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J Clin Outcomes Manage
2009 Jun;16(6):281-295
Vulvovaginal disease: an evidence-based approach to medical management
Andrews J
Program Audience Primary care physicians. Educational Needs Addressed Vulvovaginal discharge complaints are common, accounting for more than 10 million U.S. office visits annually and countless phone contacts. Annual medication costs for these complaints are estimated at more than $700 million. Although the diagnosis of initial vulvovaginal discharge complaints is usually straightforward, patients with recurrent and resistant infections and patients without evidence of any of the common causes pose a diagnostic challenge. An algorithmic approach, incorporating symptoms, signs, vaginal pH, and microscopy, can aid clinicians in making the diagnosis. Knowledge of the likelihood ratio test properties of common components of the evaluation will support an efficient and accurate diagnostic process. Educational Objective: After participating in this CME activity, primary care physicians should be able to 1. Identify the most common causes of abnormal vaginal discharge 2. Describe the evidence-based workup of a patient with vulvovaginal complaints 3. Describe the diagnostic criteria and recommended treatments for bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis 4. Name the less common conditions associated with abnormal vaginal discharge
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