The Experts below are selected from a list of 255 Experts worldwide ranked by ideXlab platform
Jacob Bornstein - One of the best experts on this subject based on the ideXlab platform.
-
The International Classification of Diseases, 11th Revision: A Step-Back for Women With Vulvodynia?
Journal of lower genital tract disease, 2020Co-Authors: Gianluigi Radici, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, Jacob BornsteinAbstract:Objective The aim of the study was to compare the International Classification of Diseases, 11th revision, (ICD-11) with current terminology of vulvodynia, approved by a broad-based consensus of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS). Methods The diagnostic criteria and descriptions of vulvodynia as well as the definition and classification of chronic pain in ICD-11 were reviewed and compared with the Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, endorsed in 2015 by the ISSVD, ISSWSH, and IPPS. Results Diagnostic criteria and descriptors of vulvodynia in the ICD-11 are outdated. Moreover, vulvodynia is not identified among chronic pain diagnoses, despite fulfilling the diagnostic criteria of chronic primary pain. Specifically, vulvodynia is a vulvar pain of at least 3-month duration, which is associated with significant emotional distress and functional disability, and is not better accounted for by another specific condition. Conclusions The ICD-11 is not aligned with current vulvodynia diagnostic criteria and terminology, approved by the ISSVD, ISSWSH, and IPPS. Collaboration among the International Association for the Study of Pain Task Force on Classification of Chronic Pain, ICD team, ISSVD, ISSWSH, and IPPS is needed to harmonize terminologies, codes, and clinical approach regarding vulvar pain and vulvodynia classification.
-
Descriptors of Vulvodynia: A Multisocietal Definition Consensus (International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women Sexual Health, and the International Pelvic Pain Society).
Journal of lower genital tract disease, 2019Co-Authors: Jacob Bornstein, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, James A. Simon, Sawsan As-sanie, Amy Stein, Sharon J. Parish, Gianluigi Radici, Caroline F. PukallAbstract:ObjectivesThree scientific societies, the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) developed the “2015 ISSVD, ISSWSH, and IPPS Consensus Terminology a
-
THE NEW CONSENSUS TERMINOLOGY OF CHRONIC VULVAR PAIN AND VULVODYNIA
Harefuah, 2019Co-Authors: Sandy Bornstein, Jacob BornsteinAbstract:INTRODUCTION We review the process of establishing the new terminology of persistent vulvar pain and vulvodynia. Three international scientific societies: the International Society for the Study of Vulvovaginal Disease - ISSVD, the International Society for The Study of Women's Sexual Health - ISSWSH, and the International Pelvic Pain Society - IPPS, prepared a consensus terminology of vulvar pain and vulvodynia. This terminology includes the definition of vulvodynia, descriptors of the clinical presentation of vulvodynia, and evidence-based data on the possible causes of vulvodynia. The controversy behind the introduction of the possible causes of vulvodynia, a condition which was considered an idiopathic condition, is revealed. The inclusion of these possible causes has changed the paradigm enabling tailoring treatment.
-
2015 issvd isswsh and ipps consensus terminology and classification of persistent vulvar pain and vulvodynia
Journal of Lower Genital Tract Disease, 2016Co-Authors: Jacob Bornstein, Colleen K Stockdale, Caroline F. Pukall, Andrew T. Goldstein, Sophie Bergeron, Denniz Zolnoun, Deborah CoadyAbstract:INTRODUCTION In 2014, the executive council of the International Society for the Study of Vulvovaginal Disease, the boards of directors of the International Society for the Study of Women's Sexual Health, and the International Pelvic Pain Society acknowledged the need to revise the current terminology of vulvar pain, on the basis of the significant increase in high-quality etiologic studies published in the last decade. MATERIALS AND METHODS The new terminology was achieved in the following 4 steps. The first involved a terminology consensus conference with representatives of the 3 societies, held in April 2015. Then, an analysis of the relevant published studies was used to establish a level of evidence for each factor associated with vulvodynia. The terminology was amended on the basis of feedback from members of the societies. Finally, each society's board accepted the new terminology. RESULTS AND CONCLUSIONS In 2015, the International Society for the Study of Vulvovaginal Disease, International Society for the Study of Women's Sexual Health, and International Pelvic Pain Society adopted a new vulvar pain and vulvodynia terminology that acknowledges the complexity of the clinical presentation and pathophysiology involved in vulvar pain and vulvodynia, and incorporates new information derived from evidence-based studies conducted since the last terminology published in 2003.
-
2015 issvd isswsh and ipps consensus terminology and classification of persistent vulvar pain and vulvodynia
The Journal of Sexual Medicine, 2016Co-Authors: Jacob Bornstein, Colleen K Stockdale, Caroline F. Pukall, Andrew T. Goldstein, Sophie Bergeron, Denniz Zolnoun, Deborah Coady, Andrew Goldstein, Gloria Bachmann, Ione BissonnetteAbstract:Abstract Introduction In 2014, the Executive Council of the International Society for the Study of Vulvovaginal Disease (ISSVD), the Boards of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) acknowledged the need to revise the current terminology of vulvar pain, based on the significant increase in high quality etiologic studies published in the last decade. Methods The new terminology was achieved in four steps. The first involved a terminology consensus conference with representatives of the three societies, held in April 2015. Then, an analysis of the relevant published studies was used to establish a level of evidence for each factor associated with vulvodynia. The terminology was amended based on feedback from members of the societies. Finally, each society's board accepted the new terminology. Results and Conclusion In 2015, the ISSVD, ISSWSH, and IPPS adopted a new vulvar pain and vulvodynia terminology that acknowledges the complexity of the clinical presentation and pathophysiology involved in vulvar pain and vulvodynia, and incorporates new information derived from evidence-based studies conducted since the last terminology published in 2003.
Mario Preti - One of the best experts on this subject based on the ideXlab platform.
-
Management of Vulvar Cancer Precursors: A Survey of the International Society for the Study of Vulvovaginal Disease.
Journal of lower genital tract disease, 2020Co-Authors: Nicole Green, Mario Preti, Tolu Adedipe, Julia Dmytryshyn, Amanda SelkAbstract:OBJECTIVE The aim of the study was to determine how experts treat vulvar high-grade squamous intraepithelial neoplasia (VHSIL) and differentiated vulvar intraepithelial neoplasia (dVIN). METHOD A 26-question survey was designed through a literature review, reviewed by the Survey Committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), and distributed to all ISSVD members via e-mail in January 2019. RESULTS Overall, 90 of 441 physician members consented to participate and 78 of 90 were eligible to complete the survey. Most respondents were gynecologists (77%), followed by dermatologists (12%). Forty-five percent responded that their pathology was being reported using the 2015 ISSVD terminology of vulvar squamous intraepithelial lesions. The most common first-line treatments were as follows: unifocal VHSIL-excision (65%), multifocal VHSIL-imiquimod 5% (45%), VHSIL in a hair-bearing area-excision (69%), and clitoral Disease-imiquimod 5% (47%). In the recurrent VHSIL, excision was favored (28%), followed by imiquimod 5% (26%) and laser (19%). Differentiated vulvar intraepithelial neoplasia was most often first treated with excision (82%), and more patients were referred to gynecologic oncology. Most patients were seen in follow-up at 3 months (range: 1 week-6 months). Sixty-seven respondents provided 26 different ways to follow treated patients, which were most commonly every 6 months for 2 years and then yearly (25%), followed by every 6 months indefinitely (18%). CONCLUSIONS Treatment of VHSIL and dVIN varies among vulvar experts with excision being the most common treatment, except in multifocal VHSIL where imiquimod is commonly used. There is wide variation in how patients are followed after treatment.
-
The International Classification of Diseases, 11th Revision: A Step-Back for Women With Vulvodynia?
Journal of lower genital tract disease, 2020Co-Authors: Gianluigi Radici, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, Jacob BornsteinAbstract:Objective The aim of the study was to compare the International Classification of Diseases, 11th revision, (ICD-11) with current terminology of vulvodynia, approved by a broad-based consensus of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS). Methods The diagnostic criteria and descriptions of vulvodynia as well as the definition and classification of chronic pain in ICD-11 were reviewed and compared with the Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, endorsed in 2015 by the ISSVD, ISSWSH, and IPPS. Results Diagnostic criteria and descriptors of vulvodynia in the ICD-11 are outdated. Moreover, vulvodynia is not identified among chronic pain diagnoses, despite fulfilling the diagnostic criteria of chronic primary pain. Specifically, vulvodynia is a vulvar pain of at least 3-month duration, which is associated with significant emotional distress and functional disability, and is not better accounted for by another specific condition. Conclusions The ICD-11 is not aligned with current vulvodynia diagnostic criteria and terminology, approved by the ISSVD, ISSWSH, and IPPS. Collaboration among the International Association for the Study of Pain Task Force on Classification of Chronic Pain, ICD team, ISSVD, ISSWSH, and IPPS is needed to harmonize terminologies, codes, and clinical approach regarding vulvar pain and vulvodynia classification.
-
The International Society for the Study of Vulvovaginal Disease Surgical Oncological Procedure Definitions Committee "Surgical Terminology for Vulvar Cancer Treatment".
Journal of lower genital tract disease, 2020Co-Authors: Leonardo Micheletti, Hope K. Haefner, Kamil Zalewski, Allan Maclean, Facundo Gomez Cherey, Claudia Pereira, Celeste Sluga, Josep M. Solé-sedeno, Victor M Vargas-hernandez, Mario PretiAbstract:Objectives The International Society for the Study of Vulvovaginal Disease (ISSVD) Surgical Oncological Procedure Definitions Committee propose a consistent terminology based on well-defined and reproducible anatomic landmarks that can be used by all who are involved in care of patients with vulvar conditions. Materials and methods The fundamental principles behind the new terminology contained descriptions of the area extension and depth of the surgical procedure. Results Vulvar Surgical Topographic Anatomy LandmarksExtension. The internal border of the vulva is the hymenal ring. The genitocrural folds are the external lateral borders.The vertical line through the clitoris and the anus defines lateral portions of the vulva.The horizontal line from the upper border of the hymenal ring defines anterior and posterior portion of the vulva.Depth. The floor of the vulva is represented by the median perineal fascia or perineal membrane of the urogenital diaphragm.A. Vulvectomy1. Extension: partial/total vulvectomy. Removal of part/entire vulvar/perineal integument independent of the depth.2. Depth: superficial/deep. Removal of the most superficial layer/removal of the vulvar tissue to the superficial aponeurosis of the urogenital diaphragm and/or pubic periosteum.B. Inguinofemoral lymphadenectomy1. Superficial inguinofemoral lymphadenectomy. Removal of the nodes located beside the inguinal ligament and along the great saphenous vein.2. Deep femoral lymphadenectomy. Removal of the nodes below the cribriform lamina and medial to the femoral vein. Conclusions This terminology helps avoid confusion and promote better understanding and exchange of experiences among gynecologic oncologists involved in vulvar carcinoma care.
-
Descriptors of Vulvodynia: A Multisocietal Definition Consensus (International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women Sexual Health, and the International Pelvic Pain Society).
Journal of lower genital tract disease, 2019Co-Authors: Jacob Bornstein, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, James A. Simon, Sawsan As-sanie, Amy Stein, Sharon J. Parish, Gianluigi Radici, Caroline F. PukallAbstract:ObjectivesThree scientific societies, the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) developed the “2015 ISSVD, ISSWSH, and IPPS Consensus Terminology a
-
The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions
Journal of lower genital tract disease, 2016Co-Authors: Jacob Bornstein, Hope K. Haefner, Mario Preti, Colleen K Stockdale, Fabrizio Bogliatto, Tanja Gizela Bohl, Jason ReutterAbstract:Objectives The impact of terminology for vulvar intraepithelial lesions has been significant over the years, because it has affected diagnosis, treatment, and research. The introduction of the Lower Anogenital Squamous Terminology (LAST) in 2012 raised 2 concerns in relation to vulvar lesions: firstly, the absence of reference to "differentiated vulvar intraepithelial neoplasia" (differentiated VIN) could lead to its being overlooked by health care providers, despite its malignant potential. Secondly, including the term "low-grade squamous intraepithelial lesion" (LSIL) in LAST recreated the potential for overdiagnosis and overtreatment for benign, self-limiting lesions. Materials and methods The International Society for the Study of Vulvovaginal Disease (ISSVD) assigned the terminology committee the task of developing a terminology to take these issues into consideration. The committee reviewed the development of terminology for vulvar SILs with the previous 2 concerns in mind and reviewed several new terminology options. Results The final version accepted by the ISSVD contains the following:•Low-grade SIL of the vulva or vulvar LSIL, encompassing flat condyloma or human papillomavirus effect.•High-grade SIL or vulvar HSIL (which was termed "vulvar intraepithelial neoplasia usual type" in the 2004 ISSVD terminology).•Vulvar intraepithelial neoplasia, differentiated type. Conclusions The advantage of the new terminology is that it includes all types of vulvar SILs, it provides a solution to the concerns in relation to the application of LAST to vulvar lesion, and it is in accordance with the World Health Organization classification as well as the LAST, creating unity among clinicians and pathologists.
Colleen K Stockdale - One of the best experts on this subject based on the ideXlab platform.
-
The International Society for the Study of Vulvovaginal Disease Vaginal Wet Mount Microscopy Guidelines: How to Perform, Applications, and Interpretation.
Journal of lower genital tract disease, 2021Co-Authors: Pedro Vieira-baptista, Facundo Gomez Cherey, Švitrigailė Grincevičienė, Caroline Oliveira, José Alberto Fonseca-moutinho, Colleen K StockdaleAbstract:Objectives The aims of the study were to assess the available literature concerning the indications, performance, technique, and classification of wet mount microscopy (WMM) and to establish evidence-based recommendations. Methods Literature review from the main scientific databases was performed by the ad hoc "Vaginitis and Microbiome Committee" of the International Society for the Study of Vulvovaginal Disease. The document was approved by the executive council and membership of the International Society for the Study of Vulvovaginal Disease. Results Available data are limited and usually of low level of evidence. Nevertheless, it shows that WMM is capable of reducing misdiagnosis, overtreatment, and undertreatment of vaginal conditions. It has an excellent performance for the diagnosis of bacterial vaginosis and variable performance for trichomoniasis and candidiasis. It is the gold standard for aerobic vaginitis/desquamative inflammatory vaginitis. Currently, there is no recommendation to use WMM in the screening of asymptomatic women.The use of phase contrast is recommended to improve performance and reproducibility. Sampling location, devices, and technique have an impact on the results.Available scoring and classification scores have significant limitations. Conclusions Wet mount microscopy is a point-of-care, inexpensive, and fast technique that, with practice, can be mastered by office clinicians. It should be considered a basic skill in the curricula of gynecology and obstetrics residencies. Recommendations are provided on sampling, reading, and scoring.
-
The International Classification of Diseases, 11th Revision: A Step-Back for Women With Vulvodynia?
Journal of lower genital tract disease, 2020Co-Authors: Gianluigi Radici, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, Jacob BornsteinAbstract:Objective The aim of the study was to compare the International Classification of Diseases, 11th revision, (ICD-11) with current terminology of vulvodynia, approved by a broad-based consensus of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS). Methods The diagnostic criteria and descriptions of vulvodynia as well as the definition and classification of chronic pain in ICD-11 were reviewed and compared with the Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, endorsed in 2015 by the ISSVD, ISSWSH, and IPPS. Results Diagnostic criteria and descriptors of vulvodynia in the ICD-11 are outdated. Moreover, vulvodynia is not identified among chronic pain diagnoses, despite fulfilling the diagnostic criteria of chronic primary pain. Specifically, vulvodynia is a vulvar pain of at least 3-month duration, which is associated with significant emotional distress and functional disability, and is not better accounted for by another specific condition. Conclusions The ICD-11 is not aligned with current vulvodynia diagnostic criteria and terminology, approved by the ISSVD, ISSWSH, and IPPS. Collaboration among the International Association for the Study of Pain Task Force on Classification of Chronic Pain, ICD team, ISSVD, ISSWSH, and IPPS is needed to harmonize terminologies, codes, and clinical approach regarding vulvar pain and vulvodynia classification.
-
Descriptors of Vulvodynia: A Multisocietal Definition Consensus (International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women Sexual Health, and the International Pelvic Pain Society).
Journal of lower genital tract disease, 2019Co-Authors: Jacob Bornstein, Mario Preti, Pedro Vieira-baptista, Colleen K Stockdale, James A. Simon, Sawsan As-sanie, Amy Stein, Sharon J. Parish, Gianluigi Radici, Caroline F. PukallAbstract:ObjectivesThree scientific societies, the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) developed the “2015 ISSVD, ISSWSH, and IPPS Consensus Terminology a
-
2015 issvd isswsh and ipps consensus terminology and classification of persistent vulvar pain and vulvodynia
Journal of Lower Genital Tract Disease, 2016Co-Authors: Jacob Bornstein, Colleen K Stockdale, Caroline F. Pukall, Andrew T. Goldstein, Sophie Bergeron, Denniz Zolnoun, Deborah CoadyAbstract:INTRODUCTION In 2014, the executive council of the International Society for the Study of Vulvovaginal Disease, the boards of directors of the International Society for the Study of Women's Sexual Health, and the International Pelvic Pain Society acknowledged the need to revise the current terminology of vulvar pain, on the basis of the significant increase in high-quality etiologic studies published in the last decade. MATERIALS AND METHODS The new terminology was achieved in the following 4 steps. The first involved a terminology consensus conference with representatives of the 3 societies, held in April 2015. Then, an analysis of the relevant published studies was used to establish a level of evidence for each factor associated with vulvodynia. The terminology was amended on the basis of feedback from members of the societies. Finally, each society's board accepted the new terminology. RESULTS AND CONCLUSIONS In 2015, the International Society for the Study of Vulvovaginal Disease, International Society for the Study of Women's Sexual Health, and International Pelvic Pain Society adopted a new vulvar pain and vulvodynia terminology that acknowledges the complexity of the clinical presentation and pathophysiology involved in vulvar pain and vulvodynia, and incorporates new information derived from evidence-based studies conducted since the last terminology published in 2003.
-
2015 issvd isswsh and ipps consensus terminology and classification of persistent vulvar pain and vulvodynia
The Journal of Sexual Medicine, 2016Co-Authors: Jacob Bornstein, Colleen K Stockdale, Caroline F. Pukall, Andrew T. Goldstein, Sophie Bergeron, Denniz Zolnoun, Deborah Coady, Andrew Goldstein, Gloria Bachmann, Ione BissonnetteAbstract:Abstract Introduction In 2014, the Executive Council of the International Society for the Study of Vulvovaginal Disease (ISSVD), the Boards of Directors of the International Society for the Study of Women's Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) acknowledged the need to revise the current terminology of vulvar pain, based on the significant increase in high quality etiologic studies published in the last decade. Methods The new terminology was achieved in four steps. The first involved a terminology consensus conference with representatives of the three societies, held in April 2015. Then, an analysis of the relevant published studies was used to establish a level of evidence for each factor associated with vulvodynia. The terminology was amended based on feedback from members of the societies. Finally, each society's board accepted the new terminology. Results and Conclusion In 2015, the ISSVD, ISSWSH, and IPPS adopted a new vulvar pain and vulvodynia terminology that acknowledges the complexity of the clinical presentation and pathophysiology involved in vulvar pain and vulvodynia, and incorporates new information derived from evidence-based studies conducted since the last terminology published in 2003.
Hope K. Haefner - One of the best experts on this subject based on the ideXlab platform.
-
The International Society for the Study of Vulvovaginal Disease Surgical Oncological Procedure Definitions Committee "Surgical Terminology for Vulvar Cancer Treatment".
Journal of lower genital tract disease, 2020Co-Authors: Leonardo Micheletti, Hope K. Haefner, Kamil Zalewski, Allan Maclean, Facundo Gomez Cherey, Claudia Pereira, Celeste Sluga, Josep M. Solé-sedeno, Victor M Vargas-hernandez, Mario PretiAbstract:Objectives The International Society for the Study of Vulvovaginal Disease (ISSVD) Surgical Oncological Procedure Definitions Committee propose a consistent terminology based on well-defined and reproducible anatomic landmarks that can be used by all who are involved in care of patients with vulvar conditions. Materials and methods The fundamental principles behind the new terminology contained descriptions of the area extension and depth of the surgical procedure. Results Vulvar Surgical Topographic Anatomy LandmarksExtension. The internal border of the vulva is the hymenal ring. The genitocrural folds are the external lateral borders.The vertical line through the clitoris and the anus defines lateral portions of the vulva.The horizontal line from the upper border of the hymenal ring defines anterior and posterior portion of the vulva.Depth. The floor of the vulva is represented by the median perineal fascia or perineal membrane of the urogenital diaphragm.A. Vulvectomy1. Extension: partial/total vulvectomy. Removal of part/entire vulvar/perineal integument independent of the depth.2. Depth: superficial/deep. Removal of the most superficial layer/removal of the vulvar tissue to the superficial aponeurosis of the urogenital diaphragm and/or pubic periosteum.B. Inguinofemoral lymphadenectomy1. Superficial inguinofemoral lymphadenectomy. Removal of the nodes located beside the inguinal ligament and along the great saphenous vein.2. Deep femoral lymphadenectomy. Removal of the nodes below the cribriform lamina and medial to the femoral vein. Conclusions This terminology helps avoid confusion and promote better understanding and exchange of experiences among gynecologic oncologists involved in vulvar carcinoma care.
-
The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions
Journal of lower genital tract disease, 2016Co-Authors: Jacob Bornstein, Hope K. Haefner, Mario Preti, Colleen K Stockdale, Fabrizio Bogliatto, Tanja Gizela Bohl, Jason ReutterAbstract:Objectives The impact of terminology for vulvar intraepithelial lesions has been significant over the years, because it has affected diagnosis, treatment, and research. The introduction of the Lower Anogenital Squamous Terminology (LAST) in 2012 raised 2 concerns in relation to vulvar lesions: firstly, the absence of reference to "differentiated vulvar intraepithelial neoplasia" (differentiated VIN) could lead to its being overlooked by health care providers, despite its malignant potential. Secondly, including the term "low-grade squamous intraepithelial lesion" (LSIL) in LAST recreated the potential for overdiagnosis and overtreatment for benign, self-limiting lesions. Materials and methods The International Society for the Study of Vulvovaginal Disease (ISSVD) assigned the terminology committee the task of developing a terminology to take these issues into consideration. The committee reviewed the development of terminology for vulvar SILs with the previous 2 concerns in mind and reviewed several new terminology options. Results The final version accepted by the ISSVD contains the following:•Low-grade SIL of the vulva or vulvar LSIL, encompassing flat condyloma or human papillomavirus effect.•High-grade SIL or vulvar HSIL (which was termed "vulvar intraepithelial neoplasia usual type" in the 2004 ISSVD terminology).•Vulvar intraepithelial neoplasia, differentiated type. Conclusions The advantage of the new terminology is that it includes all types of vulvar SILs, it provides a solution to the concerns in relation to the application of LAST to vulvar lesion, and it is in accordance with the World Health Organization classification as well as the LAST, creating unity among clinicians and pathologists.
-
The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions
Obstetrics and gynecology, 2016Co-Authors: Jacob Bornstein, Hope K. Haefner, Mario Preti, Colleen K Stockdale, Fabrizio Bogliatto, Tanja Gizela Bohl, Jason ReutterAbstract:OBJECTIVES:The impact of terminology for vulvar intraepithelial lesions has been significant over the years, because it has affected diagnosis, treatment, and research. The introduction of the Lower Anogenital Squamous Terminology (LAST) in 2012 raised 2 concerns in relation to vulvar lesions: first
-
Test Your Knowledge: Can you Diagnose these Vulvar Diseases?
2013Co-Authors: Hope K. Haefner, Lynette J. MargessonAbstract:Vulvovaginal Disease is common, but often difficult to diagnose. Yeast infections, vulvodynia, and contact dermatitis may be easy to identify, but chronic or overlapping conditions can be difficult to spot. Can you accurately diagnose these patients?
-
2011 terminology of the vulva of the International Federation for Cervical Pathology and Colposcopy.
Journal of lower genital tract disease, 2012Co-Authors: Jacob Bornstein, Mario Sideri, Silvio Tatti, Patrick Walker, Walter Prendiville, Hope K. HaefnerAbstract:h Abstract Objective. This study aimed to present the clinical and colposcopic terminology of the vulva (including the anus) of the International Federation of Cervical Pathology and Colposcopy. Materials and Methods. The terminology has been developed by the International Federation of Cervical Pathology and Colposcopy Nomenclature Committee during 2009Y2011. Results. The terminology is part of a comprehensive terminology of the lower genital tract, allowing for standardization of nomenclature by colposcopists, clinicians, and researchers taking care of women with lesions in these areas. The terminology includes basic definitions and normal findings that are important for the clinician lacking experience with management of vulvar Disease. This terminology introduces definitions for abnormal findings recently accepted by the International Society for the Study of Vulvovaginal Disease and includes patterns to identify malignancy. Conclusions. The terminology differs from past terminologies in that it includes colposcopic patterns and anal colposcopy. Nevertheless, the role of the colposcope in the management of vulvar Disease is limited. h
Amanda Selk - One of the best experts on this subject based on the ideXlab platform.
-
Management of Vulvar Cancer Precursors: A Survey of the International Society for the Study of Vulvovaginal Disease.
Journal of lower genital tract disease, 2020Co-Authors: Nicole Green, Mario Preti, Tolu Adedipe, Julia Dmytryshyn, Amanda SelkAbstract:OBJECTIVE The aim of the study was to determine how experts treat vulvar high-grade squamous intraepithelial neoplasia (VHSIL) and differentiated vulvar intraepithelial neoplasia (dVIN). METHOD A 26-question survey was designed through a literature review, reviewed by the Survey Committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), and distributed to all ISSVD members via e-mail in January 2019. RESULTS Overall, 90 of 441 physician members consented to participate and 78 of 90 were eligible to complete the survey. Most respondents were gynecologists (77%), followed by dermatologists (12%). Forty-five percent responded that their pathology was being reported using the 2015 ISSVD terminology of vulvar squamous intraepithelial lesions. The most common first-line treatments were as follows: unifocal VHSIL-excision (65%), multifocal VHSIL-imiquimod 5% (45%), VHSIL in a hair-bearing area-excision (69%), and clitoral Disease-imiquimod 5% (47%). In the recurrent VHSIL, excision was favored (28%), followed by imiquimod 5% (26%) and laser (19%). Differentiated vulvar intraepithelial neoplasia was most often first treated with excision (82%), and more patients were referred to gynecologic oncology. Most patients were seen in follow-up at 3 months (range: 1 week-6 months). Sixty-seven respondents provided 26 different ways to follow treated patients, which were most commonly every 6 months for 2 years and then yearly (25%), followed by every 6 months indefinitely (18%). CONCLUSIONS Treatment of VHSIL and dVIN varies among vulvar experts with excision being the most common treatment, except in multifocal VHSIL where imiquimod is commonly used. There is wide variation in how patients are followed after treatment.
-
Vulvovaginal Disease Education in Canadian and American Gynecology Residency Programs: A Survey of Program Directors.
Journal of lower genital tract disease, 2018Co-Authors: Christine Edwards, Nupur Dogra, Annet Antanrajakumar, Aparna Sarangapani, Amanda SelkAbstract:ObjectiveThe aims of the study were to assess and describe the current Vulvovaginal curriculum in gynecology residency training programs in Canada and the United States and to compare this with national training objectives.Materials and MethodsA 22-question electronic survey was sent to 252 gynecolo
-
A Survey of Experts Regarding the Treatment of Adult Vulvar Lichen Sclerosus.
Journal of lower genital tract disease, 2015Co-Authors: Amanda SelkAbstract:OBJECTIVE The objective of this work was to survey physician members and fellows of the International Society for the Study of Vulvovaginal Disease to determine current expert opinion regarding the management of adult vulvar lichen sclerosus. MATERIALS AND METHODS A cross-sectional design was used. An electronic survey was emailed to all members and fellows of the International Society for the Study of Vulvovaginal Disease. Responses were analyzed using univariate methods. Subgroup analyses were performed to report treatment differences between gynecologists and dermatologists and between physicians in the United States and Europe. RESULTS In total, 128 (42%) of 305 providers responded to the survey. Analysis was confined to the 114 physician respondents who treat patients with lichen sclerosus. Clobetasol propionate 0.05% is the most common first-line agent used in lichen sclerosus (85%). The most common second-line agents used are tacrolimus (39%), other topical steroids (28%), and intralesional steroids (13%). Most physicians (59%) start all patients with lichen sclerosus on drug therapy at an initial visit, regardless of symptoms. Dermatologists are more likely to treat all patients (both symptomatic and asymptomatic) than gynecologists (p < .01). Most physicians (64%) continue maintenance therapy in all patients. Gynecologists are more likely than dermatologists to treat only when patients are symptomatic versus using maintenance therapy (p = .03). Physicians practicing in the United States are more likely than those practicing in Europe to treat all patients with maintenance therapy (p < .01). CONCLUSIONS Lichen sclerosus management varies among experts. Variations exist between physician specialties and between those practicing in different geographic locations. Uncertainty regarding optimal treatment remains, especially regarding long-term management.
