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Biomedical subjects

E G Stewart

Publications and source records attributed to E G Stewart.

3 recordsLinked to original sources

Prevalence and predictors of chronic lower genital tract discomfort.

OBJECTIVE: We sought to determine the prevalence of chronic lower genital tract discomfort in the general population and to identify demographic and reproductive characteristics associated with this disorder. STUDY DESIGN: We surveyed a random sample of 480 women (age range, 20 to 59 years; 60 women for each 5-year age category) from 1 Boston area suburban community. Participants were asked to complete a 1-page self-administered optically scannable questionnaire that pertained to current and previous genital tract discomfort. RESULTS: After 2 mailings and 1 telephone follow-up, as well as the elimination of 42 ineligible women, 303 (70%) questionnaires were returned. Fifty-six women (18.5%) reported a history of lower genital tract discomfort that persisted for >3 months. Approximately 12% reported a history of chronic knife-like or excessive pain on contact to the genital area, whereas 6.6% experienced persistent lower genital tract itching or burning. Women who reported their age at menarche to be <or=11 years old were more than twice as likely to report a history of chronic lower genital tract discomfort compared with women who began menses at age 12 or later (odds ratio, 2.4; 95% confidence interval, 1.1 to 4.8). Reported pain at the time of first use of tampons was associated with an increased risk of chronic lower genital tract discomfort later in life (odds ratio, 2.4; 95% confidence interval, 1.1 to 4.9). CONCLUSIONS: We have shown that women from the general population are willing to provide sensitive information on lower genital tract discomfort-a first step toward bringing notice to this understudied disorder. In addition, our data support the theory that vulvar trauma in early life may influence or serve as a marker for risk of subsequent chronic vulvar disorders.

Adult↗

Parallel pathologies? Vulvar vestibulitis and interstitial cystitis.

OBJECTIVE: To determine if epithelial defects found only with periodic acid-Schiff/colloidal iron staining and Van Gieson counterstaining of the bladder in interstitial cystitis (IC) exist in the vulva in vulvar vestibulitis syndrome (VVS) and to determine if immunofluorescence seen in IC exists in VVS. STUDY DESIGN: Vulvar biopsies from 16 prospective and 16 retrospective cases of VVS were stained with Van Gieson stain, as were 30 controls of normal vulvar vestibule from biopsies obtained for benign lesions. Sixteen prospective vulvar biopsies from patients with VVS were evaluated for immunofluorescence. RESULTS: No obvious epithelial defects were found with Van Gieson staining in VVS. Three cases were eliminated for diagnoses other than VVS. Nine of 13 cases showed + to +3 complement (P = .0000005). Seven of 13 showed +IgM (P = .0000005). CONCLUSION: Vulvar epithelium stained with Van Gieson stain did not show defects in VVS but did show complement deposition along the dermoepithelial junction and perivascular IgM. Vascular injury associated with altered central neuronal processing could mediate the positive immunofluorescence findings in both VVS and IC.

Adult↗