ABSTRACT
This chapter considers the urogynecological conditions that affect the vulva, principally urinary incontinence and genitourinary syndrome of menopause. Vulvar conditions may present to genitourinary medicine physicians, dermatologists, and gynecologists and treatment modalities also span across this spectrum. The urogenital system is very sensitive to estrogen deprivation, and the low levels of circulating estrogen after menopause result in physiological, biological, and clinical changes in the urogenital tissues. Incontinence-associated dermatitis is a common skin disorder affecting patients with urinary and/or fecal incontinence. A typical presentation is an inflammation of the skin surface, redness, swelling, and possible blister formation. Urinary incontinence dermatitis typically affects the female labial area, the thighs, and the buttock area. Physiological changes result in reduced vaginal blood flow, diminished lubrication, decreased flexibility and elasticity of the vaginal vault, and increased vaginal pH. Symptomatic women should be counselled on adopting lifestyle changes to ameliorate vulvovaginal atrophy and the onset of urinary tract infections.
