In vulvitis (plural: vulvitides; synonyms: acute infection of the labia majora pudendi; acute infection of the labia minora pudendi; acute vulvar infection; acute vulvitis; allergic vulvitis; aphthous vulvitis; atrophic vulvitis; Candida albicans vulvovaginitis; chronic vulvitis; inflammation of the labia majora pudendi; inflammation of the labia minora pudendi; erosive vulvitis; gangrenous vulvitis; hypertrophic vulvitis; intertriginous vulvitis; labial inflammation; vulvovaginitis; vulvar infection; vulvar catarrh; senile vulvitis; subacute vulvitis; vulvovaginitis; vulvar infection; vulvitides; vulvitis allergica; vulvovaginal candidiasis; ICD-10 N76. 2: acute vulvitis) is inflammation of the external genitalia, the vulva. The vulva consists of the mons veneris, the labia majora pudendi and labia minora pudendi, the clitoris (“clit”) and the vaginal vestibule (vestibulum vaginae), into which the urethra and numerous glands (clinically important is the Bartholin’s gland) open. It is one of the external sexual organs. The hymen (“hymen”) is the upper boundary to the vagina. Vulvitis very often occurs in association with colpitides (vaginitis) and vice versa. It is often not clear which is the primary cause. For this reason, vulvitis and vaginitis (inflammation of the vagina) are named together in the ICD 10 as the generic term “vulvovaginitis”, so to speak, and then further differentiated. Clinically, symptoms and clinical pictures in the area of the external genitalia, i.e. vulvitides, are much more frequent than colpitides. For this reason, the two clinical pictures – although they frequently occur together – are presented separately (see section on colpitis/vaginitis). Since the basic principles of vulvovaginitis are in part very complex, some basic principles are presented in the chapter on colpitis under the sub-topic “Anatomy-physiology”. The disease can be caused by various pathogens (see also “Etiology/Causes”):
- Bacteria – e.g. gonococci, streptococci, staphylococci.
- Fungi – Candida albicans
- Viruses – e.g. Herpes viren
- Parasites – e.g. trichomonads
The transmission of pathogens (route of infection) often occurs during sexual intercourse. Also, poor hygiene or disease can cause vulvitis. The incubation period (time from infection to onset of the disease) depends on the pathogen in infections. In bacterial vulvitis, the incubation period is usually less than a week. According to the cause, a distinction is made between primary vulvitis and secondary vulvitis:
- Primary vulvitis – the cause is an infection of the vagina (vagina).
- Secondary vulvitis – the cause is an infection of adjacent organs (v. a. anus (anus), urethra (urethra)).
According to the clinic, the following forms of vulvitis are distinguished:
- Acute vulvitis with acute, pronounced symptoms and a laboratory diagnosis.
- Subacute vulvitis (clinically less severe symptoms than acute) with minor or absent symptoms but with a laboratory diagnosis
- Chronic vulvitis with often absent or chronic recurrent (recurring) symptoms and a laboratory diagnosis.
- Infectious vulvitis
- Non-infectious vulvitis
The prevalence (disease frequency) of vulvitis is not known, despite its frequency. Inflammation is possible at any age, but is clustered after puberty, during the period of sexual maturity until menopause. In childhood oxyuren (pinworms), in sexual maturity infections, in menopause atrophic vulvitis (estrogen deficiency-related vulvitis) are common. Course and prognosis: They depend on the cause, e.g. allergies, bacteria, fungi, parasites, viruses, and are generally well treatable with adequate and consistent therapy, but frequently recur. However, if the infectious germs are carried over, the disease can also spread to the internal genital organs. Note: The vulva and above all the introitus vaginae (vaginal entrance) are very well supplied with nerves. Diseases in general and inflammations are therefore often noticed before they are externally visible. Symptoms and complaints can therefore persist for days even after they have healed visually. In addition, they are perceived as particularly unpleasant or painful.
- The outer area is relatively resistant to mechanical irritation and infection due to a multilayered squamous epithelium
- The inner area (Introitus vaginae) is particularly sensitive due to a very delicate epithelium, so that often even a delicate touch can be painful in an underlying disease.
