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What is a Diplomate?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery.

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Vulvar Fold Dermatitis

Associated Terms:

Juvenile Vulva, Recessed Vulva, Episioplasty, Vulvoplasty

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards. After completing the residency program, the individual passed a rigorous examination. Only then did your veterinary surgeon earn the title of ACVS Diplomate.

Overview: 

Excessive skin folds around the vulva can lead to the accumulation of urine and vaginal secretions. A moist, dark environment is created where bacteria and yeast can thrive, resulting in vulvar fold dermatitis (Figure 1). Episioplasty, also known as vulvoplasty, is a reconstructive surgical procedure performed to remove excess skin folds around the vulva to provide better ventilation of the area.

 

Signs and Symptoms: 
  • Licking or scooting
  • Foul odor may be present
  • Frequent or bloody urination may be noted
  • Red irritated skin around the vulva
  • Inappropriate urination
  • Persistent urinary tract infections
Diagnostics: 
  • Physical examination
  • Complete blood work
  • Urinalysis
  • Bacterial culture or the urine
  • Ultrasound of the urinary bladder
Treatment: 

Medical management of vulvar fold dermatitis with systemic antibiotics, topical antibiotics, cleansing, drying agents, or lotions may be successful, but is often unrewarding. For the majority of cases surgery is warranted.

Surgical treatment (episioplasty), is a reconstructive procedure aimed at removing the redundant skin folds around the vulva. The amount of perivulvar skin to be removed is determined by pinching the redundant skin between the thumb and forefingers. A crescent-shape incision is made around the vulva and the excessive skin and subcutaneous tissue is removed (Figure 2).

Aftercare and Outcome: 
  • Controlled activity for 2 weeks
  • Cold compresses during the first 24–48 hours will aid in decreasing inflammation
  • Oral analgesics, such as non-steroidal anti-inflammatory drugs or mild opioids may be recommended
  • Surgical sutures are removed 10–14 days after surgery. Most pets are irritated by the surgical wound and need to wear an Elizabethan collar until the sutures are removed.
  • Antibiotics may be necessary to control the skin infection.

The prognosis after episioplasty is excellent. Inadequate removal of perivulvar skin may result in persistence of perivulvar dermatitis, and removal of too much perivulvar skin may cause dehiscence due to tension. These complications are avoided with good surgical technique and operative planning.

Content Theme: 
Also known as: 
Vulvar Fold Dermatitis
Juvenile Vulva
Recessed Vulva
Episioplasty
Vulvoplasty

This Animal Health Topic was written by and reviewed by Diplomates of the American College of Veterinary Surgeons.  Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.

The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.

To find an ACVS Diplomate, visit www.acvs.org/find-a-surgeon.