综合护理干预在尿道紧缩重建术加外阴整形术中的效果分析

目的 探讨综合护理干预在尿道紧缩重建术加外阴整形术成年女性尿道上裂患者中的护理效果.方法 将80例行尿道紧缩重建术加外阴整形术的成年女性尿道上裂患者随机分为对照组和实验组,2组患者入院后均按照围手术期护理常规进行护理,实验组在此基础上予以综合性护理干预措施.结果 两组患者的术后并发症如尿道狭窄、尿瘘的发生率、护理满意度调查、出院3月后的生活质量比较,差异均有统计学意义.结论 对于行尿道紧缩重建术加外阴整形术成年女性尿道上裂患者,综合护理干预可以减少并发症的发生,提升护理满意度,改善患者的生活质量.     

Late recurrence of sigmoid carcinoma mimicking primary vulvar cancer: case report and review of the literature

Objective

To demonstrate a unique case report about late and isolated vulvar metastasis of sigmoid adeno-carcinoma with review of the literature.

Material-method

57 year old postmenopausal patient with prior sigmoid colon cancer history was admitted with isolated vulvar mass. Immunohistochemistry (IHC) and KRAS gen mutation analysis following surgery were performed to discriminate the metastasis from a vulvar primary malignancy. Further imaging techniques were also performed to exclude additional tumours.

Results

Immunohistochemistry (IHC) and KRAS gene mutation analysis revealed isolated metastasis of the colonic adeno-carcinoma in the vulva.

Conclusion

Isolated and late occurring vulvar metastasis of colonic origin is very unusual. Careful evaluation and IHC is useful for such cases.     

Aloneness: the lived experience of women with cancer of the vulva

Cancer of the vulva is a rare condition that has been subject to limited research with a paucity of studies into the impact of this disease. Although the physical effects may readily be described, little is known about the psychological, emotional and social impact of this condition. To increase insights, a qualitative research study was undertaken to explore the experiences of women with vulval cancer living in the UK. An interpretive phenomenological approach based on the work of Heidegger and Van Manen was used to frame the study in which 13 women under 50 years of age were interviewed between 6 months and 5 years after their surgery. Data were analysed using framework analysis described by Ritchie and Spencer. This article describes the concept of aloneness which emerged from the data. This includes consideration of the women's sense of isolation due to the geographical distance between the woman's home and the hospital, and a sense of separation as they described their loss of sexual function and ability to enjoy the sexual relationship they had previously, following the onset of their symptoms of vulval cancer and subsequent treatment. The women's sense of aloneness was also manifest in their perception that there was a lack of knowledge and understanding about this condition both in their social world and the healthcare system in which they received treatment.     

聚焦超声治疗外阴白色病变前后神经生长因子和P物质的变化分析

目的 探讨聚焦超声治疗外阴白色病变的机制.方法 采用免疫组化SP法检测外阴白色病变患者超声治疗前、后外阴皮肤组织中神经生长因子(NGF)和P物质(SP)的表达.结果 外阴白色病变患者皮损中NGF和SP表达较正常皮肤增强(P<0.05),超声治疗后,患者皮损中NGF和SP表达较治疗前降低(P<0.05).结论 NGF和S...     

Vulvar inflammatory dermatoses for the non-dermatopathologist: an approach for the practising surgical pathologist

Recognition of tissue patterns of injury will help the non-dermatopathologist when confronted with biopsies of vulvar inflammatory dermatoses. This paper defines and discusses the most common inflammatory patterns including: spongiosis, psoriasiform, interface and vesiculobullous, providing a brief overview of the clinical, histologic and differential diagnoses of the more common lesions to affect the vulva. Also included are entities with specific predilection for the female gynaecologic tract including Zoon’s vulvitis and Behcet’s disease. A comprehensive review of this topic is beyond the scope of this mini-symposium. However we hope to provide an approach to the diagnosis of vulvar inflammatory dermatitis which will be of practical use to the surgical pathologist.     

Metastatic Crohn’s disease accompanying granulomatous vasculitis and lymphangitis in the vulva

Metastatic Crohn’s disease (CD) is an extremely rare extragastrointestinal manifestation of CD, and is characterized histopathologically by the presence of non-caseating granulomatous inflammation. Granulomatous vasculitis and lymphangitis have rarely been documented in metastatic CD. Herein, we report the first documented case of metastatic CD accompanied by both granulomatous vasculitis and lymphangitis in the vulva. A 35-year-old Japanese female with CD presented with multiple small nodules in her vulva. Biopsy was performed under a clinical diagnosis of genital warts. A histopathological study revealed marked lymphangiectasia in the papillary dermis. Within the dilated lymphatics, lymphocytes and aggregates of macrophages were present, which are typical features of granulomatous lymphangitis. Tiny non-caseating granulomas and granulomatous vasculitis were also observed. Accordingly, a diagnosis of metastatic CD accompanied by both granulomatous vasculitis and lymphangitis was made. The occurrence of cutaneous lesions in patients with CD is well known. Albeit extremely rare, lymphangiectasia has been reported in the vulva of CD patients that clinically mimicked viral warts, as in the present case. The diagnosis of metastatic CD in the present case was not difficult because characteristic histopathological features were present, and a clinical history of CD was available. However, a few cases of genital swelling associated with granulomatous inflammation prior to a diagnosis of gastrointestinal CD have been documented. Therefore, granulomatous vasculitis and lymphangitis in the external genitals should be considered as potential indication of metastatic CD even in cases without a history of gastrointestinal CD.     

Sarcoma epitelioide de vulva

We report a case of vulvar epithelioid sarcoma in a 30 year old woman treated by extensive local excision. The literature on this subject is reviewed.     

Benign vulvovaginal cysts

This article discusses the common benign cysts found in the vagina and vulva. While not commonly encountered in routine surgical pathology practice, these cysts are a relatively frequent occurrence. The cysts are often asymptomatic and do not come to clinical attention. Cysts of the vagina and vulva can be classified as embryologic or non-embryologic in origin, with müllerian and mesonephric cysts being the most common embryologic cysts. A discussion of the embryologic origin of the vagina and vulva is included as this knowledge can help in accurately characterizing cystic lesions found in this location. Non-embryologic cysts include endometriosis, inclusion cysts, and other rare lesions. These entities are discussed to allow distinction from cysts of embryologic origin. With accurate clinical history, anatomic site of origin, and identification of the epithelial lining, definitive classification of the cyst is possible.