Genitourinary physicians and vulval clinics: a UK survey

Our objectives are to examine the extent to which genitourinary physicians participate in vulval clinics in the UK; to determine the geographic distribution of such clinics and to study aspects of clinical practice and staffing of the vulval clinics identified in the survey. In February/March 1998 a questionnaire on vulval clinics was distributed via regional representatives of the British Co-operative Clinical Group to all the 174 consultants in charge of genitourinary medicine clinics in the UK. One hundred and sixty-four replies were received which identified a total of 61 vulval clinics in the UK. All former health regions had at least one vulval clinic or equivalent. Three former regions had 7 vulval clinics each. Forty-six vulval clinics had a dermatologist, 38 a genitourinary physician, and 30 had a gynaecologist. Only 7 vulval clinics claimed to have a counsellor or health adviser present. Ninety-four per cent took biopsies but only half this proportion met with a pathologist to discuss the histology. Eighty per cent had colposcopes and cameras available but rather fewer actually used them. Twenty-nine per cent had performed research in the past 5 years and 24% had either published or presented this. The majority of vulval clinics would accept direct referrals from all the agencies. This survey has demonstrated an increased number of genitourinary physicians participating in vulval clinics. Other studies have demonstrated the value of such clinics in improving diagnosis and management. It is to be hoped that further such clinics will be set up, particularly in parts of the country which are poorly served at present.