Vaginal and vulvar disorders: Pathology review


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Vaginal and vulvar disorders: Pathology review


Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy


Penile cancer


Benign prostatic hyperplasia

Prostate cancer


Inguinal hernia




Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders


Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid



Endometrial hyperplasia

Endometrial cancer


Cervical cancer

Pelvic inflammatory disease


Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder


Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption



Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage


Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis


Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review


Vaginal and vulvar disorders: Pathology review

USMLE® Step 1 questions

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USMLE® Step 1 style questions USMLE

of complete

A 45-year-old woman presents to a women's health clinic for evaluation of vaginal and vulvar itching. She also reports thick vaginal discharge for two days. Past medical history is significant for type II diabetes mellitus. The patient was recently hospitalized for a complicated urinary tract infection. Vitals are within normal limits. The pelvic examination is shown below. Evaluation of the vaginal swab shows a vaginal pH of 4.0. Which of the following best describes the features of the causative pathogen for this patient’s condition?
Reproduced from Wikimedia Commons


Content Reviewers

Yifan Xiao, MD


Antonia Syrnioti, MD

David G. Walker

Sam Gillespie, BSc

Zachary Kevorkian, MSMI

62-year-old Tess comes to the emergency department with vaginal bleeding for the past couple of hours. She also mentions that she has occasionally noticed some watery, foul-smelling vaginal discharge. After ensuring that she is hemodynamically stable, history reveals that her last menstrual period was about 10 years ago and she has had multiple sexual partners. On speculum examination, a suspicious-looking mass is identified in the upper third of the posterior vaginal wall.

Later that day, 69-year-old Oshun comes to the physician's office complaining of an intense burning sensation, itching and pain in her genital region. Her last menstrual period was at the age of 48. On further history, she has been smoking 1.5 packs daily for 40 years. On examination, a white, asymmetrical lump with irregular borders and 1.2 cm in size is seen in the right labia majora.

All right, both Tess and Oshun have some type of vaginal or vulvar condition. Let’s take a look at the Anatomy real quick. The external sex organs, together referred to as the vulva, contain the labia majora, which cover the labia minora, and between the two labia minora there is a space called the vulvar vestibule that includes the opening of the vagina and the the urethral opening. Now, vaginal and vulvar conditions are classified into non- neoplastic ones including bartholin cyst, lichen sclerosus, lichen simplex chronicus, and imperforate hymen and neoplastic ones, which are relatively rare cancers of the female genital tract.

Okay, let’s start with the first non-neoplastic condition, which is the Bartholin cyst. The Bartholin glands are two small glands that lie underneath the vestibule and on each side of the vaginal opening. Normally, they secrete a mucus- like fluid that drains through ducts into the vestibule in order to lubricate the vagina. But when their ducts get blocked, the fluid builds up, causing cystic dilation of the gland. For your exams, remember that blockage typically occurs in females of reproductive age as a result of a mucus plug or a sexually-transmitted infection, and especially, Neisseria gonorrhoea. If the cyst itself gets infected, an abscess occurs.


Vaginal and vulvar disorders refer to a wide range of conditions affecting the female reproductive system. Common vaginal and vulvar disorders include bartholin's cysts, where a blockage of the bartholin's gland duct results in cystic dilation and may lead to an abscess; lichen sclerosus which is a benign condition characterized by thinning of the epidermis and sclerosis of the dermis. There's also imperforate hymen which classically presents as primary amenorrhea with hematocolpos.

Other conditions include vaginal cancers, like squamous cell carcinoma, and clear cell adenocarcinoma, and vulvar cancers like melanomas and adenocarcinomas. There may also be infections like vaginal yeast infections, bacterial vaginosis, and genital warts. Diagnosis of these disorders involves a physical examination, medical history review, and potentially laboratory tests or biopsies. Treatment depends on the underlying cause and can range from topical creams and medications to surgery. Regular gynecological exams and good hygiene practices can help prevent and detect these conditions early.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathology of the Vulva and Vagina" Springer Science & Business Media (2012)
  4. "DC Dutta's Textbook of Gynecology" JP Medical Ltd (2014)
  5. "Bartholin Duct Cyst and Gland Abscess: Office Management" Am Fam Physician (2019)
  6. "Lichen sclerosus" International Journal of STD & AIDS (2005)
  7. "Imperforate Hymen: A Comprehensive Systematic Review" Journal of Clinical Medicine (2019)

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