kraurosis vulva - is progressing pathological changes in the skin and mucous membrane of the external genitalia in the form of atrophy and sclerosis.Kraurosis vulva is diagnosed mainly in patients in pre- and postmenopausal against the backdrop of ovarian failure and neuroendocrine disorders.In women who have not reached menopause, kraurosis vulva detected infrequently and is usually associated with chronic hormonal and neuroendocrine diseases or metabolic diseases.
kraurosis vulvar disease is considered to be older women, as the disease is associated with age-related hormonal and endocrine changes.However, the same religion causes of the disease are not allowed, we can only speak of predisposing and precipitating factors of this disease, as in the presence of equivalent age-related changes in the body, the disease does not develop in every woman.
The vulva is the external genitalia area bounded by the pubis on the one hand, and the entrance to the vagina (virgins - hymen)
Status tissue of the vulva is controlled by the hormonal and immune systems.Under the influence of estrogen skin and mucous vestibule maintain their proper characteristics and resist adverse effects.In premenopausal started restructuring of the system "hypothalamus - pituitary - ovary", reduced functional activity of the adrenal cortex and thyroid.In such changes in a woman's body tissue of the vulva meet the structural and functional disorders: they thinning (atrophy), become more dry and vulnerable to traumatic or infectious agents.
Processes moderate atrophy of the tissues of the external genitalia in elderly women are the result of age-related physiological changes.When kraurosis vulvar atrophy processes expressed significantly.With increasing atrophic changes in the kraurosis begin the process of replacement of normal parenchyma on the connective tissue of the vulva, a process called sclerosis.If multiple sclerosis progresses, excessively overgrown connective tissue of the vulva begins to deform or wrinkle.
kraurosis vulva are no symptoms.The disease has a long progressive nature, but the majority of patients to seek medical care in the later stages of the disease.This situation is due to the false notion that the annual visits to the gynecologist older women are not shown.
kraurosis vulva Diagnosis is not difficult because of the outside localization of the pathological process and the possibility of unhindered instrumental examination.
timely detection of cases of vulvar kraurosis allow time to stop the progression of atrophy and sclerosis.The disease can not be cured completely, therapeutic interventions aimed at improving the state of the tissues of the external genitalia, the elimination of local inflammation and the elimination of the active patient complaints.The success of treatment is determined kraurosis vulva stage of the disease and the state of hormonal, nervous and endocrine systems.
kraurosis vulva refers to pre-cancerous disease, that does not mean it mandatory malignant degeneration.Complex local structural changes in the tissues of the external genitalia and systemic violations that accompany kraurosis vulva supposedly can cause cancer of the vulva.
reasons kraurosis vulva
reason kraurosis vulva is a long-term progressive pathological tissue atrophy of the external genitalia.The appearance of the vulva kraurosis precede major neuroendocrine abnormalities.Most clearly expressed in the pre - and postmenopausal hormonal changes against the backdrop of the hypothalamic-pituitary-ovarian system.In this period comes hypovarianism, decreases the activity of the adrenal cortex and thyroid changes of the brain.
Until now, the question remains, why a similar system on the background of the age changes in some women the changes of the tissues of genitals compensated, and in others it leads to the development of symptoms kraurosis.In addition, rare cases of vulvar kraurosis young women rule the age factor as the sole cause of the disease.
risk of vulvar kraurosis increase:
- The short reproductive period.Early menopause is associated with severe ovarian hypofunction and possible irreversible changes in the tissues of the genitals.
- Surgeries or injuries to the external genitalia.There are cases of vulvar kraurosis a result of chemical burns of the mucous after douching with a concentrated solution of potassium permanganate.
- Removing the ovaries at a young age.
- Chronic inflammatory and infectious processes (vulvitis, vulvovaginitis) in the area of the vulva and vagina.
- a long-term HPV or herpes infection.
- Chronic immune diseases.
- Psychoemotional disorders, depression, stress, various fears, etc.
- endocrine pathology.The most common of them - diabetes.
- kraurosis vulva is usually preceded by a long-lived itching of the vulva, which indicates a common etiologic factors in the development of these processes.Often combined with kraurosis vulva leukoplakia.
None of these factors, or a combination may not be absolute provocateurs kraurosis vulva.Progression of the disease depends on the individual woman's body's ability to cope with the disturbances and avoid the negative scenario.
Symptoms and signs kraurosis vulva
As a rule, patients with kraurosis vulva obese and have chronic extragenital diseases: diabetes, thyroid disease, hypertension or immune disorders.They observed bright clinical manifestations of psychological and emotional discoordination: emotional instability, tendency to depression, irritability, sleep disorders, etc.
kraurosis vulva Symptoms almost always expressed very clearly.The disease never asymptomatic.The leading complaint of patients with kraurosis is permanent or periodic itching of the vulva.Often it is accompanied by a burning sensation, "contraction" or dryness of the vulva.Itching may be increased to unbearable at night, after physical or emotional stress or hygiene.Atrophic processes in the tissues of the vulva are distributed to numerous nerve endings, causing a chemical reaction, causing itching.
thinning veils of the vulva are easily injured and inflamed (secondary vulva) with the formation of small cracks and ulcers, so the patient a feeling of discomfort or pain.
When expressed sclerosis processes in meatus appear urinary disorders.
sexual life at kraurosis vulva becomes impossible because of the severe pain.
All symptoms kraurosis deliver the woman and cause a lot of suffering neurosis.
During a pelvic examination reveals the typical changes in the tissues of the vulva and is determined by the stage of disease:
- Stage edema and hyperemia (initial).The changes are within the labia majora (large and small), and similar to normal inflammation.Accompanied by tingling, burning or itching of varying intensity.At this stage it is necessary to make a differential diagnosis kraurosis vulvae and infectious and inflammatory diseases with similar symptoms (vaginal candidiasis and trichomoniasis, etc.).We should not forget that in the area of inflammatory diseases of the external genitals can accompany kraurosis vulva or precede it.
- Stage atrophy.The changes are more pronounced in the upper third of the vulva.Labia look flat and thinning, the clitoris shrinks.Characteristic change in color skin and mucous membranes of the vulva: they have a whitish tint (pale - bluish to waxy).In some of the patients there is a narrowing of the vaginal opening.The hairy part of the vulva at this stage remains unchanged.
- Stage sclerosis.The clitoris and labia "smoothed".Large labia are fused with small and turn into the fold flat, the entrance to the vagina and distal urethra much narrower.The coat almost disappears.Fabric vulva becomes glossy pearlescent appearance and forms numerous small folds, making her look like a crumpled piece of parchment.Since the vulvar tissue loses elasticity and is easily injured, during an inspection of the skin and mucous seen numerous scratches, microtrauma, and small hemorrhages.
wrinkling process (MS) may extend to the neighboring areas of fabric - the perineum, perianal and groin, and the skin inner thighs.
unbearable itching causes the patient to comb the area of the vulva.Thus cracks and sores, which are easily inflamed and infected.
For a more detailed examination of the tissues of the external genitalia held vulvoskopiya (colposcopy).It allows you to consider a significant increase in tissue and collect material for cytological and histological examination to exclude malignancy process and determine the degree of atrophy.
Patients with vulvar kraurosis undergo laboratory examination for the presence of HPV, herpes simplex virus.Immunogram and determine the level of sugar in the blood to help determine the nature of the immune and endocrine disorders.
Treatment kraurosis vulva
Therapy kraurosis vulva is a complex, multi-step process with a long and not always predictable outcome.Heal kraurosis vulva never fully succeed, but well chosen treatment strategy can save a woman from the debilitating symptoms of the disease and stop further progression of the disease.In addition, timely diagnosis and treatment of vulvar kraurosis helps prevent the development of cancer process.
kraurosis treatment consistent with the age of the patient and the stage of development of the disease.Therapy includes:
- Symptomatic treatment: pain relievers, antihistamines, sedatives, biostimulants and immunomodulators.
- Therapeutic and physiotherapy.
- In severe hypofunction ovarian hormones are appointed, preference is given estriol or mikrofollin and progestogen.
- Local treatment.Ointments and creams containing hormones estriol, estradiol, progesterone, androgens and korikosteroidy.Ointments with androgens have a very strong antipruritic effect.
- Antimicrobial local therapy.It is used for the development of secondary inflammation.
- Laser therapy, reflexology.
- traditional medicine.They have a secondary importance, but sometimes quite successfully combat manifestations of itching, burning and inflammation.
success of the treatment depends on many factors.Conservative therapy kraurosis vulva does not always have the proper result, in this case, recourse to the following invasive treatment:
- Denervation vulva.Performed in order to eliminate nerve endings in the vulvar tissues responsible for subjective symptoms (itching, pain and so on).
- Laser ablation of diseased tissue.The method of "evaporation" lesions on the surface of the vulva.
- Cryosurgery."Freezing" hotbeds kraurosis.
If the threat of cancer is high, or in the case of failure of all previous therapies, surgical treatment, namely the excision of the skin of the vulva - vulvectomy.
kraurosis vulva - a doctor will help ?If you have or suspect a development kraurosis vulva should immediately consult a gynecologist.