Cytolytic Vaginosis: a Critical Appraisal of a Controversial Condition

Cytolytic vaginosis is a controversial condition that some clinicians have traditionally included as a potential cause of vulvovaginal symptoms despite the lack of scientific evidence.

Recent articles have focused on the evaluation of patients once they carry the diagnosis of cytolytic vaginosis, rather than on diagnostic criteria.

Our review revealed inadequate criteria for excluding other causes of vulvovaginal symptoms, especially VVC, when diagnosing women with cytolytic vaginosis. Treatment recommendations have remained stagnant with no single case report or case series with detailed information about affected patients. Finally, with the inconsistencies in sampling sites and inadequacies in sampling techniques across studies, the reported evidence of lactobacilli overgrowth is unreliable and cannot be used to support the diagnosis of cytolytic vaginosis. Any future investigations of the condition would need to have strict criteria for diagnosis which can be reproduced by other investigators, so that common ground for diagnosis can begin as a basis for studies. We further recommend that any study evaluating patient treatments include information about patient demographics, details about their treatment, and the results in terms of changes in symptoms and findings.