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Vaginal Adenosis

Maeve K. Hopkins, MD and Michael P. Hopkins, MD, MEd Reviewed 06/2019
 


BASICS

DESCRIPTION

  • The normal vagina is lined with squamous epithelium. Adenosis is characterized by the presence of columnar epithelium or glandular tissue in the wall of the vagina.

  • Around week 15 of ...

DIAGNOSIS

HISTORY

  • Maternal DES exposure

  • Complaints of

    • Profuse mucoid vaginal discharge from the glandular epithelium

    • Pruritus

    • Pain/soreness of the vaginal introitus

    • Postcoital bleeding

    • Dyspareunia

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Unless malignancy is present, treatment is conservative.

  • In most young females with this condition, it will resolve with expectant management.

  • Treatment is warranted in women w...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

If the initial colposcopy is normal, a yearly four-quadrant Pap smear of the vagina and of the cervix should be performed. 

DIET

No special diet i...

REFERENCES

1
Reich O, Fritsch H. The developmental origin of cervical and vaginal epithelium and their clinical consequences: a systematic review. J Low Genit Tract Dis.  2014;18(4):358–360. [View...

ADDITIONAL READING

  • Bamigboye AA, Morris J. Oestrogen supplementation, mainly diethylstilbestrol, for preventing miscarriages and other adverse pregnancy outcomes. Cochrane Database Syst Rev.  200...

CODES

ICD10

  • Q52.4 Other congenital malformations of vagina

  • N89.8 Other specified noninflammatory disorders of vagina

  • T38.5X5A Adverse effect of other estrogens and progestogens, initial encounter

ICD9

  • 752....

CLINICAL PEARLS

  • Adenosis is characterized by the presence of columnar epithelium or glandular tissue in the wall of the vagina.

  • Adenosis is common among the daughters of women exposed to DES.

  • Rarely, ad...

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