established by CT myelography, which will confirm the connection with the spinal theca and reveal the bony anatomy well. MRI scanning will demonstrate the presence of the mass and its relationship with the pelvic organs, but may not identify the neck of the sac. It is important to distinguish these masses from other pelvic masses such as an ovarian cyst or other tumor, and, similarly, no attempt should be made to aspirate the cyst through a potentially infected area.
Symptomatic cysts are best treated by sacral laminectomy, aspiration and ligation of the cyst neck. If access is not possible posteriorly, an abdominal approach may be indicated, but it is not necessary to excise the meningocele wall. Asymptomatic cysts may require no treatment, although progressive enlargement with time may be expected.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.