Vulvovaginitis before Puberty

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Introduction

Infection or inflammation of the vagina or vulva before a young girl reaches puberty. Affects female infants and children.

FREQUENT SIGNS AND SYMPTOMS

  • Redness, pain and itching around the genital area.
  • Vaginal discharge, which may or may not have an odor.
  • Pain with urination.
  • Bleeding from the affected area (sometimes).

CAUSES

  • Infections caused by bacteria, parasites (including pin-worms), yeast-like fungi, or viruses.
  • Allergies to synthetic fabrics, soap or other items in contact with the genitals.
  • Scratches, abrasions or genital injury from insertion of foreign bodies in the vagina by the child or a playmate.
  • Genital injury from sexual abuse.
  • Irritation from sources such as bubble bath or bath additives.

RISK INCREASES WITH

  • Diabetes mellitus.
  • Infrequent bathing or unsanitary living conditions.
  • Co-existing pharyngitis or other infection.

PREVENTIVE MEASURES

  • Teach the child to wipe from the vagina toward the anus after bowel movement.
  • Don’t let the child sit around in wet clothing, especially a wet bathing suit.
  • Don’t use dyed or perfumed toilet tissue, scented soap or bubble baths.
  • Provide the child with cotton underpants or nylon underpants with a cotton crotch.
  • Teach your child to resist and report any attempted sexual contact with anyone.

EXPECTED OUTCOME

  • Usually curable in 10 days with treatment.

POSSIBLE COMPLICATIONS

  • Adhesions (fibrous tissue within the body that joins normally unconnected parts; they are usually scar tissue formed after inflammation).

GENERAL MEASURES

  • Diagnostic tests may include laboratory blood studies, examination of vagina and culture of the vaginal discharge.
  • Removal of any foreign object in the vagina.
  • Discontinuance of the source of any irritation or allergy, such as soap or bubble bath.
  • If urinating causes burning, the child may urinate while bathing or urinate through a toilet-paper roll or plastic cup with the bottom cut out or pour a cup of warm water over the genital area while urinating. This prevents urine from stinging inflamed skin.