gynaecological oncologist practicing at the Mercy Hospital for Women and the Peter MacCallum Cancer Centre, East Melbourne. He is an Associate Professor in the Department of Surgery at the University of Melbourne.
James Scurry is one of Australia's leading gynaecological pathologists. He is a pathologist in Newcastle, New South Wales.
Dr Dennerstein is an Obstetrician and Gynaecologist with medical expertise in the health of the vulva and vagina. He is the former Head of the Dermo-gynaecology Clinic at The Mercy Hospital for Women and co-author of the book entitled: The Vulva and Vagina Manual. He has lectured extensively on this topic, both internationally and nationally. Graeme has extensive experience in family planning and reproductive health. In 1971 he established the Family Planning and Infertility Clinic at the Western General Hospital in Melbourne, serving as its director until 1986. From 1980 to 1989 he was the ...
Grazia Marin is a psychologist in private practice in Melbourne and past committee member and Education Officer of the Victorian Psychosexual Society. She is also a member of the International Society for the Study of Vulvovaginal Diseases and is serving on its Patient Education and Sexual Difficulties committees.

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