Practical vulvovaginal perspectives

Despite an ongoing clinical interest, I usually find books on vulvovaginal disorders instantly soporific. These authors, who have been working together at a dermogynaecology clinic, have done a fine job making this manual readable. The book reflects a collaborative approach from their different specialties: gynaecology, pathology, dermatology, gynaecological oncology, and psychology. A combination of clinicians ideal in management but, unfortunately, not often available.

I liked most that the manual is applicable to clinical practice and practical — most of us have evolved our own system of examination and investigation through imperfect instruction and trial and error. The vulva and vagina manual covers the basics with great practical detail, such as which position and speculum to use during examination, and how to do a vulval biopsy.

Clinical experience is only acquired over a great period of time and most of us in practice will be confronted by a lesion (or lesions) we’ve never seen before. The most stunning contribution in the manual is the collection of clinical photographs of both common and rare conditions. There is also an extraordinary list of vulvovaginal disorders and their mode of presentation (pruritus, discharge, etc). These should be helpful in sorting out possible diagnoses of conditions when you don’t know what it is you are seeing but you know what it’s not — a common scenario in this field. I would have liked more clinical photographs in the cancer section, which was complete but similar to those in other textbooks.

Whether you are a general practitioner with little experience, or a specialist with experience in the area, you will find this book good value and useful.

Gregory K DavisObstetrician and gynaecologist St George Hospital, NSW