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Advanced Lower Genital Tract Disorders

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Provision of optimal health care for women requires that the health care provider be adept in the management of difficult vulvovaginal and cervical conditions such as abnormal cervical cytology screening tests, recurrent candidiasis, lichen sclerosus, introital dyspareunia, recurrent HPV or herpes virus lesions, and vulvar and cervical intraepithelial neoplasia (VIN and CIN).  This ASCCP advanced course best serves those licensed physicians and advanced practice clinicians who are intermediate to advanced in the level of knowledge and treatment of vulvar, vaginal, and cervical diseases.  Physician candidates include gynecologists, gynecologic oncologists, family practitioners, dermatologists, pathologists, ob/gyn and family practice residents, and advanced practice clinicians (e.g., nurse practitioners, physicians’ assistants, nurse midwives).  

Course Competencies and Objectives

This course reflects the current status of clinical knowledge in lower genital tract diagnosis and treatment, including the recent Updated Consensus Guidelines for Managing Abnormal Cervical Cancer Screening Tests and Cancer Precursors.  It is designed to improve medical knowledge, practice-based learning, patient outcomes, systems-based practice, and interpersonal and communication skills. Specific goals are set for the learner to obtain upon completion of the course and it is expected the learner will be able to:

•  Discuss HPV to include the biology, epidemiology, natural history, and immune response of HPV, as well as

•  Understand the costs to society and to the individual of HPV infections, and discuss the efficacy and limitations of the HPV vaccines;

•  Understand current screening tests for neoplasias of the lower genital tract;

•  Apply HPV DNA testing and relevant diagnostic tests to clinical practice in a directed and cost-effective manner;

•  Apply screening and management guidelines to women and those selected special populations (e.g., adolescents, post- menopausal women) with cervical cytological abnormalities and cervical intraepithelial neoplasia/adenocarcinoma in-situ;

•  Understand the new classification system for vulvar pain syndromes;

•  Describe the methods used to diagnose vulvodynia;

•  Understand the types of vulvar pain that respond to surgery and be familiar with the surgical techniques;

•  Understand the various conditions associated with vulvar edema;

•  Recognize the gross and histologic changes of lichen sclerosus;

•  Understand the various treatments for pruritus;

•  Know the differential diagnosis of pigmented vulvovaginal conditions; and,

•  Utilize correct treatments for various STI’s including herpes, molluscum contagiosum, and HIV.



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