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Complete blockage of the hymen of the vaginal orifice is rare, occurring in approximately 0.05–0.1% of newborn girls. These patients go unnoticed at birth and present after the onset of puberty when the menstrual blood accumulates in the vaginal outlet tract and subsequently a haematotrachelos, haematometra and haematosalpinx develop following which accumulated blood can also be discharged into the peritoneal cavity. This condition requires an excision of the imperforate hymen. Conservative (simple) vulvectomy is recommended in many patients with widespread VIN when it may be difficult to rule out invasive cancer or Paget disease of the Vulva. It may also be appropriate when premalignant lesions, such as granulomatous diseases, do not respond to medical therapy or wide local excision.

The book is enhanced by full colour illustrations and photographic reproductions. Special attention has been paid to the illustrations and photographs to make them more accessible and informative. The technical description is superb and to the point.