Talk:Vagina/Archive 11

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Recent edits

Barbara (WVS), regarding this, I've addressed that the wording in the article has already been thoroughly worked out and now it's just a matter of me filling some things in and tweaking the article before I nominate it for WP:GA.

I've also asked you to discuss significant changes beforehand because you and I often do not agree on your editing style, including your copyedits. Even your copyedits tend to be significant. I would rather not have an edit war going on at this article. Recently, you made a number of mistakes or otherwise problematic edits when editing this article. As seen at Talk:Vagina/Archive 10#Recent revisions, I addressed them on this talk page. You did not respond. So what am I to think? Flyer22 Reborn (talk) 20:08, 11 December 2017 (UTC)

And when it comes to copyediting things that Tom (LT) has already copyedited, I have to state that I choose his edits over yours. Flyer22 Reborn (talk) 20:14, 11 December 2017 (UTC)

Barbara (WVS), regarding stuff like this, why can't you discuss first? Why should I have to wait? You are adding STI and vaginal flora stuff to the Microanatomy section. We already have specific sections for these aspects. When it comes to stuff like this, this, and this, "firstly," "secondly" and "thirdly" are important for context. This is also an aspect of the article that was thoroughly discussed. We are identifying the three layers, and it is not an "obvious" matter to readers. Flyer22 Reborn (talk) 20:41, 11 December 2017 (UTC)

When I am done, it will probably pass GA with flying colors. You told me once (sorry no diff to send you to) that it was 'okay' if an article contains the same content in another place. After I am done adding this important content, I will go back through to make certain that the appropriate amount of redundant content remains. If you are concerned that all this editing means that the article is not stable, then consider this effort of mine to collaborative and that I am an editor assisting you in getting it to GA. Then it is not contentous. The only one who is lending a contentious 'tone' to the article is . Respectfully and with Best Regards, Barbara (WVS) ✐ ✉ 20:49, 11 December 2017 (UTC)

Barbara (WVS), regarding what you stated on your talk page, it is not collaboration when you are not listening and are reverting to your preferred wording. You talk about grammar issues, but you make many when editing. You made a number of them when editing the article on November 27, 2017‎. One editor cleaned after you. So did I. And another was worried about your edits via email. You are changing things that have been thoroughly discussed among multiple editors. What makes you think that your wording and formatting is so much better than theirs? Tom (LT), for example, knows what he is doing on topics like these. Why do you think that his edits need to be copyedited by you? When I point to your mistakes, you get defensive and state that you are here to build an encyclopedia, as if I am not; you did that on your talk page minutes ago and clearly above. Have you forgotten how you acted when multiple editors, including Tom (LT), Iztwoz and I told you that the anus is not a part of the vulva? You refused to listen. You stick to your guns even when you are wrong. And now you act like your edits are needed for the article to "pass GA with flying colors." They are not. Tom (LT) is our top anatomy editor, has gotten a number of our anatomy articles to WP:GA status with flying colors and stated that this article is ready for GA. I told him that I wanted to work on it some more. That is how much I care. What you refer to as "my talk page essays" and your argument that "responding eats up valuable time which is better spent inserting updated and relevant content" is beyond dismissive and arrogant. You stated pretty much the same thing at Talk:Nipple, where you were also wrong. It is clear that my so-called talk page essays are part of the communication and review process that we are supposed to do at Wikipedia. If you would not make so many mistakes and be so stubborn about them when an editor is trying to correct you on them, you would not be subjected to my so-called talk page essays. If you talked more and were not so dismissive, you would not make so many mistakes. How many times must Iztwoz, Doc James, Jytdog and I clean up after you? I am not sure what is your deal with this odd competition thing you have going on with me, which is something you had since the day you stalked me and was blocked for it under your Bfpage account, but it is beyond silly and I wish that you would get over it.

As for your claim that I "told [you] once that it was 'okay' if an article contains the same content in another place," that was a recent discussion and I was clearly talking about overlapping content being in two different articles. As for lending a contentious tone to the article, going by what the sources state and with WP:Due weight is not "lending a contentious tone," except to those who disagree with the literature. Flyer22 Reborn (talk) 21:31, 11 December 2017 (UTC)

Message recieved. You've given me much to think about. Best Regards, Barbara (WVS) ✐ ✉ 22:26, 11 December 2017 (UTC)

Checking in

What is considered a major change? I read the archives containing all the discussions related to the article and the other reviews of the editors and don't see any conflict between my editing and their comments.

This is not accurate:

"The wall of the vagina from the lumen outwards consists firstly of a mucosa of non-keratinized stratified squamous epithelium with an underlying lamina propria of connective tissue."

This is accurate:

"The wall of the vagina from the lumen outwards consists firstly of a mucosa of keratinized stratified squamous epithelium with an underlying lamina propria of connective tissue."

better:

"The vaginal wall from the lumen outward consists of a multi-layered epithelium." and so on.

Barbara (WVS) ✐ ✉ 23:06, 11 December 2017 (UTC)

Barbara (WVS), see Talk:Vagina/Archive 7. Yes, the layers and cells aspect was hotly debated because sources state different things on the matters. As that discussion shows, there was also a RfC on it. Don't just skim the discussion. Read enough of it to see what the issues were and how they were resolved.

"Non-keratinized stratified squamous epithelium" is correct, according to this 2012 "Pathology of the Vulva and Vagina" source, from Springer Science & Business Media, page 6, that is used in the article. Other sources state the same. Why are you stating that "keratinized stratified squamous epithelium" is correct? Also, "multi-layered epithelium" is vague. Are you suggesting we state "multi-layered epithelium" and then clarify?

As for a major change, my concern is when you change things that take away context (deleting words and content that should be retained) and when you make changes that conflict with what sources state or what the literature generally states. I take WP:Due weight very seriously. So my issues with your edits are more about significant changes than major changes (although significant changes can be major changes). But, yes, I would prefer that you discuss major changes first. I think major changes are easily identified; they include adding a decent amount of content, deleting significant pieces and changing the format of the article. That stated, I'm not stating that everything you are thinking about adding needs discussion first. When it comes to edits like this, my issues are the following: You quoted a source without adding WP:In-text attribution. Quoting a source without the use of in-text attribution can be a WP:Copyvio problem. And you added a link within the quote, which is something to typically avoid per the MOS:LWQ subsection of MOS:QUOTE. Better to just summarize the source anyway. Flyer22 Reborn (talk) 23:46, 11 December 2017 (UTC)

Keratinized

The review article on the epithelium of the vagina, specifically states that the top layer of the epithelium consists of "keratinized, ennuecleated, dead and flattened cells". In Brown's book, vaginal epithelium is not mentioned on page 6 or 7. Barbara (WVS) ✐ ✉ 00:02, 12 December 2017 (UTC)

Why did you feel the need to start a different section about this when I just replied in the above section about it? Are you seeking input other than mine? If so, I will go ahead and again ping fellow anatomy editors Tom (LT) and Iztwoz. I'll also ping Axl, who edits significantly less than us, but is very knowledgeable on matters such as these.

Like I stated above, this 2012 "Pathology of the Vulva and Vagina" source, from Springer Science & Business Media, page 6, states differently. It states, "The surface epithelium is of nonkeratinizing stratified squamous epithelium type." It (this Brown source) is indeed speaking of the vaginal epithelium.

As for other sources, this 2010 "Cytology and Surgical Pathology of Gynecologic Neoplasms" source, from Springer Science & Business Media, page 1, states, "The vagina is a tubular organ consisting of nonkeratinizing stratified squamous epithelium mucosa, muscularis, and adventitia. Labia minor and inward to vaginal introitus and hymen are mainly covered by nonkeratinizing squamous epithelium associated with no or rare sweat and sebaceous glands." This 2010 "Diagnostic Cytopathology" source, from Elsevier Health Sciences, page 556, states, "Under normal conditions, the vagina is lined by stratified squamous non-keratinising epithelium throughout." This 2012 "Sexually Transmitted Diseases: Vaccines, Prevention, and Control" source, from Academic Press, page 81, states, "The lower FRT (vagina and ectocervix) is covered by a multilayered non-keratinized stratified squamous epithelium overlying a basement membrane and muscular layer." This 2013 "Gynecological Imaging: A Reference Guide to Diagnosis" source, from Springer Science & Business Media, page 687, states, "At the lower 2/3, a nonkeratinizing stratified squamous epithelium." This 2015 "Handbook for Principles and Practice of Gynecologic Oncology" reprint source, from Lippincott Williams & Wilkins, page 125, states, "The vaginal wall is composed of three layers: the mucosa, muscularis, and adventitia. The inner mucosal layer is formed by a thick, nonkeratinizing, stratified squamous epithelium."

That's six academic sources stating "nonkeratinizing." I'm not sure how you are confusing matters, but keratinizing stratified squamous epithelium occurs in the dry surface. Are you reading your review wrong? If not, it deviates from what the literature usually states on this matter. I suggest you wait for others to comment on this topic. Flyer22 Reborn (talk) 01:01, 12 December 2017 (UTC)

All I can say is that the relatively recent review article I have states that the top epethelial layer is keratinized. Also the cells themselves are 80-90% keratin. I can't see how anyone else would even want to comment on this. This is not a hill to die on, at least not for me. Barbara (WVS) ✐ ✉ 01:49, 12 December 2017 (UTC)

Barbara (WVS), you are doing it again. You are not listening! And because you are not, you are going to make a mess of this article unless I take our disputes to WP:ANI because you are editing disruptively and are engaging in WP:IDIDN'THEARTHAT behavior. It appears that your response to what I stated in the #Recent edits section above was just talk. You are trying to challenge what the preponderance of the literature states by stating that your relatively recent review article states differently. What review article? And exactly what does it state? Quote it. Given that you were so mistaken at the Vulva article about the vulva's relation to the anus (which still boggles my mind), I do not have confidence that you are reading the source correctly. Perhaps Doc James or Jytdog would be willing to review whatever source you are talking about. Either way, what one source states, even if recent, does not trump what the vast majority of other sources state. That is what following the WP:Due weight policy means. And WP:MEDDATE is clear about not falling prey to WP:Recentism. The vast majority of sources state "nonkeratinizing" and "non-keratized." Am I to believe that the literature has gotten it wrong for so long and that the new source is correct? Or could it be that the new source is wrong, or has made a typo? Or that you are reading it wrong?

You stated, "I can't see how anyone else would even want to comment on this. This is not a hill to die on, at least not for me." Any editor wanting to get this right should want to comment on it. And you are the one who brought it up and has repeatedly insisted that "nonkeratinizing" is wrong. Flyer22 Reborn (talk) 02:12, 12 December 2017 (UTC)

Perhaps we are defining "top layer of the epithelium," "the surface epithelium" and similar differently. Or maybe it's just a matter of sources stating different things, which is always problematic, as in the case of the vaginal artery topic. Not only do sources state different things about the vaginal artery, they state different things about the number of vaginal layers, which is why there was that big debate over it and the article currently states, "Some texts list four layers by counting the two sublayers of the mucosa (epithelium and lamina propria) separately." And above, some of the sources are focusing on the lower vagina when speaking of "nonkeratinizing," while others are not.

When it comes to the stratum corneum, sources usually don't state "stratum corneum" or "stratus corneum" with regard to the vagina (as a quick, basic Google search and a search on Google Books shows), which is why I am dealing with stuff like this and this. If anything, those words are mainly used when talking about the rat vagina and the like. However, you added a 2014 "The Structure of the Human Vaginal Stratum Corneum and its Role in Immune Defense" source. It obviously mentions "stratum corneum." And while the Vagina article currently states that "the vaginal epithelium is divided into layers of cells, including the basal cells, the parabasal cells, the superficial squamous flat cells, and the intermediate cells," this 2017 "The Human Microbiome" source, from Academic Press, page 59, states, "The layers of vaginal epithelium include the basal, superbasal and stratum corneum cells."

I suggest waiting for Tom (LT) to weigh in so that we can the sort out the wording and get things right. Flyer22 Reborn (talk) 05:03, 12 December 2017 (UTC)

Barbara, which review article are you referring to? Axl ¤ [Talk] 13:39, 12 December 2017 (UTC)

Appears to be this one.[1] Which says in figure one "vaginal stratum corneum... usually not keratinized" Doc James (talk · contribs · email) 19:23, 12 December 2017 (UTC)

That's the correct 2014 review article that lists the different layers of the vaginal epithelium.Barbara (WVS) ✐ ✉ 22:06, 12 December 2017 (UTC)

It than goes on to say "After menopause, the vaginal epithelium thins, glycogen stores diminish, and the SC shows variable degrees of keratinization.[16, 27, 28] Keratinization of the vaginal SCmay also occur as a result of trauma, for example in cases of uterine prolapse."

So yes this edit has concerns[2] IMO. Doc James (talk · contribs · email) 19:23, 12 December 2017 (UTC)

? Not all agree seems to mean the same as a debate. Not a problem. Barbara (WVS) ✐ ✉ 22:03, 12 December 2017 (UTC)

Doc James is not talking about your "Not all agree" edit. He is talking about your keratin edits. You were interpreting the source wrongly. He obviously was not referring to your "Not all agree" edit, which concerns a different topic/part of the article. Also, regarding this, per Wikipedia:Talk page guidelines#Editing others' comments, be careful not to break up an editor's comment. I went ahead and placed Doc James's signature in the spot you broke up. So now that signature is in two different spots.

Thanks for asking, Axl. And thanks for providing the text, Doc James. I always appreciate when you and Jytdog take the time to quote WP:PAYWALL sources for me or others. Misreading/misinterpreting the source in this case is obviously what I was concerned Barbara (WVS) was doing. It's partly why I've insisted that she take the time to listen. We need to take care not to have incorrect material in our medical and anatomy articles (or any of our articles, really, but especially these). When I post my so-called essay comments on talk pages, they are meant to explain and educate. Cases I challenge Barbara (WVS) on often are not "explain in a single sentence or a single paragraph" matter. I noted above that keratinizing stratified squamous epithelium occurs in the dry surface. A simple Google Books search shows that I am correct on that. Like this 2012 "Medical Histology: A Text-Atlas with Introductory Pathology" source, from Springer Science & Business Media, page 60, states of keratinized vs. nonkeratinized, "New cells are continuously produced by mitosis in the basal layers and gradually move to the free surface where they are eventually lost. As they migrate they pass through a series of stages of maturation depending on whether the epithelium will be keratinzed for dry surface, or non-keratinized, for wet areas. If this type of epithelium is to have a dry surface, as in the epidermis, the process of maturation is completed by the accumulation of a special fibrous protein, keratin, that eventually replaces all of the contents of each cell and that results in its transformation to a nonliving, tough, and relatively impervious plate that is finally shed. If the epithelium is faced with a moist environment, keratinization does not normally occur, and the sharply demarcated states in the maturation process are not apparent. The cells simply flatten as they approach the lumen but are still recognizable as cells, even in the most superficial layers."

I now await commentary from Tom (LT) about this matter, and Barbara (WVS) has also indicated that she will wait for Tom (LT) to comment on this before continuing to edit the Microanatomy section, but that section needs further edits because of the content Barbara (WVS) added. Flyer22 Reborn (talk) 22:24, 12 December 2017 (UTC)

Listen, I get it. More sources say non-keratinized, so lets go with that. I'm not denying that the sources use the term 'non-keratinized'. I only added content that I found in the review article. I am perfectly happy to go along with the non-keratinized. Not all review articles agree with each other and not all books agree with each other. Thanks for fixing up the order of the threads and accompanying signatures. I didn't realize that had happened. I did not agree with waiting for Tom (LT) to weigh in before any more edits to the Microanatomy section on my talk page but since it seems pretty important, I certainly will do so now. Any suggestions on how to bring some calm to our exchanges? Best Regards, Barbara (WVS) ✐ ✉ 23:25, 12 December 2017 (UTC)

It's not just a matter of more sources stating non-keratinized. What sources state that the vaginal epithelium is keratinized, other than in abnormal circumstances? It's not there in what Doc James quoted above. As for waiting for Tom (LT) to weigh in, I suggested on your talk page that we wait before continuing with that section. To me, it seemed that you agreed. You've clarified that you didn't, but will wait now. I'll hold you at your word. Regarding this, pings only work with a new signature. But Tom (LT) will weigh in. I've already left a message on his talk page about weighing in, and I've so far pinged him twice in two different sections on this talk page. As for bringing our interactions to a calm, I don't have any suggestions other than what I stated in the #Recent edits section. It is frustrating when I try to get you to see why you are in error about something and you get defensive and/or refuse to listen. It is frustrating when you dismiss my talk page comments as simply essays distracting from editing the article...when what I am stating in those "essays" are very important because they are meant to improve the article and hopefully your edits. I am not trying to condescend to you (not usually); it's just that I am very knowledgeable on the topics we clash on, and, when I see mistakes (whether it's mistakes that deviate from the literature, lend undue weight to something, are simply errors, or are otherwise problematic), I am passionate about fixing them. And if an editor insists on continuing with such edits, it becomes important to explain why the editor is wrong. Sometimes this will take a few paragraphs, especially when the editor has made a lot of edits that need addressing. Flyer22 Reborn (talk) 23:59, 12 December 2017 (UTC)

I am listening, I don't intend to be defensive. I thought others wanted explanations of the source. I guess not. What would you like me to say here? You write something, I respond. I wish there were some other way to communicate. Perhaps I give this impression since I don't check the talk page often enough? Perhaps it is because I typically don't reply with paragraphs? I don't know how to agree with you any more than I have already than to say: "Hey, let's go with non-keratinized". Barbara (WVS) ✐ ✉ 00:19, 13 December 2017 (UTC)

Barbara (WVS), you say that you are listening. But I told you in the #Checking in section above that you were wrong. After that, you created this section, which seemed to be created to get the input of editors other than me and to not respond to me directly. Getting input from others is fine, of course, but it should be obvious by now that when I challenge you on a literature matter, I have good reason for doing so. Anyway, I then provided a number of sources indicating that you were in error and asked if you are misreading the source. Your response was, "All I can say is that the relatively recent review article I have states that the top epethelial layer is keratinized. Also the cells themselves are 80-90% keratin. I can't see how anyone else would even want to comment on this. This is not a hill to die on, at least not for me." So it seems that not only did you misinterpret the source, you implied that I was making a big deal out of nothing when you were the one challenging me and when, yeah, getting this material right is a big deal. You came across as defensive, and you still do. Like I told you before at Talk:Nipple, this continues to happen -- I make some edits based on my knowledge of the research, you object in some way, and then I make my case on the talk page with sources and/or by pointing to a policy and/or guideline. You become defensive and essentially state that I am talking too much (which is a dismissive jab). We trade a few provocative words and then we part ways. It is not difficult to communicate on Wikipedia. All you have to do is stop and talk. And, yes, communicating on talk pages is important for reasons such as these. It is only time-wasting when it's not productive (for example, when one continues to argue something in the face of overwhelming evidence that they are wrong). One admitting that they are wrong does not have to be a bad thing. Anyway, I'd still like Tom (LT) to review the Microanatomy section and tweak it. Flyer22 Reborn (talk) 00:46, 13 December 2017‎ (UTC)

Regarding this, I guess you just can't wait. Flyer22 Reborn (talk) 13:08, 13 December 2017 (UTC)

Barbara helpfully left links to a couple of sources on my talk page. (Thank you, Barbara.) I intended to comment on the sources here, but this now appears to be redundant. In short, I agree with Flyer22 Reborn. Axl ¤ [Talk] 00:00, 13 December 2017 (UTC)

Ah...which parts? Keratinization? I'm going along with what Flyer is saying about kerantinized as the word that should be used. Barbara (WVS) ✐ ✉ 00:05, 13 December 2017 (UTC)

I've been stating that "non-keratinized" is the wording to use, per the sources. Not "keratinized." Flyer22 Reborn (talk) 00:15, 13 December 2017 (UTC)

Thanks, I guess my eyes are crossing and I mis-typed again. Another error. Best Regards, Barbara (WVS) ✐ ✉ 00:19, 13 December 2017 (UTC)

Yes: non-keratinized. Axl ¤ [Talk] 00:49, 13 December 2017 (UTC)

Note: Tom (LT) stated that he does not have time to thoroughly go over the section or devote significant time to the article, but that he did "a quick skim and couldn't identify any major issues" with the section in question. Axl also reviewed the section. I had cut some of the section's content and tweaked it before suggesting that we wait for Tom (LT) to review it; so I am glad that it seems I cut and tweaked the section well enough. I will be looking over it more closely later. Flyer22 Reborn (talk) 22:58, 13 December 2017 (UTC)

Iztwoz, regarding this, I can see why you made the edit, but I'm so used to sources pointing out "non-keratinized" regarding the stratified squamous vaginal epithelium (see above) that I'm kind of reluctant to forgo mentioning it early on. Sources apparently think it's important to state upfront. And given the above discussion, they very likely have a point on that. Some probably mention it early on simply because stratified squamous epithelium can either be keratinized or non-keratinized and they don't take the time to address the "keratinization happens when" aspect. But, yeah, we do mention keratinization later in that section. Flyer22 Reborn (talk) 16:27, 3 January 2018 (UTC)

I had completely missed out on all this section - but from what I've read about epithelium generally is that if there is mucosa involved there is no need for keratinisation so I did not see any relevance for its mention. I don't see why it's mentioned in so many other sources. but clearly if you want to use it, do so.--Iztwoz (talk) 16:53, 3 January 2018 (UTC)

Braxton Hicks

Braxton Hicks may not even be relevant in an article about the vagina since the false labor is felt in the uterus.

• Braxton Hicks contractions are called false labor
• Braxton Hicks symtoms are different than the symptoms of impending labor.

There are more, does it matter? Perhaps you can find many sources that state that Braxton Hicks is one of the symtoms of labor I would expect.

This is probably original research but I ended up at the hospital weeks before the birth of my children about five times with Braxton Hicks. I was sent home. My labor was not even close.

Barbara (WVS) ✐ ✉ 01:52, 12 December 2017 (UTC)

Regarding this, this and this, the source notes Braxton Hicks contractions as a sign of nearing labor. So do many other sources. It can happen weeks or days before labor. For example, this 2010 "Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family" source, from Lippincott Williams & Wilkins, page 345, states, "In the last week or days before labor begins, a woman usually notices extremely strong Braxton Hicks contractions. Women having their first child may have great difficulty distinguishing between these and true contractions." So, yes, this is very relevant to the Childbirth section in the Vagina article. The text in the Wikipedia article was not stating that it happens during labor (and neither are sources supporting this aspect); so the "false labor" aspect is beside the point. Flyer22 Reborn (talk) 02:37, 12 December 2017 (UTC)

Why do we want to remove it exactly? Doc James (talk · contribs · email) 19:17, 12 December 2017 (UTC)

Braxton Hicks don't have much to do with the anatomy of the vagina. Barbara (WVS) ✐ ✉ 22:48, 12 December 2017 (UTC)

They have to do with this topic per what I stated above. You have yet to give a valid reason to exclude this material. So unless you or someone else does, I will be re-adding it and my text will be clearer regarding when Braxton Hicks contractions happen. Flyer22 Reborn (talk) 23:12, 12 December 2017 (UTC)

Message received, but what does Braxton Hicks have to do with the vagina? I would prefer to have a valid reason to retain the content on Braxton Hicks. Thank for being willing to clarify the text when you add it back into the article. Best Regards, Barbara (WVS) ✐ ✉ 23:29, 12 December 2017 (UTC)

I already stated that Braxton Hicks contractions are a sign of nearing labor, and cited the fact that "women having their first child may have great difficulty distinguishing between these and true contractions." The article already lists other signs of nearing labor. There is no need to exclude Braxton Hicks contractions, which are confused for labor. That is my argument. We can wait and see if others weigh in. So far, it seems that Doc James is for including the material. Flyer22 Reborn (talk) 23:59, 12 December 2017 (UTC)

____

References

Lymphatics

I can understand the reason for removing the section title of Lymphatics. I was preparing to add additional content and references regarding the significance of the three separate sites of drainage related to propensity of infection and cancer to spread through these lymphatic channels. It should eventually be enough content to adequate fill a section. Best Regards, Barbara (WVS) ✐ ✉ 13:38, 13 December 2017 (UTC)

I made this and this edit because the "Blood and nerve supply" section already covers lymphatics and you added redundant information. Why should we have a separate "Lymphatics" section, as if it is distinct from "Blood and nerve supply"? Why can't additional material simply go in that small section? Having a "Lymphatics" section, as if it is separate from "Blood and nerve supply" is confusing. And why should cancer material go there? Why shouldn't the cancer material go in the "Clinical significance" section where cancer material already is? Flyer22 Reborn (talk) 13:56, 13 December 2017 (UTC)

I'm conflicted on whether this (the cancer aspect of it) should remain in the "Blood and nerve supply" section or be moved to the "Clinical significance" section, but, for now, I'm going along with its placement in the former. Flyer22 Reborn (talk) 17:41, 13 December 2017 (UTC)

Moved. Flyer22 Reborn (talk) 14:13, 15 December 2017 (UTC)

Microanatomy

From "Microanatomy", paragraph 3: "The epithelial covering of the cervix is continuous with the epithelial lining of the vagina. The vaginal epithelium is divided into layers of cells, including the basal cells, the parabasal cells, the superficial squamous flat cells, and the intermediate cells." Two references are provided: DC Dutta's Textbook of Gynecology, and Modern Colposcopy Textbook and Atlas.

Modern Colposcopy does not seem to explicitly state that the vaginal epithelium is continuous with the cervical epithelium. (Perhaps this is obvious for readers of the textbook?) Nevertheless, Dutta does mention this. Therefore I recommend using only Dutta as the reference for the first sentence. (Although Dutta uses the word "continuous", I wonder if "contiguous" would be more accurate?)

Dutta does not mention the parabasal cell layer. Therefore I recommend removing this reference from the second sentence. Axl ¤ [Talk] 02:33, 14 December 2017 (UTC)

Thanks for the review, Axl. Feel free to make the changes. Flyer22 Reborn (talk) 03:10, 14 December 2017 (UTC)

Done. :-) Axl ¤ [Talk] 15:31, 14 December 2017 (UTC)

I am slightly concerned that reference 32, Fundamentals of Toxicologic Pathology, is based on rats. Axl ¤ [Talk] 15:38, 14 December 2017 (UTC)

It was added by Barbara (WVS). I'm glad you spotted it. Something like this is one reason I suggested that the section be reviewed and noted that I was going to thoroughly look over it again (although I don't have access to WP:PAYWALL sources). In the #Keratinized section above, I stated, "When it comes to the stratum corneum, sources usually don't state 'stratum corneum' or 'stratus corneum' with regard to the vagina (as a quick, basic Google search and a search on Google Books shows), which is why I am dealing with stuff like this and this. If anything, those words are mainly used when talking about the rat vagina and the like." So, yeah, I'm concerned as well, and suggest that it and the sentence it supports be removed. Flyer22 Reborn (talk) 16:04, 14 December 2017 (UTC)

Removed. Flyer22 Reborn (talk) 16:29, 15 December 2017 (UTC)

All that stated, the stratum corneum is commonly discussed when speaking of the epidermis (which, like the Epidermis article states, is 95% keratinocytes) and basal cells, and it is the case that researchers commonly use rats in relation to human anatomy (especially for things that have a possibility of affecting humans). Flyer22 Reborn (talk) 17:39, 15 December 2017 (UTC)

Some sources state "vaginal skin," usually when speaking of vaginal surgery, but skin is usually considered "the soft outer tissue covering vertebrates," which is why keratin is so often associated with skin. As noted before, the vaginal epithelium only becomes keratinized if exposed to air/the dry surface, which is considered an unusual case. Of course, the epithelium dries after menopause. Flyer22 Reborn (talk) 18:11, 15 December 2017 (UTC) Flyer22 Reborn (talk) 19:29, 15 December 2017 (UTC)

Okay, thanks. Axl ¤ [Talk] 13:23, 18 December 2017 (UTC)

citation consistency

reference info for Vagina

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named refs	221
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List of cs1 templates cite book (162) Cite book (19) cite encyclopedia (2) cite journal (22) Cite journal (23) cite news (2) Cite news (3) Cite web (12) cite web (13)
explanations

I have been asked by Editor Flyer22 Reborn to have a look at citation consistency in this article.

There were two invalid tag name errors. These were both introduced by Editor Barbara (WVS) who should check my repairs to make sure that I did the right thing:

1. created with this edit and repaired with this edit
2. created with this edit and repaired with this edit

I would suggest that in future, it is best practice to use meaningful names for the <ref>...</ref> tag name="" attribute. Name attributes like name=":1" convey no contextually meaningful information to editors who come after you.

I will fix the citation templates that are showing maintenance messages. Should I be doing anything beyond those fixes?

—Trappist the monk (talk) 12:32, 14 December 2017 (UTC)

Thank you, Trappist the monk. You know that I care about citation consistency, but I felt that simply stating so to Barbara (WVS) on this talk page would not be helpful. I have mentioned citation consistency to her before in the past. As for doing anything else for the article, what do you have in mind? Flyer22 Reborn (talk) 14:14, 14 December 2017 (UTC)

Probably not much more than to make the cs1 templates consistent. The table at right indicates that there is a diversity of date and author styles that might be unified. The article has a {{use mdy dates}} template so that's an obvious first step.

You might choose an author style as the next step. WP:MED has a fondness, it seems, for Vancouver author style. While this article isn't strictly associated with that WikiProject, the WikiProjects that claim it are related to WP:MED.

—Trappist the monk (talk) 14:25, 14 December 2017 (UTC)

Yes, sources at this article need to be WP:MEDRS-compliant for the biological and medical stuff; so anatomy topics are related to that WikiProject. As for style, what do you think of this sourcing style that I usually use for book sources? I simply use "author" and "authors." Quicker than "first" and "last" and two or more "first" and "last" additions in one reference. But when it's a news or web article, or a journal article, I usually use "first" and "last" format. Flyer22 Reborn (talk) 16:18, 14 December 2017 (UTC)

Yeah, quicker, but use of |authors= is discouraged (see the template docs) because the underlying Module:Citation/CS1 cannot reliably extract individual names from it for the citation's metadata (because editors are wildly inconsistent in how they write the value assigned to |authors=). Because of that, author names are not included in the metadata for templates that use |authors=. The purpose of the cs1|2 templates is to render consistent and correct citations for all readers – that includes those of us who consume the citations by reading them with our eyes and those who consume the citations by reading them with a machine via the metadata. You might have noticed that I have 'fixed' those two templates.

Because the article is WP:MED related, the Vancouver system seems appropriate and there is a tool to help you along:

Wikipedia Template Filling

Caveat: its a tool; tools are not omniscient and are prone to errors (because the data that they rely on may not be properly curated (incomplete of just plain wrong); because there's a bug in the code; because ...) so take a few moments to carefully proofread what the tool produces and make corrections as necessary. This same caveat, of course, also applies to the WP:RefToolbar and WP:Visual Editor citation tools – especially where they take data from WorldCat.

For cs1|2 templates that have a PMID identifier, the author list is available at the PMID page already formatted correctly for the |vauthors= parameter so its usually just a matter of copy and paste (sometimes necessary to cleanup numeric superscripts and to handle certain names (collaborations, transliterations of non-Latin text – but these are fairly simple tweaks).

But, you have to decide. It is not for me to do that for you.

—Trappist the monk (talk) 17:55, 14 December 2017 (UTC)

Okay, let's go with the Vancouver system. Expansion of the article is mostly done anyway. I never use the tools for adding citations, though. Flyer22 Reborn (talk) 18:33, 14 December 2017 (UTC)

And media sources in the article will continue to be formatted with the typical "first" and "last" style? Flyer22 Reborn (talk) 18:38, 14 December 2017 (UTC)

I guess I don't understand what you mean by media sources. So far all that I've tweaked is book, journal, and web citations – which are printed and on-line 'media'. So what is it that you really mean?

—Trappist the monk (talk) 01:46, 15 December 2017 (UTC)

I simply mean the type of sources you see in the "In contemporary literature and art" section, which I didn't write most of. It has some sources like Slate.com, for example. I was also wondering about sources like this. Flyer22 Reborn (talk) 02:10, 15 December 2017 (UTC)

If the purpose of this exercise is consistency, why should the author-list for a Slate reference be written any differently from how we write an author list for an International Urogynecology Journal reference?

It is unclear to me what you mean by your last sentence. What were you wondering?

—Trappist the monk (talk) 11:24, 15 December 2017 (UTC)

The same thing about media sources. Basically, I meant media and web sources in general. The sources that are not books or journals. Flyer22 Reborn (talk) 14:15, 15 December 2017 (UTC)

Regarding this and similar, I wasn't expecting the accessdates to be removed; I prefer them because they usually let editors know when the citations were added. They are a reminder of when I added what. Flyer22 Reborn (talk) 00:42, 15 December 2017 (UTC)

The puspose of an access date is to identify the date on which an ephemeral source was consulted. For those sources that have nil chance of changing from one day to the next (books; encyclopedia; journal, newspaper, magazine articles; any on-line something with a doi, etc.) access dates are unnecessary, do not benefit the reader, and add to the clutter that is the reference section. For ephemeral sources (web pages, on-line news articles, etc), an access date is important because it allows the reader to hunt down an archived copy of the page as it was on the access date.

If it is necessary to determine when you added a cs1|2 template to an article, there is a tool to help you. At the top of every article's history page is a link Revision history search. For example: say that you want to know when you added the Ferri's Clinical Advisor 2013 template. Copy the title (best from the wiki source because the template or browser may have modified the what you see), go to the history page and click the history search link and paste the title into the 'Search for' box. Click the 'Start' button and get the result.

—Trappist the monk (talk) 01:46, 15 December 2017 (UTC)

I know that some editors prefer not to use the acccessdate parameter for book citations, but others do. See this brief discussion from my talk page in 2016. One editor was opposed to them and another preferred them and agreed with me. It's not a huge deal for me, however, and I wouldn't want you to have to go back and add the accessdates you removed. So we can just continue to move forward without them. I think it's editors (instead of readers) who care more about accessdates, though. Flyer22 Reborn (talk) 02:10, 15 December 2017 (UTC)

Also, I know I come across as curt to the editor who addressed me about the acccessdate parameter for book citations, but that's because we were having challenging interactions at the time. We're on slightly better terms now, but I've chosen not to ping the editor -- either of the editors -- here to comment further on their styles. It's better that I don't. Flyer22 Reborn (talk) 02:20, 15 December 2017 (UTC)

Thank you so much for fixing these errors. I have no problem modifying my practice of adding such references in the preferred formats. I can anticipate the problems that you have discussed to avoid them. I have been using VisualEditor to insert references and that script assigns the ref names automatically. It also formats book citations. I can certainly do this by hand. Not a problem, and I will gladly start doing so now. My intention is never to introduce errors and will work toward citation consistency.

Best Regards, Barbara (WVS) ✐ ✉ 16:52, 14 December 2017 (UTC)

This probably doesn't matter at this point, but most of the citations that have been corrected by Trappist the monk (thank you!) were not ones that I added. I am pleased that there is more consistency now. Best Regards, Barbara (WVS) ✐ ✉ 00:36, 15 December 2017 (UTC)

He mainly is not correcting formats; he's changing them. But he has fixed some of your errors, such as the "defined multiple times with different content" pieces. Flyer22 Reborn (talk) 00:42, 15 December 2017 (UTC)

But, yes, since I wrote most of the article, most of the citation formats he's changing are ones I added. Flyer22 Reborn (talk) 00:52, 15 December 2017 (UTC)

Iztwoz, for future reference, we are using Vancouver author style. An example is here, where Trappist the monk recently changed the reference format. So, if you were wondering, that's why he changes the reference style when an editor uses a different format. Flyer22 Reborn (talk) 17:33, 6 January 2018 (UTC)

Vaginectomy and Vaginoplasty

The article probably needs descriptions of both. Basically, vaginectomy is the removal, and not reconstruction, of all or part of the vagina. Vaginoplasty is more like plastic surgery. Barbara (WVS) ✐ ✉ 00:27, 15 December 2017 (UTC)

I'm fine with including a little bit on vaginectomy, but I don't see that much needs to be stated about it in this article, certainly not more than what is currently in the article about vaginoplasty. The Vaginectomy article is currently small, and in-depth material on it should go there instead of here. This article should not have more on vaginectomy than the Vaginectomy article has. Flyer22 Reborn (talk) 00:37, 15 December 2017 (UTC)

I've only included it in the list of modifications...with a properly formatted ref of which I am very proud. Barbara (WVS) ✐ ✉ 20:09, 15 December 2017 (UTC)

Yeah, that's good. Flyer22 Reborn (talk) 20:11, 15 December 2017 (UTC)

As seen here, here and here, I added a brief mention of what vaginectomy is and tweaked its inclusion. Flyer22 Reborn (talk) 20:39, 15 December 2017 (UTC)

Cystocele

...has been updated with some very recent (2018??) review articlel refs. Best Regards, Barbara (WVS) ✐  ✉ ^{and Merry Christmas} 00:33, 18 December 2017 (UTC)

Barbara (WVS) has stated that she plans to add some cystocele material to the article. My response was the following: "The Vagina currently has a brief mention of cystocele that I added. Why does the article need more than that brief mention? Why should it be given more detail than urinary incontinence, rectocele and stress, which are also related to aging and childbirth? I am going for WP:Summary style for sections in the article unless whatever content in question does not have its own Wikipedia article and needs more room in the Vagina article than other stuff because of that. Anyway, I will post your message at Talk:Vagina. And I see that Doc James has also edited the Cystocele article."

That stated, I'm not opposed to having some more cystocele material in the article. I'm just thinking of balance. We don't need to go in depth about every infection, disease or disorder that affects the vagina. Flyer22 Reborn (talk) 00:34, 18 December 2017 (UTC)

More than a brief mention would help readers understand what cystocele is and possibly get them interested in clicking on the article. And since it's related to urinary incontinence (frequent urination, overactive bladder or urge incontinence, depending on how the terms are defined) and sometimes rectocele, those two things can be seamlessly expanded right along with it. Let's just not get carried away with the expansion(s) since they have their own Wikipedia articles for further detail. I'll worry about tweaking the addition(s). Flyer22 Reborn (talk) 01:08, 18 December 2017 (UTC)

Missing -- stress

In the sentence: "Other vaginal changes related to aging and childbirth are urinary incontinence, rectocele, cystocele, and stress.[90]" I went to the source but didn't find 'stress' listed as a vaginal change. Is it supposed to be something else? Best Regards, Barbara (WVS) ✐  ✉ ^{and Merry Christmas} 20:40, 18 December 2017 (UTC)

The source is referenced as being pages 688–690. Stress is noted on page 690 as an associated problem. I used the word related instead of associated. Flyer22 Reborn (talk) 21:00, 18 December 2017 (UTC)

Looking again, the source states "stress urinary incontinence." I will go ahead and fix that. Flyer22 Reborn (talk) 21:05, 18 December 2017 (UTC)

Fixed. Not sure how I missed the full "stress urinary incontinence" part since, for article editing, I usually re-read a source's text even though a lot of the text usually stays in my mind well enough after initially reading it, but there are some sources that state that stress can affect vaginal change. Flyer22 Reborn (talk) 21:22, 18 December 2017 (UTC)

Stress information included with this edit. Flyer22 Reborn (talk) 04:34, 20 December 2017 (UTC)

Followup edit here. Flyer22 Reborn (talk) 04:51, 20 December 2017 (UTC)

Added physiology section

Barbara (WVS) ✐  ✉ 21:13, 31 December 2017 (UTC)

Well, that's odd. Why would physiology come under Function? For that matter, why would a section about hormones and microbiota be called Vaginal physiology? And I have to ask, did you proofread before posting? Rivertorch^FIRE_WATER 21:21, 31 December 2017 (UTC)

If we consider the past editing history of this article, it has been my experience that content that I add may be moved-which is fine since collaboration works this way. The physiology refers to changes in metabolism, growth and other processes. The physiology article states: "normal mechanisms, and their interactions, which works within a living system." Best regards, Barbara (WVS) ✐  ✉ 21:38, 31 December 2017 (UTC)

Barbara (WVS), I felt the need to revert. That Vaginal physiology section you added is redundant to what is already in the article. Look at it. All of it is already covered in the respective sections. The only thing I see worth retaining from that section is the the following: "Vaginal support structures change in composition after menopause. Specific collagens become altered in composition and ratios. It is thought that the weakening of the support structures of the vagina is due to the physiological changes in this connective tissue." And that can go in the section about aging, which is where I will move it.

As for the other content you added, I am thinking over you changing "a thin dense layer of connective tissue, and it blends with loose connective tissue containing blood vessels, lymphatic vessels and nerve fibers that is present between the pelvic organs." to "collagen, elastin, and adipose tissue; It also contains nerves blood vessels, and lymphatic tissue. The adventitia is continuous with and an extension of the endopelvic fascia located around the vagina. This flexible tissue layer can adapt to the movements of other pelvic organs." This is partly because of the detail/removal of previous text and because some of the language in that section was changed by Tom (LT) for simplification. I prefer medical terms and detail, but he is very concerned about simplifying text when we can make it easier to understand for readers. This is per WP:Technical.

And why remove "vaginal transudation, which initially forms as sweat-like droplets"? Flyer22 Reborn (talk) 23:33, 31 December 2017 (UTC) Flyer22 Reborn (talk) 23:56, 31 December 2017 (UTC)

Also retained this for now, although I feel that its inclusion is unnecessary.

As for having a Physiology section, we commonly title the section "Function." We choose "Function" or "Physiology." See Wikipedia:Manual of Style/Medicine-related articles#Anatomy. Sometimes, as in the case of the Human brain article (an article I also worked on), we include both a "Function" and "Physiology" section (although we debated that, and that section may be merged at a later date). In the case of the Vagina article, physiology material is already adequately covered under the Structure and Function sections. And then, of course, we have the " Clinical significance" section for the clinical aspects of the physiology material. Flyer22 Reborn (talk) 23:56, 31 December 2017 (UTC)

I completely disagree with your mass deletion and I am requesting a third opinion. I put in hours of time finding the best, WP:MEDRS citations to substantially improve the quality of this article and a mass reversion is unacceptable. I am hoping that we will all see that collaboration is best for WP. Still, Best Regards, Barbara (WVS) ✐  ✉ 00:04, 1 January 2018 (UTC)

Barbara (WVS), as stated above, I reverted redundancy and restored material that is less redundant. I am also keeping Wikipedia:Manual of Style/Medicine-related articles#Anatomy in mind. You created an unneeded physiology section. We don't create new sections for material that can fit into existing sections and especially not when the section also repeats aspects already covered by existing sections. You would do well to justify the need for a Physiology section -- explaining how it's not redundant and how any non-redundant material cannot fit into existing sections. For example, how is this not better placed in the "Effects of aging and childbirth" section, which already discusses menopause? And how does this not fit in the Secretions section? Redundancy and lack of organization do not help readers. To me, this is yet another case of you not listening. But I await other opinions. Flyer22 Reborn (talk) 00:18, 1 January 2018 (UTC)

Saying that I'm not listening is hindering progress on this article and sounds like scolding or regarding me as an inferior. I listen, well read actually. Your sources are skewed toward out-of-date and sometimes inferior content. Some of the content in this article is out of date and needs to be updated with high quality sources that include subscription-based literature. When I insert content and a ref, it is almost always from a more recent, evidence-based, reliable and high quality source. I am interested in article improvement based upon the best sources possible. When you delete content in favor of inferior, out-of-date sources you are missing the chance to make this the article all that it could be. Physiology is a better and more descriptive term for the physiological processes. Instead the Function section should have been made part of the physiology section and not the other way around. Still, Best Regards, Barbara (WVS) ✐  ✉ 00:37, 1 January 2018 (UTC)

Barbara (WVS), well, you aren't listening. You stated, "[My] sources are skewed toward out-of-date and sometimes inferior content." In what way? Do read Wikipedia:Wikipedia Signpost/2014-09-03/WikiProject report and WP:MEDDATE. There is no need for a source from 2016 or 2017 for the vast majority of anatomy material. This is because anatomy is usually still the same as it was many years ago. If the content is still current knowledge, then the source is essentially up-to-date. I've tried to tell you this before. There is no need whatsoever to replace sources with newer sources in cases such as those. Newer sources are simply for show in those cases. See when you were reverted here at the HIV/AIDS article by Doc James? And that is a very important article about a virus/disease. Newer is not always better or necessary. You didn't listen then either. When it comes the medical aspects of the Vagina article, I have generally kept the sources within the five-year window noted at WP:MEDDATE. And I do not see where you have been replacing my sources anyway. You have been using new sources for content you've added. In the #Recent edits section above, I mentioned this odd competition thing you have when it comes to me. And it's showing yet again. I knew you would start off the new year like this. I was waiting. On your talk page, you recently posted, "Don't think of editing as a competition." It's time that you stick to that. As for the article setup, I obviously disagree. And there was no "other way around." The physiology material is already covered. Flyer22 Reborn (talk) 00:58, 1 January 2018 (UTC) Flyer22 Reborn (talk) 01:08, 1 January 2018 (UTC)

Left a note about this at WP:Anatomy. Flyer22 Reborn (talk) 02:19, 1 January 2018 (UTC)

Discussion continued

DYK that when you cite the Signpost article you are citing yourself? Also, the most current sources that I have found include the older sources as references! And (too many ands) the anatomy of the pelvic organs HAS changed. This is according to the more recent literature and this mostly due to the imaging studies with MRI. MRI has shown that some structures that were previously described (even by Gray) don't actually exist and that other structures that haven't been previously described now have names. In addition, the nomenclature for the anatomical structures is being standardized and the older references that are 'ok' don't use the standardized anatomical terms. Sure, we can use the older sources but why? And just because I get reverted doesn't mean I was wrong... When we can use high quality sources we should (even though some might disagree with that). My favorite reversion was when I inserted a reference from a graduate level gynecology textbook only to get reverted and told that an older, paramedic training manual was a good-enough source. Ah sure. I get reverted when I edit the leads of medical articles that are identified as needing translation. That is because it is a lot of trouble to go to the shortened versions of the articles for translation and bring them up-to-date or to admit that there might be a better reference for content in the lead.

There is still so much content missing from this article: fistulas, anomalies, supportive structures, better embryonic information. Please work with me. We can make this a good article, a better article. Let's not settle for 'ok' when it could be better. I would like to suggest that we use the uterus article as a template instead of the jumbled content that we have now, what do you say? Still, Best Regards, Barbara (WVS) ✐  ✉ 03:29, 1 January 2018 (UTC)

Barbara (WVS), I don't think there is a need for a new reply in a different section. I have made this section a subsection of the previous. When it comes to Wikipedia:Wikipedia Signpost/2014-09-03/WikiProject report, I am citing what three different anatomy editors (including me) stated. First, we have CFCF, who stated, in part, "Without insulting all to many people I'll make use of the pun: 'Anatomy is a dead science'. Apart from smaller advancements–macroscopic anatomy hasn't really moved in the last 100–120 years. New naming conventions have come with the TA, but for the most part–what stood true in 1890 about large scale anatomy is true today. This means certain aspects of WP:MEDRS are very hard to follow: for example we don't bother looking for 'reviews from the past 5 years' – because in the case there are any reviews at all they are often from 1970–80 at best. Any college level or more advanced text-book from the past 70 years should be a viable source for us." Then we have what Tom (LT) and I stated. I did not agree with CFCF about the "dead science" aspect, but I was very clear that "like CFCF has indicated, [anatomy] has not advanced as much as many other medical fields. This is primarily because so much of what scientists know about anatomy is the same as it was many years ago. For other topics, such as the human brain or aspects of female sexual anatomy, it's not always going to be the case that anatomy sources from 70 years ago are good to use. For example, for many years, scientists believed that the Bartholin's glands, which are located to the left and right of the vaginal opening, were the primary source of vaginal lubrication. These days, plasma seepage from the vaginal walls (vaginal transudation) are what the vast majority (if not all) of scientists believe to be the primary source of vaginal lubrication."

Unlike CFCF, Tom (LT) and Iztwoz, I do not cite Gray, mainly because I cite other textbooks and also because some sources differ on what Gray texts state, but the aforementioned editors cite Gray for valid reasons. And they can weigh in here for why that is. In the aforementioned Wikipedia Signpost, you can also see that Tom (LT) noted that Gray's texts can contrast what other sources state. If you think we are missing something at the Human brain article due to MRIs, then, by all means, make your case at Talk:Human brain. If you mean the Vagina article, then specify what we are missing MRI-wise at this article. You asked: "Why cite older sources?" I ask: "Why cite newer sources when they are not needed?" Why are you so stuck on newer being better? If knowledge on an anatomical matter is the same as it was years ago, why in the world is a 2017 source needed over, say, a 2010 source? The article currently states, for example: "The Bartholin's glands, located near the vaginal opening, were originally considered the primary source for vaginal lubrication, but further examination showed that they provide only a few drops of mucus." This is supported by a 2002 source. Why do we need a 2017 source for that? How is the quality of the article any lower because of that? It's not. Either way, when looking at the current state of the Clinical significance section (and discounting what you added), it's clear that (over the years) I have generally stuck to sources that are within the five-year aspect noted at WP:MEDDATE. But by "up-to-date," WP:MEDDATE does not mean that the sources need to be newer; it doesn't mean that I need trade out an older source for a newer source every couple or few years. It means that the content should be up-to-date when it comes to the text we are including. This is why it states, "In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written." The content should be current knowledge. The sources I've included are very much WP:MEDRS-compliant. I do not need to trade out a 2013 source for a 2017 source simply for appearances' sake. Still, because some editors interpret WP:MEDRS wrongly in that way, which has been challenged time and time again, I sometimes trade out older sources for newer sources when it's not necessary. That is only for show.

As for reverting you and missing content, I stated to you before (recently on your talk page) that you should not take being reverted so personally. You've stated before that you consider being reverted harsh or sort of as an attack. Reverting you does not mean that I am attacking you or not working with you. When you are reverted, you should consider more often that you might be wrong. I sometimes consider whether or not I am wrong when reverting someone. Doc James was in the right to revert you at the HIV/AIDS article. A newer source was not needed in that case. You stated, "There is still so much content missing from this article: fistulas, anomalies, supportive structures, better embryonic information." A lot of the medical stuff you add to articles does not need to be covered in-depth at those articles, but rather only needs a brief mention in those articles and pointers to the main articles for greater detail. That is WP:Summary style. For example, like I stated above, we don't need a lot of cystocele stuff in this article. As for jumbled content, I see no jumbled content. Jumbled content is having menopause material in a number of different sections instead of in one main section with only a little in a different section (such as the needed, brief mention of menopause in the Microanatomy section). Mixing clinical significance content with general anatomy content, as you've repeatedly done, is jumbled content, which is why I have repeatedly re-located the material to the Clinical significance section. Notice that Doc James also often relocates material you add to articles? Flyer22 Reborn (talk) 05:11, 1 January 2018 (UTC)

As for the Uterus article, a better article to look at is the GA Cervix article. And do look at the date of the sources used there. The current state of the Uterus article is poor. Regardless, we do not need to set up these articles in the same exact way. It's about what setup works best for whatever article. There is more that can be added to the Cervix article as well, but it's easy to see that we let a lot of the in-depth material in that case be handled at other articles. Again, for the matter at hand, I am waiting for others to weigh in on the physiology section aspect and the sourcing arguments. Flyer22 Reborn (talk) 05:41, 1 January 2018 (UTC)

Proposed content

Vaginal physiology

"Vaginal tissue is influenced by hormones secreted by the ovaries. Not only is hormonal influence evident in puberty, pregnancy, and menopause, there are changes to the vaginal tissue during the menstrual cycle. Most of these changes occur during week following ovulation until menstruation begins again. The vaginal mucosa and epithelium respond the changing hormones and vary in thickness and composition during the menstrual cycle. It is thought that the vaginal microbiota influences the physiological processes in the vagina The vagina responds to topically applied estrogen and become thicker. Vaginal support structures change in composition after menopause. Specific collagens become altered in composition and ratios. It is thought that the weakening of the support structures of the vagina is due to the physiological changes in this connective tissue."

References

• Per this sentence "It is thought that the vaginal microbiota influences the physiological processes in the vagina" why here when we already have a section on "vaginal microbiota" under "function"?Doc James

Not only does the vagina interact and support the microbiota, the microbiota interacts with the vagina and produces antimicrobial peptides that benefit vaginal tissue. That is a physiological effect of the microbiota on the vagina.Barbara (WVS) ✐  ✉ 19:45, 1 January 2018 (UTC)

• Under micro anatomy we says "When puberty begins, the epithelium thickens and glycogen containing cells are formed again, under the influence of the girl's rising estrogen levels" This sentence is not so much about physiology as about a specific treatment for atrophy "The vagina responds to topically applied estrogen and become thicker." and would go under clinical significance.Doc James

The epithelium is mentioned multiple times in the article. It is mentioned once in the clinical significance section. That is fine with me to move the content under clinical significance section. That doesn't completely solve the problem, if it is a problem, of the term appearing elsewhere.Barbara (WVS) ✐  ✉ 19:45, 1 January 2018 (UTC)

• We already say "The vaginal mucosa and epithelium vary in thickness and composition during the menstrual cycle." under function section. So why say "there are changes to the vaginal tissue during the menstrual cycle" again?Doc James

By combining the sections, this will be eliminated. Function is 'what this piece of anatomy does'. Physiology is 'what are the biological processes that involve this piece of anatomy'.

• Function and physiology are the same section. One has "form" which is structure and "function" which is physiology. Doc James (talk · contribs · email) 07:25, 1 January 2018 (UTC)

Yes, lets combine the sections, good idea. It makes sense to combine the two. According to Wikipedia, function has a different definition than the Wikipedia article physiology. They are similar but not equivalent. Combining the sections would eliminate redundancy. Best Regards, Barbara (WVS) ✐  ✉ 19:45, 1 January 2018 (UTC)

I agree with what is said above - I do not see a need for a 'physiology' section at present. --Tom (LT) (talk) 00:36, 2 January 2018 (UTC)

I will go with the consensus of other editors - having more input is helpful. I would be glad to edit out the physiology section. If there is information in this content that doesn't exist in the function section, I will simply move it there. Best Regards, Barbara (WVS) ✐  ✉ 23:51, 2 January 2018 (UTC)

Barbara (WVS), then I hope you keep what I stated in the #Playing nice, discussing, etc. section below in mind. Reverting because there are issues with content, or likely issues with content, is normal. And so is proposing content before it is added. Flyer22 Reborn (talk) 00:03, 3 January 2018 (UTC)

There is much redundancy in this article that should be combined according to MEDMOS. I would like to facilitate that process and collaborate to improve the article.

• Yeast infection is mentioned multiple times.
• Epithelium is mentioned multiple times and in different sections.
• Lymphatics is described and mentioned in two different sections.
• Prolapse is described in two different sections.
• Estrogen is described in multiple sections.
• Labia is mentioned at least nine times and in multiple sections. Barbara (WVS) ✐  ✉ 19:54, 1 January 2018 (UTC)

Barbara (WVS), Doc James is not proposing content. He is citing the content you added and is criticizing where you placed it. He is stating that the Physiology section you created is not needed. He is agreeing with me.

As for your idea of redundancy, it is very off. For example, epithelium is going to be mentioned multiple times and in different sections since it pertains to those different sections. What you are stating is like suggesting that there should be one "Epithelium" section with all of the epithelium material in it. That is not how things work. Not according to WP:MEDMOS#Anatomy or any general formatting guideline. To be even clearer: Mentioning epithelium is obviously going to be relevant to both the Microanatomy section and the Secretions section. Mentioning the term epithelium in those sections is no more redundant than mentioning the term vagina in those sections. Redundancy is creating a section with material that is already covered elsewhere in the article, or adding material that is already covered elsewhere in the article, which are things you have done. Flyer22 Reborn (talk) 20:28, 1 January 2018 (UTC)

Creating a second section on "function" by a different name is not needed. That stuff is mentioned multiple times was not the point of my comments. User:Barbara (WVS) your last comment sounds kind of pointy. Doc James (talk · contribs · email) 03:59, 2 January 2018 (UTC)

If you say that another section is not needed, and others also think that the section is not needed, I gladly will comply by removing it. I don't know what 'pointy' means and you don't have to tell me but I'm guessing that it probably is not a good thing. My last comment was about the multiple references to labia in the article. Is that what you mean? Best Regards, Barbara (WVS) ✐  ✉ 00:02, 3 January 2018 (UTC)

I found out what [[WP:POINT}} refers to. Barbara (WVS) ✐  ✉ 02:23, 3 January 2018 (UTC)

Resolved

I appreciate the attention of other editors in providing feedback regarding the editing issues of this article-I feel that it is a more collaborative effort now. Iztwoz and Trappist the monk made much needed improvements. I don't believe the editing conflicts exist between just two editors any longer. Best Regards, Barbara (WVS) ✐  ✉ 19:54, 1 January 2018 (UTC)

Barbara (WVS), what are you asserting is resolved? There are no editing conflicts between Iztwoz and me or Trappist the monk and me. I don't see where they have agreed with your edits and conflicted with me. Trappist the monk is here because I asked him to be here for reference fixing. And Iztwoz is here because I pinged him above, he has an interest in anatomy articles and likely because I work well with him. Flyer22 Reborn (talk) 23:54, 1 January 2018 (UTC)

The editing conflicts were (are?) between you and me. The resolution to the problem of only the two of us not coming to consensus is resolved because now others have given their attention the article and talk page. The purpose of the third opinion was to help address an editing problem between you and me. That is not the problem any longer since others have given the article their attention. I don't see how what I posted above is critical of anyone. I'm not even saying that other editors agree with my edits. I am only saying that the editing conflict that previously involved you and me, now has some oversight of other editors. See my apology and response to Iztwoz below. Still, Best Regards, Barbara (WVS) ✐  ✉ 23:01, 2 January 2018 (UTC)

Barbara (WVS), WP:30 is not for editor conduct, which is why Robert McClenon made this edit to your report. Your comment in the #Third opinion section below is also all about editor conduct (comments I've made and reverting you) rather than the content at hand. The dispute was/is about the content and your view that I should not have reverted all of your edits (even though I restored enough material). So the only thing resolved by other editors showing up is that it's not just two editors weighing in on the content you added. But below, we can see that the editor who accepted the WP:30 case still wants to weigh in despite the flaws in your report. Flyer22 Reborn (talk) 23:20, 2 January 2018 (UTC)

Barbara (WVS) - There are no editing conflicts with Flyer22 Reborn. I would have given feedback but Doc James had already done so, more competently. As for my edits - any I make (on any page) are open for reversion, if they are not wanted they are not wanted and I rarely ask for a post mortem. It is somewhat irritating to have a wrong slant put on things.--Iztwoz (talk) 07:08, 2 January 2018 (UTC)

You are correct that there are no editing conflicts between you and F22 RB. I should have been more clear in the above post, I can see that now, and regret the confusion. As far as I know there have never been any editing conflicts between you, F22 RB or Doc James. With the participation in article improvement that you did, and TTM, did, the article then became something other than an edit conflict between myself and F22 RB. Your attention to the article, the attention of DJ and the attention of TTM provided some oversight to the editing efforts. I didn't even say that you or anyone else has agreed that my edits were appropriate. You responded to F22 RB and her request to take a look at the article. I think the attention that you gave the article and the attention that TTM gave the article helped bring back the idea that the whole purpose is to improve the article and got the focus off an editing conflict between two editors. That's all. Thank you again for your edits. Best Regards, Barbara (WVS) ✐  ✉ 23:01, 2 January 2018 (UTC)

Doc James and I have disagreed at times; it's just that we are usually in agreement. Flyer22 Reborn (talk) 23:20, 2 January 2018 (UTC)

And I did ping Iztwoz, but that was so that he could comment on using Gray as a source, what sources to use for anatomy articles in general, and/or the "up to date" aspect. As always, I appreciate him taking a look at the article, though. Flyer22 Reborn (talk) 23:30, 2 January 2018 (UTC)

Just saying...

CFCF mentioned that there are not enough MEDRS sources related to anatomy and that review articles are difficult to find. This is not true for female pelvic anatomy and Tom (LT) notes that female anatomy is the exception by saying "[For]the human brain or aspects of female sexual anatomy, it's not always going to be the case that anatomy sources from 70 years ago are good to use."

Therefore, if ya got em, use em. I have no intention of removing older references. I intend to insert the content from review articles and more recent medical textbooks and cite them. There is no consensus on the belief that the older refs in this article are good enough. MEDRS wants editors to use the highest quality references if they are available, i.e., review articles and meta-analyses. In addition:

I will be inserting content related to the assessment of vaginal structure with MRI. It would be a waste of time to tell you F22rb, exactly I will insert because I don't even have it drafted up yet. I'm still reading the review articles that describe the anatomical study of the vagina by MRI.

Cut out the personal remarks about me. I'm not going to cite all the policies regarding this. I am asking nicely and I am willing to have this addressed by posting a description of this behavior to the ANI. Play nice. Keep your remarks directed toward improving the article. Stop telling me to listen (What does that mean, anyway? What, I don't do exactly what you want me to?)

Quite the contrary, I posted a photo and comment about being reverted not being a big deal. And if I was annoyed by being reverted, I am not now.

I never said that the other topics need to be covered in depth.

We don't have a lot of cystocele stuff, that's okay.

There is content about the same thing in many article sections. It is described above. That is my definition of jumbled. You don't have to agree, I'm cool.

I'm all for using the cervix article as a template for this one.

Listen. Relax. Go watch some football.

Still, Best Regards, Barbara (WVS) ✐  ✉ 20:28, 1 January 2018 (UTC)

Barbara (WVS), if we go to WP:ANI, I do believe that it will be you who will be reprimanded there. And your past disturbing behavior regarding me will no doubt be taken into account. I have no issue with going ahead and going there since, yes, you still are not listening and seem to be intent on doing whatever you want despite the concern of others and precedent. I have not engaged in WP:Personal attacks at this talk page involving you. I have criticized your edits and behavior. And criticism is obviously something you cannot take.

If you keep wrongly interpreting WP:MEDRS, this will need to be something that will be addressed at the WP:MEDRS talk page, even though editors interpreting it wrongly is something that has been addressed times before at that talk page. I just told you above that "by 'up-to-date,' WP:MEDDATE does not mean that the sources need to be newer; it doesn't mean that I need trade out an older source for a newer source every couple or few years. It means that the content should be up-to-date when it comes to the text we are including. This is why it states, "In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written." The content should be current knowledge. The sources I've included are very much WP:MEDRS-compliant. I do not need to trade out a 2013 source for a 2017 source simply for appearances' sake. Still, because some editors interpret WP:MEDRS wrongly in that way, which has been challenged time and time again, I sometimes trade out older sources for newer sources when it's not necessary. That is only for show."

Despite stating that, you are still insisting that we need "the highest quality references if they are available, i.e., review articles and meta-analyses" for anatomy material that is largely the same as it was many years ago and/or for non-controversial material. No, quality textbooks work just fine for this topic and WP:MEDRS notes quality textbooks as being fine. Pinging TenOfAllTrades since he has addressed this "within five years" misinterpretation times before. Bluerasberry might also be willing to weigh in since the current WP:MEDDATE wording about five years is partly because of him. And, to think, he was trying to soften the text. Flyer22 Reborn (talk) 20:57, 1 January 2018 (UTC)

And, for the record, it was me who stated, "[For] the human brain or aspects of female sexual anatomy, it's not always going to be the case that anatomy sources from 70 years ago are good to use." You misquoting that is another example of you often misreading things, which remains one my concerns when you are editing anatomy and medical articles. Flyer22 Reborn (talk) 21:09, 1 January 2018 (UTC)

As for "content about the same thing" in the article's sections, I addressed your odd definition of jumbled in the section immediately above. Flyer22 Reborn (talk) 23:54, 1 January 2018 (UTC)

Playing nice, discussing, etc.

Taking a page out of your book by creating a separate section to address a few things: Barbara (WVS), regarding my interactions with you and your statement that I should play nice, I have been trying to place nice. But, again, you do not make it easy. Can you not understand how unnecessary the #Keratinized section was? I had just replied to you in the section above that, making it clear that the wording was correct. You went on to create a different section just to readdress it and debate it. That was a waste of time, unless one can state you now see that it was not a matter of conflicting sources but rather that you were simply wrong. Stuff like this leaves a fiery back and forth between us, and others do not want to weigh in. You sometimes eventually state that you understand (though never acknowledging that you are wrong) and that you will keep what I've stated in mind, but it seems that you never do. We find our ourselves right back in the same type of exchange. It's recycle and repeat. I've asked you to first discuss significant changes so that we will not have these problems, or so that they will at least not happen so often. It is not me trying to stifle your choice to be WP:Bold. It is me wanting to get the text right, it is me knowing that we often disagree and wanting to avoid unnecessary conflict, and me trying to collaborate. For example, right now, you are arguing that you will be "inserting content related to the assessment of vaginal structure with MRI." There is no intent to discuss first that is evident in that statement.

And considering that MRI studies sometimes conflict, or depart from what other studies state, and we should not give WP:Undue weight to aspects not well-supported in the literature, it is something that should first be discussed before it is added. This 2012 "Spine Surgery 2-Vol Set E-Book: Techniques, Complication Avoidance, and Management (Expert Consult - Online)" source, from Elsevier Health Sciences, page 1514, demonstrates how MRI studies can be just one aspect of the literature and should not automatically get more weight. It states, "The reasons for the variance in study outcomes likely include dissimilar end points (e.g., listhesis, loss of disc height, stenosis, signal change), different radiographic measures (e.g., radiography, CT, MRI), and different reporting methods across studies." I know that the source is not about the vagina; I'm obviously listing it as an example of MRI studies not being the be-all and end-all. I've learned this from years of studying medical topics. If what you stated in the #Discussion continued section is about the research on vaginal anatomy when you state that "the anatomy of the pelvic organs HAS changed. This is according to the more recent literature and this mostly due to the imaging studies with MRI. MRI has shown that some structures that were previously described (even by Gray) don't actually exist and that other structures that haven't been previously described now have names," you should demonstrate that here on the talk page for review. If you are misinterpreting something again, this is where fresh eyes would be a huge benefit. We are clearly not the only ones watching the article. You can wait for others to weigh in. Flyer22 Reborn (talk) 23:54, 1 January 2018 (UTC)

Third opinion

François Robere (talk · contribs) wants to offer a third opinion. To assist with the process, editors are requested to summarize the dispute in a short sentence below.

Viewpoint by (Flyer22 Reborn)

François Robere, my viewpoint can be seen at #Added physiology section, #Discussion continued, #Proposed content and higher up in this #Just saying... section. No easy way to summarize all of that. But since the third opinion listing was not neutrally worded and two editors have since weighed in here and here, I'm wondering why the WP:Third opinion request was not declined. Flyer22 Reborn (talk) 01:14, 2 January 2018 (UTC)

Comment: When the "rehashing" of past interactions has to do with an editor's concerning behavior toward another that still continues to this day, it is relevant. The so-called contentious and questionable comments that Barbara (WVS) alludes to are supported by two past WP:ANI threads involving the two of us, and discussions since then. I was not the one being reprimanded or sanctioned in those WP:ANI discussions. As for why I reverted Barbara (WVS), I explained why at #Added physiology section above. So far, two other anatomy and medical editors -- Doc James and Tom (LT) -- have agreed with me. There is not a policy or guideline that says that one cannot temporarily revert another editor's edits to see if there are problems with it. I saw problems with Barbara (WVS)'s most recent additions to the article and decided against reverting myself. Instead, I chose to restore some of Barbara (WVS)'s material and (as noted) explained why. Doc James analyzed the content and agreed. And Tom (LT) has agreed. Not everything needs its own section, and when content fits better in an existing section, it should go in that existing section. Stating that "content should be removed if it is not cited" is only one of the many reasons that material is reverted on Wikipedia. Flyer22 Reborn (talk) 03:34, 2 January 2018 (UTC)

Viewpoint by (Barbara (WVS)

François Robere (talk · contribs)thank you for helping with issues between myself and Flyer22 Reborn. Basically I would like to keep all our interactions and discussions centered on collaboration to improve this article. I am not concerned about the 'history' because I feel it to be irrelevant. Though, as you have noted, there is continual 're-hashing' of past interactions-with little relevance to improving this article. Since other editors have stepped in to help, I am satisfied knowing that this is not an issue between just two editors any longer but a group effort and we are moving toward real improvement in the article.

1. There were some contentious and questionable comments by Flyer22 Reborn on my talk page and the talk page of another editor about me and I would rather that kind of behavior stop. It is not productive.
2. I originally asked for a third opinion because of the deletion of a large amount of content I added. Flyer22 Reborn wanted to go over it. This is unacceptable. Content shouldn't be removed because another editor wants to go over it (approve?). Content should be removed if it is not cited. I have no problem with content being moved and consolidated. I hope that your invovement will prevent the need for mediation or registering a complaint via ANI.

Thank your for stepping in to help. Best Regards, Barbara (WVS) ✐  ✉ 03:15, 2 January 2018 (UTC)

Comments by François Robere

I realize there's some history here, but let's try to keep to just one issue at a time. Alternatively, if you'd like to discuss more than one ongoing issue, please number them (#) to keep everything orderly. Keep in mind this isn't ANI or Mediation, but clarifying things here won't hurt if you decide to take it there later. Thanks. François Robere (talk) 01:09, 2 January 2018 (UTC)

Thank you both for your cooperation so far. The discussion has been reopened by Guy, so I'll get back to it ASAP. In the meanwhile bear in mind a moderator has removed part of the WP:3O request regarding conduct; whether I avoid it altogether or not remains to be seen, but in any case this seems mostly content- and practice-related rather than anything uncongenial, at least from what I've seen thus far. I'll ping you both when I've went through everything. François Robere (talk) 21:36, 2 January 2018 (UTC)

Response to third opinion request :

Whether a 3O request should've been denied or not: While it wasn't neutrally worded throughout - the reference to "mass deletions", in particular, I found non-netural - it seemed like there was an attempt to comply with policy, so that alone didn't seem to justify denial. A bigger problem is that this discussion spans multiple threads and pages, and seems much bigger than those 3O was intended to handle. The request's lack of specificity didn't help either (eg. linking to the talk page rather than to a specific discussion on that talk page). But rather than making the call myself I decided to wait, and 24 hours later it was still up - it wasn't taken nor denied by any of the thousand or so editors watching that page - so I decided to take it, if only to untangle some of the mess. Regardless - as it's not an obligatory process no harm should come from engaging, and what to do later is at the participating editors' discretion. The 3O request asked rather vaguely for comments on content, and rather specifically on conduct (which a moderator later removed owing to his interpretation of some policy or another). Some of the attached links were dated, and I found them less relevant for that reason. I've read through all the links, but haven't delved deeper into the entire history of discourse between the sides. What I did see seems eerily familiar - suggestive of one editor's frustration with another's conduct. Whether that frustration is justified or not I cannot tell (nor can I pretend to ignore my past experiences in similar cases), so I'll only say this: Wikipedia is a human endeavour, and while we're all expected to act "professionally" it's only understandable that editors' emotional state and subsequent reactions would affect their activity here, and vise versa. I haven't seen anything out of the ordinary in the other editor's conduct, and whatever personal references he made are not out of line with what one can expect in certain lengthy, heated interactions that take place here. However, I would specifically advise said editor to roughly follow Hanlon's razor, and not attribute to malice what could be more adequately explained by more benign motives, as this is both often wrong, and a possible violation of WP:NPA. Finally, if either editor finds the other's behavior inappropriate, Wiki has a plethora of tools for dealing with it without resorting to anything distasteful. I'm assuming good faith on behalf of both sides, and haven't seen anything to convince me otherwise. I also commend the editors' attempts of dealing with this properly, whether by reaching for 3O or attempting a "reset" in the relationship. Removal of content en masse: I've seen several of those in the logs, but as the request did not link to a particular one I can only reiterate the general principles: The rule of thumb is that articles should be changed in small, focused portions; discussed where appropriate; and perfected over time (see WP:PERFECTION and WP:CAUTIOUS, as well as Jeff Atwood's post on similar practices in computer programming). There is no clear policy on proper reversals. WP:PRESERVE (and WP:DON'T PRESERVE) offers just general guidelines, providing much room for consideration for individual editors. However, as Wikipedia encourages editors to trust each other (assume good faith etc.), and assumes all editors are of equal status, unless decided otherwise by the community (and in any case all are accountable for their edits). It follows that a change should not be undone just because some editor suspects it might justify a reversal, it has to be shown to justify one. In other words: "I know this editor and they usually do this and that" is not enough, unless a previous ANI (or any other suitable forum) has ruled or acted as much. In the case of massive changes and subsequent massive reversion, not all of the change needs to justify the reversal - it's enough for an editor to spot several glaring errors introduced by the change to justify a temporary reversal of the entire change to allow for further review (this is another reason multiple small, adequately explained changes are preferable to one massive change). In either case I would expect the reversing editor to explain the reversal either in the edit summary or the relevant talk page. Physiology section: I Believe User:Flyer22 Reborn adequately explained their positions regarding the structure of the article, readability to the lay reader, "parent/child" articles and sources' age, and how they correlate with Wiki's guidelines. The user did preserve some of the material in other sections, but I believe they could've preserved some more (eg. the explicit mention of the ovaries as the source of certain hormones). As an aside, I found the phrase "anatomy is a dead science" very amusing. +2 points to User:CFCF for entertainment value (the user is otherwise only indirectly related to this discussion). Finally, I'd like to make a suggestion: The discussion makes it obvious that both editors are deeply knowledgeable in the subject, and wish to contribute to Wikipedia in good faith. It's also clear that User:Flyer22 Reborn has been involved in WikiProject Anatomy for some time, and has made significant contributions to the project. What's more, there seems to be a general consensus between the different editors who's been working on the article, resulting in significant progress in content and style. Therefore, what I believe is the best course of action in this case has already been chosen by the sides: discussion. Users Flyer22 Reborn, Tom (LT), Doc James and others who've been active on this discussion seem to know the article its associated work processes well, and were I to contribute to it I would listen to them carefully. Barbara (WVS) has noticed possible lacunae in the article (which can also be worked on in their own articles). Why not start there? I believe with some guidance from the handful of editors that are more acquainted with the article a lot of good work could get done, and achieving consensus would be less of a problem (including for more significant changes). If any future conflict necessitates ANI or Mediation the editors are free to do so, but until then I believe what I've just described could serve both the editors and the project better. Best regards, François Robere (talk) 22:57, 4 January 2018 (UTC)

François Robere, I appreciate you taking the time to thoroughly analyze this matter. It looks like you looked over a lot. As you know, I stated the following to you elsewhere: "The editor who requested the case also seems to be asking more so about me reverting to look over matters, which is an acceptable form of reverting. Commonly, editors move content they've reverted to the talk page for discussion because they are concerned about the content. I do not see what I did as being much different than that. There have been errors in the other editor's additions and care needs to be taken when working on the article in question." I do stand by the revert because this is such an important article and I did restore most of the material. My main focus was to make sure that there were no errors and to restore non-redundant material. And I do think temporarily reverting to check for errors, as I've done elsewhere (with no objection from the editor in that case), is fine. The content will be restored sooner rather later if there are no errors, redundancy, and if it is obviously content that should be WP:Preserved. WP:Preserve is a policy I care a lot about, and I have mentioned that policy to Barbara (WVS) more than once, as seen, for example, here and here. If I had removed any valid material that should be re-added, I would have no problem with it being restored. But I do not see a need for the following line: "Vaginal tissue is influenced by hormones secreted by the ovaries." This is because the "Microanatomy" section already addresses estrogen (which is secreted by the ovaries) and its effects on the vaginal tissues. Any other specific hormones that deserve a mention in that section can obviously be added there. Like I also recently stated on my talk page and in an email to Robert McClenon afterward, I will be trying harder to not let my tempestuous history with Barbara (WVS) affect our future interactions, and that includes preventing spillover on article talk pages. I also mentioned the word professional to Robert McClenon. Thanks for understanding about past conflicts having the ability to affect future interactions with editors.

Oh, and I'm female, by the way. Flyer22 Reborn (talk) 00:07, 5 January 2018 (UTC)

My apologies. I try to use "they" to avoid gender-related mistakes, but I occasionally slip.

I'd like to explain my thinking regarding "mass" reversals: I understand your concerns, and initially shared them. The reason I finally concluded these should be generally avoided is twofold: First, the rational is contrary to Wiki's spirit of cooperation, where's one's edits are assumed "innocent until proven otherwise". What's more, where editors take this approach it often leads to scuffles based on editors' past acquaintance and not necessarily the quality of their edits. Second, and closely related to the first, it's bound to lead to the creation of "editors in chief" who take control of specific articles, filtering prospective edits as they please - again problematic on multiple levels. That's why I preferred the approach where a massive change that's yet to be reviewed should not be reversed, even at the risk of introducing errors to important articles; and once it's been reviewed thoroughly enough to show that it does indeed contain significant errors - then it can be reversed, revised and reintegrated as needed. Again this is my thinking about the general case, not a particular edit or user. Best regards, François Robere (talk) 01:34, 6 January 2018 (UTC)

I understand what you are stating. But when there are a lot of successive edits, it is easier to simply review them with a temporary revert. It's an approach I've taken at times, and don't use often. And it works. Obviously, in this case, there is unpleasant history between me and the other editor, however. Flyer22 Reborn (talk) 02:40, 6 January 2018 (UTC)

---

I've no idea why Guy did that, but I'll take it to their talk page rather than here. François Robere (talk) 15:01, 2 January 2018 (UTC)

Re-opened, I misread the past history. Sorry everyone. Guy (Help!) 17:06, 2 January 2018 (UTC)

Edit comment: Involutions, folds and Human vaginal size article

Hi Flyer22 Reborn - a late reply to your edit comment (just noticed), think folds already used on page a better choice; it does seem that the page re size could be merged here, there are a lot of unexpandable headings on the page. best --Iztwoz (talk) 09:12, 2 January 2018 (UTC)

For those wondering, Iztwoz is referring to this edit (followup note/edit here).

Iztwoz, I was referring to use of "involutions"; I was asking if we should use "shrinkage" in its place. By suggesting "folds," I take it that you are referring to "rugae," but I think we should continue to state "rugae" for that part for clarity. It's a technical term that we should introduce readers to, and we do use the term in the "Microanatomy" section, where we currently state, "It forms folds or rugae, which are more prominent in the outer third of the vagina; they appear as transverse ridges and their function is to provide the vagina with increased surface area for extension and stretching." And we also state "Folds of mucosa (or vaginal rugae) are shown in the front third of a vagina" for one of the image captions. For female genital anatomy, I don't like stating "folds" unless we are clear what we are referring to; this is because "folds" is often used for the labia minora and labia majora.

As for merging the Human vaginal size article, I was obviously for doing that. I still am...if a lot of the content is cut and the sourcing is traded out for better sourcing. Flyer22 Reborn (talk) 16:18, 2 January 2018 (UTC)

As for using "shrinkage," it's not like we are talking about vaginal atrophy, so that doesn't seem right either, but "shrinkage" is what is meant when "involution" is used for anatomy. I went ahead and removed this bit, which was added by Barbara (WVS). In the #Keratinized section above, Doc James read some of the source for me. Barbara (WVS) had misinterpreted something. Part of the source is talking about menopause. And after menopause, the rugae does thin out/shrink. This takes time, however, since vaginal atrophy is a slow process that often is not noticed until several years (like five to ten years) after menopause. It seems that Barbara (WVS) misinterpreted another aspect of the source. On a side note, I added ":Involutions, folds and Human vaginal size article" to the above discussion title so that it's clearer what we are talking about. Flyer22 Reborn (talk) 16:51, 2 January 2018 (UTC)

Flyer, I just didn't think involutions was a good choice - I would have referred again to 'folds or rugae'. But how could that statement hold up anyway about the area being equal to one square foot - its already on the Vaginal size page that there is considerable difference in lengths and widths. ? As for the merge I was giving my opinion as asked for.--Iztwoz (talk) 17:22, 2 January 2018 (UTC)

"Involutions" was added by Barbara (WVS), and per what I stated above, I believe it to be a misreading of the source. Involutions of rugae concerns vaginal atrophy. As for the merge, yes, I know, and I appreciate it. Flyer22 Reborn (talk) 17:30, 2 January 2018 (UTC)

Either the source is referring to some other definition of involution, or it means the shrinking definition. Doc James, do you mind clarifying which definition of "involution" the source is referring to? Flyer22 Reborn (talk) 17:56, 2 January 2018 (UTC)

Have just read the ref and it makes no mention of involutions let alone rugae; it just states that the surface area is UP to 360 cm squared. --Iztwoz (talk) 19:26, 2 January 2018 (UTC)

I have to say that I support the use of "folds" which are the English language equivalent of rugae and more commonly understood. "Involutions" (pl.) is a very unusual description even anatomically in my experience so far, as Iztwoz mentions. --Tom (LT) (talk) 00:13, 3 January 2018 (UTC)

Tom (LT), the text that was there stated "involutions of the rugae"; so it seems to me that "involutions" was not being used as a synonym for "rugae." Maybe Barbara (WVS) meant "folds of the rugae"? But even that latter word choice would be off since, as noted, "folds" equates to "rugae," like the "gastric folds" (or gastric rugae). Anyway, do you oppose any mention of "rugae" in the article? I definitely think we should include the anatomical term by using parentheses or the word or, like we do elsewhere in the article. And if not that, we should definitely WP:Pipelink to it for clarity. Flyer22 Reborn (talk) 00:25, 3 January 2018 (UTC)

I personally do not think we need to include it at all, as the word "folds" does just a good job at explaining what those things are morphologically as rugae, and has the same meaning ("Ruga" is "crease" or "wrinkle" in Latin as per wiktionary) but is much more understandable. If we are to include the term I would support parentheses or a piped link. --Tom (LT) (talk) 23:38, 3 January 2018 (UTC)

Possibly Useless Comments

I came here because I saw that there had been a request for a Third Opinion. I won't be offering a Third Opinion, and I don't think that a Third Opinion is applicable, but I will offer a few comments. You are all free to disregard my comments, and there may be too much hard feeling already, but I think that my comments will reflect the ideas of at least a few other experienced editors.

First, it appears that there has been some unpleasantness in editing this article in the past. I don't know the history and am not sure that I want to know the history. However, the purpose of this article talk page is to discuss how to improve the article, not to discuss problems with other editors. The whole purpose of all activity in Wikipedia is to improve the encyclopedia. If anyone who has hard feelings can put them aside, please do.

Second, Third Opinion probably isn't appropriate here, because there have already been more than two editors discussing issues.

Third, content dispute resolution forums such as Third Opinion, the dispute resolution noticeboard, Requests for Mediation, and Requests for Comments are used to discuss article content. They are not used to discuss issues about editor conduct. In general, it is best to avoid raising issues about editor conduct. It is often better to ignore conduct issues than to try to argue about editor conduct. In any case, we have learned that mixing content issues and conduct issues doesn't help.

Fourth, it appears to me that the issues may have gotten sufficiently involved that the best way to address any remaining content issues may be a formal Request for Mediation with a skilled mediator who will try to work through the content issues and encourage everyone to set aside any conduct issues (or to resolve them by resolving the content issues).

Robert McClenon (talk) 23:53, 2 January 2018 (UTC)

Thank you, Robert McClenon. Like I stated on my talk page, it is not easy, but I will try harder. Flyer22 Reborn (talk) 00:06, 3 January 2018 (UTC)

Also, I want to thank you, Robert McClenon for your insight into some of the problems that have been discussed on this talk page. I also concur, that a third opinion is no longer necessary since other editors have become involved in improving this article and providing feedback on content. A consensus was formed and resulted in the removal of a section I added-I also agreed to remove the section when it was clear that the others thought it was unnecessary. I heartily agree to set aside any more comments about editor conduct. Since this page now has the attention of other highly respected medical editors who are willing to discuss content, we can continue to improve the article collaboratively. Thank you for weighing in. Best Regards, Barbara (WVS) ✐  ✉ 02:11, 3 January 2018 (UTC)

Format

Flyer - seems that para 5.3 is out on a limb - think it would be better incorporated into 4.4 or follow on from it.--Iztwoz (talk) 22:36, 3 January 2018 (UTC)

Iztwoz, it seems you mean having the "Modification" section being a subsection of the "Clinical significance" section and the "Cosmetic or traditional reasons for vaginal modification" section being a subsection of the "Society and culture section"?

This has come up before; for example, when Tom (LT) copyedited the article in early 2017 because I queried getting it ready for WP:GA; see Talk:Vagina/Archive 9#Edits. In that discussion, one editor suggested combining the material. My response was the following: "I have the 'Modification' and 'Reasons for vaginal modification' sections set up the way that I do for the same reasons that I have a similar set up in the Clitoris article. Vaginoplasty, labiaplasty and female genital mutilation are all clinical significance matters, but they are also society and culture matters and the society and culture material, which is what the 'Reasons for vaginal modification' section concerns, doesn't overlap much with the Modification section. I am opposed to combining the material, since reasons for vaginal modification are a significant aspect of the Society and culture section."

After stating that, I reiterated that "modification material is important to both the Clinical significance section and the Society and culture section" and that "leaving societal/cultural reasons to the Society and culture section makes more sense to me," but also noted that I would give combining the material more thought. And I have (at different times when I look at the article), but I can't seem to push myself on the side of wanting them combined. And Tom (LT) stated, "I can see both sides of this coin and think that the article could be written both ways, so I am not too fussed. IMO I prefer content to be separated as it is, if possible, because it is easier to read and will help direct future editors to an appropriate section. But as stated not fussed." Flyer22 Reborn (talk) 22:57, 3 January 2018 (UTC)

With this edit (followup edit here), I better distinguished the two sections (and that includes retitling the latter). I intend to do similarly for the Clitoris article at some point. Flyer22 Reborn (talk) 18:20, 4 January 2018 (UTC)

More tweaks here, here and here. Of course, there may be more in the future or further expansion in the future. I thought about titling the "Impacts on vaginal modification" section "Societal impacts on vaginal modification," but the "Society and culture" heading is clear that its subsections are about society and culture. Even so, I might add "societal" to the heading. When it comes to this source I used, I saw that Otto Placik, who is indefinitely blocked, is one of the contributors. That made me second-guess using the source, since he is such a strong proponent of cosmetic labial and vaginal surgery, but I did list the risks. Flyer22 Reborn (talk) 19:33, 4 January 2018 (UTC)

I see that the Vulva article separates the societal/cultural material content by having a "Surgery" section in the "Clinical significance" section and an "Altering the female genitalia" section in the "Society and culture" section. Its "American College of Obstetricians and Gynecologists" material is redundant, though, and should instead only be in the Surgery section. I'll probably get around to consolidating that material there. As for the Vagina article, I might change the section titles to a similar setup since the term modification is so often associated with cosmetic surgery. I might change "Modification" to "Surgery" and leave the latter heading as is. Flyer22 Reborn (talk) 08:58, 7 January 2018 (UTC)

But then again, female genital mutilation usually is not considered surgery (in the traditional sense), and I think it is important to mention female genital mutilation in both sections. Hmm. Flyer22 Reborn (talk) 09:18, 7 January 2018 (UTC)

Moved FGM content to modification section, retitled previous "Surgery" and the latter "Influence on modification." That latter heading is subject to tweaking, though. Would rather not have it simply titled "Modification" since surgery is also modification. But the "Society and culture" heading is clear that content in that section concerns societal/cultural influences. Flyer22 Reborn (talk) 00:22, 16 January 2018 (UTC)

History section?

I'd like to know if other editors would like to have a history section in the article. I found some information regarding the medical development of the anatomical study of the vagina. If this section is not preferred, I won't have to put in any time drafting up a history section. I only have a few sources and don't have a draft available for view. Best Regards, Barbara (WVS) ✐  ✉ 02:24, 4 January 2018 (UTC)

Another question - Mesh is used to repair vaginal defects. It has some side effects associated with its use and these include vaginal erosion. It is slightly controversial. Would information about this be something that readers might be looking for? Barbara (WVS) ✐  ✉ 02:29, 4 January 2018 (UTC)

The "Society and culture" section already covers history. I've never liked the idea of arbitrarily dividing up such material into two different sections just for a "History" heading, which is why I forgo doing that. I see no non-arbitrary way to divide the content. I'm sure that what you want to add can seamlessly go in the "Society and culture" section. Having two different sections seems to work okay for the Human brain article, but I really don't see that the same would work for this article. Genitalia and reproductive organ-wise, the Vulva, Clitoris and Human penis articles also stick to one section for the material. In fact, the Vulva article places its Etymology section in the Society and culture section instead creating a History section just for that, which contrasts the suggested setup at WP:MEDMOS#Anatomy. And I agree with that article doing that. Articles like Cervix seemingly don't have enough material on the subject. The Cervix article covers a little history in its "Etymology and pronunciation" section, but that's it at the moment.

As for mesh, I don't have a strong opinion on including some material on that...as long as it's well-sourced and given appropriate WP:Weight. Flyer22 Reborn (talk) 02:43, 4 January 2018 (UTC) Flyer22 Reborn (talk) 03:09, 4 January 2018 (UTC)

The material I found is the medical history, past medical observations and discoveries and anatomical history. I'm not suggesting that another section be created. Barbara (WVS) ✐  ✉ 11:30, 4 January 2018 (UTC)

You asked, "I'd like to know if other editors would like to have a history section in the article." That seemed to be suggesting a History section, which would be separate section. Even if it were a subsection of the Society and culture section titled "History," it would imply that some material that the Society and culture section covers is not history. Anyway, as long as the material is not already covered by the Society and culture section, there should be no problem fitting it in that section, either in an existing section or as a subsection. Flyer22 Reborn (talk) 15:43, 4 January 2018 (UTC)

Out of place content ?

There are several references to cervical cancer that do not seem to be related to the vagina. Also refs to labiaplasty - not really concerning the vagina.--Iztwoz (talk) 06:47, 5 January 2018 (UTC)

Which mentions concern you, Iztwoz? There isn't much on labiaplasty in the article, but I have included mention of it because labiaplasty can concern the vaginal opening, which, as you know, is a part of the vulva. In addition to surgery to the vaginal opening being termed labiaplasty often enough, labiaplasty without a focus on the vaginal opening can result in scarring of the vaginal opening or near the vaginal opening. As for cervical cancer, I've included mention of it because, as noted in the article, there is a relationship between cervical cancer and vaginal cancer. Flyer22 Reborn (talk) 07:10, 5 January 2018 (UTC)

See this American Cancer Society source, which states, "Having cervical cancer or pre-cancer (cervical intraepithelial neoplasia or cervical dysplasia) increases a woman’s risk of vaginal squamous cell cancer. This is most likely because cervical and vaginal cancers have similar risk factors, such as HPV infection and smoking. Some studies suggest that treating cervical cancer with radiation therapy may increase the risk of vaginal cancer, but this was not seen in other studies, and the issue remains unresolved.'" Flyer22 Reborn (talk) 07:37, 5 January 2018 (UTC)

Thanks Flyer- I also saw a ref that treatment of c.cancer can impinge on the vagina. --Iztwoz (talk) 12:16, 5 January 2018 (UTC)

Rearranged and included a little on the "treating cervical cancer with radiation therapy may increase the risk of vaginal cancer" aspect. Flyer22 Reborn (talk) 04:56, 6 January 2018 (UTC)

Followup edit here. Flyer22 Reborn (talk) 05:13, 6 January 2018 (UTC)

And another followup edit here. Flyer22 Reborn (talk) 06:20, 6 January 2018 (UTC)

Puberty, and keratinization again

Iztwoz, what do you think of this setup? It makes more sense to me to talk about puberty later on in the section, after the mention of estrogen, and right along with menopause after that. Flyer22 Reborn (talk) 17:50, 5 January 2018 (UTC)

I think its better placed at beginning when first discussing the type of epithelium. To me it doesn't detract from the later info. It could even be repeated a bit with later info. ? I've also come across new source stating that there are two types of this stratified epithelium - keratinised non-cornified epithelium (vaginal epithelium) and keratinised cornified epithelium. intend adding this to epithelium page and could intro this in the section with an appropriate link. ? cheers --Iztwoz (talk) 18:06, 5 January 2018 (UTC)

Iztwoz, is the source the one that was mentioned in the #Keratinized section above? I mean, the one that I questioned as likely differing from what most sources state? If it's another source, I still question it since the vast majority of sources on the vaginal epithelium describe it as non-keratinizing and only mention keratinization of the vaginal epithelium when noting unusual cases; for example, one source I included in the aforementioned discussion states, "Under normal conditions, the vagina is lined by stratified squamous non-keratinising epithelium throughout." Pinging Axl and Tom (LT) for additional thoughts on this. Do you mind waiting for them to weigh in on the keratinized aspect before adding information on that?

As for the setup, I tried this. I still prefer the puberty content to come later on in the section. I also think we should clarify what we mean by "cuboidal," which currently redirects to the Epithelium article. And we should obviously cut any redundancy.

On a side note, I added "and keratinization again" to the title of this discussion section since it's being discussed again. Flyer22 Reborn (talk) 18:29, 5 January 2018 (UTC)

The source is PMC2736122 --Iztwoz (talk) 18:39, 5 January 2018 (UTC)

So you mean this 2009 "Structure and functions of keratin proteins in simple, stratified, keratinized and cornified epithelia" source. It has a free reading. It's looking at the definition of keratinized from a different point of view; for example, it states, "Currently, the term ‘keratin’ covers all intermediate filament-forming proteins with specific physicochemical properties and produced in any vertebrate epithelia. Similarly, the nomenclature of epithelia as cornified, keratinized or non-keratinized is based historically on the notion that only the epidermis of skin modifications such as horns, claws and hooves is cornified, that the non-modified epidermis is a keratinized stratified epithelium, and that all other stratified and non-stratified epithelia are non-keratinized epithelia. At this point in time, the concepts of keratins and of keratinized or cornified epithelia need clarification and revision concerning the structure and function of keratin and keratin filaments in various epithelia of different species, as well as of keratin genes and their modifications, in view of recent research, such as the sequencing of keratin proteins and their genes, cell culture, transfection of epithelial cells, immunohistochemistry and immunoblotting. Recently, new functions of keratins and keratin filaments in cell signaling and intracellular vesicle transport have been discovered. It is currently understood that all stratified epithelia are keratinized and that some of these keratinized stratified epithelia cornify by forming a Stratum corneum."

The source is departing from the general literature, which is tricky. Well, more than tricky since what the source is stating affects anatomy research as a whole. This is something that WP:Anatomy needs to address, given so many anatomy sources stating differently than this source. Going by what you stated at the end of the Keratinized section above and this edit you made to the Stratified squamous epithelium article, you weren't expecting this either. Anyway, I think that, at this point in time, we shouldn't completely depart from what the vast majority of the literature states. We have to give WP:Due weight to what the literature usually states, like this 2011 "Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology E-Book" source, from Elsevier Health Sciences, page 333, relaying the following: "The vagina is lined with stratified, squamous, non-keratinized epithelium, some 10–30 cells deep, which rests upon a basement membrane and is continuous at the upper end with an identical epithelium covering the vaginal portion of the cervix. Should the epithelium be exposed to the dry external atmosphere, keratinization occurs." We could mention that newer research states differently. Still waiting to see what Axl and Tom (LT) state. Flyer22 Reborn (talk) 19:37, 5 January 2018 (UTC)

How interesting! Conventional teaching and most sources state that the stratified squamous epithelium of the mucosal surfaces within the body is non-keratinised, however this is a reliable source in a popular journal, so I would support including both descriptions (with weight to the non=keratinised for the moment). --Tom (LT) (talk) 00:25, 6 January 2018 (UTC)

I can confirm that Guyton & Hall Textbook of Medical Physiology (13th edition, chapter 82, page 1045) states: "In addition, estrogens change the vaginal epithelium from a cuboidal into a stratifed type, which is considerably more resistant to trauma and infection than is the prepubertal cuboidal cell epithelium."

Bragulla's paper ("Structure and functions of keratin proteins in simple, stratified, keratinized and cornified epithelia") seems to be an intention to re-define "keratinization" in stratified squamous epithelia. However as previously demonstrated, this viewpoint is not widespread among medical authors. I think that it is preferable to use the prevalent terminology in the medical literature—the vaginal epithelium is non-keratinizing. I don't think that we should confuse the picture by including Bragulla's alternative definition. Axl ¤ [Talk] 00:54, 6 January 2018 (UTC)

Iztwoz, Tom (LT), and Axl, I got back from the library a few hours ago and I'm not seeing any sources stating that the stratified squamous epithelium is always keratinized (that there is no non-keratinized type). I also looked at many online sources, some of which I paid for. Like Axl, I'm only seeing this one source stating this. This sort of reminds me of how so many anatomical textbooks still do not give a fuller description of the clitoris while newer research shows that the clitoris is much bigger than previously thought. But in that case, there are newer academic sources making it clear that the clitoris is much bigger than previously thought. In the case of keratinization, I'm not seeing other sources repeating this keratinization view. Literature reviews are good and all (just ask WP:MEDRS, of course), but we shouldn't give WP:Undue weight to one of them when it deviates so much from the literature. So, like Axl, I don't think we should include this aspect in the Vagina article. It would only make Wikipedia look wrong and like it's trying to lead while Wikipedia is supposed to follow. I do think that a mention of this alternative definition is worthy of inclusion in the Epithelium, Stratified squamous epithelium and Keratin articles. Axl, what say you on that? Also, if you see any tweaking or expansion that needs to be done on the Microanatomy section in this regard or with regard to something else in the article, please tweak and expand away. The article can always do with a pair of extra, knowledgeable eyes. I know that Tom (LT) is still busy.

Looking at images on the matter (which I also did) can also help. Sciencetopia.net is a poor source, but it's similar to sources I viewed at the library. It has images and states, "Stratified Squamous Epithelium [...] It is much thicker than simple epithelial tissue. This tissue is composed of several layers of cells of various shapes representing newly formed mature cells. The innermost layers mainly contains columnar cells cubiodal cells which are germinative in nature and as they grow towards surface. They become more flattened and then shed. It is two types: non-keratinized epithelium and keratinized epithelium. Non-keratinized stratified epithelium - This tissue is formed lower cubiodal cells. It is found on wet surfaces that are subjected to considerable wear and tear and are protected from drying. They are found in lining of mouth cavity, tongue, pharynx, oesophagus and vagina. Keratinized stratified epithelium - This tissue is found on outer dry surfaces of body like skin, hair claws and nails. The outer surface layer consists of dead epithelial cells. This tissue contains Keratin, a highly insoluble fibrous protein with water-proofing qualities. This epithelium is also resistant to friction and bacterial invasion." This student atlas source also shows pictures. Flyer22 Reborn (talk) 02:13, 6 January 2018 (UTC)

"I do think that a mention of this alternative definition is worthy of inclusion in the Epithelium, Stratified squamous epithelium and Keratin articles." With only one source that uses this definition, I don't think that it should be included even in those articles. The definition is effectively a neologism. If several appropriate sources are found, then this definition could be included. Axl ¤ [Talk] 16:59, 7 January 2018 (UTC)

Axl, I agree. After suggesting that, I immediately thought better of it. WP:Due weight is something I adhere to, and noting that an author or authors have advocated for a different definition than the widely used one is a WP:Due weight issue. In a similar case, for the Clitoris and G-spot articles, I have included Vincenzo Puppo challenging Helen O'Connell, Emmanuele Jannini, Odile Buisson and others' terminology for/anatomical descriptions of the clitoris, but this is only because of clitoral debate and because Puppo directly responded to them. And it's made clear in the articles that Puppo is the odd man out on his challenges and rebuttals. Well, except for doubting the existence of an orgasmic G-spot, female ejaculation and using the term "vaginal orgasm." There is also debate about the vestibular bulbs, as seen here and here; so Puppo is on one side of the debate for that as well. Because he often pops on forums to debate clitoral matters and G-spot claims, I think he made this edit to the Vestibular bulbs article, which I just changed. Not sure if I saw that edit earlier or not. Anyway, because some authors state differently about the anatomy of the clitoris, I had to be careful to not just go by what one source states when writing that article. Flyer22 Reborn (talk) 20:47, 7 January 2018 (UTC)

For review

Please see this page for the revision I would like to put into the article. All original references have been retained. Best Regards, Barbara (WVS) ✐  ✉ 00:13, 6 January 2018 (UTC)

I would support that going in the General section, where pelvic exams are already mentioned. However, except for "the guideline did not consider pap smears" part, your text does not mention "Pap test," while the Vagina article does. And we should continue to mention the Pap test. Also, "the guideline did not consider pap smears" is vague. By this, I mean "the guideline" part. Your proposed text is a heftier paragraph than I would include, but it's not too hefty. I don't think we need a "Pelvic exam" subsection. So I prefer no subheading for it. Flyer22 Reborn (talk) 02:40, 6 January 2018 (UTC)

I also question adding "well woman care" and "the current recommendations state there is little benefit but evidence of harm that comes with pelvic exams on asymptomatic, nonpregnant adult women" part. This is because "well woman care" can be reworded and the Pap test has been shown to be beneficial. I know that your "the guideline did not consider pap smears" part is meant to explain why the line is stating that there is little benefit, but our paragraph on pelvic exams should consider the Pap test as more than a passing mention. Flyer22 Reborn (talk) 02:51, 6 January 2018 (UTC)

I would be glad to include more on pap smears but didn't want the content to get to long. Perhaps it would be more clear if it was said: "Though pap smears are still recommended, routine pelvic exams on asymptomatic, non-pregnant, adult women are not recommended...." The recommendation is based on at least one evidence-based study by a reliable organization, so it is a good 'fact' to include. I assumed that the content would go where it exists now and don't see any need for a separate section either. Best Regards, Barbara (WVS) ✐  ✉ 13:33, 6 January 2018 (UTC)

Why not keep the following "The vagina and cervix are examined during gynecological examinations of the pelvis, often using a speculum, which holds the vagina open for visual inspection, taking samples, or a Pap test." sentence and combine your material with it (cutting any redundancy, of course)? I'm not suggesting that we add more about the Pap test. I am concerned about discouraging its use, especially based on one source. Asymptomatic, non-pregnant women commonly get a past Pap test and doing so can prevent or reduce medical issues, such as cancer. I don't want it to seem like we are suggesting that women should only get the Pap test if they are having symptoms. Most medical sources suggest that women get a Pap test every three years (and others suggest every five years). That is what sources mean by "routine," unless some are defining it as more frequent than that. Also, such a caution against the Pap test is not yet in its Wikipedia article (though I suppose you plan to add it there?). Pinging Doc James for his opinion on how to include the Pap test material. Flyer22 Reborn (talk) 17:21, 6 January 2018 (UTC)

According to the article on pap test, the frequency of testing varies by country. The age of a first pap test also varies by country. Should information in the article be about what is done in the US only. Since the article is about the vagina, how much detail should there be about the cervix. Also, the vagina is also screened in a similar way to identify dysplasia, or pre-cancerous changes. Sorry, I haven't drafted that yet, either. But cancer screening for vaginal cancer does occur and this information can be included at some future time. Also...sorry to be so slow, it appears that the HPV vaccine for cervical cancer also protects the vagina from HPV-related cancer. Best Regards, Barbara (WVS) ✐  ✉ 21:59, 6 January 2018 (UTC)

I'll be able to get the content into the article in a few days after I format the refs. Barbara (WVS) ✐  ✉ 22:00, 6 January 2018 (UTC)

As you likely saw, the lead of the Pap test article currently states, "In the United States, Pap smear screening is recommended starting around 21 years of age until the age of 65. However, other countries do not recommend pap testing in non-sexually active women. Guidelines on frequency vary from every three to five years." I think we should include that. And as for the cervix, like I noted in the #Out of place content ? section above, cervical cancer is related to vaginal cancer. Either way, the Pap test is an important exam that is carried out by inserting a speculum into the vagina. Including a little more Pap smear material is not taking away focus from the vagina. As for "the HPV vaccine for cervical cancer also protects the vagina from HPV-related cancer," is this a response to something either of us has included in the article?

How about we go with the following wording below? Flyer22 Reborn (talk) 22:46, 6 January 2018 (UTC)

Who has recommendations around cervical cancer screening.[3] Doc James (talk · contribs · email) 06:46, 7 January 2018 (UTC)

Thanks for the WHO source, Doc James. Are you okay with the proposed content below? Think we should add something to it? And, on second thought, Barbara (WVS), I think it should be a subsection. Flyer22 Reborn (talk) 08:58, 7 January 2018 (UTC)

"other countries" could use clarification. But otherwise looks reasonable. Doc James (talk · contribs · email) 09:40, 7 January 2018 (UTC)

Doc James, yeah, we could add a few examples within parentheses by stating "such as." Like I noted below, I took the wording from the lead of the Pap test article. Also, if you don't want me to ping you because you are watching the article, let me know. It seems pinging you helps because you are often busy with other articles and may not be watching the article or the talk page closely. Flyer22 Reborn (talk) 10:12, 7 January 2018 (UTC)

Proposed content

Vaginal health can be assessed during a pelvic examination along with most of the organs of the female reproductive system. Such exams may include the Pap test. In the United States, Pap test screening is recommended starting around 21 years of age until the age of 65. However, other countries do not recommend pap testing in non-sexually active women. Guidelines on frequency vary from every three to five years.

Pelvic exams are often done as part of preventive care services for women (sometimes termed "well woman care"), and are most commonly performed when there are unexplained symptoms of discharge, pain, unexpected bleeding or urinary problems. Excluding the Pap test, health recommendations state there is little benefit but evidence of harm that comes with pelvic exams on asymptomatic, nonpregnant adult women. The vaginal opening is assessed for position, presence of the hymen, and shape. The vagina is assessed by the examiner with gloved fingers before the speculum is inserted to note any weakness, lumps or nodules that may be present. Inflammation and discharge are noted if present. During this time, the Skene's and Bartolin's glands are palpated to identify abnormalities in these structures. After the external and digital evaluation of the vagina is complete, the speculum is carefully inserted to make the cervix visible. An internal exam of the vagina utilizes the speculum for seeing structures. Samples of vaginal fluids may be taken to screen for sexually transmitted infections or other infections. Examination of the vagina may also be done during a cavity search. If consent is given, a pelvic examination is part of the assessment of sexual assault. Pelvic exams are also performed during pregancy and those with high risk pregnancies have exams more often.

____

I took the Pap test stuff from the Pap test article and didn't tweak the references to the style we are using; so that will need to be fixed. I was going to change your "Many medications are referred to" wording to the wording in the article, but I don't see the need to include the Latin material; so I dropped that. Flyer22 Reborn (talk) 22:46, 6 January 2018 (UTC)

Barbara (WVS), I see that you have started to add the material, but you do not appear to have addressed my concerns. The proposed content above is what I support, per my arguments. Doc James also stated the wording I suggested is fine, although he suggested clarifying "other countries." There is no point in reviewing/discussing material if the editor asking for review is going to add what they want anyway. Flyer22 Reborn (talk) 22:22, 7 January 2018 (UTC)

Please feel free to edit as you like, I need about ten minutes to fix one of the refs. I came back to add the content without checking the talk page. I didn't mean to ignore you or address your concerns. My apologies. Best Regards, Barbara (WVS) ✐  ✉ 22:27, 7 January 2018 (UTC)

Ok-good to go. Take care with the refs, it's kind of tricky. Best Regards, Barbara (WVS) ✐  ✉ 22:33, 7 January 2018 (UTC)

I may not have been able to correct the ref before the content was removed. Not to worry, it is easy to fix. Barbara (WVS) ✐  ✉ 22:39, 7 January 2018 (UTC)

Looks great, I like your improvements. Barbara (WVS) ✐  ✉ 10:05, 8 January 2018 (UTC)

Done. Since you removed the "well woman care" aspect, which does appear to have addressed my questioning the vagueness of it, I left out mention of it (including my clarifying text) as well. As for removal, all I that removed is the Latin text. And Doc James, I am still reading over this source to see what the lead of the Pap test article means by "other countries." Flyer22 Reborn (talk) 23:30, 7 January 2018 (UTC)

____

References

Dinner plates

Any reason for Sojourner Truth's plate being the odd one out - what was depicted on it ? --Iztwoz (talk) 20:49, 6 January 2018 (UTC)

When it comes to the "In contemporary literature and art" section, I didn't write most of it. It was eventually expanded at Vagina and vulva in art. See the discussion on that. I removed some material from the section, but I wondered if I didn't downsize the section enough. Anyway, feel free to add what you think is missing there. Flyer22 Reborn (talk) 20:55, 6 January 2018 (UTC)

I added some material to that section, but, again, not most of it. And with the exception of minor tweaks or a small addition by someone else, I added everything that is in the "Perceptions, symbolism and vulgarity" section (with a little bit of it taken from the Orgasm article, but it was material I added there anyway, and a little bit taken from the Clitoris, G-spot and Cunt articles). And I see that the Vagina and vulva in art article has taken some material from the "Perceptions, symbolism and vulgarity" section. Flyer22 Reborn (talk) 21:08, 6 January 2018 (UTC)

Have removed material as specific to vulva not vagina and available on target page. --Iztwoz (talk) 08:05, 7 January 2018 (UTC)

I'm okay with the removal. I think part of the reason vulva material has been included in that section is because of the terminology issue. As noted in the article, the term vagina is often used to refer to the vulva or to all of the female genitalia. The Vagina Monologues, for example, is not solely about the vagina. Granted, it's about things women go through in addition to being about the female genitalia. Anyway, because of how broadly the term vagina is often applied, I've hesitated on removing vulva material in that section. Take "L'Origine du monde," for instance, it doesn't show the vagina, despite Huff Post calling the painting "a frank image of a vagina" and Slate referring to it as "A Painting of A Vagina." Flyer22 Reborn (talk) 08:58, 7 January 2018 (UTC)

Completely agree with that - again just examples of wrong use of the name - would support its removal.--Iztwoz (talk) 09:28, 7 January 2018 (UTC)

Removed. Flyer22 Reborn (talk) 09:39, 7 January 2018 (UTC)

___

References

Lead

Had changed link to that in menstrual cycle as it makes direct reference to menses which is clearly more helpful ? --Iztwoz (talk) 10:05, 7 January 2018 (UTC)

Have added menses to lead of menstruation page. --Iztwoz (talk) 10:10, 7 January 2018 (UTC)

Regarding the edit, I changed the link because it makes more sense to me to link to the Menstruation article for "menstrual flow" instead of to a subsection within the Menstrual cycle article, which points to the Menstruation article for further detail. It also makes it so that we are not linking to the same article twice. I didn't think about the term menses, which you added in parentheses, being a concern. Readers will understand that it's being used as an alternative term even if not seeing it at the Menstruation article. But, yes, having it mentioned at the Menstruation article doesn't hurt. Flyer22 Reborn (talk) 10:22, 7 January 2018 (UTC)

That's why I added it to the lead of menstruation.--Iztwoz (talk) 10:27, 7 January 2018 (UTC)

Menopause

There seems to be a lot of unrelated material such as hot flashes added. --Iztwoz (talk) 12:27, 8 January 2018 (UTC)

I don't see that when looking at the "Effects of aging and childbirth" section. Hot flashes are an aspect of menopause. Because stress can trigger hot flashes and make them worse during menopause, it seemed relevant for me to mention. It also seemed relevant to mention that the exact origin of hot flashes are not well understood. There is more that can be added about menopause and hot flashes, but I've only included a little because the Menopause article can go into detail about that and other effects of menopause (and that article does indeed include hot flashes material). So I'm lost on what you mean by "a lot of unrelated material." Flyer22 Reborn (talk) 17:22, 8 January 2018 (UTC)

Flyer22 Reborn the page is about the vagina - how are hot flashes related to the vagina? The only aspect of menopause that is relevant to the vagina is dryness or atrophy. ? --Iztwoz (talk) 09:32, 9 January 2018 (UTC)

I'm not strongly tied to the hot flashes material, but this is my rationale: Like the Wikipedia article states, "Menopause [...] is the time [...] when menstrual periods stop permanently, and [women] are no longer able to bear children." Hot flashes are one of the top symptoms of perimenopause and menopause, can be felt throughout the body, and can make menopause worse. The Mayo Clinic and some other sources call them the "the most common symptom of the menopausal transition." Additionally, there is some research noting effects of hot flashes in relation to menstruation.

In this 2006 "Menopause: A Biocultural Perspective" source, from Rutgers University Press, page 27, the author cites their own research for stating that menstrual cramps and menopausal hot flashes are significantly related, and also states, "[H]aving experienced cramps with menstruation during younger years was a significant predictor of hot flashes with menopause during midlife. [...] The association between menstruation cramps and menopausal hot flashes has also been shown [in other countries]." This "Menopause-related hot flashes and night sweats can last for years" source, from Harvard Medical School, states, "Women who had their first hot flashes before their menstrual periods ended had hot flashes for an average of nine to 10 years. When hot flashes didn't start until after the last menstrual period, the average duration was only about three and a half years. But even on the short end of the spectrum, that's a long time to deal with hot flashes and night sweats." This 2010 "Endocrinology - E-Book: Adult and Pediatric" source, from Elsevier Health Sciences, page 2431, states "Menstrual migraines peak during the transitional years, as do often unrecognized hot flushes around menses. [...] Hot flashes are considered to be a hallmark symptom of the menopausal transition. [...] Approximately 40% to 70% of menopausal women experience hot flashes, and 10% to 20% of these women obtain medical treatment of their hot flashes. [...] Although the original of hot flashes is not entirely clear, studies suggested that changes in core body temperature regulation or changes in endogenous hormone levels or both are associated with the onset of hot flashes. Hot flashes negatively affect the quality of life for women by causing sleep disturbances, which often result in fatigue, irritability, forgetfulness, acute physical discomfort, and negative effects on work." This 2014 "Managing Hot Flushes with Group Cognitive Behaviour Therapy: An Evidence-based Treatment Manual for Health Professionals" source, from Routledge, pages 4-5, states, "Hot flushes and night sweats, also called vasomotor symptoms, are the main physical signs of menopause, as well as cycle changes. They are reported by 70-80 per cent of women in Western cultures during the menopause transition. [...] Although hot flushes are part of normal development given their prevalence, they are problematic for some women; it is estimated that 20-25 per cent of menopausal women seek help for troublesome hot flushes and/or night seats and they are associated with reduced quality of life (Utian 2005; Ayers and Hunter 2013)."

I'm not arguing to include any of this in the article. I just feel that leaving out mention of hot flashes with regard to menopause would probably be an unhelpful omission, and I'd rather not leave out mention of hot flashes. Flyer22 Reborn (talk) 20:54, 9 January 2018 (UTC)

Still do not see the relevance to the vagina. Why not mention osteoporosis if it's just related to menopause? What about the documented evidence that they happen due to lack of oestrogen and are treatable by supplementing this.? --Iztwoz (talk) 21:08, 9 January 2018 (UTC)

Considering that we mention menopause, which concerns the end of menstrual periods, and there is some evidence of a relationship between menstruation and hot flashes, I don't see the issue with mentioning hot flashes. It's a little bit of content. I'm not arguing to include all symptoms of menopause. I'm arguing to retain mention of what many sources consider one of the biggest signs, or the biggest sign, of menopause. Flyer22 Reborn (talk) 22:20, 9 January 2018 (UTC)

But what is the relevance to the vagina ? There is a page dealing with the menopause. Hot flashes have nothing whatsoever to do with the vagina. On a page that is already very lengthy would have thought it paramount to rm extraneous material. You mention a connection between hot flashes and menstruation if the cessation of menstruation was responsible for hot flashes they would be experienced every month. They are due to the lack of estrogen. You have argued yourself about material being available on links --Iztwoz (talk) 07:17, 10 January 2018 (UTC)

Menstruation concerns the vagina, and hot flashes are reported to concern menstrual aspects (per references I listed above). It is also the case that hormonal vaginal creams, an aspect mentioned in the article as a treatment for menopausal symptoms, are often used to treat hot flashes. So are vaginal rings and hormone replacement therapy (HRT) in general, although the Vaginal estrogen article, while listing vaginal creams and vaginal rings as forms of vaginal estrogen, currently states that vaginal estrogen will not alleviate the hot flushes and hormonal imbalance caused by menopause. So these articles will need to be tweaked to be uniform, and I will do that. Anyway, many women purchase the creams and rings to specifically treat hot flashes rather than vaginal dryness. If we retain the hot flashes material, we should perhaps briefly note that these things are also used to treat accompanying hot flashes, note the risks of the treatments, and that some sources state that things like vaginal rings won't relieve hot flashes or may not relieve hot flashes. However, sources like this 2014 "Pharmacology for Nurses" source, from Jones & Bartlett Publishers, page 80, do note that the Femring is used to treat hot flashes. The Femring article (officially titled Estradiol acetate) also states this, with the support of sources. These aspects can certainly make the mention of hot flashes look more relevant for anyone else who would otherwise find the mention out of place. We should mention vaginal rings anyway, which I will. And while mentioning them, we should obviously note what they are used for and any risks.

I stated "relationship between menstruation and hot flashes." I did not state "responsible for." We both know why menopause occurs. Yes, a number of sources state that hot flashes during menopause are caused by vasomotor instability due to a lack of estrogen, but enough sources are clear that they do not know, or entirely know, what causes hot flashes. Either way, some of these same sources and other sources directly speak of hot flashes in relation to menstruation, not just in relation to menopause. And menopausal cramps are an aspect of menstruation.

Many women note having menstrual cramps in relation to hot flashes. Although what I've witnessed in my life is of no concern to Wikipedia, which is why I listed sources above, it's something I've witnessed among women. I'm not old enough yet to have personally experienced it (although discomfort from hot flashes during menstrual periods or the lead up to them is not solely associated with perimenopause and menopause). To me, asking what hot flashes have to do with the vagina is similar to (though not close to exactly like) asking what premenstrual syndrome has to do with the vagina. And although we have yet to mention premenstrual syndrome in the article, it is certainly something to consider briefly mentioning. I do not consider the article very lengthy, but that may be because I'm used to seeing articles that are much bigger than this, including ones that breach WP:SIZE. Mention of hot flashes is not taking up so much room as to complain about its mention. And it is common to list associated problems in our Wikipedia even when those associated problems are not considered to concern the title of the article directly. Look at some of our medical articles, for example. I listed one problem (one of the biggest, if not the biggest for some women) that is an aspect of menopause, and I've explained why. Clearly, we're at impasse on this. But maybe, with the mention of vaginal creams and vaginal rings, you will reconsider? Vaginal rings are definitely something we should mention, and, like I stated, they partly concern hot flashes. Flyer22 Reborn (talk) 17:56, 10 January 2018 (UTC)

Have just linked vaginal rings already mentioned on page. --Iztwoz (talk) 18:04, 10 January 2018 (UTC)

I see that it's in the General section; yeah, I remember seeing that added. Per what I stated above, I'm going to either move the vaginal ring material to the aging section and add on to it, or have it be in both the General and aging sections. Flyer22 Reborn (talk) 18:23, 10 January 2018 (UTC)

Changed it to this. Left the general vaginal ring material in the "General" section since it also concerns birth control. Altered the Vaginal estrogen article to this. Didn't see what to mention on risks for vaginal creams and vaginal rings. Most of the sources talk in terms of side effects instead of risks, although "side effects" commonly means the same thing as risks and this Mayo Clinic source does list the side effects of the NuvaRing as risks. This 2010 "Pharmacology for Rehabilitation Professionals - E-Book" source, from Elsevier Health Sciences, page 212, states, "Other forms of HRT such as skin patches, vaginal creams, and vaginal rings might not present the same risks; but further study of these products is warranted." This 2014 "Reviewing the options for local estrogen treatment of vaginal atrophy" source states, "Currently available local vaginal estrogen therapies are well tolerated and effective in relieving symptoms of vaginal atrophy. Recent data support the endometrial safety of low-dose regimens for up to 1 year." The Hormone replacement therapy (menopause), Vaginal estrogen and Vaginal ring articles can cover the in-depth detail on benefits and risks, of course. Flyer22 Reborn (talk) 20:36, 11 January 2018 (UTC)

Flyer22 Reborn - Just some final comments as you are about to have it GA reviewed - think the section Effects of aging and childbirth would be improved by separating out the aspects of childbirth and menopause, and aspects of ageing could just be referred to individually. Instead of thinking about changes as effects of ageing think it better to consider them as stages in human development. As childbirth is included on the Disease page as a Medical condition - childbirth section could go to Clinical significance. as could Menopause. By the way the second paragraph refers to a list of items that i cannot find any ref to in source.? Again i suggest pH info be moved to General section as relating it to age is unhelpful. Shall add some more comments re this in reply at later section. Also i think on the page as a whole there is a lot of WP:Citation overkill - there are instances of three refs given for very short sentences. --Iztwoz (talk) 08:07, 13 January 2018 (UTC)

With regard to the aging section, all of the content has to do with aging, though (like I noted below). As seen at Talk:Vagina/Archive 9#Edits, I was originally opposed to an Aging section, but I changed my mind. It makes sense to me to keep the age-related pH material in the aging section since the sources tie those changes to aging. I don't see how the content is unhelpful where it is. As for function, childbirth is a function of the vagina; so I think it should remain in the Function section. Its detailed clinical aspects are in the Clinical significance section. I think it's best to keep the detailed clinical significant aspects confined to that section. I think that the Function section should mainly stick to "function," as is done with with the GA Cervix and Human brain articles. As you know, we worked on the latter together. As for mention of childbirth in this section of the Disease article, that is only to document the broad "medical condition" term. The section is clear about the different terminology that may or may not be used synonymously. Pregnancy and childbirth are not usually considered diseases. Just ask Doc James. Not sure what you mean by "the second paragraph refers to a list of items that [you] cannot find any ref to in source." That current second paragraph shows that page 690 supports most of that content. As for the "The uterus can also drop through and prolapse past the vaginal entrance, sometimes for inches." piece, that was added by Barbara (WVS). I don't know what it states since a URL is not provided for it. As for WP:Citation overkill, which I helped tweak, I usually don't think that two to three sources is citation overkill. I don't mind removing unnecessary references, but some of these references might be supporting an aspect of a sentence or a paragraph that another reference does not. Flyer22 Reborn (talk) 09:35, 13 January 2018 (UTC)

And controversial stuff, like the G-spot, should have two to three references. Flyer22 Reborn (talk) 09:49, 13 January 2018 (UTC)

Was just returning to say that I found the relevant material on the source page - but why are the conditions are lumped together as ageing and childbirth, and also unexplained such as bleb (whilst linked explains nothing here) is in my view, amiss. --Iztwoz (talk) 09:59, 13 January 2018 (UTC)

The source lumps them together that way. It specifically states "aging and childbirth"; like I stated in the #Aging section below, it seems to be talking about a relationship between aging and childbirth. It does not seem to be speaking of these things independently of one one another. If it is intended to be read that way, the source is doing a poor job of giving that indication. Flyer22 Reborn (talk) 10:19, 13 January 2018 (UTC)

Update: With this edit, I used this 2016 "Nursing Care Plans - E-Book: Nursing Diagnosis and Intervention" source, from Elsevier Health Sciences (page 111), and this 2014 "Maternity and Women's Health Care - E-Book" source, also from Elsevier Health Sciences (page 133), to clarify the stress urinary incontinence, rectocele, and cystocele aspects. I added, "Physical changes resulting from pregnancy, childbirth, and menopause often contribute to stress urinary incontinence. If a woman has weak pelvic muscle support and tissue damage from childbirth or pelvic surgery, a lack of estrogen can further weaken the pelvic muscles and contribute to stress urinary incontinence." And "A reduction in estrogen does not cause rectocele, cystocele and uterine prolapse, but childbirth and weakness in pelvic support structures can." I was going to use the 2014 source to add "but age-related vaginal changes also occur when estrogen is not a factor" to the second sentence of the first paragraph, but the source does not clarify on that and I found no other sources to pick up the slack. I would have used the source to add "although symptoms of vaginal atrophy do not present in all women," but, while some sources report that some women don't experience genital atrophy, other sources, such as this 2009 "Clinical Manual of Sexual Disorders" source, from American Psychiatric Pub, page 405, states, "Although the impact of menopause on sexual behavior is quite variable, all women experience atrophy of urogenital tissue and diminished vaginal lubrication that can negatively impact sexual function (Table 14–1)." And the American Psychiatric Association is authoritative. Of course, I could add a line about research not being consistent on that.

I moved the menopause content back up to where it was because of flow; for example, the stress urinary incontinence, rectocele, and cystocele material addresses menopause and estrogen. Flyer22 Reborn (talk) 21:52, 13 January 2018 (UTC) Flyer22 Reborn (talk) 22:09, 13 January 2018 (UTC)

Nearing labor vs. nearing delivery

Iztwoz, regarding this, you stated, "labour can precede delivery by some time - ought not be used as synonym for childbirth." On that note, the sources are talking about signs of nearing labor. The sources use the words "nearing labor" or "approaching labor." So I don't think we should state "Another sign of nearing delivery" when the source says "Another sign of nearing labor." Flyer22 Reborn (talk) 17:29, 8 January 2018 (UTC)

The Childbirth article uses "also known as labour and delivery" in its lead as a WP:Alternative title. Anyway, as seen here, here and here, I tweaked and expanded the material. I added "a physiological process preceding childbirth" in parentheses to briefly explain what labor is for our readers and so that we don't need to link to the Childbirth article twice, but if you instead want to link to the section on labor there, feel free. I also made it clear that most water breaking happens during labor rather than before labor. I removed your addition of "in some women" for Braxton Hicks contractions because I am not aware of any reliable sources stating that some women don't have Braxton Hicks contractions. Some sources do note that some women don't feel them. So, yes, in the "don't feel them" sense, they are not a sign of nearing labor for those women. With this edit, I made it clear that some women never feel Braxton Hicks contractions. Flyer22 Reborn (talk) 18:47, 8 January 2018 (UTC)

Think its not right to call labour a synonym of childbirth (know that needs to go on that talk page). In Britain it's always been very common to speak of having a hard labour, a difficult labour; someone was in labour for twelve hours - how can that be equally said using a synonym - they were in childbirth for twelve hours etc. And one last point I read in sources on pages that Braxton Hicks contractions are not felt by all women. --Iztwoz (talk) 21:17, 9 January 2018 (UTC)

I'm not stating that it's right to use labor and childbirth synonymously. I agree (well, sort of) that they should not be used that way. Above, I was stating that we should be consistent on that. The sources state "nearing labor" or "approaching labor," not "nearing delivery." So I tweaked the section per the sources and per consistency. As for "Braxton Hicks contractions [not being] felt by all women," I argued this above; I stated, "Some sources do note that some women don't feel them. So, yes, in the 'don't feel them' sense, they are not a sign of nearing labor for those women. With this edit, I made it clear that some women never feel Braxton Hicks contractions." However, not feeling them is not the same thing as not having them. I am not aware of any reliable sources stating that some women never have Braxton Hicks contractions. There are sources stating that all women have them, but that some don't feel them. Flyer22 Reborn (talk) 22:20, 9 January 2018 (UTC)

As for the Childbirth article stating "also known as labour and delivery," that is because medical sources use that terminology and "labor" is grouped under "childbirth." I don't think we can have a Labor Wikipedia article (about the body preparing for delivery of a baby) that would not be wholly redundant to the Childbirth article...unless it's a stub. Flyer22 Reborn (talk) 22:53, 9 January 2018 (UTC)

Changed my parentheses wording since so many sources include "delivery" as one of the two aspects of childbirth. Flyer22 Reborn (talk) 00:58, 12 January 2018 (UTC)

Vaginal weightlifting

Regarding this and this, I think that vaginal weightlifting is too WP:Fringe to mention in the article, at least not without noting the criticism regarding it. Flyer22 Reborn (talk) 18:28, 10 January 2018 (UTC)

Moved here with mention of a review disputing one aspect of it. Needs more criticism, but I am not seeing any good sources on the topic. I do not want to add media sources to the Clinical significance section. Also, vaginal weightlifting is a topic I brought to the attention of WP:Med in 2014: Wikipedia talk:WikiProject Medicine/Archive 49#Vaginal weightlifting article. I received no replies on it, but I did receive replies on vaginal tightening/vaginal laxity in 2015: Wikipedia talk:WikiProject Medicine/Archive 61#Vaginal tightening and Vaginal laxity articles.

Doc James, do you think we should mention vaginal weightlifting in the article at all or leave it solely in the See also section, which is where it previously was? Flyer22 Reborn (talk) 18:59, 10 January 2018 (UTC)

Iztwoz, given what I stated above, why did you make this edit? Does the source state that? Everything I see shows vaginal weightlifting to be WP:Fringe and something we should not be suggesting as a health benefit. Just look at its Wikipedia article. I mainly see sources noting that Gwyneth Paltrow has endorsed it, doctors warning against it, and no good sources supporting its use. I have removed the content for now. Suggesting that it is a health benefit is not much better, if any better, than suggesting that vaginal steaming is. Axl, can we get you for a third opinion on this when you're available? Flyer22 Reborn (talk) 16:00, 12 January 2018 (UTC)

Flyer - PMID 23836411 is a Cochrane review noted by the title 'Weighted vaginal cones for urinary incontinence' - and cones are just a part of vaginal weightlifting - they go together - its probable that the pages could be merged. I can only say that their mention is of more relevance than hot flashes.--Iztwoz (talk) 16:32, 12 January 2018 (UTC) Further to this the weightlifting aspect (using cones) is also incorporated into Kegel exercises - lots of refs on searches but nothing citable. --Iztwoz (talk) 16:37, 12 January 2018 (UTC)

I know that it's a review; I stated this above. But I added it per the claims that vaginal weightlifting has significant advantages over Kegel exercises. I also know that cones are one aspect. None of this distracts from the fact that vaginal weightlifting is fringe/poorly supported and we should not be stating that it can help urinary incontinence. As for the Kegel exercise article, it has a "Pelvic toning devices" section, which needs work. It speaks of devices that have been marketed to women. That section is where cones are mentioned. Mentioning a product marketed to women does not mean that the product works. The section does due diligence by stating, "During the latter part of the 20th century, a number of medical and pseudo-medical devices were developed and launched on to the market. Some of these are used in a clinical setting, but most are designed for women to use in the privacy of their own home." The section goes on to state, "Clinical research published in the British Medical Journal compared pelvic floor exercises, vaginal weights and electro-stimulation in a randomised trial. The research recommended that pelvic floor exercise should be the first choice of treatment for genuine stress incontinence because simple exercises proved to be far more effective than electro-stimulation or vaginal cones. This situation was confirmed in a comprehensive review of the treatment of stress incontinence published in the British Journal of Urology International in 2010. The report author noted that electrical stimulation devices and weighted vaginal cones are not recommended by the UK National Institute for Clinical Excellence (NICE) and 'are not universally advocated by clinicians as they have yet to produce sufficient evidence of efficacy'."

Given how fringe and disputed vaginal weightlifting is and that hot flashes are one of the most cited aspects of menopause and have been linked to menstrual issues and many women insert rings, termed vaginal rings, into the vagina to treat hot flashes, I fail to see how mention of vaginal weightlifting is more relevant than hot flashes. As for merging, which articles are you looking to merge? If it's the Kegel exercise article and the Vaginal weightlifting article, I disagree. No need to confuse the topics. The lead of the Vaginal weightlifting article currently states, "Proponents claim that the exercises yield better results than pelvic floor muscle exercises such as Kegels." Flyer22 Reborn (talk) 18:22, 12 January 2018 (UTC)

And the aforementioned review makes it clear that caution should be taken when stating that weighted vaginal cones are beneficial. It's clear that more research is needed before such a statement can be presented as fact. Flyer22 Reborn (talk) 18:36, 12 January 2018 (UTC)

It seems you mean merging the Vaginal weightlifting article and Vaginal cone articles. Yes, those could be validly merged, and the unsourced parts cut. The poorly sourced parts in the Vaginal weightlifting article should also be removed or replaced with better media sources. And, to reiterate, claims by media sources are pretty much all there is supporting vaginal weightlifting. Flyer22 Reborn (talk) 20:20, 12 January 2018 (UTC)

Flyer22 Reborn - Final comments - think there ought to be mention of vaginal cones as the review did review these and conclude that they offered an alternative treatment - if they were of no relevance why would there have been a review? And there are a lot of websites giving info on the use of cones combined with Kegel exercises as Kegel8.--Iztwoz (talk) 08:16, 13 January 2018 (UTC)

Iztwoz, I read the whole source. And the authors are clear that more research is needed before it can be validly stated that use of weighted vaginal cones are a benefit. The review was apparently conducted because of the unsubstantiated claims. It is not unusual for researchers to look into something that does not have much, if any, scientific support. If we are to mention this aspect, we should not state that weighted vaginal cones can help urinary incontinence. We should summarize the conclusion of the review. But, no, I do not think that this fringe aspect needs to be mentioned in the article. And "a lot of websites giving info" are the aforementioned media sources I mentioned. They are poor sources making claims with nothing substantiating those claims. The review is clear about the lack of research. It appears that there are no WP:MEDRS-compliant sources for this material other than the aforementioned review. Flyer22 Reborn (talk) 09:35, 13 January 2018 (UTC)

"Do you think we should mention vaginal weightlifting in the article at all or leave it solely in the See also section? ... I mainly see sources noting that Gwyneth Paltrow has endorsed it, doctors warning against it, and no good sources supporting its use." I think that we should include one or two sentences about it – precisely because celebrities like Gwyneth Paltrow endorse it. We should have a statement that indicates the (absence of) evidence. Axl ¤ [Talk] 10:15, 15 January 2018 (UTC)

Axl, okay. I will add a sentence about the lack of evidence supporting it. Flyer22 Reborn (talk) 16:29, 15 January 2018 (UTC)

Aging

Iztwoz, with this edit, you stated, "mv info on pH to rest in General; changed heading to menopause - aging not really appropriate menopause can start at 40 for example aging usually refers to over 60; women to female - pregnancy can occur in very young girls." And with this edit, you changed "aging" to "menopause."

I reverted. I did so for the following reasons: The "Effects of aging and childbirth" section is not solely about menopause and childbirth. The term aging does not solely refer to people over the age of 60 (see the Aging article); given different sources on aging and all of the anti-aging products that exist for women, I'm not even sure that it mostly does, despite people commonly thinking of elderly people when they state "aging." There is no need to split the aging content. And the "vaginal changes that happen with aging and childbirth include" paragraph is about aging and childbirth, not menopause and childbirth. The source (page 690) clearly states "aging and childbirth." It is speaking of a relationship between aging and childbirth. Menopause has nothing to do with diastasis or disruption of the pubococcygeus muscles caused by poor repair of an episiotomy, and blebs that may protrude beyond the area of the vaginal opening. Well, little if anything to do with all of that anyway. Yeah, menopause can impact the pubococcygeal muscles, and stress urinary incontinence is greater in women going through menopause and in elderly women, and there are sources that state rectoceles are more common among women who have entered menopause, but vaginal birth increases the risk of getting a cystocele or rectocele, and women who have never given birth can get them (this is partly explained by congenital weakness). As noted in the Rectocele article, childbirth is one of the top two causes of a rectocele; the other is a hysterectomy. The vast majority of sources tie rectoceles to childbirth rather than to menopause.

As for changing "the healthy vagina of a woman of child-bearing age" to "the healthy vagina of a post menarche female of child-bearing age," I don't object to that, but we should perhaps follow what the source states, which is "reproductive-aged woman." This source, which is used in the section, states, "The vaginal microbiota of adolescent girls (13-18 years) are comparable to those found in adults, but less is known whether this is also the case for premenarcheal or perimenarcheal girls (Farage and Maibach, 2006)." Also, the term woman can refer to girls. We currently use the terms females, women and girls in the lead of the Teenage pregnancy article. As for girls younger than the teenage years, earlier puberty and precocious puberty are something to consider, but we currently don't state "female" in the Childbirth section; we state "woman." I'll go ahead and rearrange the "Effects of aging and childbirth" section so that the menopause material comes after the other material since there current setup may be confusing. Flyer22 Reborn (talk) 23:42, 11 January 2018 (UTC)

When it comes to aging and childbirth (as in the two being related), the issues concern the fertility topic pondering which age is the best age for a female to have a child and the risks for different ages, and at which ages the pelvic floor muscles are weakest or strongest, and other age-related effects. Girls under 15, for example, have greater difficulty with pregnancy and childbirth because of underdevelopment. The Age and female fertility and Advanced maternal age articles touch on the fertility issues and other issues. For more, look at some of the "childbirth risks by age" sources. If expanding the section to include this material, we could change the heading to "Effects of age and childbirth," "Age and childbirth" or "Age range and childbirth." Right now, "age" doesn't really fit since we are not talking about specific ages, although we mention "pre-pubertal," "women of reproductive age," and "during menopause." We could also simply title the section "Aging" or "Age," but some readers might assume that childbirth material is not in the section, and there is currently age-focused material in the "Infections, safe sex, and disorders" section. So I don't think we should simply go with "Age" (it's too broad since other aspects in the article concern age). Flyer22 Reborn (talk) 00:58, 12 January 2018 (UTC) Flyer22 Reborn (talk) 01:16, 12 January 2018 (UTC)

Flyer - The first sentences of Aging and childbirth, just state without explanation the changes in the pH. These changes are purely related to the menstrual cycles - (not to ageing - and sometimes to infection) their beginning and ending. which is why i think these sentences would be better placed in the General section with the other info on pH with clearer info. For example since a child as young as five years old has been known to conceive, her hormonal and menstrual cycles must have begun - she cannot be spoken of as a woman in normal language use - and her ability to conceive or her vaginal pH cannot be attributed to ageing. ? --Iztwoz (talk) 12:31, 12 January 2018 (UTC)

Pre-pubertal, reproductive age, and menopause are related to age. They all have to do with the aging process -- things that happen to the female body at certain time periods (as they become older). Of course they relate to the menstrual cycle, but this doesn't negate that the female body undergoes these changes at certain age ranges and that vaginal pH is influenced by age. It's why this aforementioned source is speaking of the matter in terms of age and hormones. Sources commonly speak of these changes in terms of age, by explicitly using the word age or aging. Like this 2005 "Microbial Inhabitants of Humans: Their Ecology and Role in Health and Disease" source, from Cambridge University Press, page 214, states, "The pH of the vagina is strongly affected by age and hormone levels." It also states, "There is considerable controversy as to whether the pH of the vagina is dictated primarily by the host or by the indigenous microbiota. Strong evidence in support of the former hypothesis is that the vagina is acidic at birth (a pH of approximately 4.5). despite the fact that it is free of bacteria. This suggests that acids, such as lactic acid produced by metabolism of the glycogen present in the epithelial cells, may be the prime factor governing vaginal pH." This 2009 "Textbook of Aging Skin" source, from Springer Science & Business Media, page 250, titles one of its sections "Vaginal pH with Age" while speaking of menopause. But as other sources show, the term age does not solely concern menopausal women when speaking of age-related vaginal pH changes. This 2010 "Infectious Diseases of the Fetus and Newborn E-Book" source, from Elsevier Health Sciences, page 1052, states, "By 3 to 6 weeks of age, the vaginal pH is no longer acid." This 2014 "Strange and Schafermeyer's Pediatric Emergency Medicine, Fourth Edition" source, from McGraw Hill Professional, page 567, states, "There is a high degree of variability in timing of these changes among children. The vaginal pH during this time is alkaline. Older school-age children (ages 7–12): The labia continue to develop and the hymen thickens, while the vagina elongates to about 8 cm. The vaginal mucosa thickens and the vaginal pH becomes acidic. A thin white vaginal discharge (physiologic leucorrhea) may be noted. Adolescents (ages 12–21): The labia are well developed and the hymen is thick."

As for "a child as young as five years old has been known to conceive," you must be speaking of Lina Medina. I've researched her case and have worked on her Wikipedia article. She is the only case of a girl going through puberty and being able to conceive that young. And the only reason she was able to is because of extreme precocious puberty, which is abnormal. As one can see by looking at the List of youngest birth mothers article, there are not many girls aged 8 and younger on that list. See the Precocious puberty article and the reason that girls may enter puberty early or earlier than normal. If beginning to menstruate had nothing to do with age, it would be common for girls of any age to be pubertal. As it is, we know the typical ages that girls enter puberty and the typical ages that women enter menopause. Menarche and puberty obviously concern aging. Menopause obviously concerns aging. Flyer22 Reborn (talk) 17:45, 12 January 2018 (UTC)

Flyer22 Reborn - Final comments - As earlier reply in menopause section - think there is no need to refer to ageing to relate to these normal stages of human development, which as you say above have wide margins of onset. The five year old child, as the other children on the list of young mothers, had been a victim of rape as would all of the other youngest mothers so this would leave a significant number of young children who are precociously pubertal, that would be undocumented. to exclude them by referring to pH in terms of women of reproductive years is not right.--Iztwoz 08:38, 13 January 2018 (UTC)

Iztwoz, per my arguments and sources I've included, I don't quite understand your points on this matter. And I would state more, but I really don't know what else to state on the matter...except that when sources are speaking of vaginal changes in relation to age and pH, they are not negating rape victims and young girls who have entered precocious puberty. There is no indication that rape caused Medina to go through early puberty. Stated more in the #Menopause section above. Flyer22 Reborn (talk) 09:35, 13 January 2018 (UTC)

Who suggested that rape caused the child's puberty ? All I have been trying to say is that hormonal changes cause pH changes not age.--Iztwoz (talk) 10:06, 13 January 2018 (UTC)

Your following comment is not clear to me: "The five year old child, as the other children on the list of young mothers, had been a victim of rape as would all of the other youngest mothers so this would leave a significant number of young children who are precociously pubertal, that would be undocumented. to exclude them by referring to pH in terms of women of reproductive years is not right." As for age/pH, I've disagreed per above. Flyer22 Reborn (talk) 10:19, 13 January 2018 (UTC)

And it is the sources that state "pH of a healthy woman of child-bearing age"; it does not seem that any of the sources are talking about girls who have entered early puberty when stating that. Indeed, this source I listed above states, "The vaginal microbiota of adolescent girls (13-18 years) are comparable to those found in adults, but less is known whether this is also the case for premenarcheal or perimenarcheal girls (Farage and Maibach, 2006)." If the sources are not speaking of girls younger than the teenage years by stating "pH of a healthy woman of child-bearing age" (and it's clear that they are not), we shouldn't either. Flyer22 Reborn (talk) 10:29, 13 January 2018 (UTC)

For "child-bearing" or "reproductive" age, it is simple enough to state "adolescents aged 13 to 18 and adults," but the sources usually state "women" and "adults." Flyer22 Reborn (talk) 10:34, 13 January 2018 (UTC)

Moved the menopause content back up, as noted in the #Menopause section above. Flyer22 Reborn (talk) 21:52, 13 January 2018 (UTC)

Altered the section with sources listed above. Flyer22 Reborn (talk) 07:14, 14 January 2018 (UTC)

Moving toward WP:GA again

Barbara (WVS) and others, I've consulted two editors about reviewing this article for WP:GA. One of the editors is SilkTork, since we've worked together on bringing articles to GA before...and because we worked well together both times. But because SilkTork may be too busy to review, I also consulted another editor. The other editor brought up the question of stability and wanting to know if most editing of the article is done. I feel that the article is mostly stable with minor disagreements here and there and that it's mostly complete. I'm not seeing that it needs to be expanded with much more, and Tom (LT) has repeatedly stated that the article looks good. I suggested to both reviewers that they have a look at the article talk page for things that have been discussed, including minor issues. User:Barbara (WVS)/fistulas was brought up. Judging by Barbara using the vauthors style in her draft, it's clear that she is looking to add this content to the article. My opinion on that is this: It should be downsized to one or two paragraphs for this article. It's too in-depth. There's no valid reason that that these disorders should be given so much more weight than some other vaginal issues, which may be more serious. Per the Urinary fistula article (officially titled Obstetric fistula) and the Rectovaginal fistula article (which is relatively small and could use expansion) existing, and per WP:summary style, only a paragraph or two on these matters needs to be included here in the Vagina article. The rest should go in the main articles on the topics. Flyer22 Reborn (talk) 01:00, 13 January 2018 (UTC)

I'll be glad to pare down the fistula information, but obstetric fistula is really a title related to the cause of urinary and gastrointestinal fistulas in developing countries. Fistulas in developed countries have little or nothing to do with childbirth or labor but are caused by other things. The types of fistulas are not really covered in WP or are articles that are generally lacking or stub-ish. The impact of fistulas is pretty great, as indicated by the references and according to WHO.

One major omission at this point are vaginal anomalies, an important part of many anatomy articles. The coverage of the supportive structures are not well described. There is no reason to cover all aspects of clinical conditions or diseases of the vagina, but there are a lot. Also missing is mention of the different types of vaginal cancer and Vaginal intraepithelial neoplasia. All this can be added-in summary style. I will help out as best as I can. Best Regards, Barbara (WVS) ✐  ✉ 01:42, 13 January 2018 (UTC)

Barbara (WVS), make sure to pare it down to one or two paragraphs. Also, if you go with two, make sure that the paragraphs are not big. If I think that too much has been added, I will pare it down. I'm discussing matters such as these to keep the article stable and to prevent edit warring. I'm not denying that fistula material is important, but there really is no need for so much fistula material in this article, not when there are a number of vaginal problems and when we have main articles for these topics. There is a bit of vaginal anomalies material in the "Infections, safe sex, and disorders" section. More can be added on to that paragraph, but not a lot more is needed. And we do mention congenital conditions in the "Modification" section. I do not see that we need to state much more about vaginal cancer. There is a hefty paragraph devoted to vaginal cancer. Yes, it mentions cervical cancer as well, but, as noted before, cervical cancer is related. Unless briefly mentioning the different types, all the different types of vaginal cancer should be confined to the Vaginal cancer article. That article doesn't even currently have a lot of material on types of vaginal cancers, which again speaks to what I've stated before about expanding the main article first. Also remember that vaginal cancer is very rare, which adds to my point about not adding a lot more (if anything else) about it. You stated, "The coverage of the supportive structures are not well described." What are you referring to? Flyer22 Reborn (talk) 01:57, 13 January 2018 (UTC) Flyer22 Reborn (talk) 02:35, 13 January 2018 (UTC)

Since Barbara (WVS) has requested deletion of the aforementioned page, I have included the content below for others to assess since it concerns this article and shows one of the matters currently being discussed. Flyer22 Reborn (talk) 03:44, 13 January 2018‎ (UTC)

Barbara (WVS)'s fistula material

The involuntary passage of air through the vagina (vaginal wind) affects some women. The air has been trapped in the vagina through sexual activity, exercise or postural changes. Since it is audible, it can result in the avoidance of sexual activities, generate shame and social isolation that can lead to a decreased quality of life. Urinary fistulas Abnormal passageways or fistulas can exist between the vagina and bladder, ureters, uterus and rectum with the resulting passage of urine or feces from the vagina. These vaginal fistulas are named according to the origin of the defect: vesicovaginal, urethrovaginal, ureterovaginal, vesicocervical, and vesicouterine fistulae. The vagina is susceptible to fistula formation because the gastrointestical tract and urinary system are relatively close to the vagina. A small number of vaginal fistulas are congential. The presence of a vaginal fistula has a profound effect on the quality of life since there is little control over the passage of urine and feces through the vagina. Globally, 75% of urogenital fistulas are related to obstructed labor. The average age of a woman who develops a fistula due to prolonged labor is 28 years-old. The average age of a women who develops a fistula from other causes is 42 years-old. Women with a small pelvis are more likely to develope a fistula. In developed countries the causes are iatrogenic (caused by surgical accidents). Surgical accidents or iatrogenic injuries to pelvic organs are a cause of fistulas. Fistulas can form after long-term pessary use, hysterectomies, malignant disease and pelvic irradiation, pelvic surgery, cancer or pelvic fracture. Fistulas are sometimes found after a cesarean section. Providers can also inadvertently cause a fistula when performing obstetric or gynecological surgery. The more training the physician has had, the less likely a uro-vaginal fistula will occur. Some women develop more than one fistula. Though rare, a fistula can form after the minimally invasive oocyte retrieval part of infertility treatment. Surgery is often needed to correct a fistula leading to the vagina, though conservative treatment with an in-dwelling catheter can be effective for small and recently formed urinary fistulas. Collagen plugs are used but have been found not to be successful. The different surgical approaches to correcting the fistula is surgery through the vagina and has a success rate of 90%. Other treatment uses abdominal surgery by laparoscopic and robot-assisted laparoscopic surgery. Rectovaginal fistulas Abnormal passage of stool through the vagina is caused by a rectovaginal fistula. Treatment is often surgical with the use of tissue grafts. The presence of bowel disease increases the risk of a rectovaginal fistula. An entero-vaginal fistula can form between the bowel and the vagina. Rectovaginal fistulae result from inflammatory bowel disease, Chrohn's disease trauma, or iatrogenic injury. Major causes are obstructed labor and iatrogenic injuries including episiotomies. After surgery establishing a ileo-anal pouch,a fistula can form leading to the vagina up to ten years after the surgery. Pelvic sepsis can lead to the formation of a fistula leading to the vagina. Ano-vaginal fistulas can lead to candidiasis, recurrent vaginitis and irritation to the vulva.  ___ References

Also, Barbara (WVS), regarding your new draft, I ask that you use WP:Prose-style. Prose is preferred to bullet-point style. While some medical articles include bullet-point style, I do not see that it is needed for any aspect of this article. I know you like that style, but I certainly don't prefer it. Flyer22 Reborn (talk) 06:39, 13 January 2018 (UTC)

• I've looked it over, and while I think there is still work to be done and questions to be asked, the article is sufficiently advanced to be ready for what is likely to be a fairly lengthy review. Flyer and I have worked together before, and she knows I am a fairly exacting reviewer, so by asking me to do a review she is not going for a quick and easy pass! This is a large, complex, controversial, and very popular topic, so due consideration and care will need to be taken throughout. There will be points of contention, but as long as all people involved are willing to be patient and understanding, and to respond neutrally to concerns raised, then we can get through this with minimal pain. As another reviewer has been approached, I am quite happy to do a dual review. I have done this before on significant topics, as with Catholic Church: Talk:Catholic Church/GA1. SilkTork (talk) 08:22, 13 January 2018 (UTC)

Thank you for being willing to take this on, SilkTork. The other reviewer stated that he was thinking of reviewing if you decided not to. And I did make it clear that you are my top choice. So you'll be the only reviewer from what I can see. And you're right: Part of the reason I asked you is because of your thorough methods. I never would look for an easy pass on a topic such as this. When do you think we should begin? After Barbara (WVS)'s latest text is added? Flyer22 Reborn (talk) 09:35, 13 January 2018 (UTC)

I am comfortable starting any time you wish. I have no problem with significant text being added or removed during the review as long as it's part of the legitimate process. I would only have a concern if there was edit warring over such text. So if it was decided to add the text, then people agreed it didn't work that way, and it was removed that wouldn't be a problem. It will take me a while to read around the subject to see if there are areas that need attention anyway, so even if the review started today I doubt if I'd be making any significant contributions for a week or two, beyond obvious comments about use of images and layout, etc. SilkTork (talk) 11:21, 13 January 2018 (UTC)

SilkTork, okay. I know that you will ask me for clarifications on things if you need to. What I like about us working together is that you really do throw yourself into the research and you don't expect me to simply go along with every suggestion you make. We discuss it, work it out and move on, sometimes compromising. Anyway, as for the article setup, you might want to see Talk:Vagina/Archive 9#Edits (and higher up in that archive). Well, I think you should since there are different arguments there about what is the best setup for the article. We kept WP:MEDMOS#Anatomy in mind, but we also didn't follow it exactly since WP:MEDSECTIONS states, "The following lists of suggested sections are intended to help structure a new article or when an existing article requires a substantial rewrite. Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition." And I know that you might want all of the modifications material together, but my rationale for the split is at #Format above. Still thinking of different titles for both sections, and whether to have the FGM material covered solely in the Society and culture section, like the Vulva article currently does. Either way, I am open to suggestions you might make.

I will wait for the content that Barbara (WVS) is working on at User:Barbara (WVS)/sandbox II/ fistulas and anomalies since, per what I stated above, I might object if I think it's too much material for the Vagina article and that some of it should instead go into the main articles on the topics (for those that have main articles). Flyer22 Reborn (talk) 16:53, 13 January 2018 (UTC)

I am unconvinced that this level of detail should be included in Wikipedia's general "Vagina" article. Rather, it should be a separate spin-out article "Vaginal fistula", which currently redirects to "Obstetric fistula". Axl ¤ [Talk] 10:25, 15 January 2018 (UTC)

axl, I'm glad you just explained the quandary here because I couldn't decide how to handle this. I was going to do what you suggest, and it is on my 'to-do' list but yes, obstetric fistula is only one type of urogenital fistula that affect the vagina. Fistulas are a very notable topic since they occur in thousands if not hundreds of thousands of women globally and has a majorif not devestating impact on the lives of women. I am hesitating to create spin-offs because it irritates other editors. I've been encouraged to stop creating spin-offs and stubs. The number of spin-offs needed to reduce the detail is massive. So the problem is that the information in the proposed content addition does not yet exist on WP. This puts us in a position of witholding?? information that would make this article more comprehensive. I'm going to try to pare down the information and will repost the proposed content elswhere since this talk page is getting massive. I will leave a message on other editor's talk pages to solicit input on the proposed draft. What appears as my proposed draft on this talk page has changed since its posting and so might need to be discarded. You have no idea how glad I am to have you address this. Best Regards, Barbara (WVS) ✐  ✉ 21:21, 15 January 2018 (UTC)

If you mean that I have told you not to create spin-offs, that is not true. Instead, I have discouraged you from unnecessarily creating spin-offs, per WP:No page, WP:Spinout and WP:No split. You still create them anyway, though. As for leaving messages on editors' talk pages, do see more of what I stated in the #Contacting other editors section below. You should not be randomly going around contacting editors, especially in the hopes of pulling in outside editors. All you need to do is post a section on this talk page pointing to your draft like you did before. The talk page being big doesn't make it so that the latest section will be overlooked. And we can obviously archive old and finished discussions. We can also cease creating a section for every new dispute and simply have a "Latest edits" section, which can have subsections when needed. As for your latest draft, I not only pointed to the previous draft and listed it here, I pointed to User:Barbara (WVS)/sandbox II/ fistulas and anomalies, which is where you are currently working on the material. Flyer22 Reborn (talk) 22:14, 15 January 2018 (UTC)

• I don't wish to get engaged in discussions regarding content before the review starts, otherwise it becomes a slippery slope toward becoming involved; I will say that amount of detail is covered in a GA review under 3b: "it stays focused on the topic without going into unnecessary detail (see summary style).". I would expect, under 3a: "it addresses the main aspects of the topic", that common problems would be mentioned, with some detail on particularly noteworthy problems that a general reader may expect some detail on - the amount of detail to be determined by considering evidence of levels of interest, and how much reliable sources cover the problem. If obstetric/vaginal fistula is a common problem with a high level of interest, and is mentioned by a number of reliable sources, then it could be argued that a paragraph might be needed - though I would question it if more than the opening paragraph of Obstetric fistula were used, which seems to sum up as much as a general reader would require. I would say that it would be likely that a debate in a GA review would be if a single sentence or a paragraph would be sufficient for mention of the fistula. I haven't looked into Barbara's sandbox to see how much is being suggested because, as I say, I don't wish to get drawn in at this stage. But if it is significantly more than a paragraph, then it is likely that I would question the amount of detail during the GA review, particularly as we already have an article on the topic. SilkTork (talk) 12:18, 15 January 2018 (UTC)

Thank you, Axl and SilkTork. Flyer22 Reborn (talk) 16:29, 15 January 2018 (UTC)

With this edit, I created an "Anomalies and other health issues" section, where Barbara (WVS)'s content can go. Of course, this still does not mean that too much should be added to the section. Flyer22 Reborn (talk) 20:09, 15 January 2018 (UTC)

Thank you for the feedback. I helps me focus on making the appropriate content additions. It is frustrating to come upon a notable topic related to this article and find that an separate article does not yet exist that could contain more detailed information. I have 18 references related to the all the fistulas that exist between the vagina and other organs and the sources indicate that these complications are quite common after hysterectomy - up to 30%. I even left that out of my draft. I certainly don't mind reminders and suggestions before the review begins and I appreciate the oversight. Thank you. Best Regards, Barbara (WVS) ✐  ✉ 21:21, 15 January 2018 (UTC)

"Fistulas are a very notable topic since they occur in thousands if not hundreds of thousands of women globally and has a majorif not devestating impact on the lives of women." I agree! I want to see that information in a separate spin-out article.

"I am hesitating to create spin-offs because it irritates other editors. I've been encouraged to stop creating spin-offs and stubs." Hmm, that's unfortunate. Nevertheless, in this case I think we have a very good case for creating/expanding a spin-out article. May I suggest that you go ahead and add/create this information to the relevant article. If you receive complaints from other editors, please start a discussion on that talk page and let us know here. Axl ¤ [Talk] 17:43, 16 January 2018 (UTC)

The lead paragraph

I've been trying to locate a source for this for most of the morning:

"The vagina has been studied in humans more than it has been in other animals. Its location and structure varies among species, and may vary in size within the same species."

Best Regards, Barbara (WVS) ✐  ✉ 14:18, 13 January 2018 (UTC)

Barbara (WVS), this is a fact as a simple Google search shows. I do not think that WP:Sky is blue matters need to be sourced, but I will look to source it. The source will not go in the lead, however, since the lead has been without sources for everything else. Per WP:CITELEAD, we can have citations in the lead or not. Flyer22 Reborn (talk) 00:07, 14 January 2018 (UTC)

And when it comes to Talk:Vagina/Archive 9#In preparation for GA status, that is an old discussion that resulted in the editors (me included) working things out and moving on. In the #Moving toward WP:GA again section above, I pointed to the latter Talk:Vagina/Archive 9#Edits aspect of that matter (meaning the last section that ended with editors working together and resolving issues). I pointed to this for SilkTork to review, and suggested that he also look at the discussions above that latter discussion, so that he could see what has already been discussed and how the article ended up in its current format. Flyer22 Reborn (talk) 00:22, 14 January 2018 (UTC)

I don't mind sources being in the lead or not being in the lead. I only noticed when I read the rest of article for information on the lead content on animals I couldn't find it. There weren't any sources for the statement about animals. We can tally up all the sources about animals and humans that we want but to do this would be inserting our research (counting) into the article. A source needs to state the vagina size varies between animals of the same species. Another source needs to state that there are more studies on humans than animals - which might not be true after my reading veterinary journals and texts. Our count doesn't even matter. We don't even have to prove this one way or another since a source doesn't exist that states this. I am reading up on the history and found the statement and since I concurred, I removed the content until it can be referenced. Thanks for discussing it with me. I appreciate your insight and knowledge about past discussions. Best Regards, Barbara (WVS) ✐  ✉ 00:48, 14 January 2018 (UTC)

Barbara (WVS), if you haven't taken the time to read WP:Sky is blue, what that page states is what I mean. I am not talking about WP:Original research. There are sources that have noted that there is little research on non-human vaginal anatomy. The most that is perhaps out there is research on rats, since rats are commonly used as a reference to better understand human anatomy. The male reproductive system and female reproductive system literature mostly concerns humans, which is why those articles only cover humans at present. But like I stated, I will look for a source on the aforementioned matter. Flyer22 Reborn (talk) 01:01, 14 January 2018 (UTC)

I'm looking too, but the sky may not be blue. I put in a couple of searches with "(animal name)" and vagina and got hundreds of thousands of hits. It is an excellent question, btw and I am really curious now. Best Regards, Barbara (WVS) ✐  ✉ 01:07, 14 January 2018 (UTC)

Barbara (WVS), compare all of the detail that is in this article to non-human vaginal material. There simply is not as much material on other animals. For years, I've been through the research back and forth. And, yes, I am speaking of journal sources as well, not just scholarly book sources. If the study of the vagina was as popular with regard to non-human animals, the research would on the vagina would not be so human-centered. Flyer22 Reborn (talk) 01:22, 14 January 2018 (UTC)

The "Its location and structure varies among species, and may vary in size within the same species" text is very WP:Sky is blue. We have sources in the "Other animals" section speaking of different structures and locations. The spotted hyena is obviously a unique case. But, anyway, I will look for sources for that piece as well. In the meantime, I expanded the section with comparison information. More on that or simply on other animals can obviously be added to the section. It can obviously have subsections. Flyer22 Reborn (talk) 03:06, 14 January 2018 (UTC)

In addition to the "Other animals" section being clear that the vagina and vagina-like structures vary among species, which means that we are simply summarizing this in the lead, this 2008 "Comparative Reproductive Biology" source, from John Wiley & Sons (page 15), that you added makes it clear that vaginal structures are not the same within all species; it states, "The vagina is a unique canal located between the cervix and the external urethral orifice, or the hymen. The fornix, ventral and dorsal walls, hymen, vaginal opening into the vestibule, and, in some species, the remnant of the caudal part of the mesonephric duct are the structures of the vagina. The fornix is the most cranial extent of the vagina, looking like a blind pouch that the surrounds vaginal part of the cervix. In some species the fornix is discontinuous due to the presence of dorsal and/or ventral frenula (singular, frenulum) of the cervix." But I do not see where the source states "Cows have many of the same vaginal structures as humans." A Google search does not pull up a match either. Flyer22 Reborn (talk) 05:10, 14 January 2018 (UTC)

I've read all of the above text and links and diffs and still have not found any indication that the vagina "may vary in size within the same species". This is not 'sky is blue'. And if it were 'sky is blue' there would be a plethora of references that would be so numerous I would have to admit my error. The only return for the above phrase are mirrors of this article - which means the phrase has existed in the article for a while. I will recheck the 'cow' reference and delete it if it is not appropriately sourced. This may be something that can be addressed in the GA review. Best Regards, Barbara (WVS) ✐  ✉ 08:37, 15 January 2018 (UTC)

Barbara (WVS), not all "sky is blue" matters are stated in sources. Some things are so apparent that sources do not bother to cover them. I don't see sources specifically stating that humans and spotted hyenas have a different vaginal size and structure (although some do state "in contrast to other female mammals" or similar), but this is obviously a fact. We have a Human vaginal size article. The vagina varies in size in humans (although there is not much variation). This 2010 "Contraceptive Choices and Realities: Proceedings of the 5th Congress of the European Society of Contraception" source, from CRC Press, page 174, states, "The length and elasticity of the vagina also varies from woman to woman, and even varies in the same woman, relative to pregnancy and delivery history." This 2007 "Anatomy and Physiology" source, from Rex Bookstore, page 802, states, "The vagina has an average length of 7.5-9 cm (3-3.5 in.) but is highly distensible, so its size varies." And we know that the vaginal opening varies among women. Do you think the vagina, including the vaginal opening, does not vary in size in other animals as well, even though there are sources that talk about the average length of the vagina for whatever species is being discussed? Why state "average" if all vaginas within a species are the same size?

Regardless, it is more than clear that the location and structure of the vagina varies among species. The "Other animals" section shows this for everyone to see. Humans do not have the same vaginal location and structure as all other animals. And other animals do not have the same vaginal location and structure as every other animal. I will remove the "The vagina has been studied in humans more than it has been in other animals." piece since I do not yet have a source for it, although I did have sources for it years ago when working on the Clitoris article. And, no, I was not confusing the sources. But I will be retaining the "Its location and structure varies among species" piece since that is very WP:Sky is blue and is merely a summary of what is clear in the "Other animals" section. Flyer22 Reborn (talk) 16:29, 15 January 2018 (UTC)

Wait, I think I know what is going on. Should the phrase be "varies between species" instead of "varies among species". Those phrases mean different things and yes, the 'between' version is the sky color. I see where you are coming from. Better: "varies in structure between species"? Best Regards, Barbara (WVS) ✐  ✉ 20:51, 15 January 2018 (UTC)

Both "varies among species" and "within the same species" are in the lead. The line is currently: "The vagina's location and structure varies among species, and may vary in size within the same species." This is true per what I stated above. Not all women have the same size vagina. Not all non-human animals within a species have the same size vagina. The vagina is not the same in structure and location for all species. Flyer22 Reborn (talk) 22:14, 15 January 2018 (UTC)

Then I still do not concur with the phrase "...within the same species...". I've looked for days and can not find any references for this phrase. If 'sky is blue' were true for the above phrase, then the returns would be massive. (BTW, for the fun of it, I did do a search for the 'sky is blue' and was overwhelmed with the number of references). And the word 'among' does not mean the same as the word 'between'. Did you know that WP:SKYISBLUE is not a policy or gudeline? Also, read the talk page and see that there may be no consensus for this. WP:CK is a pretty good essay, too. Since this specific discussion about this specific phrase takes up enough talk page space to qualify as 'controversial', the engagement of other editors will be welcome. Even if other editors don't address this uncited factoid, it may come up in the GA review. Best Regards, Barbara (WVS) ✐  ✉ 12:43, 16 January 2018 (UTC)

Why do you think we need a reference for the exact phrase when humans are a species and when the vaginal size varies within the human species, and when sources are clear that the vagina varies in size within other species by talking about what the average vaginal size is within certain species and by sometimes noting differences in genitalia between females of those species? Why do you think humans are the only exception? Why do you think a difference in vaginal size is not also the case for non-human primates, whose DNA is so close to human DNA? As for the rest, I've already been over your "then the returns would be massive" argument. There are not massive returns for the vagina varying in size among women either. As for "between," I certainly know that "among" does not mean the same thing as "between." I never even used "between" above. But the fact is that if vaginal size varies between individual women, then, yes, it varies among women. It's not as though the vagina varies between two women and that's it. And we shouldn't imply in the lead that vaginal size is always the same. And as grammar guides note, "between" is not always restricted to "two" anyway. And the vagina varying in size is not a factoid. And considering how long and how extensively I have been editing Wikipedia, I obviously know that WP:SKYISBLUE is not a policy or guideline, but is rather an information page. The same as WP:CK. I am, after all, one of the editors who work on our policies and guidelines while you have stated that you are often ignorant to them and Wikipedia procedures. Either way, I won't be agreeing with you on this matter. But I did change "and may vary in size within the same species" to "and may vary in size." And, no, per what I stated above, I do not think we should limit "vary in size" to humans. Flyer22 Reborn (talk) 16:44, 16 January 2018 (UTC)

Also changed "may" to "can." Flyer22 Reborn (talk) 23:01, 16 January 2018 (UTC)

Uterine prolapse

Barbara (WVS), regarding this, yes, you added the sentence and I added the uterine prolapse link. I added that link because pelvic organ prolapse is descent of pelvic organs from their normal positions. Yet you removed the link and added the following wording: "The uterus can also leave its normal position and sometimes even extend past the hymen." That is uterine prolapse. I am not sure how you are distinguishing matters. Flyer22 Reborn (talk) 15:37, 13 January 2018 (UTC)

Asymptomatic uterine prolapse often does not extend beyond the hymen. The sentence I edited clarified the symptom of uterine prolapse as not always extending beyond the hymen. I guess a plain English defintion might be: just because everything lets loose doesn't mean it all starts to fall out. Best Regards, Barbara (WVS) ✐  ✉ 15:44, 13 January 2018 (UTC)

Barbara (WVS), I see that you added back the link. My point is that whether or not the uterus extends past the hymen, it is uterine prolapse if the uterus leaves its normal position. Anyway, the link is fine.

As for your additional edits, I reiterate that I am trying to keep the article stable for GA. I don't think that any of us should make edits that might be contested, at least not without discussion. But small additions, like the ones you made to the Other animals section, are okay. Also, there is no need for an extra reference if a source is already covered by a decent source...unless the content is contentious. Flyer22 Reborn (talk) 16:00, 13 January 2018 (UTC)

As for my additional edits, I would like to also highlight all the instances where I ask for congenial, amicable collaboration to improve the article to make it the best it can be and pass the GA Review. We already have the instructions that the addition of content is appropriate during the review process. I don't contest your edits. The reference you removed is the only reference that supported the content you deleted. I trust that you will move both to the aging section as you prefer. It shouldn't be controversial. Best Regards, Barbara (WVS) ✐  ✉ 16:19, 13 January 2018 (UTC)

Barbara (WVS), SilkTork also stated above, "I would only have a concern if there was edit warring over such text." This talk page documents that we often do not agree, even on copyedits you make, which sometimes change the meaning of things or cut too much. As for significant additions, this talk page shows a third opinion where the third voice made it clear that it's best that we discuss significant additions. Its why the #For review section was a good idea, and why me taking the time to address your draft in the GA section above was a good idea. Flyer22 Reborn (talk) 16:27, 13 January 2018 (UTC)

• As I will be working closely with both of you, I just clicked on your account page Barbara (WVS). Are you editing this article in your capacity as Visiting Scholar with the University of Pittsburgh? If so, does that mean you are editing this article based on sources which are only available in the University of Pittsburgh? SilkTork (talk) 18:42, 13 January 2018 (UTC)

From what I've seen, Barbara (WVS)'s been using sources that are not only available in the University of Pittsburgh. I'd need to check closer to see if any are restricted in that sense. Jytdog has expressed concern about her using or relying on those sources. Flyer22 Reborn (talk) 19:01, 13 January 2018 (UTC) Flyer22 Reborn (talk) 19:07, 13 January 2018 (UTC)

If the sources are generally available, that's fine. If Barbara is simply using the University of Pittsburgh library in the same manner as a student, and wishes to acknowledge the non-student access she has been given via her (WVS) tag, that is also fine. I just want to have it clarified that no unpublished material, such as research papers, are being used. SilkTork (talk) 19:28, 13 January 2018 (UTC)

The answer is somewhat long, and I apologize. The University of Pittsburgh continues to allow me access to their databases and subscription-based content. I have not been assigned specific women's health articles but was told that they are very happy that I've been able to create and improve content related to these topics. I also create and cite content in other medical articles. I also own medical textbooks that I purchased myself to help source content that I add and references to content that already exists. In this article, I've used the D'amico reference to support the section on vaginal health and pelvic exams. I bought that book as required for my nursing classes. I have purchased other medical textbooks (8+) for the class. The University of Pittsburgh does not have digital access to most of the textbooks that I have been using, well none really, so it is good that I have these books to use. If I have a book for a source, I use it. I also go to the library to use books there and have been able to use the Pitt medical school library (which is open to the public). I have access to subscription-based content and sources through the nursing school which is not part of the University of Pittsburgh. I have access to subscription-based content through our county library system. If I search the databases through the University of Pittsburgh Library System to find a journal article or a specialized text that I don't own, I will cite it to support content that I add. At this point in the process, I don't go into other search engines to determine whether or not other editors have access to the same journal articles. If I know about the source existing 'free' somewhere else, then I add the url to the free source. I have also posted to the project Medicine talk page and offered to obtain subscription-based content for other editors. For medical topics, I don't use unpublished materials or research papers. I have used unpublished sources for historical articles (dissertations). I used to add a tag to citations to indicate that they were behind a paywall, but was asked by other editors to stop doing that. I stopped. I am always happy to see that a source that I accessed through the University of Pittsburgh is also available without charge from another source. I don't rely on sources behind the paywall but use them when appropriate. I've made a handful of errors regarding the use of primary sources and then the opposite-deleting sources that are not primary sources by mistake (these instances are on my talk page). Thanks for asking. I've never been asked to explain the access I have through the three libraries that I use so I hope it helps.

Best Regards, Barbara (WVS) ✐  ✉ 20:04, 13 January 2018 (UTC)

Thanks for clarifying that. My understanding from the above is that the University of Pittsburgh has little to no role in your involvement in this article, and your use of the (WVS) tagged account on this article is more for personal reasons than to indicate sourcing. Personally I'm OK with you using either of your accounts to edit the article, though it makes more sense to keep using the (WVS) account only, as you appear to have done so far, in order to aid record keeping. SilkTork (talk) 23:42, 13 January 2018 (UTC)

You are correct about the record keeping. The University likes to follow my edits as does WikiEd. My other user name is Bfpage. I try to use that one for administrative purposes like new page patrolling and such. Best Regards, Barbara (WVS) ✐  ✉ 23:48, 13 January 2018 (UTC)

Left field

I didn't know where this factoid should go so anyone can insert it anywhere they like. It was contained in the D'amico source and that ref can be used to support it. Here it is: "The vagina appears bluish during pregnancy". Best Regards, Barbara (WVS) ✐  ✉ 23:53, 13 January 2018 (UTC)

Article focus

I'd prefer to keep my questions and observations for when the review starts. However, this question will need to be addressed before we start as it may have a significant impact on the article. Is the focus on this article to be on the vagina in all mammals or just the human? The clitoris article dealt with that organ in all relevant animals, and I think that was helpful. The penis article deals with all animals, with a separate article for the human penis, and that seems to work. I have no opinion at this moment on which approach is more appropriate for the vagina, though if it is to remain as an article on the vagina in all mammals (and is it just mammals that have a vagina - is the mullerian duct in some fish, such as sharks and guppies, though which they give live birth, not counted as a vagina?), then it might need a little refocus with the language, as a casual read though seems to suggest the main focus is human. The Structure section, for example, appears to be entirely human focused. Is the structure of the human vagina different from or similar to the vagina in other mammals/animals? SilkTork (talk) 00:14, 14 January 2018 (UTC)

SilkTork, this goes back to what is stated at Talk:Vagina/Archive 9#In preparation for GA status. In that discussion, I relayed the following: There is far more information on the human vagina than there is on the vagina in other animals. In some of these animals, the organ is not even called a vagina...but is simply compared to one. A simple Google search reveals this. And, as seen at Talk:Vagina/Archive 5#Human-centric, it is for this very reason that we don't have a separate article for the vagina in other animals. All we would have for such an article is pretty much what you see in the 'Other animals' section of the article, which would make splitting off the material unnecessary. In cases such as these, we follow WP:MEDMOS#Anatomy and simply have an 'Other animals' section. The [lead sentence on this] makes it clear to readers early on why the article is mostly about humans."

Remember, this is also done with the Clitoris article because the clitoris is not as extensively studied in non-human animals as it is in humans. That article is mostly about humans as well. We also have an "Other animals" section in that article. As Tom (LT) can attest to, this is the standard way we set up anatomy topics when research on the topic mostly concerns humans. Including non-human animal material in the Function section, for example, would be confusing. Flyer22 Reborn (talk) 00:30, 14 January 2018 (UTC)

I have no preference. The article would be better if the content about animals in the lead paragraph were sourced somewhere, but not necessarily in the first paragraph. Best Regards, Barbara (WVS) ✐  ✉ 08:56, 15 January 2018 (UTC)

Stated more on this at #The lead paragraph above. Flyer22 Reborn (talk) 03:06, 14 January 2018 (UTC)

Reference 98

Are you sure this should be a reference? The content it supports is already referenced and this is not a medical textbook. Best Regards, Barbara (WVS) ✐  ✉ 08:52, 15 January 2018 (UTC)

The content in that section (Pelvic examinations) came from your draft (with the exception of the United States and "other countries" part I added from the lead of the Pap test article). But we obviously do not need that reference. Flyer22 Reborn (talk) 16:29, 15 January 2018 (UTC) Flyer22 Reborn (talk) 16:57, 15 January 2018 (UTC)

Using a heading in the edit summary that is different than the section that is actually being edited

Barbara (WVS), as seen here and here, you sometimes (well, more than sometimes) edit a section that is different than what your edit summary shows. Although you may not be doing this on purpose, it is misleading. Flyer22 Reborn (talk) 16:29, 15 January 2018 (UTC)

I noticed that recently myself and it seems to be a quirk of the Visual Editor interface. I have no intention to mislead anyone. I don't know if you use Visual Editor or not but it can be opened up by clicking anywhere on the page and it allows you to edit anywhere on a page. That means if I click on the microanatomy 'edit' word, I am able to edit anywhere in the article. It shouldn't be misleading. I have no intention of misleading anyone. Best Regards, Barbara (WVS) ✐  ✉ 20:44, 15 January 2018 (UTC)

Contacting other editors

I also see here, here, here and here that Barbara (WVS) contacted others to weigh on. First, the article is not yet under GA review. Second, I can understand why the first three editors were contacted since they have been involved with the article before. But the last editor (Megalibrarygirl) has never been involved with this article. And so I point Barbara (WVS) to WP:Canvassing. Third, GA reviews are often between two editors (the GA reviewer and the editor who sought the GA review/nominated the article for GA), or three editors. It is not like WP:FA, where there are always multiple editors involved. Axl was already watching the article; so I do not see why he needed to be personally contacted. It is likely that ArnoldReinhold was already watching the article as well, since he weighed in the last time I queried taking the article to GA status without me personally asking him to weigh in: Talk:Vagina/Archive 9. In the "Edits" section seen in that archive, ArnoldReinhold made it clear that he was pleased with the current state of the article and wished me well. He trusted me to continue on. The article has changed since then, but not so significantly that I can see him feeling that much differently about it. In fact, I've since added that aging section he wanted. So it seems to me that Barbara (WVS) contacted him because of our #The lead paragraph disagreement. Otherwise, why not also contact Joyous!, who was also involved in that "In preparation for GA status" discussion (although, yes, Joyous!'s contribution history shows that Joyous! hasn't edited much lately)? As for Snowmanradio, who disagreed with me and others years ago on a matter (Talk:Vagina/Archive 7) and on layout, and with editors at Talk:Cervix/GA2, it also seems that he is still watching the article. But as he's made clear on his talk page and as his contribution history shows, he edits much less these days.

So I remind Barbara (WVS) of what Robert McClenon stated about not seeking out a third opinion when it's clear that there are already other editors who are clearly watching the talk page, and to not merely look for an editor who will agree with you. Flyer22 Reborn (talk) 17:52, 15 January 2018 (UTC)

Contacting other editors to help in the effort to promote this article is an act of good faith on my part. If they choose to help out, that will mean that they also will act in good faith. Though the article and talk page are watched by over a 1000 editors, few have become involved. The lack of participation in the talk page is not an indication of a tacit approval of the article changes that have been and will occur. As fantastic as this might sound, I would feel a lot better if other editors took a look over the content that I have added, removed and changed. I apologize for any offense. Best Regards, Barbara (WVS) ✐  ✉ 20:39, 15 January 2018 (UTC)

Barbara (WVS), the number of talk page watchers can mean nothing since it can simply be an accumulation over the years that doesn't accurately reflect how many are currently watching the page. Either way, if I thought having others weigh in was a problem in and of itself, I would not have asked for input before and put in the time and effort to work with ArnoldReinhold. It's how you went about contacting editors that I questioned. ArnoldReinhold clearly disagreed with me on a matter you also took issue with (mentioning in the lead that the vagina has been studied in humans more than it has been studied in other animals). You should have simply pinged him since it's clear you wanted him to weigh in on that again. And while you might not have been aware of disputes with Snowmanradio (which, as seen at Talk:Cervix/GA2, may keep Tom (LT), who was then known as LT910001, from weighing in), you still seemed to me to be selective in who you contacted. And I did partly revert Snowmanradio on that recent edit he made. At this stage, we do not need any unnecessary disputes or tension. As for your statement that "the lack of participation in the talk page is not an indication of a tacit approval," see WP:Silent consensus. Editors watching this article can obviously weigh in any time they want. We have a number of experienced anatomy and medical editors watching this article. Axl, Tom (LT) and Doc James are three. It is likely that CFCF is also watching (after being pinged earlier in the #Discussion continued and #Third opinion sections above). And I am another. Doc James, Axl, Tom (LT), and CFCF trust my knowledge and judgement on anatomy and medical articles. They have for years. I realize that you think I'm not enough, but we have other knowledgeable editors watching. Not every disagreement needs the involvement of a group of editors. And SilkTork is also now watching and will also obviously be mediating during the GA review. And although Wikipedia is the encyclopedia everyone can edit, having editors who specialize in, or otherwise have significant knowledge of, a topic is of great benefit. And again, GA is not FA. Flyer22 Reborn (talk) 22:14, 15 January 2018 (UTC)

Yes, Flyer, I am watching, though not wanting to get drawn in before the review starts, so remaining at arm's length for the time being. I have no concerns about other people being asked to look at the article either now or during the review. Given the recent editing history, and the comments on the talkpage, I understand Barbara wishing to reach out to others as there is some tension between you two. As an outsider looking in, and as someone with experience of content disputes, I don't have a concern regarding your relationship: disagreements are being handled appropriately with both of you giving the other some space on the article, and you communicate reasonably respectfully with each other. As I have been brought in by Flyer I can understand Barbara being somewhat concerned about that. However, Flyer and I are not friends. Flyer asked me to do the GA review for the Clitoris article: Talk:Clitoris/GA1. We had some history leading up to that review, and may possibly have been in touch since then, though I suspect that may have been the last time we communicated significantly. So we are not editors who have a history of working together. I have respect for Flyer, and we communicate politely, but we are not friends. I haven't asked Flyer why she asked me to get involved - I suspect she wanted someone with a reputation for good work on GA reviews, someone with experience of handling disputes and conflict situations, someone respected by the community, someone with a reputation for impartiality, and someone who clearly was not a friend so there would be suspicion of bias. That we had worked together successfully on the Clitoris review is also worth bearing in mind. I have said to Flyer in our email conversation regarding doing this review, that I actually like it when two people working on an article have slightly differing views because then various aspects of the structure and content of the article get challenged and tested. I want both of you to work on this article. I don't expect you to become friends. And I don't expect that it will be the warmest and most comradely of atmospheres during the review. But I expect that both of you will want Vagina to become a decent article that the approx 7,500 daily readers consult, and that both of you will be proud of it in the years to come, knowing that you did your bit to improve it. SilkTork (talk) 14:18, 16 January 2018 (UTC)

SilkTork, like I stated above, I don't have an issue with others being contacted, but I do have an issue with others being contacted specifically because they have disagreed with me (not stating that Barbara (WVS) definitely did this) and with others being randomly contacted (which is against the WP:Canvassing guideline). Others are clearly watching this article. Rivertorch, who recently made a number of copyedits to the article, obviously is. And to stress my point about contacting people, how am I to know what relationship Barbara (WVS) has with Megalibrarygirl unless I checked? So far, I see that she awarded Megalibrarygirl a barnstar in 2016. I don't know if they are closer than that. I haven't yet checked. If she is friendly with and familiar with any of these people, it is a biased contact. It's like me going to the talk pages of individual people I have awarded barnstars to or know to favor me to ask them to weigh in because I am often disagreeing with one editor. That is not the way things are supposed to be done. And, again, per WP:Canvassing, editors should not be randomly contacted anyway. Like I told you via email, I definitely agree about two or more people with different or opposing views sometimes or often being good for the article. I told you, that, for example, I have been working with editors at Draft talk:Star Wars Last Jedi audience response. Not all of us agree, but we are generally getting along well. But with Barbara (WVS)‎, it's often like she is not truly listening when one is trying to explain matters to her. And it has been double or triple that when she's interacted with me. Doc James and Jytdog have expressed similar concerns. So have others. And by "listening," I do not mean agreeing with me. I do not like the competition feel that has existed between Barbara (WVS) and I ever since she took an interest in me and medical and anatomy articles specifically because of me; years ago, she stated that she got involved with these articles because of me. I would be flattered if it were not for how things transpired. And, as you know, I am never competing.

As for why I contacted you, SilkTork, this is covered in the #Moving toward WP:GA again section above. In addition to what is stated there, I thought it would be awesome to have the two editors who brought the Clitoris article to GA also bring the Vagina article to GA. Also, we worked together at Talk:2011 Tucson shooting/GA1 as well. This and the clitoris matter is what I meant by us working well together "both times." Flyer22 Reborn (talk) 16:44, 16 January 2018 (UTC)

SilkTork, I couldn't be more pleased that you have agreed to review the article. I read your user page. I have no concern at all about your review especially since you have worked with F22 RB. Your future comments regarding the upcoming review will be objective. I've been wrong before and I will be wrong again! Other editors can point that out and it makes me a better editor. I am impressed with your experience with GA reviews. Having other editors watching over the further development of the article has already improved it. As for 'knowing' other editors I'm not sure how that works on WP. I contacted editors who I saw had worked on this article on their talk page. I don't 'know' Megalibrarygirl but she is a top medical and content creator. I respect her. And as an editor who has not edited the article, I had hoped that a 'new' pair of eyes might be an advantage. I am actually looking forward to the review. This is a pretty important article. Best Regards, Barbara (WVS) ✐  ✉ 02:51, 17 January 2018 (UTC)

Barbara (WVS), besides what I stated before, all that I am relaying is that Wikipedia:Canvassing#Inappropriate notification states, "'Posting an excessive number of messages to individual users, or to users with no significant connection to the topic at hand. [...] Indiscriminately sending announcements to editors can be disruptive for any number of reasons. If the editors are uninvolved, the message has the function of 'spam' and is disruptive to that user's experience. More importantly, recruiting too many editors to a WP:dispute resolution can often make resolving the dispute impossible. Remember the purpose of a notification is to improve the dispute resolution process, not to disrupt it." You stated that Megalibrarygirl is a top medical editor, but I do not see any indication of that from her contribution history or on her user page. I also looked at her "Articles started" and "More articles" tabs. I do not see her in the talk page history of WP:Med. I'm not stating that all medical editors participate at WP:Med, but all of the ones very familiar with stuff like WP:MEDRS and WP:MEDMOS have at some point paid a visit to WP:Med. And many or most editors who have gotten the "Cure Award" from Doc James are not medical editors; that barnstar has a broad reach, as noted by Doc James and others, including those who, to their surprise, have gotten the award. Not sure if Megalibrarygirl has gotten one, but that's not the point. The point is that medical and anatomy topics are not her specialty, but I do see that she creates and contributes to a lot of societal/cultural content. Flyer22 Reborn (talk) 03:15, 17 January 2018 (UTC)

I'll say again that I am not concerned about any editor getting involved in this article, nor in any editor reaching out to others to get involved. We have an open house policy, and encourage open involvement. However, I think it's fair to point out that there is a known motivational factor involved in those dedicated editors who often spend months and even years working on an article, spending time on deep research, and honing material to a readable form where information is easily understood by the general reader. This is hard work, sustained by personal pride, and the pleasure of bringing an article to fruition. Wikipedia benefits from this work. Some of our best work is done by such editors, and it is important to recognise this, and keep the motivation levels going. We are aware of some of the potential risks attached to such long term dedication - a certain degree of what we term "ownership" - and we do punish those who inappropriately restrict the access of others to an article. But the reality is that we do benefit greatly from the work of these dedicated editors, and should not undermine their motivation. As such I would want this review to be as free from stress as possible. Going through a high level audit can be very draining if there are a lot of demands being made, and too many unnecessary comments, particularly hostile or dismissive comments, can derail a review, and damage the future motivation of dedicated editors. If people joining in the review are disruptive, I will take steps to eliminate such disruption. SilkTork (talk) 10:12, 17 January 2018 (UTC)

SilkTork, we have an "open house policy," but we also have the WP:Canvassing guideline (which only encourages outside editors being contacted under certain circumstances) for a reason and editors have been reprimanded and/or blocked for violating that guideline. So, in short, I stand by what I stated above. But Barbara (WVS) did not egregiously violate that guideline. She contacted one outside editor and appears to have thought that editor is a medical editor. So no big deal. But I did want to discourage this type of thing before it continues. WP:Canvassing has a valid point about too many cooks in the kitchen, and so does a colleague who recently stated similarly. Thanks for understanding about the dedicated editors and stress aspects, though. Flyer22 Reborn (talk) 15:28, 17 January 2018 (UTC)

Hi everyone! I'm not sure, but I have may have been pinged since I have worked on articles like Disability and women's health, Vaginal syringe and several women doctors, birth control advocates and so on. As for having a close working relationship with anyone in this discussion, I don't work with anyone regularly on editing articles except for SusunW, who I collaborate with on WiR. Otherwise, my usual contact is with other members of the WiR and other related WikiProjects, AfD, etc. I'm happy to help out if you need someone to review references, etc, or to add to anything in a historical context. I'm also happy to sit it out if that's best for all involved. Keep me posted by pinging me if needed. Hope this helps! :) Megalibrarygirl (talk) 17:56, 17 January 2018 (UTC)

Megalibrarygirl, thanks for explaining. Flyer22 Reborn (talk) 18:34, 17 January 2018 (UTC)

Apparently, Barbara (WVS) confused Megalibrarygirl for Medgirl131. The thing about Medgirl131 is that she does not communicate on talk pages, which would make working together difficult since communication is key not only for the GA process but for Wikipedia in general. When one pushes the "Edit" button on Medgirl131's talk page, it states, "For reasons related to personal privacy, I prefer not to converse on talk pages. If you would like to speak with me, please email me instead. If you edit my talk page, I will read your message, but I won't respond to it. At least, not on-Wiki. For confirmation that I've read your message, I always WP:BLANK my user talk page after I've read new messages. Please note that I'm happy to speak with anyone, just not in public. Thank you, and apologies for any inconvenience!" Flyer22 Reborn (talk) 00:29, 19 January 2018 (UTC)

So if Medgirl131 is contacted by Barbara (WVS), on her talk page or via email, about getting this article ready for WP:GA, she should be made aware of the GA process and that communicating is key. Simply coming in and making substantive changes that might be contested will not work. Flyer22 Reborn (talk) 00:36, 19 January 2018 (UTC)

Vaginal evisceration

Vaginal evisceration is not a type of modification but instead a pathological condition that can actually cause significant disability or even death. It is more in the 'fistula' or prolapse category of things. It probably belongs somewhere else in the article. Best Regards, Barbara (WVS) ✐  ✉ 21:30, 15 January 2018 (UTC)

As seen here, you added the content. With this edit, all I did was move the content and add "vaginal" to "hysterectomy" since vaginal hysterectomy is the main cause of vaginal evisceration and is significantly more relevant than other causes. I moved it under "Modification" because the section overwhelmingly concerns surgery and the effects of surgery, and because vaginal hysterectomy is a surgery. As noted in the #Format section above, I've also considered renaming the section "Surgery," which is a heading that the Vulva article uses, but the only reason I have yet to do that is because the section includes female genital mutilation material and female genital mutilation is not usually considered a surgery. And I am conflicted about having female genital mutilation only covered in the "Society and culture" section when it concerns "Clinical significance" as well. Flyer22 Reborn (talk) 22:14, 15 January 2018 (UTC)

Changed title to "Surgery." Flyer22 Reborn (talk) 00:22, 16 January 2018 (UTC)

I purposefully contribute content that I expect you may want to move. I defer to you on the organization of the article. Though vaginal evisceration and Urogenital fistulas are not surgeries, I am confident that your judgement in organizing the article's content will eventually be okay. You seem to enjoy it and are able to adapt to additional content as it is added. Hysterectomy is surgery. Various surgical techniques are used to correct and treat evisceration and urogenital fistulas variy so widely that a specific surgery to correct these pathologies is probably not needed in this article. Best Regards, Barbara (WVS) ✐  ✉ 12:57, 16 January 2018 (UTC)

Just another thought-There probably is not a problem with Female Genital Mutilation having its own section. It is a pretty significant topic except that the vagina is not usually involved in the practice. I certainly would not oppose such a section. Then all the information can be in one place. Best Regards, Barbara (WVS) ✐  ✉ 13:04, 16 January 2018 (UTC)

I also considered adding the vaginal evisceration material to the "Anomalies and other health issues" section. I explained why I added it to the Surgery section, but I am not opposed to it being moved to the "Anomalies and other health issues" section. I don't see that female genital mutilation needs its own section. Why should it be separated from the "Influence on modification" subsection in the "Society and culture" section? It's an aspect of modification and societal/cultural influences on modification. It's not a lot of content and I don't see that more on it needs to be added. Also, female genital mutilation mainly concerns the vulva, including the clitoris. See the Female genital mutilation article. Despite that, it doesn't have its own section in the Vulva and Clitoris articles. Flyer22 Reborn (talk) 16:44, 16 January 2018 (UTC) Flyer22 Reborn (talk) 16:58, 16 January 2018 (UTC)

More about Urogenital fistulas and Vaginal anomalies

Urogenital fistulas I have extra time today to create the above article where I can place most of the fistula information contained in the draft proposed for this article. An event I had was cancelled and can help pare down information in this article to that it is not so overwhelming. DYK vaginal fistulas are more common than vaginal cancer? Best Regards, Barbara (WVS) ✐  ✉ 12:57, 16 January 2018 (UTC)

It's done. Urogenital fistulas is pretty rough but now it exists. Best Regards, Barbara (WVS) ✐  ✉ 02:21, 17 January 2018 (UTC)

Vaginal anomalies

Heads up: This is probably another article that will need to be created to contain all the content and references that exist on this topic. I will submit proposed content for this article for review as soon as I get it drafted up. Best Regards, Barbara (WVS) ✐  ✉ 13:00, 16 January 2018 (UTC)

I created the "Anomalies and other health issues" section in the article specifically for your fistula and anomalies material. As stated in the #Moving toward WP:GA again section above, not too much should be added. Certainly, the section should not have more than the articles themselves have. Flyer22 Reborn (talk) 16:44, 16 January 2018 (UTC)

Also, Barbara (WVS), "Urogenital fistulas" should simply be "Urogenital fistula." Per WP:Article title (the WP:TITLEFORMAT section), we go with the singular. It's why Cancer is not "Cancers." And as for urinary fistula redirecting to Obstetric fistula, you might want to talk to the editor who created that redirect. The editor's rationale was: "The most common urinary fistula is obstetric fistula." Seems to me that the editor was looking for a home for "urinary fistula." Flyer22 Reborn (talk) 04:03, 17 January 2018 (UTC)

There are ten or more fistulas that can 'empty' into the vagina. They are all not urogentital fistula(s)/fistula/fistulae. The most common type of fistula is probably not the obstetric fistula, though it is the most common in developing countries-Subsahara Africa and Southeast Asia. Also an obstetric fistula is a title that reflects the cause of a fistula, not the anatomical details. We might have an article called "Hysterectomy fistula/fistula(s)/fistulae" because that is another major cause of fistula formation. If you want to identify ten different things with a singular noun, it may be awkward. There is inconsistency between the sources, yes, but most of them use the plural.

• this journal article calls these "fistulas"
• this journal article calls these "fistulas"
• this journal calls these "fistulas"

If you change the title, it will not reflect the title given to this pathology in most of the literature. Perhaps the authors of the literature don't know the WP policy. Besides, a parenthetical explanation can be given in the first sentence that contains this content. Best Regards, Barbara (WVS) ✐  ✉ 20:36, 17 January 2018 (UTC)

Barbara (WVS), I don't intend to change the title. But per WP:TITLEFORMAT, it will eventually be changed by someone if you do not do it first. You created the article in the singular format and then you moved it to the plural. The plural is not needed. It matters not that the sources use the plural when talking about various fistulas. Sources use the plural "cancers" when talking about various cancers. Notice that you already begin the article by stating, "A urogenital fistula is an abnormal connection between the vagina and bladder, ureters, or urethra." You don't begin with the plural. The singular title would not contradict the literature in any way. Flyer22 Reborn (talk) 21:06, 17 January 2018 (UTC)

Copyediting concerns

I did a quick run-through of the article last night and made a number of changes, mostly relatively minor, to improve clarity and flow. I also identified a number of other issues that I did not address. These include:

• Lead section. Lead sentence. Current wording: In mammals, the vagina is the fibromuscular, tubular part of the female genital tract, which, in humans, extends from the vulva to the cervix. It is the vagina that extends from the vulva to the cervix, but the current wording is ambiguous, leaving open the possibility that it is the entire female genital tract that extends thus. One possible fix: "In mammals, the vagina is the fibromuscular, tubular part of the female genital tract extending, in humans, from the vulva to the cervix." Another possibility is to make it two sentences: "In mammals, the vagina is the fibromuscular, tubular part of the female genital tract. In humans, it extends from the vulva to the cervix." I'm also not sure about the "In mammals" bit. Nearly the entire article is about mammals, but it seems weird to qualify it here without saying anything in the lede about non-mammals.
• Lead section. Fourth paragraph. Current wording: By its dictionary and anatomical definitions, however, vagina refers exclusively to the specific internal structure, and understanding the distinction can improve knowledge of the female genitalia and aid in health care communication. This is slightly awkward for two reasons. First, dictionary and anatomical definitions aren't necessarily disparate, but this wording implies that they are. Second, the last clause comes across as just a bit preachy. I understand why it's there, and it is very properly discussed later in the article, but I'm not sure there's enough discussion later to warrant a mention in the lede. Suggestion: "Strictly speaking, however, vagina refers exclusively to the internal, tubular structure connecting the vulva to the cervix."
• Structure section. Overview. Current wording: it connects the outer vulva to the cervix of the uterus. I'm not sure, but I wonder if this isn't redundant on two fronts. First, what is the "outer vulva"? Is there an inner vulva? Second, what is "the cervix of the uterus"? Is there some other cervix? Also, there's an obvious problem with the last part of this sentence: These are the cardinal ligaments (transverse cervical ligaments), pubocervical ligaments, and the uterosacral ligaments the sacrocervical ligaments. I have no idea how to fix it.
• Development section. Current wording: Originally full of cells, as the central cells of the plate break down, the lumen of the vagina is formed. This is unclear. What was originally full of cells? It can't be the lumen because it isn't formed until the central cells break down.
• Microanatomy section. Current wording: the epithelium thins out during menopause onward. This is confusing. "During" suggests an interval, but "onward" suggests it's open-ended. It should either be "from menopause onward" or just "during menopause".
• Blood and nerve supply section. Current wording: The lower vagina is supplied by the pudendal nerve supplying the lower area. Huh? The lower area of what, the lower vagina? I.e., the lower lower vagina? I have no idea what this means.
• Sexual activity section. Current wording: Heterosexual couples may engage in cunnilingus or fingering as forms of foreplay to incite sexual arousal, with penile-vaginal penetration as the primary sexual activity, or they may engage in them in addition to penile-vaginal penetration; in other cases, heterosexual couples use the latter acts as a way to preserve virginity or as a type of birth control. I really wouldn't know, but it occurs to me that heterosexual couples may engage in cunnilingus or fingering as a primary sexual activity regardless of concerns about preserving virginity or birth control. This wording implies otherwise.
• Childbirth section. Current wording: however, it will maintain a larger shape than it previously had. There's no such thing as a larger shape. Does it mean a larger size? A different (fatter? wider?) shape? This needs to be reworded.
• Pelvic examinations section. Current wording: Excluding the Pap test, health recommendations state there is little benefit but evidence of harm that comes with pelvic exams on asymptomatic, nonpregnant adult women. I'm confused. There's little benefit but there's also evidence of harm? And why "comes with"? If I were sure what this is trying to say, I'd reword it.
• Infections, diseases and safe sex section. Current wording: Cervical cancer may be prevented by pap smear screening and HPV vaccines. Not really. A vaccine can directly prevent something; a screening cannot. I don't know enough about it to try rewording, however. Also, there's this: However, most cervical cancers are asymptomatic (present no symptoms). I wonder if the parenthetical phrase is necessary. Some readers won't know what "asymptomatic" means, I realize, but there are far more esoteric words in the article without any handy definition afterward. So this is mostly a consistency concern. And also in this section, but maybe elsehere as well, I think that ranges should have en-dashes instead of hyphens, but perhaps there's an exception for medical-related ranges; I really don't know.
• Surgery section. Current wording: The medio-lateral incision is made between the vagina at an angle and is not as likely to tear through to the anus. Between the vagina and what? Presumably the anus, but it doesn't say. Also, "at an angle" is imprecise; every incision is at an angle. I think what is meant is at a diagonal, but I can't be sure. Also, in this and other sections, I'm bothered by the use of the word "stated" preceding quotations. This is a no-no in news writing, and while I realize we're not writing news here I still think it seems unnecessarily stilted, almost legalese. If a quote is from a written work, how about using "wrote" instead? In the unlikely event it's from the transcription of a speech or oral presentation, "said" (or various other more precise words) might work better.
• In contemporary literature and art section. Current wording: In October 2013, artist Peter Reynosa created a "... red and white acrylic painting [that] depicts [pop singer] Madonna painted in the shape of a defiant yonic symbol that looks like a vagina or vulva. We're told earlier in the article that a vagina is not a vulva, so this seems odd. Unless it's a very clever Boring figure or other optical illusion, it can't look like either a vagina or a vulva; it must look like one or the other. So which is it? (I googled it and didn't think it looked like either one :-p)

Sorry for the wall of text. These are my outstanding concerns as of today. Rivertorch^FIRE_WATER 18:51, 16 January 2018 (UTC)

Thanks for copyedting and reviewing, Rivertorch. As has been clear times before, you know grammar better than I do. Since you are also questioning anatomy, Axl and Tom (LT) can also help with some of your above questions. Although we are following sources for the wording, we don't always use the exact wording (partly because of WP:Copyvio, of course). Feels likes a GA review right now, LOL.

"In mammals, the vagina is the fibromuscular, tubular part of the female genital tract..." I'd go with your first suggestion.

"By its dictionary and anatomical definitions..." This was discussed, and another editor suggested the wording you see now. See Talk:Vagina/Archive 9#In preparation for GA status. It used to state: "In common speech, the word vagina is often incorrectly used to refer to the vulva, which can impact knowledge of the female genitalia." I think it is important for the lead to not only mention the correct use of the term...but also why using the correct terminology is important.

"The epithelium thins out during menopause onward..." I am fine with you changing that.

"The lower vagina is supplied by the pudendal nerve supplying the lower area..." Not sure who added that. Definitely needs clarification.

"Heterosexual couples may engage in cunnilingus"... The text states that "in other cases, heterosexual couples use the latter acts as a way to preserve virginity or as a type of birth control." So it is only attributing technical virginity and birth control to being a sometimes matter. But as for either being a primary sexual activity, it is not as common for heterosexual couples as it is for lesbian couples to engage in cunnilingus and fingering as a primary sexual activity. For heterosexual couples, both acts are most commonly used as foreplay -- as a lead up to what they consider the main even (penile-vaginal sex). Like this 2018 (likely a reprint) "Sexuality Now: Embracing Diversity" source, from Cengage Learning, page 299, states, "The majority of heterosexuals define foreplay as 'anything that happens before penetration' or something a man does to get a woman in the mood." and "The majority of heterosexual couples engage in sexual intercourse almost every time they have sex." It's also the case that while women often perform fellatio on men without any other form of sex happening after that, a man performing cunnilingus on a woman without any other form of sex happening after that is not as common. But the wording can be tweaked. For example, this 2012 "An Invitation to Health" source, from Cengage Learning, page 317, states, "Though such forms of stimulation often accompany intercourse, more couples are gaining an appreciation of these activities as primary sources of sexual fulfillment—and as safer alternatives to intercourse." I will tweak that now.

"However, it will maintain a larger shape than it previously had..." The source (pages 431-432) state, "The vagina returns to its approximate prepregnant size by 6 to 8 weeks postpartum but will always remain a bit larger than it had been before pregnancy." We can go with "size."

"Excluding the Pap test, health recommendations state there is little benefit but evidence of harm that comes with pelvic exams on asymptomatic, nonpregnant adult women..." This is a result of a concern I had in the #For review section above. My concern was that the wording could imply the Pap test has "little benefit" and so on. The source did not consider the Pap test, and the original wording stated this. Feel free to reword.

"Cervical cancer may be prevented by pap smear screening and HPV vaccines." The first source states, "Screening with Papanicolaou (Pap smears) continues to be an important cervical cancer prevention strategy." Feel free to reword. As for removing "asymptomatic," I don't feel strongly about it, but I added it for clarity. No strong feelings on dashes.

"In October 2013, artist Peter Reynosa created..." We can simply remove that. Flyer22 Reborn (talk) 20:23, 16 January 2018 (UTC)

Also no issue with changing "stated" to "wrote," but I don't see a difference between "stated" and "said." Whenever the comment is something that was verbally stated, though, then I think either "said" or "stated" is fine. I've addressed some of your other concerns via editing. Flyer22 Reborn (talk) 23:08, 16 January 2018 (UTC)

Thanks for your detailed comments and for your neat fixes of several of my concerns. I think there are only two points I'm still wondering about:

First, the wording "the uterosacral ligaments the sacrocervical ligaments" needs to be fixed but I don't know how. Should there be an "and" between "the uterosacral ligaments" and "the sacrocervical ligaments" or is the latter supposed to be in parentheses or what?

Second, I still don't quite get the bit about the pelvic exams. Is there little benefit and evidence of harm? Maybe it's just the conjunction that's confusing me. Rivertorch^FIRE_WATER 06:05, 18 January 2018 (UTC)

I can understand the issue about the harm of a pelvic examination, because it is not intuitive. In evidence-based medicine, treatments are now assessed based upon statistical proof of benefit, cost, and possible negative harms. Harms include distress, anxiety and avoidance of future pelvic exams. Here is a good example: If a twelve-year-old has a pelvic exam, no statistically valid improvement in health is found because of the screening. Instead, the negative effect of a pelvic exam in this young woman can be trauma, anxiety and the future avoidance of pelvic exams. Another harm would be a bill of $10,000 for the procedure. I hope that explains things. But if it is not clear in the article, then it needs to be changed.

A major rewrite of the supportive anatomy which includes the structures you name above is in the works. Best Regards, Barbara (WVS) ✐  ✉ 16:22, 18 January 2018 (UTC)

Rivertorch, I fixed the "the uterosacral ligaments the sacrocervical ligaments" material here and here. As for the pelvic exams material, it's the "there is little benefit but evidence of harm that comes with pelvic exams on asymptomatic, nonpregnant adult women" part that you are concerned about? Barbara (WVS) added the material. And the text is trying to state what it states. There is more harm than benefit. But the Pap test is not a part of that "more harm" review. For example, with a source, the lead of the Pelvic examination article states, "The American College of Physicians published guidelines against routine pelvic examination in adult women who are not pregnant and lack symptoms in 2014." And, Barbara (WVS), what do you mean "a major rewrite of the supportive anatomy which includes the structures you name above is in the works"? I do not see that a major rewrite of any part of the Overview section is needed. When sources talk about the upper third, middle third and lower third muscles and ligaments of the vagina, not much more detail than what the Vagina article has is included. And we already know that you can go into unnecessary detail. The Overview section is not meant for extensive detail. Given that I'm trying to get this article ready for GA and that the nomination is currently on hold because we are waiting for your "anomalies and other health issues" material, you should be discussing any substantive edits you are looking to make. And, yes, I know that you likely have not written anything on what you consider "a major rewrite," but still. Flyer22 Reborn (talk) 17:11, 18 January 2018 (UTC)

Rivertorch, I changed the ligament material again. I'll likely be changing it again soon or eventually. Reviewing sources, I'm seeing that some are stating different things, which requires stating these things in a way that do not contradict each other, being brief, or noting conflicting definitions. See the Urogenital diaphragm article, for example; some sources consider stating "urogenital diaphragm" outdated. Flyer22 Reborn (talk) 19:28, 18 January 2018 (UTC)

Axl and Tom (LT), can I get your assistance on how to describe the "supports of the vagina" material, including the aforementioned "urogenital diaphragm" outdated aspect? Tom (LT) copyedited that section before, but sources do not always describe the supports in the same way. For example:

• This 2004 "Clinical Anatomy: An Illustrated Review with Questions and Explanations" source, from Lippincott Williams & Wilkins, page 98, states, "Upper third: Levatores ani muscles; transcervical, pubocervical, and sacrocervical ligaments. Middle third: Urogenital diaphragm. Lower third: Perineal body." This is used in the article.

• This 2011 "Oxford Desk Reference: Obstetrics and Gynaecology"source, from OUP Oxford, states, "The middle third of the vagina is supported by the levator ani muscles and the lower portion of the cardinal ligaments. The upper third is supported by the upper portions of the cardinal ligaments and the parametrium."

• This 2011 "Netter Collection of Medical Illustrations: Reproductive System E-Book" source, from Elsevier Health Sciences, page 443, states, "The lower third of the vagina is surrounded and supported by the urogenital and pelvic diaphragms. The levator ani muscles and the lower portion of the cardinal ligaments support the middle third of the vagina, whereas portions of the cardinal ligaments and the parametria support the upper third."

• This 2011 "Atlas of Pelvic Anatomy and Gynecologic Surgery - E-Book" source, from Elsevier Health Sciences, states, "The principal supports of the upper part of the vagina are the transverse cervical, the pubocervical and uterosacral ligaments (Fig. 22.5). The lower part of the vagina is supported by the perineal body and the pubovaginal part of the levator ani muscle." Above that, it also states that the lower part of the vagina is related to the urogenital diaphragm and the bulb of the vestiblue.

Flyer22 Reborn (talk) 20:31, 18 January 2018 (UTC)

@Barbara Barbara (WVS): No, I understand about evidence-based medicine. I just didn't understand what the sentence meant, as written. Anyway, it seems to be fixed now. Rivertorch^FIRE_WATER 04:24, 20 January 2018 (UTC)

Hmm, it is peculiar that these ostensibly reliable sources contradict each other. I shall look into the matter. Axl ¤ [Talk] 12:48, 22 January 2018 (UTC)

Although human anatomy has not changed much in the last 15 years, I think that it is preferable to use the most recent sources. Among these, the specialist gynaecology texts are perhaps the best.

I have access to Atlas of Pelvic Anatomy and Gynecologic Surgery, 4th edition (2015, Baggish & Karram). This is a more recent edition of Flyer22's last listed source. The description of vaginal supports in the 4th edition is slightly different from that in the 3rd edition. 4th edition, page 43: "The upper vagina shares support with the uterus and bladder. Principally, this consists of the deep cardinal ligament and, to a lesser extent, the uterosacral ligaments.... The lower vagina is clearly supported by the levator ani muscle, the anal sphincter, and the deep vascular structures located beneath the bulbocavernosus muscle, as well as by the commonly shared connective tissue, smooth muscle, and vessels found in the tissues between the rectum and vagina, and, likewise, between the bladder and vagina. Between these anchors, the lateral vaginal wall is not attached and opens into fat-flled paravaginal space." Axl ¤ [Talk] 14:32, 22 January 2018 (UTC)

Axl, does that source describe the middle third? For example, the section in the article begins by stating, "Supporting the vagina are its upper third, middle third and lower third muscles and ligaments." I also wonder if we should include specific mention of the cardinal ligaments, parametrium, urogenital diaphragm and perineal body, or leave it out. Sources consistently state that the lower part of the vagina is supported by the perineal body, for example. Anyway, if we are to describe the upper and lower third, we should describe the middle third as well. And how do you suggest we word it so that we are not using the exact wording of the source? Flyer22 Reborn (talk) 15:47, 22 January 2018 (UTC)

Okay, looking at the URL link again, I see that the it mentions the middle third. But I was also wondering about the updated version you speak of, since you stated, The description of vaginal supports in the 4th edition is slightly different from that in the 3rd edition." Flyer22 Reborn (talk) 16:03, 22 January 2018 (UTC)

The URL link also specifically mentions the cardinal ligaments. I'm wondering if we should go with something like what the "Oxford Desk Reference" and "Netter Collection of Medical Illustrations" source states for the beginning and then use the "Atlas of Pelvic Anatomy and Gynecologic Surgery" source for more detail. Flyer22 Reborn (talk) 16:10, 22 January 2018 (UTC)

On page 40: "Anatomically, the vagina is anchored caudally and directly at the introitus by the levator ani muscles and bulbocavernosus muscles. Indirectly, other structures may contribute to the caudal vaginal support; these include the external sphincter ani, superficial transverse perineal muscles, and the perineal membrane. The anterior and posterior vaginal walls share fascial support in a manner analogous to that in unibody automobile construction with the bladder/urethra and rectum/anus. The vagina is intimately close to the bulb of the vestibule and clitoral apparatus. At the upper (cranial) end, the vagina shares support with the same structures that support the uterus. Specifically, these are the cardinal and uterosacral ligaments. Between the two terminals, the vagina is relatively flexible and may be easily freed from surrounding fatty tissue and loose fascia. Anteriorly and posteriorly, the potential spaces are the vesicovaginal and rectovaginal, respectively. Laterally, on either side, the free space may be identifed by cutting medially to the bulbocavernosus and levator ani muscles and developing the space along the outer wall of the vagina."

This seems to imply that the middle third has little, if any, direct support. (I am unconvinced by the automobile construction analogy.) Axl ¤ [Talk] 17:50, 22 January 2018 (UTC)

Thanks, Axl. So what type of wording/focus do you think is best for the section? As is clear, Barbara (WVS) has also weighed in a little below. Flyer22 Reborn (talk) 23:38, 22 January 2018 (UTC)

Vaginal support (section break)

Forgive my boldness in creating this break in the discussion of vaginal support. I'm still working on vaginal anomalies and haven't pulled together all the content regarding the support of the vaginal walls that I have found. This is an important topic, it probably could have its own article some day, and the sources do not necessarily agree. If you have access, here are some of the sources I have:

• Liedl, Bernhard; Inoue, Hiromi; Sekiguchi, Yuki; Gold, Darren; Wagenlehner, Florian; Haverfield, Max; Petros, Peter (February 2017). "Update of the Integral Theory and System for Management of Pelvic Floor Dysfunction in Females". European Urology Supplements.
• Walters, Mark D; Karram, Mickey M (2014). Urogynecology and Reconstructive Pelvic Surgery. Saunders. pp. 326–341. ISBN 978-0323113779.
• Karram, Mickey; Maher, Christopher (2013-11-01). "Surgery for posterior vaginal wall prolapse". International Urogynecology Journal. 24 (11): 1835–1841. doi:10.1007/s00192-013-2174-z. ISSN 0937-3462.
• Walters, Mark D; Karram, Mickey M (2014). Urogynecology and Reconstructive Pelvic Surgery. Saunders. pp. 326–341. ISBN 978-0323113779.

A couple of things-the sources do not all agree. I'm fine with that. An example of this is when one anatomist claims that there is no fascia between the posterior vaginal wall and layers of the rectum for support and another contradicts this. The 'names' of the support structures are also inconsistent. This will be a difficult section. Best Regards, Barbara (WVS) ✐  ✉ 23:09, 22 January 2018 (UTC)

Barbara (WVS), as you can see a little above, Axl and I are working this out. You can obviously work with us, but I do not see how the section will be difficult, or at least too difficult, or that the content needs its own Wikipedia article. Just like with the #Puberty, and keratinization again stuff, we should be going with what sources usually state, not with what the minority of sources state. If any minority view is substantial, then we can include both viewpoints, just like we do for the "Sources differ on which portion of the vagina is formed from the Müllerian ducts and which from the urogenital sinus by the growth of the sinovaginal bulb." aspect in the Development section, and the "Some texts list four layers by counting the two sublayers of the mucosa (epithelium and lamina propria) separately." aspect in the Microanatomy section. As for the sources you included, yes, we should assess those as well. Axl likely has access. And if he does not, Doc James more than likely does. Pinging Tom (LT) one last time because we all want to do right by this. I'll also leave a message on Tom's (LT)'s talk page about this material. Flyer22 Reborn (talk) 23:38, 22 January 2018 (UTC)

"So what type of wording/focus do you think is best for the section?" The different descriptions in the various sources make it rather awkward. I suppose that we could avoid the controversy by just stating what the supporting structures are, without stating which parts of the vagina are supported? Axl ¤ [Talk] 16:03, 25 January 2018 (UTC)

Hmm, I'll think this over some more and see about proposing some wording. Flyer22 Reborn (talk) 17:55, 25 January 2018 (UTC)

Sorry, I am still very busy presently, but happy to provide feedback once the wording is nutted out. --Tom (LT) (talk) 04:55, 26 January 2018 (UTC)

Why the fistula section is so long

First, small, relevant contents of multiple articles were added. In most articles I found few to no references that support any content related to vaginal fistulas. There was rarely content, fistulas are not mentioned and if there were references, they were from the early 2000s. Since this is clinical content the best referencing is necessary to be aligned to MEDRS. The fistula content that I added IS a summary of the following articles. The related articles or article sections that are included in the Fistula section of the Vagina article, some of which don’t even exist or lacking are:

• Vaginal fistulas

• Gastrointestinal fistulas

• Obstetric complications

• Hysterectomy complications

• Pelvic radiation therapy

• Vaginal anomalies

• Iatrogenic fistulas

• Medical training

• Pessary complications

• cesarean section (complications)

• Pelvic fracture (complications)

• Bowel disease (complications)

• entero-vaginal fistula

• inflammatory bowel disease (complications)

• Crohn's disease (complications)

• episiotomy (complications)

If the article were reformatted with subsections, there were could be “See Main Article links” for Obstetric fistula and Rectovaginal fistulas, A Urogenital fistulas subsection which would allow this fistula section of the Vagina article to be pared down by providing a link to the article. At this time, only the Urogential fistulas article contains up-to-date information regarding vaginal fistulas. I mentioned before that the effort to add content and create related articles is massive. This section does not constitute undue weight because the global problem of vaginal fistulas affects tens of thousands of women globally. There are no places to put this fistula information at this time. As soon as articles exist in which content from this article can be moved this would be a good thing. Without this fistula information, the article is not comprehensive. I would like to suggest delaying the good article review until this work can be finished. If other editors could help with this effort, then the fistula section of this article could be pared down by the creation of sub-articles and movement of content into relevant articles that already exist. Please propose other solutions to this problem.

I guess the simplest explanation of the problem is this: The fistula section of the Vagina article is the only place on Wikipedia that contains all this information. The information belongs in other articles some of which do not even exist. And even what I added is not WP:EVERYTHING.

Best Regards, Barbara (WVS) ✐  ✉ 14:01, 19 January 2018 (UTC)

Barbara (WVS), in the #Moving toward WP:GA again section above, there were three editors who were clear that the previous level of detail you proposed should not be included. Well, two -- Axl and me -- stated that. SilkTork expressed similar concerns. Despite what was stated, you added even more. What you added really is not WP:Summary style. Summary style also does not include non-existent articles. And having a huge third paragraph does not really make the section look any smaller. Instead of posting a link to the final content for review, you went ahead and added the content knowing that there might be objections to the level of detail you included. You are not really collaborating when it comes to adding content to this article. You simply state that you plan to add content, even knowing that it will likely be disputed, and then you add it. Being WP:Bold is one thing; not listening to concerned editors is another. Even in the #Copyediting concerns section above, I asked for editors' opinions on how best to add vaginal support material. Instead of weighing in there, you moved content I included there to Vagina#Anomalies and other health issues, which implies that you plan to work on it by yourself and then simply post it. My concern about you going into unnecessary detail was ignored. I cannot work like this. We both know how offended you get when reverted. And yet will not discuss first, even when this article is nearing GA, where discussion is key, and even knowing that you might be reverted? Again, I cannot work like this. And regarding this, it seems you contacted Medgirl131 via email. Medgirl131 told me via email that she declined to work on this article because talk pages are not her thing and she knows that talk page discussion is important for a GA review. You have similarly stated that talk pages are not your thing, which is one of a number of reasons the two of us working together is not a smooth result.

I will likely be cutting some of the "Anomalies and other health issues" material you added. But first, I will let others weigh in. You know, because communication is key. Rivertorch might also want to weigh in. Flyer22 Reborn (talk) 16:56, 19 January 2018 (UTC)

Since no one has yet weighed in, I will wait until your content is copyedited. After that, I will see about downsizing it. Whether I downsize it or not, there is no solid reason that it should hold up GA. It is not true that there is no home for this material on Wikipedia. It is not hard to put some or most of that material into the Fistula, Urinary fistula, Obstetric fistula or Rectovaginal fistula articles. You stated, "There was rarely content, fistulas are not mentioned and if there were references, they were from the early 2000s." This goes back to what I stated before. WP:MEDDATE does not mean that the sources need to be newer. It means that the content should be up-to-date when it comes to the text we are including. This is why it states, "Keeping an article up-to-date while maintaining the more-important goal of reliability is important. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published. [..] In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written." The content should be current knowledge. If the current knowledge is the same as it was in the 2000s and/or there has not been much research on the matter since then, well, then those are the sources we go with. Again, look at Talk:Cervix/GA2 and what was argued there about WP:MEDDATE. Flyer22 Reborn (talk) 06:00, 20 January 2018 (UTC)

Taking a quick stab at copyediting it now. My initial thoughts before reading the above: too much detail overall, and that one paragraph is overwhelmingly long. Will comment again in a bit. Rivertorch^FIRE_WATER 16:59, 20 January 2018 (UTC)

I'm finding the section very difficult to copyedit. It's replete with spelling and other grammatical errors, and I can fix those, but it's also disorganized and reads like bullet points, not regular prose. Most troubling to me is that it is way too much information for this article. Seven disjointed sentences (or non-sentences, as the case may be) on the cause of fistulas? Discussion of ineffective treatment methods and the reasons why treatment is often ineffective in the Third World? This content does not belong here. Maybe there are appropriate articles for all of it, maybe not, but it shouldn't be here regardless. If the references are good, they can be used in the expansion of other existing articles or, if necessary, the creation of new ones. In the meantime, major cutting is required. I'm switching out of copyedit mode and am going to try to distill it down into something suitable for this article. Rivertorch^FIRE_WATER 17:21, 20 January 2018 (UTC)

I've copyedited three of the four paragraphs and would appreciate a check to make sure I didn't screw up the meaning somewhere. In the second paragraph of the section, I changed "movement into the vagina" to "impingement upon the vagina" because the former seemed ambiguous and confusing (Does it mean the organs moved into the vagina through the cervix or moved through a breach in the vaginal wall?) and the latter at least is safely vague. I'm a little unsure whether the bit about vaginal weightlifting ought to go; it seems like maybe more detail than is appropriate here, especially if "evidence for its effectiveness is lacking".

Now, about that very long paragraph. Most of the references are unavailable to me, so I can't check to see what source supports what text, and I don't want to leave the paragraph unsourced. Therefore, I'm pasting my proposed replacement text, sans refs, here:

Abnormal openings known as fistulas can cause urine, feces, or flatus to enter the vagina. The vagina is susceptible to fistula formation because of its proximity to the urinary and gastrointestinal tracts. Specific causes are manifold and include trauma, complications from surgery or childbirth, infection, malignancy, radiation therapy, bowel disorders, and long-term pessary use. A small number of vaginal fistulas are congenital. Various surgical methods are employed to repair fistulas. Untreated, fistulas can result in significant disability and have a profound negative impact on quality of life.

I think that's about the right length for a discussion of fistulas in this article. Rivertorch^FIRE_WATER 18:15, 20 January 2018 (UTC)

In the #Vaginal weightlifting discussion above, I argued against including the vaginal weightlifting material because it is WP:Fringe, but Axl wanted to include it precisely because it is WP:Fringe. So I re-added it. I reworded the material to address your "by whom" tag, even though I don't like the degree of acceptability that "may" gives off for that line. I thought about adding "has been used," but decided against it since it's not a past matter. The "by whom" tag is obviously not needed for "may be used" since it's clear that we mean "by women," not by anyone notable.

I like/support your proposed summary for that very long paragraph. Flyer22 Reborn (talk) 19:28, 20 January 2018 (UTC)

I appreciate the comments provided by Rivertorch. I will be happy to edit the content I added according to the the comments. I actually do add content all the time in the form of bullet points and so I'm not surprised to read your comment about this. Let me do the downsizing since the referencing is complicated and I want to make sure that the references are placed after the content they support. Also, some of the refs may need reformatting if they are deleted but used somewhere else in the article. Thanks so much for the feedback. Best Regards, Barbara (WVS) ✐  ✉ 20:03, 20 January 2018 (UTC)

But you didn't specifically comment on his proposal. Again, instead of collaborating in that way, you are going back to your draft to add what you want. Unless, of course, you will be editing the third paragraph down to what Rivertorch suggested. Flyer22 Reborn (talk) 20:20, 20 January 2018 (UTC)

I'm not following you FR 22. If you were watching me edit in the draft space, then I can understand the comment above. If you look at the article now, I inserted the revised content suggested by Rivertorch. Referencing the revised content was difficult and didn't happen instantaneously. The only thing that I altered from RT's version was to list the causes in order from the most common to the least common. There is no way for someone to know this unless they want to read the sources. Best Regards, Barbara (WVS) ✐  ✉ 21:28, 20 January 2018 (UTC)

Barbara (WVS), and I didn't state that you are following me. It's certainly clear that you don't seem to be listening to me, if that's what you mean by "I'm not following you FR 22." And if that is the case, I will state now that you should not complain if I ignore you in return (for example, if I delete any substantial material you add without discussing whether or not it should be deleted). I trust that if you really want to discuss something with me, you will post something on the talk page that is directly related to something I did. That is, unless the post is a general post. And if it's a general post, I may just ignore it and edit per the post if there are any valid points made in it. It's clear that I can make the same comment as Rivertorch or others and you will ignore me and act like they are the first ones stating it, or that it takes others weighing in before you are willing to resolve the problem. Whatever gets the job done, I suppose. Anyway, although I am not following you, it is the case that I specifically stated that I would be waiting until you added the aforementioned material before I nominated the article for GA. And it is the case that others have been watching to see what you are doing so that we can get on with everything. I look at your contributions every now and then, and only because you are working on content related to this article. If it were not for that, I would not care what you are doing or care to discuss it with others via email. And with regard to the editors you contacted to weigh in on this article (the ones I know about anyway), I had all except one of them on my watchlist. And now I am waiting to see how to deal with this vaginal support stuff since others still have not yet weighed in on that and since you intend on adding content about that as well. As for the cut you made, yes, that is much better. Flyer22 Reborn (talk) 22:25, 20 January 2018 (UTC)

When I stated that I wasn't following you I meant: "I couldn't follow your reasoning and didn't understand what you meant". As for reviewing my work, that is what the draft page is about. And if you aren't reading it to assess the content that I am working on, then someone else has been assessing my drafts since the page views are twice the number of edits to the page. Best Regards, Barbara (WVS) ✐  ✉ 23:13, 20 January 2018 (UTC)

Barbara (WVS), since I was clear about stating that you needed to significantly downsize the content, it seems you are referring to what I stated about Rivertorch's proposal. I meant that you simply acknowledged that your content needed downsizing without specifically commenting on whether or not you would go with his exact proposal. He proposed wording; you did not state if you liked the proposal or disagreed with it, or that you would go with that exact proposal. You did state, "I will be happy to edit the content I added according to the comments." But that is not the same thing as stating that you would be using his exact wording. As for your draft, I already stated that others have been watching to see what you are doing so that we can get on with everything and that I have been looking at your contributions every now and then and only because you are working on content related to this article. I don't have your draft watchlisted, though. Flyer22 Reborn (talk) 23:43, 20 January 2018 (UTC)

I also don't think you are correct on how you are framing your draft's page views vs. edits, but that is another discussion, one we won't be having. Flyer22 Reborn (talk) 23:49, 20 January 2018 (UTC)

Thanks, Barbara (WVS), for filling in the refs. Here's the rub, though: You said above, "The only thing that I altered from RT's version was to list the causes in order from the most common to the least common", but that isn't so; what you added diverged from my proposed text in multiple ways, some of them substantive. This had the effect of retaining the old, problematic wording in several places. (You also removed from my proposed wording several wikilinks and retained from the old version what appears to be a stray markup tag, but never mind.) Since you've clearly indicated that your intention was to alter only the order of causes in my proposed wording, I have revised the paragraph in question per that wording and left the order as you prefer. The value of the significant changes should be fairly obvious, but in case it isn't, I'll say this much here. If you want to mention incontinence, fine, but your wording implied that flatus via the vagina constitutes incontinence, which it really doesn't, unless incontinence has an additional meaning of which I'm unaware. Also, if you really want it to say "urinary system" instead of "urinary tract", fine, although there's no need; the latter is a widely used term and redirects to the former. But there is no such thing as "the gastrointestinal and urinary system" (your wording), and "urinary and gastrointestinal tracts" seems like perfectly accurate wording, as well as being neater. Rivertorch^FIRE_WATER 06:54, 21 January 2018 (UTC)

Thank you again for going over the content. I think your version is more focused. Here was the problem with the first sentence and its references-only one source mentioned the flatus. All others focused on the fistulas and the resulting incontinence. Fistulas are always described in the sources as resulting in incontinence. In my effort to substantially pare down content, I thought I could combine these ideas into one sentence. I would rather drop the flatus to emphasize the incontinence since that is such a profound consequence compared to flatus. The removal of the wls was unintentional. The copy editing that I had to do was complicated and I was careless to leave those links out of the new version. The extraneous markup is to hide the 'extra' references that support content. I find these 'hidden' references oftentimes when I am editing other medical articles and also insert them regularly. The purpose of retaining these references, at least in this case, is to allow me or other editors to glean these references and use them in other articles where more detailed referencing will be needed. Best Regards, Barbara (WVS) ✐  ✉ 20:18, 21 January 2018 (UTC)

In that case, by all means, let's drop the flatus and mention the incontinence. I've changed it now to accomplish just that. I'm sure you'll adjust any refs, if that's needed. I don't really understand what you said about the extraneous markup—as I recall, it was a close nowiki tag—but it really doesn't matter to me. It might confuse future editors, I guess, but I'm not going to worry about it. Rivertorch^FIRE_WATER 05:18, 22 January 2018 (UTC)

Flyer22 Reborn, for the weightlifting thing, how about "is sometimes used"? Rivertorch^FIRE_WATER 07:03, 21 January 2018 (UTC)

Nah, River, I think "may" is better than "sometimes" in this case. Flyer22 Reborn (talk) 08:34, 21 January 2018 (UTC)

I'm probably overthinking it. Rivertorch^FIRE_WATER 16:22, 21 January 2018 (UTC)

Vaginal anomalies

The proposed text for this section can be found at:User:Barbara (WVS)/condensation. I'm still formatting the references and also intend to remove some. If it is 'generally' okay, I can paste it into the article for editing for prose and such. That will cut down on the length of talk page discussions. I'm pretty sure I will concur with changes made or suggested by other editors.

Barbara (WVS) ✐  ✉ 12:18, 26 January 2018 (UTC)

I feel that there's no need for a new talk page discussion for this when one (more than one) already exists for it above. This just makes the talk page unnecessarily longer. As for the content in your draft, I assume you are pointing to the first portion (before the "pop" section). It includes some material that is already in the "Anomalies and other health issues" section. So it's not fully clear what you are proposing. The content in the draft is disorganized. The content in the Vagina article is not. From what I can tell, you are proposing that we add stuff from the draft that is not already here at the Vagina article. I'll see if Axl and Rivertorch want to weigh in on this. As for me, I do not think you should add the content as is. I do not think you should reformat the "Anomalies and other health issues" section. All that needs to happen is that some material from your draft be incorporated into the section. Flyer22 Reborn (talk) 16:19, 26 January 2018 (UTC)

Yeah, some of it does look redundant, and I'm also concerned with how disjointed it is. I'm also wondering about the incidence of some of these disorders. If they're vanishingly rare, they probably don't deserve mention in this article. In any event, without knowing the precise proposal—what specific text is intended to go where—it's hard to know what else to say. Rivertorch^FIRE_WATER 18:38, 26 January 2018 (UTC)

For all the reasons above, I concur with your comments. What I need to know is what is considered redundant. Vaginal cancer is vanishingly rare compared to many of these anomalies. I'm not sure we want to go in that direction-mentioning the most common things associated with the vagina. That would take a determination of all the occurrences of each 'thing' and then determine a cut off point for those things that are not common enough to mention. I will polish things up a bit to see if it can hang together better. Best Regards, Barbara (WVS) ✐  ✉ 00:31, 27 January 2018 (UTC)

By "redundant," we obviously mean that the draft we are looking at covers things that are already mentioned in the "Anomalies and other health issues" section. It is not hard to simply include things from the draft that are not already mentioned in the "Anomalies and other health issues" section, and to not go overboard with that material. As for vaginal cancer, which is covered in the "Infections, diseases, and safe sex" section, yes, it is rare (as I've mentioned times before). But cervical cancer, which has a relationship to vaginal cancer, is not rare, and they share one paragraph in the "Infections, diseases, and safe sex" section; there is no need for any more on them in the article. Flyer22 Reborn (talk) 00:52, 27 January 2018 (UTC)

"Because vaginal cancer can occur at the same time as, and often as a consequence of, cervical cancer (a common form of cancer), it may be that their causes are the same." Vaginal cancer is not a consequence of cervical cancer. Cervical cancer grows and metastasizes and can extend into the vagina. There is no relationship between vaginal cancer and cervical cancer (except proximity) because the malignancy originates in either the tissue of the cervix or the tissue of the vagina. IF the malignancy originates from vaginal tissue and even touches the cervix it is then classified as cervical cancer. I don't think the current text conveys this idea at this point. Also, 'overboard' is a little vague. But I suppose there is some subjectivity in the matter. Best Regards, Barbara (WVS) ✐  ✉ 01:09, 27 January 2018 (UTC)

Barbara (WVS), and yet we have three reliable sources (and other reliable sources) that disagree with you. We have this American Cancer Society society source, which lists having cervical cancer as a risk factor for vaginal cancer; it states, "Having cervical cancer or pre-cancer (cervical intraepithelial neoplasia or cervical dysplasia) increases a woman’s risk of vaginal squamous cell cancer. This is most likely because cervical and vaginal cancers have similar risk factors, such as HPV infection and smoking." We have this 2011 "Textbook of Gynecology" source, from JP Medical Ltd, page 270, which states, "Vaginal cancer is frequently found as synchronous or metachronous neoplasm of cervical cancer. This has led to the suggestion that there may be shared etiologic features between vaginal and cervical cancer." This 2017 "Principles and Practice of Gynecologic Oncology" source, from Lippincott Williams & Wilkins, page 87, also states, "Vaginal cancer is frequently found as a synchronous or a metachronous neoplasm with cervical cancer." The term synchronous means "existing or occurring at the same time." The term metachronous means "occurring or starting at different times" or (according to some medical sources) "develop consequently." And etiologic is referring to etiology, which means "cause, origin; specifically: the cause of a disease or abnormal condition." So how is there "no relationship between vaginal cancer and cervical cancer"? How does the previous or current text not align exactly with what these three sources state? How many more sources should I provide in this section to prove my point on this matter?

Nothing vague about "overboard"; it's been easy for me and others to see when you are going overboard with detail. Flyer22 Reborn (talk) 01:47, 27 January 2018 (UTC)

Changed "as a consequence of" to "or after" for now, despite sources stating that cervical cancer increases the risk of vaginal cancer and that the causes seem to be the same. The section still notes that it increases the risk. On a side note: This 2014 "Singer & Monaghan's Cervical and Lower Genital Tract Precancer: Diagnosis and Treatment" source, from John Wiley & Sons, page 186, states, "It has been assumed for many years that both cervical and vaginal neoplasias share a common etiology, although the direct evidence has been difficult to document. However, indirect evidence comes from a number of associations. The most notable is that vaginal and cervical neoplasias occur synchronously; that cervical cancer survivors have an increased risk of developing vaginal neoplasia as a second primary tumor and vice versa; and that HPVs, which are now recognized as the viral agents involved in the pathogenesis of cervical neoplasias, are present in vaginal tumor tissue. A multicenter case-controlled study of in situ and invasive vaginal carcinomas found that certain parameters of sexual behavior were only modestly related to vaginal cancer risk and that even in women who had reported five or more sexual partners in a lifetime the risk of disease was only 1.4-fold increased. An early age of first intercourse was not found to be associated, and this was surprising given the consistency in the association of these factors with cervical cancer causation. However, in that study, women who reported a history of sexually transmitted diseases, most commonly due to genital warts, were found to be at excess risk of vaginal tumors. It is believed that 70% of tumors are HPV induced, mostly as a result of HPV type 16." Flyer22 Reborn (talk) 03:01, 27 January 2018 (UTC)

Similar to the "vaginal fistula" details, I think that Barbara's proposed text about anomalies is too detailed for our generic article. Two or three sentences should be included, with a link to the main article ("Vaginal anomalies"). Also, there are several syntax/typographical errors that should be corrected. I am reluctant to edit an editor's personal subpage without permission. Axl ¤ [Talk] 11:24, 30 January 2018 (UTC)

Axl, the draft has changed significantly since River and I last replied, but, yeah, what I see there is too detailed for this article. The Vaginal anomalies article doesn't even yet have most of that material. It's currently a list and should be changed into an article. Flyer22 Reborn (talk) 18:14, 30 January 2018 (UTC)

And by "list," I mean the List of vaginal anomalies article Barbara (WVS) created. We don't need both the article and the list. It should all be covered together. Flyer22 Reborn (talk) 18:17, 30 January 2018 (UTC)

Thank you for pointing out "List of vaginal anomalies". Much of the information in the draft should be moved to that list article. Axl ¤ [Talk] 21:41, 30 January 2018 (UTC)

Axl and Rivertorch, per our concerns, I just reverted a significant amount of detail added by Barbara (WVS). Barbara (WVS), this is the type of thing I mean about you simply adding what you want despite what others state. Again, what is the point of you proposing content on this talk page if you are going to add what you like anyway? Flyer22 Reborn (talk) 12:19, 31 January 2018 (UTC)

Discuss content removal here

I reverted and would like a discussion about the removal of such a large amount of content. I incorporated all the comments and and suggestions you and others have written. In summary:

• I incorporated all comments from this talk page into the content I added to the article.
• I shortened the draft significantly after incorporating the comments that were posted here on the talk page.
• All of the content that exists in this, the vagina article is in the List of vaginal anomalies article and in all the subarticles of the new vaginal anomalies article.
• The article List of vaginal anomalies contains significantly more detail that the content I added to this article.
• The amount of content added to this article is due weight because of the massive amount of literature that exists on this topic compared to many if not most of the other sections of this article.
• The section title is Vaginal anomalies and perhaps a reader would expect to find this much information in a section with this title.
• Are we discussing the amount of space that the section anomalies takes up on the page or are we discussing the specific content that does not belong in the article? No specific content was identified as needing removal. If specific content needed to be removed, that could have been easily accomplished and I have gladly done so in the past.

Best Regards,Barbara (WVS) ✐  ✉ 12:25, 31 January 2018 (UTC)

Barbara (WVS), reverted again per above and per WP:ONUS. There are three editors contesting this level of detail. If you want to know why, then read above and actually listen. The content can indeed easily go into the List of vaginal anomalies article and be renamed "Vaginal anomalies." Do not WP:Edit war when three editors contest your content. Flyer22 Reborn (talk) 12:51, 31 January 2018 (UTC)

And, no, the list you have going on does not sufficiently cover all that you added here. That list should not be preferred to WP:Prose at all. Flyer22 Reborn (talk) 12:55, 31 January 2018 (UTC)

Flyer, There must be consensus on content removal The details follow:

"If an edit war occurs between just two users over content, it shall be discussed in hopes of a settlement from among the community.

• It is preferable that good-faith additions remain in the article pending consensus unless:
• The article is a biography of a living person, and the material is potentially harmful
• The neutrality of the material may be in question
• The copyright status of the material is in question
• One or more external links are in question"
• Material clearly not added in good faith should be removed pending consensus."

Best Regards, Barbara (WVS) ✐  ✉ 13:12, 31 January 2018 (UTC)

Barbara (WVS), no, regarding this, I do not need consensus to alter your heading. Per WP:Talk, since I have altered it and you have objected to the alteration, I should not alter it again, however. Either way, it is not for you to tell us where to discuss matters. Regarding you reverting yet again, no, consensus is not needed to remove your content. But consensus is already against your content. You clearly saw editors discussing the matter above and making it clear that this level of detail should not be included. But what did you do? You did what you always do -- add what you want anyway, after proposing something as if you actually had any intention on listening to anything others had to state. And, again, this is just one reason that I cannot work with you and why I'm sure trying to with you in a GA review would be a disaster. You are intentionally making this article unstable despite me asking you more than once not to do so. Wikipedia:Content removal is not a guideline or policy. It is an essay. WP:ONUS is a policy and you have continued to violate it. I await someone else to revert your content. And make no mistake about it... It will be reverted. Flyer22 Reborn (talk) 13:31, 31 January 2018 (UTC)

Excessive detail was removed. This is easily assessed by reviewing the page history where the draft could be reviewed. I listened. I have every intent on incorporating content and comments from other editors. Six other respected editors have added to content and edited content so far this month. I can hardly apologize or be responsible for the instability of the article. An article is stable or isn't. You can't artificially 'create' stability but stability should result once the many editors are satisfied that the article needs no more work. I also await further discussion. It is best to leave out discussions of intent because I edit in good faith. We should stick to discussions about content instead of personal characterizations. I also assume you edit in good faith. Every opportunity exists for the article to become a good article. That is what I am working toward. Best Regards, Barbara (WVS) ✐  ✉ 13:35, 31 January 2018 (UTC)

Barbara (WVS), there is no guideline or policy supporting you. Excessive detail was added. Bottom line. And you not being able to follow WP:ONUS is a problem. It's already clear that you lack collaboration skills. And I will not be retracting my characterizations of your poor behavior. Stop stating that you have listened when you have not. Best. Flyer22 Reborn (talk) 13:47, 31 January 2018 (UTC)

And regarding your add-in to your comment above, six other editors are not edit warring against consensus. You are! And having an article that has current WP:Edit warring is one of the strikes against GA review; you've already been told this. In the past, you assured that this would not happen. But as expected, you could not keep your word. Even if I wanted to discuss things with you (which I don't), you don't discuss. You've stated that talk pages are a waste of time and that you are lousy with them. You've certainly shown that here at this talk page. Time and again you do not listen. It's also abundantly apparent that you haven't a clue what it takes to make a good article. You can't even collaborate well here on the talk page. How in the world am I to work well with you in a GA review? It's not rocket science to see why I continue to be frustrated with your edits and the way you conduct yourself when it comes to trying to work matters out on the talk page. Flyer22 Reborn (talk) 14:10, 31 January 2018 (UTC)

*sigh* There is little mileage in trying to establish who correctly applied the guideline or whose reversion isn't backed by consensus.

In the interest of moving forward, may I suggest that everyone refrain from large-scale editing of the article. Even single sentence edits should ideally be discussed on this talk page first so that we can establish a clear consensus. Thanks. Axl ¤ [Talk] 14:47, 31 January 2018 (UTC)

I concur and think this is a great idea. Thanks for stepping in. The only thing that I regret is that this will use up a lot of time for the other editors. Best Regards, Barbara (WVS) ✐  ✉ 19:09, 31 January 2018 (UTC)

This is hardly any different than what I suggested before. And since you cannot effectively collaborate or follow the rules, such as WP:ONUS, it is clear that it is needed. I will also be requesting this route during the GA process. I do not have time for this nonsense from you.

In the meantime, it's clear that we have three editors thus far who feel that your "Anomalies and other health issues" material is overly detailed. WP:Consensus is not unanimity; read that policy. So there is no need for us to have your agreement to revert your overly detailed material that should be in the Vaginal anomalies article instead. Flyer22 Reborn (talk) 19:20, 31 January 2018 (UTC)

(e.c.) Since discussion is ongoing, I'll hold off on making any reverts for the time being. However, I admit to being baffled. Multiple editors have expressed concern about too much detail being added in this section, yet the article just grew by 13 kilobytes. I also indicated several days ago that I was unclear as to what specific content was proposed to be added. Barbara (WVS), in my view, you should walk this back by self-reverting and then seek consensus here instead of adding—and re-adding—the disputed content. Rivertorch^FIRE_WATER 19:36, 31 January 2018 (UTC)

(edit conflict) And your "The only thing that I regret is that this will use up a lot of time for the other editors." is reflective of your "talk pages are a waste of time" mindset. For those who actually care about significantly improving an article and listening to other editors' concerns instead of simply adding as much content as they can and claiming how much of the article they've improved, it is not taking up anyone's time to sit and discuss what is or is not best for the article. Rivertorch, Axl and myself assessed your material and plainly stated that your proposed content was not only disorganized and needed copyediting, but was also too much for this article. You questioned what "overboard" is. Instead of significantly downsizing the content and continuing to discuss with us what version we may consider appropriate, you added a buttload of material that you knew we would object to. *Sigh* indeed. Flyer22 Reborn (talk) 19:39, 31 January 2018 (UTC)

I feel that there is consensus now that enough editors want to further review the content that I added and I will self-revert. I will post the text of the proposed section on anomalies below. I am very thankful for the feedback. I would like to suggest that each sentence be discussed because the referencing has been very difficult. I'll let other editors know when the edits are not supported by the sources, but I don't see that being a major hurdle since I was able to do it before on the section on fistulas. Before you begin to evaluate the proposed content posted below, you may want to take another look at Vaginal anomalies. Best Regards, Barbara (WVS) ✐  ✉ 20:49, 31 January 2018 (UTC)

I don't see any evidence that we want to further review. You having significantly expanded the Vaginal anomalies article doesn't negate the fact that the amount of content you added to this article is too much/unnecessary for this article. Anomalies are far from the norm; they usually are not common and yet your anomalies material consists of a lot more information than more common things concerning the vagina in the article. By definition, anomalies means "oddity, peculiarity, abnormality, irregularity, inconsistency, incongruity, aberration, quirk, rarity." You have been asked to revert because there is no consensus to include all of that material and it is disputed. It is up to you to convince us to retain all of that material, and then we add it if you do. It is not up to us to convince you to exclude it, and to let it remain until we do. This is what WP:ONUS is all about. And I see that (below) you've made yet anther section for the same discussion. Good grief. Flyer22 Reborn (talk) 21:01, 31 January 2018 (UTC)

Proposed content to be added on vaginal anomalies

Perhaps we can look at the anomaly section in the cervix article here to help assess the appropriate length for this article. I would like to point out that there are more vaginal anomalies than cervical anomalies. Specific suggestions are helpful since 'trimming' certain text and accompanying refs will take careful editing. I have included my own suggestions for reducing the amount of content:

Vaginal anomalies are rare congenital defects that result in an abnormal or absent vagina. A large proportion of these defects are classified under the broader term Mullerian Duct Anomalies. Mullerian Duct Anomalies are caused by a disturbance during the embryonic time of genitourinary development. The other isolated incidents of Many vaginal anomalies can occur with no apparent cause. Oftentimes vaginal anomalies are part of a cluster of defects or syndromes. In addition, (and) inheritance can play a part as can prenatal exposure to some teratogens. Many vaginal anomalies are not detected at birth because the external genitalia appear to be normal. Other organs of the reproductive (organs) system can be functional despite the presence of a vaginal abnormality. A vaginal anomaly does not necessarily prevent conception and a successful pregnancy.

The most common vaginal anomaly is an imperforate hymen. The hymen can be unusually thick or partially obstructed by the presence of fibrous bands of tissue. Other abnormalities of the hymen can exist including the presence of septa, displacement and a hymen that consists of microperforations. Uncommonly, a double hymen is present.

Congenital adrenal hyperplasia can cause the abnormal development of the vagina. Vaginal adenosis is the abnormal presence of cervical and uterine tissue within the wall of the vagina. Ten percent of women have this condition and remain unsymptomatic. It rarely develops into a malignancy. Cloacal exstrophy is a condition when two vaginas are present.

Vaginal agenesis or the complete absence of the vagina affects 1 out of 5,000 women. A hemivagina is the abnormal presence of a partial vagina that is attached to the wall of the functioning vagina. The hemivagina does not open to the normal vagina and is attached to an abnormal, second uterus. Vaginal hypoplasia is the under-development of the vagina and is found in instances of complete androgen insensitivity syndrome. Vaginal septa are structures consisting of fibrous tissue that block the vagina. The tissue extends horizontally, blocking or partially blocking the vaginal canal or transversly essentially creating two vaginas that connect to a normal uterus. Septa can prevent menstrual flow and result in painful intercourse, though some women do not have symptoms.

Prenatal exposure to some hormones can cause vaginal anomalies as can the lack of necessary hormones needed for normal development. Some congenital syndromes present with vaginal anomalies in association with other serious conditions. These include Fraser syndrome, WNT4 deficiency, and Bardet-Biedl syndrome,

Barbara (WVS) ✐  ✉ 21:22, 31 January 2018 (UTC)

• Let me put it this way: I'm not clear why the text currently in the subsection "Anomalies and other health issues" isn't sufficient. We discussed previously the issue of incidence and the inappropriateness of mentioning very rare conditions in this article. You've created Vaginal anomalies, a new article with a much narrower focus, yet you're apparently wanting to significantly expand the section here on anomalies. I don't understand that. Are any of the anomalies you want to add reasonably common—i.e., are they conditions that occur frequently enough that the average reader would expect to find information on them in this general article? I think it would be preferable to clear up this question before looking at your proposed addition in any detail, but one thing did jump out at me: you've defined here Cloacal exstrophy (which occurs once in every 400,000 births—a very rare disorder!) as a condition involving an extra vagina. While our dedicated article doesn't rule out the possibility of that happening, neither does it specify that it's usually the case. In fact, it seems as if an extra vagina would be among the least serious of the conditions likely to result from that birth defect. Rivertorch^FIRE_WATER 03:56, 1 February 2018 (UTC)

Rivertorch, thank you again for weighing in on this. I will respond briefly:

• Very rare conditions are not mentioned in the proposed content on vaginal anomalies to be added to this, the vagina article.

• The exact incidence of some of of these anomalies is unknown and the 'rareness' can't be determined at this time. This is mostly due to the incompleteness of my editing of the vaginal anomalies article. I am working as quickly as I can to address the issues of editors that have commented about the newly created vaginal anomalies article. To put this another way would be to say, many, if not most vaginal anomalies are more common than vaginal cancer.
• The main article on cloacal extrophy has not been updated with the information that I have found-but it needs to be. A reader who has just had a child with this condition will come to this article for information. There at least needs to be a link.
• I don't expect anyone to go through the references, but the volume of web and textbook content on these anomalies is extensive. This includes governmental and professional organizations who have published information on this topic. They have, at least, determined that some of these anomalies are notable.

Assuming that most of those readers who access this article are women, at least 700 views each day are by women with a vaginal anomaly. I propose the addition of the content that I have furthered edited that appears above. Best Regards, Barbara (WVS) ✐  ✉ 07:05, 2 February 2018 (UTC)

Barbara, it is unclear to me why you are making this proposal here. It would be better placed at Talk:Vaginal anomalies. Axl ¤ [Talk] 14:00, 1 February 2018 (UTC)

Axl, I thought that the purpose of discussing vaginal anomalies here, on this talk page, was to determine exactly what amount of detail should appear in this, the main article and topic of the vagina. I'm sorry if there is any confusion. Best Regards, Barbara (WVS) ✐  ✉ 07:05, 2 February 2018 (UTC)

Agree with an entire subarticle on the topic the majority of the details should go there with only a short overview here. Doc James (talk · contribs · email) 02:48, 2 February 2018 (UTC)

Most (90%) of the the content on vaginal anomalies currently exists in its own article. Barbara (WVS) ✐  ✉ 07:05, 2 February 2018 (UTC)

Barbara, the title of this section is: "Proposed content to be added on vaginal anomalies". I interpreted this to mean that the content might be added to the article "vaginal anomalies". If that wasn't your intention, you should not have wikilinked to that article in the title.

The proposed content is too detailed for this article. Axl ¤ [Talk] 20:21, 2 February 2018 (UTC)

• OK, so we have a pretty clear consensus to keep the anomalies section short, and I think several of us would like to wrap this up pretty soon. @Barbara (WVS): Do you believe there are any serious omissions in the section as it stands now or would you say it constitutes a reasonable overview of the topic? If you think there are omissions, could you identify what they are so that we can move forward? Rivertorch^FIRE_WATER 05:07, 2 February 2018 (UTC)*

I do not believe there are serious omissions in the text (as it appears above in this thread). But I don't believe what exists in the article adequately covers the topic of vaginal anomalies as it appears in the vagina article at this time. At this time, Only one sentence appears in the article that covers this topic. As Doc James has mentioned above, a short overview would be helpful. I'm am sorry to see this drag on for everyone. No one wants to see this resolved more than I do. I've responded to the concerns of editors and proposed a newly shortened, edited, version above, in this thread. I was hoping to get feedback for the inclusion of this shortened version into this article. For the sake of brevity let me summarize:

• Editors have asked to review major changes to this article before content is inserted. Done
• Editors have asked to discuss each sentence that I would like to insert. Done
• Editors have asked to have most of the information about vaginal anomalies in its own article. Done
• Editors have asked to 'pare down' the information. Done
• Editors have asked to cover the major vaginal anomalies in this article. Done
• Editors have identified specific content that should not be included in the proposed addition as it appears above. Not done
• Editors have approved the proposed content as it appears above, in this section of the talk page. Not done

Best Regards, Barbara (WVS) ✐  ✉ 07:05, 2 February 2018 (UTC)

Here is exactly what I am proposing to be added to this article (sans refs):

Vaginal anomalies are rare congenital defects that result in an abnormal or absent vagina. Many vaginal anomalies can occur with no apparent cause. Oftentimes, vaginal anomalies are part of a cluster of defects or syndromes and inheritance can play a part as can prenatal exposure to teratogens. Many vaginal anomalies are not detected at birth because the external genitalia appear to be normal. Other reproductive (organs) can be functional despite the presence of a vaginal abnormality. A vaginal anomaly does not necessarily prevent conception and a successful pregnancy.

The most common vaginal anomaly is an imperforate hymen. The hymen can be unusually thick or partially obstructed by the presence of fibrous bands of tissue. Other abnormalities of the hymen can exist including the presence of septa, displacement and a hymen that consists of microperforations. Uncommonly, a double hymen is present.

Congenital adrenal hyperplasia can cause the abnormal development of the vagina. Vaginal adenosis is the abnormal presence of cervical and uterine tissue within the wall of the vagina. Ten percent of women have this condition and remain unsymptomatic. It can but rarely develops into a malignancy. Cloacal exstrophy is a condition when two vaginas are present.

Vaginal agenesis is the complete absence of the vagina. Vaginal hypoplasia is the under-development of the vagina and is found in instances of complete androgen insensitivity syndrome. Vaginal septa are structures consisting of fibrous tissue that block the vagina. The tissue extends horizontally, blocking or partially blocking the vaginal canal or transversely essentially creating two vaginas that connect to a normal uterus. Septa can prevent menstrual flow and result in painful intercourse, though some women do not have symptoms.

Prenatal exposure to some hormones can cause vaginal anomalies as can the lack of necessary hormones needed for normal development. Some congenital syndromes present with vaginal anomalies in association with other serious conditions. These include Fraser syndrome, WNT4 deficiency, and Bardet-Biedl syndrome.

Best Regards, Barbara (WVS) ✐  ✉ 07:20, 2 February 2018 (UTC)

I could be wrong, but my sense is that this is still considerably lengthier than ideal. Except for the adenosis, there's no indication of rate of occurrence, and at the risk of repeating myself, I really think that rare conditions don't merit inclusion. The above needs significant editing regardless of which article it ends up in, but I don't want to begin that before it's trimmed, but I have no idea which bits ought to be trimmed. Doc James, can you provide any guidance on this? Rivertorch^FIRE_WATER 16:38, 2 February 2018 (UTC)

That a given condition is notable doesn't mean it should be mentioned in this article. But let's wait and see what others, hopefully including Doc James, have to say. Rivertorch^FIRE_WATER 16:54, 2 February 2018 (UTC)

I am guessing that the issue at this time is a bit different than it was before. And though I've changed the content and length and have addressed every single concern identified on the talk page regarding what was identified as being unacceptable, this still is not 'good enough'? I've created six new articles to contain the information that I was told did not belong in this article but in sub pages that did not exist to contain such information. I have done this in the good faith effort to comply with the preferences described by other editors.

Another GA, cervix contains 8 sentences about cervical anomalies. At least that is a good template to emulate even though cervical anomalies are much less common than vaginal anomalies. Are you saying at this point editing to reduce the size of the content that I would like to add will not be appropriate? I thought that length was the issue. A section on anatomical anomalies is appropriate according to MEDMOS. An anomaly is uncommon by definition or else it would not be an anomaly. Including the rates of occurrence would double the length of the content that I am proposing! The rates of occurrence are now in the vaginal anomalies article as has been suggested by other editors.

I have gladly complied with each of the concerns expressed by the editors participating in this discussion. I don't understand what else needs to be done.Best Regards, Barbara (WVS) ✐  ✉ 21:31, 2 February 2018 (UTC)

I stand by what I stated before. I don't see that any more needs to be added. Anomalies are rare regardless of how often the rareness occurs. Flyer22 Reborn (talk) 18:15, 2 February 2018 (UTC)

Since we haven't really defined 'rare', I'm going on the assumption that because 1 in 10 women have an anomaly, it is important. Right now, there is only one sentence in the article about anomalies. Best Regards, Barbara (WVS) ✐  ✉ 21:31, 2 February 2018 (UTC)par

Above, you just stated to River, "An anomaly is uncommon by definition or else it would not be an anomaly." Before that, I stated, "By definition, anomalies means 'oddity, peculiarity, abnormality, irregularity, inconsistency, incongruity, aberration, quirk, rarity'." "Uncommon" and "rare" are synonyms. What reliable sources state that 1 in 10 women have a vaginal anomaly? "1 in 10" is not classified as uncommon/rare. Flyer22 Reborn (talk) 21:45, 2 February 2018 (UTC)

I understand where you are coming from but have found discussions on definitions to be unproductive. Best Regards, Barbara (WVS) ✐  ✉ 22:02, 2 February 2018 (UTC)

Where I am coming from is not about definitions. It's about anomalies being uncommon/rare and us not needing as much detail on vaginal anomalies as you would like in the article. I also asked: "What reliable sources state that 1 in 10 women have a vaginal anomaly?" Your silence on that matter tells me that no reliable sources state that. I certainly haven't come across any stating that. Flyer22 Reborn (talk) 06:01, 3 February 2018 (UTC)

Kranl C, Zelger B, Kofler H, Heim K, Sepp N, Fritsch P (July 1998). "Vulval and vaginal adenosis". The British Journal of Dermatology. 139 (1): 128–31. Still, Best Regards, Barbara (WVS) ✐  ✉ 23:24, 3 February 2018 (UTC)

Given that you've been wrong a number of times about what sources state -- misreading/misinterpreting them and all -- and given that you did not provide a URL and/or quote showing that the source states this, and given that I'm not seeing any other sources that state this, and given that "1 in 10" is not uncommon/rare, you will have to forgive me for doubting the accuracy of your claim. Flyer22 Reborn (talk) 01:43, 4 February 2018 (UTC)

New version of proposed content to be added to this article

I propose the following content be inserted based upon the most recent comments by other editors (sans refs):

"Vaginal anomalies are defects that result in an abnormal or absent vagina. Oftentimes, vaginal anomalies are part of a cluster of defects or syndromes. Vaginal anomalies may go undetected because other structures appear normal. The most common vaginal anomaly is an imperforate hymen and it can be unusually thick or cause obstruction of menstrual flow. Another common anomaly is Vaginal adensosis. It rarely develops into a malignancy. Other vaginal anomalies are: Congenital adrenal hyperplasia, Vaginal agenesis, Vaginal hypoplasia, complete androgen insensitivity syndrome,Vaginal septa. Some congenital syndromes present with vaginal anomalies in association with other serious conditions. These include Fraser syndrome, WNT4 deficiency, and Bardet-Biedl syndrome."

This version consists of 8 sentences-the same number as the section on anomalies in the GA cervix article. I'm a little fuzzy on capitalization but that will be fixed. Best Regards, Barbara (WVS) ✐  ✉ 22:02, 2 February 2018 (UTC)

Is the above proposed to entirely replace Vagina#Anomalies and other health issues? I believe it's vaginal adenosis. I'm not sure of the value of presenting a list of unexplained links and would recommend picking say three or four "representative" anomalies and mentioning each with a very brief indication of what is involved. Johnuniq (talk) 02:53, 3 February 2018 (UTC)

If the above is meant to replace the current section, I oppose. It would be removing content that should be there, and we don't need both a "Vaginal anomalies" section and an "Other health issues" section. Flyer22 Reborn (talk) 06:01, 3 February 2018 (UTC)

We are missing the other common problems like obstetrical fistula. This also includes a bunch of conditions I have never heard of "WNT4 deficiency"? Really? Not needed. Doc James (talk · contribs · email) 08:39, 3 February 2018 (UTC)

Barbara (WVS), can you clarify? Is the above intended as a replacement for the current section or as an addition to it? You said above that there's currently only one sentence about anomalies, and I'm confused. Does "anomaly" have a strict medical definition or does it just mean here what it usually means? Rivertorch^FIRE_WATER 15:42, 3 February 2018 (UTC)

I apologize! It doesn't seem like things are getting better but instead things are more confusing now than they were a few days ago! I know some don't like the abruptness that I use but here goes.

• The current title of the Anomalies and other health issues seems fine and I'm not proposing a change to the section title or the creation of a new section.
• I am not proposing the deletion of any of the content contained in the current section Anomalies and other health issues.
• This section already does contain information on obstetric fistulas, so I don't know how to address this as a problem.
• It is an easy fix to remove any reference to the metabolic condition WNT4.
• I'm not sure the fact that someone has heard or not heard of something should determine its inclusion since, yes, this is an encyclopedia and an article on WTN4 does exist.
• I am really not adding 'representational' links but links to other articles describing the most common anomalies.
• I am using the word 'anomaly' in the same sense as it is described as a medical term here in WP. it is a type of congenital defect.

Idea: Here is what I am proposing:

Replace this one sentence: "Vaginal anomalies are rare congenital defects that result in an abnormal or absent vagina."

With these eight sentences: "Vaginal anomalies are defects that result in an abnormal or absent vagina. Oftentimes, vaginal anomalies are part of a cluster of defects or syndromes. Vaginal anomalies may go undetected because other structures appear normal. The most common vaginal anomaly is an imperforate hymen and it can be unusually thick or cause obstruction of menstrual flow. Another common anomaly is Vaginal adensosis. It rarely develops into a malignancy. Other vaginal anomalies are: Congenital adrenal hyperplasia, Vaginal agenesis, Vaginal hypoplasia, complete androgen insensitivity syndrome, and Vaginal septa. Some congenital syndromes present with vaginal anomalies in association with other serious conditions. These include Fraser syndrome and Bardet-Biedl syndrome."

Best Regards, Barbara (WVS) ✐  ✉ 23:20, 3 February 2018 (UTC)

I'll wait to see what others think of the proposal. Of course, the unnecessary capitalization should not be retained. But the version you currently have in the article is not a complete revert. This is the previous version. Compare it to the version that is there now. In the previous version, the text stated, "Vaginal obstructions may be caused by agenesis or an imperforate hymen or, less commonly, a transverse vaginal septum. The precise cause of an obstruction must be determined before it is repaired, since corrective surgery differs depending on the cause. A lump obstructing the vaginal opening is likely a Bartholin's cyst."

I don't see why you removed the Bartholin's cyst part. Flyer22 Reborn (talk) 01:43, 4 February 2018 (UTC)

I'll go ahead and re-add the Bartholin's cyst part since it was removed without reason and since Barbara (WVS) has not truly reverted herself despite requests that she should. Flyer22 Reborn (talk) 18:41, 4 February 2018 (UTC)

And the transverse vaginal septum part. Flyer22 Reborn (talk) 18:49, 4 February 2018 (UTC)

I put what I think is the proposal in my sandbox (permalink). I omitted the hidden comments that are currently in the article as those comments should be removed in due course. Feel free to edit the sandbox. I made one correction (as previously mentioned, it's vaginal adenosis not "adensosis"), and I fixed a couple of uppercase letters. "Oftentimes" sounds antiquated to me—why not "vaginal anomalies are often part"? As I said above, I would prefer picking three or four "representative" anomalies and mentioning each with a brief indication of what is involved. It's not useful to present a list of unexplained links, particularly when there is a main article. Johnuniq (talk) 02:51, 4 February 2018 (UTC)

Thanks, Johnuniq. (How many pages will this wind up on, I wonder.) I took a stab at editing it but didn't save my changes because I'm too baffled by the intended meaning in multiple places. Are we supposed to discuss it here or in your talk space? Rivertorch^FIRE_WATER 05:11, 4 February 2018 (UTC)

Please discuss it here. Let's start with opinions on the overall proposal. My opinion is just above. Spelling that out, I think the proposed text is too long with too many details for this article. In particular, the items listed with no explanation should be omitted. I am sympathetic with the idea of including "Kegel" somewhere in this article for anyone searching for that text, but the pelvic floor exercises should go. Any thoughts on what I said above about picking three or four "representative" anomalies? If in agreement, any opinions on what should be mentioned? Johnuniq (talk) 06:18, 4 February 2018 (UTC)

Welcome to the discussion. Here is what I thought we were discussing - adding information about vaginal anomalies...only. I might be mistaken, but now Jnq is proposing the rehash-ment of content that was hammered out beginning over a month ago. If that is it what takes, then that is what will be. I have attempted to create pages in my own talk space for the exact same purpose, I'm not sure that worked out well. I wish us the best. Best Regards, Barbara (WVS) ✐  ✉ 11:36, 4 February 2018 (UTC)

Well, I have to say that this is becoming quite confusing. We apparently have two separate bits of content that we're talking about:

1. what's already in the article, comprising the "Anomalies and other health issues" section, and
2. the additional text that is proposed above in this section.

The former has already been extensively discussed, edited, copyedited, and proofread, and it has been posted to the article for some while. Perhaps we could hold off on discussing it any further, for the time being.

At issue right now is the latter. Multiple editors have suggested that it's too long and too detailed (even the latest, pared-down version). Leaving the question of length and appropriate level of detail aside for a moment, I have some questions about its meaning, which I'll detail presently. Rivertorch^FIRE_WATER 16:03, 4 February 2018 (UTC)

Here are the substantive questions I have about the proposed additional content.

Vaginal anomalies may go undetected because other structures appear normal. I have no idea what this means. What other structures, and how would their apparent normality affect detection of anomalies of the vagina?

Many vaginal anomalies only become obvious when a female reaches puberty. Also, external genitalia can appear quite normal even when internal anomalies of the vagina are present. ^{Barbara (WVS) ✐  ✉ 00:32, 6 February 2018 (UTC)}

The most common vaginal anomaly is an imperforate hymen and it can be unusually thick or cause obstruction of menstrual flow. Thick in what way? "Thick" is a vague word; it suggests excessive size in one of three dimensions, but I'm afraid that my familiarity with female anatomy isn't up to the task of discerning precisely what this means. More precise language is needed here. Also, the "or" seems odd. I'd think the obstruction of menstrual flow might result from its being unusually thick, but this wording suggests otherwise, so this is counterintuitive.

The hymen is a membrane. Dimensions describing membranes usually assume one dimension. Consider, for example, the eardrum. If an eardrum was thick, we probably would not think it was wider. A normal hymen is open and allows the flow of menstrual fluid. The obstruction of menstrual flow is because the hymen is patent. ^{Barbara (WVS) ✐  ✉ 00:32, 6 February 2018 (UTC)}

Some congenital syndromes present with vaginal anomalies in association with other serious conditions. These include Fraser syndrome and Bardet-Biedl syndrome. Huh? This is incredibly disordered. We've got three different things mentioned—congenital syndromes, vaginal anomalies, and serious conditions—with no indication of what they are or how they actually relate to each other. Which does the word "these" refer to? Also, are vaginal anomalies never congenital in and of themselves but only copresent? And does "other" mean other than congenital syndromes or other than vaginal anomalies. Rivertorch^FIRE_WATER 16:25, 4 February 2018 (UTC)

I'll try to describe the terms. There are things called congenital syndromes. Some congenital syndromes can be visually detected by the presence of a visible vaginal anomaly. Of course, not all congenital syndromes have anything to do with vaginal anomalies. Some vaginal anomalies are not very serious and are easily corrected. Other vaginal anomalies can exist as part of a life-threatening syndrome. Vaginal anomalies are always congential. ^{Barbara (WVS) ✐  ✉ 00:32, 6 February 2018 (UTC)}

Thanks, River. Yeah, the consensus so far is that the section should be how it previously was or how it is now. As for Barbara (WVS)'s proposal for the first paragraph, I am indifferent to it. Flyer22 Reborn (talk) 18:41, 4 February 2018 (UTC)

Johnuniq, you stated, "I am sympathetic with the idea of including 'Kegel' somewhere in this article for anyone searching for that text, but the pelvic floor exercises should go." The only reason we have included Kegel exercises is because of their association with the pelvic floor muscles and treating pelvic organ prolapse. I don't see that they need their own section or need to be mentioned in any other place in the article. Per the #Vaginal weightlifting discussion above, I'd rather that vaginal weightlifting not be mentioned at all, but Axl made a point about mentioning it. Flyer22 Reborn (talk) 18:41, 4 February 2018 (UTC)

@Barbara (WVS): Would you please clarify the points I asked about above? Rivertorch^FIRE_WATER 00:01, 6 February 2018 (UTC)

My responses are above. You are one day ahead of me. ^{Barbara (WVS) ✐  ✉ 00:32, 6 February 2018 (UTC)}

OK, thanks. I'll plan on editing it based on your responses sometime in the next 24 hours. Rivertorch^FIRE_WATER 03:51, 6 February 2018 (UTC)

I wish us both good luck on this. Apparently the content on vaginal anomalies has been edited to a new version that has not been discussed. Is this how things are supposed to work? I feel special. I am the only editor working on this article that has to present proposed content to all other editors for their consideration. If it is helpful to explain things further on this topic, you might want to see the Vaginal anomalies article. Best Regards, Barbara (WVS) ✐  ✉ 23:13, 6 February 2018 (UTC)

I have absolutely no idea what that means, but I detect an objection of some sort. Why don't you say it plainly? Rivertorch^FIRE_WATER 05:38, 7 February 2018 (UTC)

Plainly: I have been the only editor who has been requested to submit proposed changes to this article. This is an observation, not an objection. Best Regards, Barbara (WVS) ✐  ✉ 13:49, 7 February 2018 (UTC)

I see. Well, as long as it's just an observation, I'll reserve comment. I'm pasting my edit below and have just one more question: it says that the most common vaginal anomaly is imperforate hymen, but the hymen article says that the hymen is part of the vulva, not the vagina. I have no idea whether that's important. My edit of proposed vaginal anomalies paragraph:

Vaginal anomalies are defects that result in an abnormal or absent vagina. Many anomalies go undetected because the external genitalia appear normal. The most common vaginal anomaly is imperforate hymen, a condition in which the hymen obstructs menstrual flow. Another is vaginal adenosis, a type of abnormal growth; this rarely becomes malignent. Other vaginal anomalies include congenital adrenal hyperplasia, vaginal agenesis, vaginal hypoplasia, complete androgen insensitivity syndrome, and vaginal septa. Some congenital disorders, such as Fraser syndrome and Bardet–Biedl syndrome, present with vaginal anomalies in addition to other abnormalities.

At this point, I couldn't be happier with your version. Would you mind inserting it into the article? Best Regards, Barbara (WVS) ✐  ✉ 23:44, 7 February 2018 (UTC)

Hope this is helpful. I mostly just tried to make the wording clearer, with one or two stabs at concision. If I removed something vital, please say. Rivertorch^FIRE_WATER 16:01, 7 February 2018 (UTC)

Thanks again, River. The hymen has been called the vaginal corona, which is a relatively new term for it used to dispel sexist myths about it. It is a part of the vagina in the sense that it partially covers the vagina and lies just a little within the vagina. Keep in mind that the vaginal opening is a part of both the vulva and vagina. It is considered an aspect of the vulva because of its external opening. In addition to your tweaked content, I think that the following should be added to that paragraph: "Vaginal obstructions may be also be caused by vaginal agenesis, an imperforate hymen or, less commonly, a transverse vaginal septum. The precise cause of an obstruction must be determined before it is repaired, since corrective surgery differs depending on the cause. A lump obstructing the vaginal opening is likely a Bartholin's cyst." I think this text should be placed after the "this rarely becomes malignent" text, and that "vaginal agenesis" and "vaginal septa" should then be removed from the following text since they will have been mentioned earlier. The text I'm proposing was in the article for years and is currently there.

Barbara (WVS) stated, "Apparently the content on vaginal anomalies has been edited to a new version that has not been discussed." If she means this edit to the section in the article (which she is just now commenting on for some reason), no, Barbara (WVS), that is not a new version, except for the change in format you gave the material. It is me returning material you never added back. Consensus was for you reverting yourself, but you did not revert yourself. You simply hid text. And all of that hidden text needs to go. I tried to discuss that little bit of material with you above in this discussion section. You gave no reply. You have been asked to discuss changes first because not only can your content be overly detailed and have errors in it and/or need copyediting, you added a disputed level of content despite what was stated on the talk page about not adding it. Axl asked all of us not to make substantial changes to the article without discussion anyway. The only way that the edit I made is substantial is that it returned material you failed to return. Flyer22 Reborn (talk) 17:56, 7 February 2018 (UTC)

The presence of a vaginal septum is pretty rare and doesn't need to be included. A vaginal septum is not necessarily an obstruction when it is a longitudinal septum. A bartholin gland cyst is not anomaly. A missing vagina (agenesis) is not an obstruction because you can only obstruct a passageway that exists. Best Regards, Barbara (WVS) ✐  ✉ 23:44, 7 February 2018 (UTC)

Barbara (WVS), regarding this, per Wikipedia:Talk page guidelines#Editing others' comments, don't break up my comments. We recently had an RfC about not doing that. You've broken up River's comments above as well, but at least it's clear that you are replying to him.

As for your statement that "the presence of a vaginal septum is pretty rare and doesn't need to be included," the same can be stated of other mentioned anomalies. I'm going by what the reliable sources state. No one said anything about "not necessarily." The proposed wording states "may be." It makes sense to mention the most common one, or one of the most common ones and to then contrast that with the least common one or one of the least common ones. It's what sources do and what Wikipedia often does. When sources talk about vaginal obstruction, "transverse vaginal septum" is commonly mentioned. This 2010 "Textbook of Pediatric Emergency Medicine" source, from Lippincott Williams & Wilkins, page 841, when speaking of vaginal obstructions, states, "For hydrocolpos or one of its variations to rise, a female must have vaginal obstruction, a uterus, and a patent cervix. The two most common anomalies with these features are transverse vaginal septum (sometimes called vaginal atresia) and imperforate hymen ." Vaginal agenesis currently redirects to the Vaginal atresia article, by the way. Vaginal atresia used to be called "partial vaginal agenesis," which is a reason for me to consider rewording the text in the Vagina article and my proposal above, but "complete vaginal agenesis" and "partial vaginal agenesis" are terms that are still used. Furthermore, forms of vaginal atresia are considered forms of transverse vaginal septum. As for your statement that "A missing vagina (agenesis) is not an obstruction because you can only obstruct a passageway that exists.", when I state things that are supported by reliable sources, do you think that I'm simply pulling facts out of the air? Vaginal agenesis does not automatically mean "no vagina." It can simply mean that the vagina did not develop fully, hence "partial vaginal agenesis." In the case of vaginal agenesis, the woman may have a shorter vagina than others, a remnant of one, or not have one at all. And last time I checked this 2012 "Pediatric Surgery E-Book" source (that is used in the article), from Elsevier Health Sciences, page 1599, disagrees with you about vaginal agenesis not being an obstruction. Currently, I can't see what the page states, but this 2014 "Pelvic Pain in Women, An Issue of Obstetrics and Gynecology Clinics, E-Book" source, from Elsevier Health Sciences, page 345, lists complete vaginal agenesis as one of the causes of complete female genital outflow tract obstruction. It also lists complete transverse vaginal septum under "complete outflow tract obstruction," and incomplete transverse vaginal septum as one of the causes of partial outflow tract obstruction. This urologyhealth.org source, which is currently used in the Vaginal atresia article and says it's from the official foundation of the American Urological Association, states, "Monthly cramping and abdominal pain. The pain is due to buildup of menstrual flow from the obstruction caused by the missing vagina." Flyer22 Reborn (talk) 03:27, 8 February 2018 (UTC)

@Barbara (WVS): Glad you're happy with it, but I'd prefer to ensure there's consensus before adding anything in to the article. Let's give it a day or so and see what develops. Rivertorch^FIRE_WATER 04:08, 8 February 2018 (UTC)

Rivertorch, I'm fine with it as long as the pieces I noted above are retained. Flyer22 Reborn (talk) 04:16, 8 February 2018 (UTC)

Cool. If there are no objections, I'll add it tomorrow. Rivertorch^FIRE_WATER 04:21, 8 February 2018 (UTC)

Thank you so much for getting this section fixed up. Best Regards, Barbara (WVS) ✐  ✉ 13:13, 8 February 2018 (UTC)

Barbara (WVS), regarding this, you were asked not to make any substantial changes without discussion. You know that I support mentioning this aspect. And yet you went and made the edit anyway, knowing that I was likely to revert you. And as for consensus, that piece you removed and I reverted you on is a part of the consensus version. It seems you are focused on the Bartholin's cyst being an obstruction/abscess of the Bartholin's gland. Yes, that is what a Bartholin's cyst is, but the source states, "The Bartholin glands are located inferiorly on either side of the vaginal opening and normally secrete fluid through their openings on the side of the vestiblue. [...] Patients with a Bartholin gland cyst typically report a lump at the lateral introitus [...]." How are you defining "blocking the vaginal opening"? Blocking the vaginal opening does not automatically mean "complete blockage," as is clear by sources I've pointed to above. And like the Bartholin's cyst article states, "Sizes range from that of a pea to that of an egg and form just within each side of the lower part of the opening of the vagina." How do you not classify one or two lumps at the vaginal opening that are the size of an egg as something that is not a vaginal obstruction/something not blocking the vaginal opening? If the cyst is large enough to obstruct the vaginal canal, it will disrupt sexual intercourse and may cause painful sexual intercourse for the woman. Look at this illustration of a Bartholin's cyst in a Mayo Clinic source; that cyst is clearly in the way of the opening. The source also states, "If you have a small, noninfected Bartholin's cyst, you may not notice it. If the cyst grows, you might feel a lump or mass near your vaginal opening. Although a cyst is usually painless, it can be tender. [...]." It also lists "pain during intercourse" as one of the symptoms. For now, I've removed "obstructing," but "obstructing" is accurate. And as for anomalies, the section is not simply about anomalies, as is clear from its title.

And, yes, River, I clearly want to retain the Bartholin's cyst aspect as well. It can continue to be at the end of the paragraph. Flyer22 Reborn (talk) 19:02, 8 February 2018 (UTC)

I would totally agree with what you have written above except the source doesn't support the idea that the Bartholin gland can obstruct the vaginal opening. It doesn't say 'complete blockage' or 'partial blockage'. The size of eggs is also not mentioned in the ref either. Let me just say that you could be 'right', but the reference has to support it. All you have to do is find refs that support what you want the content to be and we'll all be happy. As for the cyst being 'in the way'... those cysts are quite mobile and do not block the flow of vaginal secretions or menstrual flow as does an imperforate hymen. If the vaginal opening were obstructed, serious symptoms would result from the blockage and no sources about the Bartholin gland state that the gland obstructs the vaginal opening. But in any rate, a reference has to support what you are saying. The current reference describes the opening of the Bartholin gland being blocked, (hence the swelling). You will need to initiate a formal process to get me blocked from editing. Every single edit does not need to be approved. Best Regards, Barbara (WVS) ✐  ✉ 03:36, 9 February 2018 (UTC)

Barbara (WVS), did you forget that I requested with my previous post that you not break up my comments? You did it again. Continuing to do that could certainly count against your editing at this article. So could continued consensus violations. No one said every little edit needs discussion. WP:Consensus, however, is policy, and consensus at this article was against your overly detailed content and was instead for the previous section. That previous section includes the Bartholin's cyst material. Axl asked us not to make any substantial changes without discussion; this is to avoid problematic text, edit warring, and hostility. You agreed. So it is best that you stick to your agreement. We both know that the matter of not making substantial changes without discussion mainly concerns our history with each other. When it comes to cysts (and a number of other things), you are off. There is no "could be right." I am right. Your criteria for "if the vaginal opening were obstructed" is flawed, as it seems you are talking about complete obstruction. You are going on the notion that unless vaginal secretions or specifically menstrual flow are blocked, then a Bartholin's cyst is not blocking the vaginal opening, which is silly. The fact is that a Bartholin's cyst that is big enough is right there obstructing the vaginal opening, as anyone who examines the histology on the matter or anyone with two eyes can see when looking at images (real-life images or illustrations) of a Bartholin's cyst. I did come across a reference stating just that, but it is very old. It is from 1941. It's a "Nelson Loose-leaf Living Surgery, Volume 7" source, from T. Nelson & Sons. And on page 652, it states, "In the case of larger Bartholin cysts the vaginal introitus may be partly occluded, rendering sexual relations difficult." I've seen other sources state similarly, but this is the one I found. Because it's so old, I decided not to reference it here on the talk page and to instead employ WP:Common sense. But looking again, there is also this 2004 "Sternberg's Diagnostic Surgical Pathology, Volume 1" source, from Lippincott Williams & Wilkins, page 2335, which states, "Large cysts may block the entrance to the vestibule." Now one could state that it either means "vestibule of the vagina, which may be defined as the vaginal opening, or it means the vulval vestibule, which our Wikipedia article currently defines as "a part of the vulva between the labia minora into which the urinary meatus (urethral opening) and the vaginal opening open." But "vestibule of the vagina" and "vulval vestibule" are treated as synonyms, which is why Vestibule of the vagina redirects to the latter. You can look at reliable sources for how the vulval vestibule is defined; sources define it as surrounding and/or meeting with the opening of the vagina. If we go by this 2007 "Vulvar Disease: A Clinicopathological Approach" source, from CRC Press, page 12, though, "In embryologic, anatomic, and architectonic grounds, the correct term is 'vestibule of the vagina' not 'vulvar vestibule,' as sometimes appears in the literature."

Either way, as noted above, I removed "obstructing"; so going by that or the Sternberg source, there is nothing left to your objection. We can also move the text so that it's not in the first paragraph. I am not trying to get you barred. But if I were trying, I would go for bigger (meaning from medical and anatomy topics altogether) due to concerns and evidence I have regarding your editing being problematic in these areas. And that includes a recent article issue I had to spend my day tending to because of negligence. I would rather have been watching a show on Netflix. Flyer22 Reborn (talk) 05:40, 9 February 2018 (UTC)

I did say I'd do it, but I'm going to wait another day. Too tired now, liable to screw it up. If there's consensus, anyone should be able to do the honors. Rivertorch^FIRE_WATER 04:03, 9 February 2018 (UTC)

Rivertorch, it's best that you do it, given the issues between Barbara (WVS) and I, and that she might leave out agreed-upon material. We can wait until you come back. Flyer22 Reborn (talk) 05:40, 9 February 2018 (UTC)

All right, it's in. I think it has lost some refs along the way, but in looking over this thread and related discussions and considering the hidden text that was in the article, I'm not confident enough about what might go where to do that. Rivertorch^FIRE_WATER 18:58, 9 February 2018 (UTC)

I added the references for the parts I wanted to retain. Barbara (WVS) can add the references for the other parts. The are two hidden references in the section ("Cowgill" and "Maslekar"). Per above, I also moved the Bartholin's cyst part and re-removed "obstructing." But, per the Sternberg source I cited above, I will at some point add that large cysts may block the entrance to the vulval/vaginal vestibule, and a few other problems Bartholin's cysts may cause. This is because it's important and the Bartholin's cyst material shouldn't be a lone line. Flyer22 Reborn (talk) 19:20, 9 February 2018 (UTC)

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