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  1. Histerectomia vaginal versus histerectomia abdominal em mulheres sem prolapso genital, em maternidade-escola do Recife: ensaio clínico randomizado

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    Costa Aurélio Antônio Ribeiro

    2003-01-01

    Full Text Available OBJETIVO: comparar os resultados intra e pós-operatórios em pacientes sem prolapso genital ou doenças anexiais, submetidas a histerectomia vaginal ou abdominal. MÉTODOS: realizou-se estudo do tipo ensaio clínico aberto, randomizado, em pacientes sem prolapso genital que se submeteram a histerectomia total, indicada por doenças benignas, no IMIP, em Recife, Pernambuco. Incluíram-se 35 pacientes, alocadas aleatoriamente em dois grupos, sendo 19 submetidas a histerectomia vaginal e 16 a histerectomia abdominal. Foram estudadas as seguintes variáveis: volume de perda sangüínea, necessidade de hemotransfusão, tempo operatório, dor pós-operatória (intensidade e uso de analgésicos, tempo de permanência hospitalar, complicações operatórias, tempo de retorno às atividades e grau de satisfação das pacientes. Para análise estatística, utilizaram-se os testes chi2 de associação, exato de Fisher e Mann-Whitney para comparação dos grupos, considerando-se significativo erro alfa menor que 5%. RESULTADOS: o volume de sangue perdido durante as histerectomias por via abdominal (mediana de 902 mL foi significativamente maior em relação à perda durante as histerectomias vaginais (mediana de 520 mL, e nenhuma paciente neste último grupo requereu hemotransfusão, contra 19% no primeiro grupo. A duração da cirurgia foi semelhante, com mediana de 120 minutos nos dois grupos. A intensidade da dor, verificada pelos escores da escala analógica visual, foi significativamente menor entre as pacientes submetidas a histerectomia vaginal, que também apresentaram menor freqüência de utilização de analgésicos. Não houve diferença na freqüência de complicações intra ou pós-operatórias entre os dois grupos, encontrando-se apenas um caso de infecção em cada grupo e um caso de trombose venosa profunda no grupo das histerectomias vaginais. O tempo de retorno às atividades das pacientes submetidas à histerectomia vaginal foi

  2. Histerectomia Vaginal Assistida por Laparoscopia em Pacientes com Necessidade de Anexectomia Laparoscopically Assisted Vaginal Histerectomy in Patients Requiring Adnexectomy

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    Francisco José Cândido dos Reis

    1998-12-01

    Full Text Available Objetivos: avaliar as vantagens da laparoscopia como instrumento para conversão de histerectomias abdominais em vaginais em pacientes com indicação de anexectomia concomitante, considerando-se a segurança e os custos hospitalares adicionais relativos ao procedimento. Pacientes e Métodos: estudo de caso controle envolvendo 9 pacientes submetidas à Histerectomia Vaginal Assistida por Laparoscopia (HVAL e 18 pacientes-controle submetidas à Histerectomia Abdominal (HA, associadas à anexectomia. Foram avaliadas as características pré-operatórias e os resultados do procedimento. Os grupos HVAL e HA são semelhantes quanto à idade, paridade, cesáreas anteriores, cirurgias prévias e IMC. Resultados: o grupo HVAL apresentou tempo cirúrgico médio de 163,9 minutos e o grupo HA de 142,8 minutos. Não ocorreram complicações pós-operatórias no grupo HVAL, ao passo que no grupo HA houve 2 casos de deiscência de sutura e 1 caso de hérnia incisional. A mediana do tempo de internação foi de 1 dia no grupo HVAL e 2 dias no grupo HA; a mediana do período de convalescença por sua vez foi de 2 e 4 semanas respectivamente. No grupo HVAL, 55,6% das pacientes necessitaram de medicação analgésica no pós-operatório, o que ocorreu em 100% das pacientes do grupo HA. Conclusões: a HVAL mostrou-se vantajosa em relação à HA em termos de melhor recuperação e menor incidência de complicações no pós-operatório. O procedimento é factível com segurança em um Hospital Universitário, não implicando tampouco em custos adicionais com equipamentos ou instrumental.Purpose: to evaluate the advantages of the laparoscopic approach for conversion of abdominal hysterectomies in vaginal hysterectomies in patients with indication of concomitant adnexectomy, being considered the safety and the additional costs of the procedure. Patients and Methods: cases: 9 patients submitted to Laparoscopically Assisted Vaginal Hysterectomy (LAVH associated with

  3. Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies Adesivo de fibrina e a síntese da cúpula vaginal após histerectomia abdominal em coelhos fêmeas

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    Ari Gonçalves Lima

    2009-02-01

    Full Text Available PURPOSE: To investigate the effectiveness of fibrin glue in comparison with polyglycolic acid suture to promote the closure of rabbit's vaginal vault, after abdominal hysterectomy. METHODS: Twenty female, adults, New Zealand rabbits, were submitted to abdominal hysterectomy and randomly distributed to polyglycolic acid suture (G-PA / n=10 or fibrin glue closure of vaginal vault (G-FG / n=10. Radiograph study allowed identifying vault vaginal suture disrupter or fistulas to urinary bladder or rectum. Videovaginoscopy study allowed identifying the presence of cellulites, abscess formation, tissue granulation or granuloma. Vaginal cuff burst test allowed to identify by the escape of air bubbles and rupture pression record. Histological sections stained with Picrosirius red allowed the measure of fibrous tissue healing. RESULTS: The videovaginoscopy identified a significant difference (Fisher Test pOBJETIVO: Investigar a eficácia da cola de fibrina e da sutura usando fio de ácido poliglicólico para promover o fechamento da cúpula vaginal de coelhas, após histerectomia abdominal. MÉTODOS: Vinte coelhos fêmeas, New Zealand, adultas foram submetidas à histerectomia abdominal e distribuídas para sutura da cúpula vaginal com fio de ácido poliglicólico (G-PA / n=10 ou cola de fibrina (G-FG / n=10. Estudo radiológico foi realizado para identificar deiscências ou fístulas vesicais ou retais. Videovaginoscopia foi realizada para identificar a presença de secreções, abscessos, tecido de granulação ou granuloma tipo corpo estranho. Teste in vitro de pressão de rompimento sob selo d'água foi realizado para identificar a perviedade da sutura. O tecido de cicatrização foi estudado pela coloração com picrosirius red para mensuração do tecido fibrótico. RESULTADOS: A videovaginoscopia mostrou uma diferença significante (Teste de Fisher p<0,3142 no tecido de granulação do grupo G-PA (40% em comparação com o grupo G-FG (20%. A an

  4. Histerectomia vaginal: o laparoscópico é necessário? Vaginal hysterectomy: is the laparoscope necessary?

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    Octacílio Figueiredo Netto

    1998-10-01

    Full Text Available Objetivos: a laparoscopia pode auxiliar na conversão de uma histerectomia abdominal em vaginal quando esta última está contra-indicada, não devendo substituir a histerectomia vaginal simples quando esta é viável. Este estudo tem por objetivo discutir o papel da laparoscopia na histerectomia vaginal. Métodos: de fevereiro de 1995 a setembro de 1998, 400 pacientes foram consideradas candidatas à histerectomia vaginal. Foram excluídas as pacientes portadoras de prolapso uterino, tumor anexial associado e útero fixo ao toque bimanual. Os procedimentos foram realizados com a técnica de Heaney utilizando métodos de redução do volume uterino no caso de úteros miomatosos. Resultados: A média de idade e paridade foi de 46,9 anos e 3,2 partos, respectivamente. Vinte e nove pacientes (7,2% eram nulíparas e 104 (26,0% não tinham antecedente de parto vaginal. Trezentas e três pacientes (75,7% apresentavam cirurgia pélvica prévia, sendo a cesárea a mais freqüente (48,7%. A principal indicação cirúrgica foi miomatose uterina (61,2%, e o volume uterino médio foi de 239,9 cm³ (30-1228 cm³. A histerectomia vaginal foi realizada com sucesso em 396 pacientes (99,0%, sendo que 73 cirurgias (18,2% foram realizadas por residentes. O tempo cirúrgico médio foi de 45 min. A laparoscopia diagnóstica/cirúrgica foi realizada em 16 pacientes (4,0%. As complicações intra-operatórias incluíram 6 lesões vesicais (1,5% e uma lesão retal (0,2%. Quatro procedimentos (1,0% foram efetivados pela via abdominal. Ocorreram complicações pós-operatórias em 24 pacientes (6,0%. Duzentas e oitenta e uma pacientes (70,2% receberam alta hospitalar 24 h após a cirurgia. Conclusões: O laparoscópio não parece ser necessário nos casos em que o útero é móvel e não existe tumor anexial associado. Em última análise, o principal papel do laparoscópio parece ser o de permitir que o ginecologista se dê conta de que histerectomia vaginal simples

  5. Tinidazol versus cefazolina na antibioticoprofilaxia de histerectomia vaginal e abdominal Tinidazole versus cefazolin in antibiotic prophylaxis of vaginal and abdominal hysterectomy

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    José Antonio Simões

    2008-11-01

    Full Text Available OBJETIVO: comparar a eficácia do tinidazol e da cefazolina na antibioticoprofilaxia da morbidade febril e infecciosa pós-histerectomia vaginal e abdominal. MÉTODOS: estudo clínico randomizado, no qual as mulheres internadas para histerectomia foram aleatorizadas para um dos seguintes grupos de antibioticoprofilaxia: Grupo C (2 g de cefazolina EV na indução anestésica; Grupo T (2 g de tinidazol VO 12 horas antes da cirurgia; ou Grupo C+T (2 g de tinidazol VO 12 horas antes da cirurgia e 2 g de cefazolina EV na indução anestésica. Amostras cervicovaginais foram coletadas para culturas específicas e o diagnóstico de vaginose bacteriana (VB foi baseado nos critérios de Amsel e Nugent. As pacientes foram reavaliadas sete e 30 dias após a cirurgia para sinais de morbidade febril e/ou infecciosa. Para avaliar as diferenças entre os três grupos, realizaram-se os testes do χ2 ou exato de Fisher com nível de significância de 5%. Calulou-se o poder da amostra (1-β através do programa SAS. RESULTADOS: morbidade infecciosa sete dias após a histerectomia foi diagnosticada em 6,6% das mulheres, mas não houve diferença significativa na distribuição entre os três grupos estudados (p=0,12. Não diagnosticou-se morbidade febril ou infecciosa no pós-operatório imediato ou após 30 dias da cirurgia. A freqüência de VB no pré-operatório foi significativamente maior entre as mulheres submetidas à histerectomia vaginal do que naquelas submetidas à histerectomia abdominal (27 versus 7%, p=0,02. Também se observou freqüência maior de VB após 30 dias entre as mulheres submetidas à histerectomia vaginal (20 versus 8%, porém sem significância estatística (p=0,19. CONCLUSÕES: o uso do tinizadol, isoladamente ou em associação com cefazolina, não apresentou maior eficácia que o uso de apenas cefazolina na prevenção de morbidade febril ou infecciosa pós-histerectomia. A elevada freqüência de VB no pré-operatório imediato

  6. Repercussões hemodinâmicas do posicionamento em litotomia exagerada para histerectomia vaginal em paciente cardiopata: relato de caso Repercusiones hemodinámicas de la posición de litotomía exagerada para histerectomía vaginal en una paciente con cardiopatía: relato del caso Hemodynamic repercussions of exaggerated lithotomy position for vaginal hysterectomy in cardiac patient: case report

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    Roberto Cardoso Bessa Junior

    2006-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A técnica de histerectomia vaginal possibilita menor tempo operatório e o uso do bloqueio do neuro-eixo, com os benefícios de melhor analgesia pós-operatória e menor resposta sistêmica ao procedimento cirúrgico. O objetivo deste relato foi descrever as alterações hemodinâmicas decorrentes do posicionamento em litotomia exagerada em paciente cardiopata. RELATO DO CASO: Paciente de 33 anos, G0P0A0, com história de sangramento uterino anormal e anemia. A ultra-sonografia evidenciava útero miomatoso com volume estimado de 420 cm³. Ela era portadora de trombofilia e miocardiopatia dilatada, com passado de dois acidentes vasculares encefálicos isquêmicos e dois infartos agudos do miocárdio. Foi monitorizada com pressão arterial invasiva e cateter de artéria pulmonar com medida de débito cardíaco contínuo. Realizada raquianestesia com bupivacaína hiperbárica e morfina. A paciente foi posicionada em litotomia exagerada sendo realizada histerectomia total pela técnica de Heaney e salpingectomia bilateral. Como intercorrência intra-operatória apresentou diminuição do índice cardíaco e aumento das pressões de câmaras direitas após o posicionamento, necessitando do uso de dobutamina. CONCLUSÕES: O posicionamento em litotomia exagerada pode ocasionar alterações hemodinâmicas que devem ser consideradas na escolha da técnica cirúrgica.JUSTIFICATIVA Y OBJETIVOS: La técnica de histerectomía vaginal permite menor tiempo operatorio y el uso de bloqueo espinal, con los beneficios en la analgesia post-operatoria y en la menor respuesta sistémica frente al procedimiento quirúrgico. El objetivo de este relato es describir las alteraciones hemodinámicas secundarias al posicionamiento en litotomía exagerada en una paciente con cardiopatía. RELATO DEL CASO: Paciente de 33 años, G0P0A0, con historia de sangrado uterino anormal y anemia. La ultra-sonografía evidenciaba útero miomatoso con volumen

  7. Representações de mulheres acerca da histerectomia em seu processo de viver

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    Nunes, Maria da Penha da Rosa Silveira

    2008-01-01

    Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2008. O presente estudo teve como objetivo compreender as representações sociais que as mulheres possuem acerca da histerectomia, antes e após o procedimento cirúrgico. Caracteriza-se por uma pesquisa qualitativa, descritiva, tendo como base teórico-metodológica a Teoria das Representações Sociais. Foram sujeitos deste estudo, treze mulheres em processo de histerect...

  8. Prolapso de tuba uterina após histerectomia vaginal: relato de caso Fallopian tube prolapse after vaginal hysterectomy: a case report

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    Maurício B. Noviello

    2003-12-01

    Full Text Available O prolapso de tuba uterina é complicação rara após histerectomia, com aproximadamente 80 casos descritos na literatura. A sintomatologia é inespecífica, podendo incluir sangramento genital, dispareunia e dor pélvica crônica. O diagnóstico diferencial deve ser feito com granuloma de cúpula vaginal e carcinoma de vagina. O tratamento deve ser individualizado, podendo ser realizado por via vaginal, abdominal ou laparoscópica. Relatamos o caso de uma paciente, 47 anos, com miomatose uterina, submetida a histerectomia vaginal, evoluindo com prolapso de tuba uterina após 11 meses de pós-operatório. O exame especular evidenciava lesão vegetante, friável e sangrante localizada na cúpula vaginal. Esses achados clínicos sugeriam o diagnóstico de prolapso de tuba uterina. A paciente foi submetida a nova intervenção cirúrgica, com ressecção da tuba uterina por via vaginal. O exame natomopatológico confirmou o diagnóstico e a paciente evoluiu com remissão completa da sintomatologia.Fallopian tube prolapse is a rare complication after hysterectomy, with approximately 80 cases described in the literature. The symptoms are nonspecific including vaginal bleeding, dyspareunia and chronic pelvic pain. The differential diagnosis must be done with granulation tissue of the vaginal cuff and vaginal carcinoma. The treatment should be individualized, and is possible to be done by vaginal, abdominal or laparoscopic approach. We report a case of a 47-year-old woman with myoma who was submitted to a vaginal hysterectomy and evolved with fallopian tube prolapse 11 months after surgery. Specular examination showed a fungating, friable and bleeding lesion at the vaginal cuff. The clinical findings suggested the diagnosis of fallopian tube prolapse. The patient was submitted to a new surgical intervention with resection of the left fallopian tube. The histologic examination confirmed the diagnosis and the patient evolved with complete remission of

  9. Efeitos da eletroacupuntura, aquapuntura e farmacopuntura em cadelas anestesiadas com isofluorano e submetidas à ovário-histerectomia

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    M.O. Taffarel

    2012-02-01

    Full Text Available Avaliaram-se os efeitos analgésicos da eletroacupuntura, aquapuntura e farmacopuntura com morfina nos acupontos VB41 e TA5 de 24 cadelas hígidas submetidas à ovário-histerectomia. Os animais foram distribuídos em quatro grupos (G de igual número - GDest, GMorf, GElet e GC - e anestesiados com acepromazina, propofol e isofluorano. Após a estabilização do plano anestésico, os animais do GDest receberam 0,5mL de água destilada em cada acuponto; os do GMorf receberam 0,1mg/kg de morfina distribuído nos quatro acupontos; os do GElet foram submetidos à eletroacupuntura; e os do GC, acupuntura em pontos sham. Os animais do GC receberam, após o término do procedimento cirúrgico e antes do início da avaliação pelas escalas de dor, 2,0mg/kg de tramadol. Foram avaliadas: frequências cardíaca e respiratória, temperatura retal e glicemia. A dor foi avaliada por duas escalas, uma de analogia numérica e outra contagem variável, por três observadores. A avaliação iniciou-se imediatamente após a extubação e foi realizada a cada 15 minutos, durante duas horas. Não houve diferença entre os tratamentos em todas as variáveis. Pode-se concluir que eletroacupuntura, aquapuntura e farmacopuntura com morfina resultaram em analgesia similar ao tramadol no pós-operatório imediato de cadelas submetidas à ovário-histerectomia eletiva.

  10. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

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    Randal Henrique de Oliveira

    2000-03-01

    Full Text Available Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL e a histerectomia total abdominal (HTA, relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve diferença estat��stica entre os grupos quanto à idade, paridade e cirurgia abdominal prévia. A principal indicação cirúrgica para ambos os grupos foi leiomiomatose uterina. O grupo das HVAL apresentou tempo de internação menor, com mediana de 1 dia e o das HTA, de 2 dias (pPurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH and total abdominal hysterectomy (TAH, reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient's records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01. LAVH showed to be 40.2% more expensive than TAH (p<0.01. Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002. Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better

  11. Cortisol sérico e glicemia em cadelas tratadas com tramadol e submetidas à ovário-histerectomia

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    Caldeira Fátima Maria Caetano

    2006-01-01

    Full Text Available O tramadol é um analgésico opióide usado em medicina veterinária, embora existam poucos estudos sobre este fármaco. O objetivo deste trabalho foi avaliar o efeito analgésico promovido pela administração do tramadol, mensurando o cortisol sérico e a glicemia de cadelas. Para isso, foram utilizadas 15 fêmeas, submetidas a ovário-histerectomia sob anestesia geral com isofluorano. Os animais foram divididos em três grupos. Grupo 1 (Tep receberam tramadol pela via epidural (1,0mg kg-1 diluído em água bidestilada ao volume final de 3,0mL e, após 15 minutos, 3,0mL de água bidestilada pela via intravenosa. No grupo 2 (Tiv, foi administrado 3,0mL de água bidestilada pela via epidural e, após 15 minutos, tramadol pela via intravenosa (1,0mg kg-1 diluído em água bidestilada ao volume final de 3,0mL. No grupo 3 (CT, os animais receberam 3,0mL de água bidestilada pela via epidural e, após 15 minutos, 3,0mL de água bidestilada pela via intravenosa. A eficácia de cada regime analgésico foi avaliada durante 12 horas após a administração da injeção epidural. Não houve diferença significativa entre os grupos experimentais para as variáveis estudadas (P>0,05. Foram observadas diferenças significativas dentro de cada tratamento. No grupo Tep houve aumento do cortisol sérico aos 25 minutos do trans-operatório (M3, em relação ao valor obtido imediatamente após a indução anestésica (M2 (P>0,05. Nos tratamentos Tiv e CT, verificou-se elevação das variáveis, duas (M4 e quatro (M5 horas da injeção epidural (P<0,05, quando comparadas ao pré-tratamento (M1. Nesses períodos, as variáveis estudadas no tratamento Tep foram estatisticamente semelhantes ao pré-tratamento (M1. Com base nos resultados, conclui-se que: 1 a metodologia empregada foi sensível para determinar os momentos de maior estresse cirúrgico, dentre os estudados e 2 o tramadol por via epidural produz analgesia mais duradoura quando comparado à administra

  12. Histerectomias: estudo retrospectivo de 554 casos

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    Eddie Fernando Cândido Murta

    Full Text Available OBJETIVO: A histerectomia é uma operação muito realizada, entretanto há poucos trabalhos na literatura nacional sobre suas indicações, técnica e complicações. O objetivo deste trabalho é avaliar estes procedimentos realizados na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. MÉTODO: Estudo retrospectivo de 470 histerectomias abdominais e 84 vaginais foi conduzido analisando as indicações, tempo de cirurgia e internação, tipo de incisão e morbidez. RESULTADOS: As principais indicações foram o mioma uterino e o prolapso uterino para as histerectomias abdominais e vaginais, respectivamente. As complicações intra-operatórias aconteceram em 3,4% e as pós-operatórias em 2,4% do total de casos. Nenhuma diferença estatística foi encontrada no número de complicações em relação ao tipo de incisão (vertical ou transversal. O tempo de cirurgia e o de hospitalização foram estatisticamente maiores nas incisões verticais. A hemorragia foi a mais freqüente complicação intra-operatória e a infecção da incisão operatória foi a mais freqüente no pós-operatório. CONCLUSÕES: A histerectomia é um procedimento de baixo risco, no entanto, a realização de revisões sobre indicações e complicações, e a pesquisa de melhores técnicas cirúrgicas são necessárias para torná-la cada vez mais segura.

  13. Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina A randomized comparison of two vaginal procedures for the treatment of uterine prolapse using polypropylene mesh: histeropexy versus histerectomy

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    Silvia Carramão

    2009-02-01

    Full Text Available OBJETIVO: Comparar os resultados anatômicos pós-operatórios de pacientes portadoras de prolapso uterino tratadas utilizando tela de polipropileno para correção dos defeitos do assoalho pélvico, comparando histerectomia vaginal com a preservação do útero. MÉTODO: Estudo randomizado com 31 mulheres portadoras de prolapso uterino estádio III ou IV (POP-Q divididas em dois grupos: Grupo HV- 15 mulheres submetidas à histerectomia vaginal e reconstrução da anatomia do assoalho pélvico com tela de polipropileno tipo I (Nazca R-Promedon e Grupo HP- 16 mulheres mulheres submetidas à reconstrução da anatomia do assoalho pélvico com tela de polipropileno tipo I (Nazca R-Promedon preservando o útero. Raça, urgência miccional, constipação intestinal, dor sacral, sangramento e tempo de operação foram os parâmetros analisados. RESULTADOS: O tempo de seguimento médio foi de nove meses. Não se observou diferença entre os grupos nas complicações funcionais. O tempo cirúrgico foi 120 minutos para grupo HV versus 58.9 minutos para grupo HP ( p OBJECTIVES: To compare surgical morbidity and time, as well as anatomical outcomes between vaginal histerectomy and uterine preservation in the treatment of uterine prolapse using a mesh kit (Nazca ®. METHODS: Randomized controled trial with 31 women with uterine prolapse POP-Q stage 3 or 4 pelvic organ prolapse who underwent vaginal surgery using tipe I polypropilene mesh (Nazca ®. They were randomized in two groups: group HV: hysterectomy and pelvic reconstruction floor with mesh (n=15; group HP: hysteropexy and pelvic reconstruction floor with mesh (n=16. Race, miccional urgency, intestinal constipation, sacral pain were assessed as well as the amount of bleeding and time of operation. RESULTS: Median follow-up was nine months on both groups. No difference was observed on complication rates and functional outcomes. Operation time was 120 minutes on group HV, versus 58.9 minutes on group

  14. Biomarcadores inflamatórios e de estresse oxidativo em cadelas submetidas à ovário-histerectomia videoassistida ou convencional

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    F. Dalmolin

    2016-06-01

    Full Text Available RESUMO A videocirurgia é atualmente uma das principais ferramentas operatórias, com vantagens que incluem menor estresse, incisões e dor pós-operatória quando comparada aos procedimentos abertos. Objetivou-se comparar o processo inflamatório e o estresse oxidativo resultantes das técnicas de ovário-histerectomia (OVH convencional e videoassistida, com dois portais em cadelas, por meio de hemograma, avaliação de acetilcolinesterase, butirilcolinesterase, catalase e malondialdeído séricos, imediatamente antes da operação e duas, seis, 12, 24, 48 e 72 horas após a cirurgia. Observou-se menor estresse cirúrgico nas pacientes operadas pela técnica videoassistida, e sugere-se que a técnica convencional possa implicar peroxidação lipídica, mesmo com o uso de anti-inflamatório.

  15. Meloxicam associado ou não ao tramadol no controle da dor após ovário-histerectomia videoassistida em cadelas

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    M.T. Oliveira

    2016-02-01

    Full Text Available O objetivo deste estudo foi avaliar a eficácia do meloxicam associado ou não ao tramadol, no controle da dor após ovário-histerectomia (OVH laparoscópica com dois portais. Foram selecionadas 14 cadelas hígidas. Os animais foram separados de forma aleatória, em dois grupos. O grupo M (GM recebeu meloxicam (0,2mg kg-1, s.i.d., enquanto os animais do grupo MT (GMT receberam a associação de meloxicam (0,2mg kg-1, s.i.d. e tramadol (4mg kg-1, t.i.d., ambos durante dois dias de pós-operatório. Para avaliação da dor pós-cirúrgica, foram utilizadas as escalas de Melbourne e escala visual analógica (EVA, além de mensurações de glicemia e cortisol sérico. Não houve diferença ao se avaliarem os grupos GM e GMT pela escala de Melbourne nem pela EVA. As mensurações de cortisol não atingiram valores superiores aos de referência para a espécie, enquanto os valores de glicemia não apresentaram variação significativa ao longo do tempo de avaliação nem entre grupos. Com os resultados deste estudo, foi possível concluir que a utilização de meloxicam associado ou não ao tramadol, nas doses e posologias propostas, é eficaz para controlar a dor pós-operatória de cadelas submetidas à OVH laparoscópica com dois portais.

  16. Prolapso vaginal e uterino em ovelhas

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    Maíra Bianchi R. Alves

    2013-02-01

    Full Text Available O presente trabalho objetivou realizar um estudo retrospectivo sobre os prolapsos vaginal e uterino em ovelhas atendidas no Serviço de Clínica de Bovinos e Pequenos Ruminantes (CBPR da FMVZ/USP no período compreendido entre 2000 a 2010, no qual, foram atendidas 56 ovinos com problemas inerentes ao sistema reprodutivo, dessas, 25 apresentaram prolapso vaginal ou uterino (44,6%. O prolapso vaginal total foi o de maior frequência (72%. As ovelhas acometidas, em sua maioria, possuíam idade superior a quatro anos (64%, eram sem raça definida (44% ou da raça Ile de France (40%. As manifestações clínicas observadas durante a maioria dos atendimentos foram: taquipnéia, taquicardia, mucosas oculares avermelhadas indicando estado de toxemia, decúbito esternal ou lateral, apatia e anorexia. O tratamento instituído para todos os casos foi a limpeza, desinfecção e reintrodução do órgão prolapsado. A sutura de Bühner foi feita em 84% dos casos e a histeropexia em um caso (4%. A evolução foi satisfatória em 80% dos casos atendidos, nos demais casos (20% observou-se óbito da fêmea acometida. Do total de óbitos, os prolapsos vaginais foram responsáveis por 60% (3/5 e os prolapsos uterinos por 40% (2/5. A etiologia dos prolapsos não foi definida nos casos atendidos, sendo esses associados com o período pós-parto em sua maioria (56%, provavelmente associados com quadros de hipocalcemia, altas concentrações séricas de estrógeno e hipertonia uterina. Além disso, a predisposição genética não pode ser descartada.

  17. Neoplasias mamárias em cadelas: influência hormonal e efeitos da ovario-histerectomia como terapia adjuvante Canine mammary tumors: hormonal influence and effects of ovariohiysterectomy as an adjuvant therapy

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    Cláudia Sampaio Fonseca

    2000-08-01

    Full Text Available As neoplasias mamarias constituem aproximadamente 50% dos tumores diagnosticados em cadelas. Apesar dosharmónios sexuais femininos desempenharem papel fundamental no desenvolvimento desses tumores em mamíferos, o valor da supressão hormonal pela ovário-histerectomia como auxiliar no tratamento do tumor de mama em caninos permanece controverso. Discute-se ainda se a realização da ovário-histerectomia após o diagnóstico influencia ou não o crescimento e progressão do tumor na glândula afetada ou em outras glândulas mamarias. O objetivo desta revisão é discutir alguns aspectos relacionados à influência hormonal na etiologia de tumores mamarias em cadelas, assim como o valor terapêutico da castração, quando realizada no momento da mastectomia.The mammary neoplasms comprises aproximatel 50% ofthe diagnosed tumor s m the bitch. Although female sexual honnones play a fundamental role in the development of these tumors in mammals, the value of the suppression hormonal (ovariohysterectomy as an adjuvam treatment remains controversial. There are still arguments on whether the ovariohysterectomy after diagnosis of the tumor possesses influences lhe growth and progression of the tumor on the affected gland or on other mammary glands. The objective ofthis review is to discuss some aspects related to the hormonal influence in the pathogenesis of the canine tumor, as well as the therapeutic value ofspaying. when accomplished in the moment ofthe mastectomy.

  18. Carga viral vaginal de HIV em mulheres brasileiras infectadas pelo HIV HIV vaginal viral load in Brazilian HIV-infected women

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    Angela Campos

    2008-02-01

    Full Text Available OBJETIVO: Avaliar os fatores associados à presença de RNA-HIV na vagina. MÉTODOS: Estudo de corte transversal, em mulheres infectadas por HIV, excluindo-se aquelas com antecedente de histerectomia, as em uso de medicações vaginais nas últimas 48 horas, as que se referiram à relação sexual desprotegida há menos de 72 horas, as gestantes e aquelas com sangramento genital. Após consentimento, coletou-se amostra sanguínea para contagem de linfócitos T CD4 e carga viral plasmática de HIV, além de lavado vaginal com 10mL de solução salina, que foi centrifugado, aliquotado e armazenado em freezer -70°C para posterior quantificação de RNA-HIV livre. A mensuração de carga viral de RNA-HIV livre plasmática e vaginal foi realizada utilizando-se o kit HIV Monitor v1.5 Cobas Amplicor®, Roche. Pesquisou-se a presença de HPV de alto e baixo risco, clamídia e gonococo por Captura Híbrida II®, Digene, em amostra endocervical. Colheu-se amostra vaginal para bacterioscopia com coloração de Gram, utilizando-se os critérios de Nugent. RESULTADOS: Entre as 200 mulheres estudadas, 73,5% usavam terapia anti-retroviral (TARV com drogas múltiplas. O RNA-HIV foi detectável no lavado vaginal de 18 delas (9%, mas em apenas uma daquelas que tinham carga viral plasmática indetectável (0,5%. A prevalência de HIV vaginal foi 24 vezes maior naquelas em que HIV plasmático era detectável. Carga viral plasmática de HIV, não usar TARV, CD4 reduzido e vaginose bacteriana aumentaram a prevalência de RNA-HIV vaginal, mas apenas a carga viral plasmática se manteve significativa na análise ajustada. CONCLUSÃO: A prevalência de RNA-HIV vaginal foi baixa (9%. A carga viral acima de 1.500 cópias/mL foi a única variável que permaneceu como fator de risco para RNA-HIV vaginal livre.OBJECTIVE: To evaluate factors associated to presence of free RNA-HIV in the vagina. METHODS: Cross-sectional study with HIV-infected women, excluding those who had

  19. Histerectomias: estudo retrospectivo de 554 casos Hysterectomies: a retrospective study of 554 cases

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    Eddie Fernando Cândido Murta

    2000-10-01

    Full Text Available OBJETIVO: A histerectomia é uma operação muito realizada, entretanto há poucos trabalhos na literatura nacional sobre suas indicações, técnica e complicações. O objetivo deste trabalho é avaliar estes procedimentos realizados na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. MÉTODO: Estudo retrospectivo de 470 histerectomias abdominais e 84 vaginais foi conduzido analisando as indicações, tempo de cirurgia e internação, tipo de incisão e morbidez. RESULTADOS: As principais indicações foram o mioma uterino e o prolapso uterino para as histerectomias abdominais e vaginais, respectivamente. As complicações intra-operatórias aconteceram em 3,4% e as pós-operatórias em 2,4% do total de casos. Nenhuma diferença estatística foi encontrada no número de complicações em relação ao tipo de incisão (vertical ou transversal. O tempo de cirurgia e o de hospitalização foram estatisticamente maiores nas incisões verticais. A hemorragia foi a mais freqüente complicação intra-operatória e a infecção da incisão operatória foi a mais freqüente no pós-operatório. CONCLUSÕES: A histerectomia é um procedimento de baixo risco, no entanto, a realização de revisões sobre indicações e complicações, e a pesquisa de melhores técnicas cirúrgicas são necessárias para torná-la cada vez mais segura.OBJECTIVE: Hysterectomy is a frequently performed surgery, but national literature gives limited information regarding indications, technique and complications. The aim of this study is to evaluate our results with this operation performed by the Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". METHODS: A retrospective study of 470 abdominal and 84 vaginal hysterectomies was conducted in which the indications, operation time, abdominal approach, hospitalization time, and morbidity were analyzed. RESULTS: Uterine myoma and uterine prolapse

  20. Representações de mulheres acerca da histerectomia em seu processo de viver Representaciones de mujeres acerca de la histerectomía en su proceso de vivir Women's representatives about hysterectomy in their lives

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    Maria da Penha da Rosa Silveira Nunes

    2009-09-01

    Full Text Available Estudo qualitativo, exploratório-descritivo, realizado com os objetivos de conhecer as representações sociais de mulheres submetidas à histerectomia e identificar alguns fatores que interferem no seu processo de viver. Foram informantes 12 mulheres histerectomizadas em um hospital universitário no Rio Grande do Sul. Os dados foram coletados em setembro e outubro de 2006 por meio de entrevistas e tratados pela análise de conteúdo temática. Foram identificadas duas categorias: representações negativas e representações positivas da histerectomia no viver das mulheres. Ambas referem-se ao significado atribuído ao útero e ao contexto vivencial da mulher. As negativas foram ancoradas em preconceitos, incapacidade de serem mães e no desinteresse sexual, com possíveis interferências na vida conjugal. As positivas, no bem-estar após a cirurgia e na melhoria da qualidade de vida. É essencial disponibilizar espaço para a problematização do viver sem útero, com vistas a prevenir conflitos pessoais e conjugais.Estudio cualitativo, exploratorio descriptivo, realizado con el objetivo de conocer las representaciones sociales de las mujeres sometidas a la histerectomía e identificar algunos factores que interfieren en su proceso de vida vivir/bienestar. Participaron en el estudio como informantes doce mujeres con histerectomihisterectomía en un hospital universitario en Río Grande del Sur. Los datos fueron recolectados colectados en septiembre y octubre de 2006 por medio de entrevistas y a través del tratamiento de contenido temático. Fueron identificadas dos categorías: representaciones negativas y representaciones positivas de la histerectomía en el vivir de las mujeres. Ambas se refieren al significado atribuido al útero y al contexto de vida de la mujer. Las negativas estaban fundamentadas en prejuicios, como la incapacidad de ser madre s y en el lo desinterés sexual, con posibles interferencias en la vida conyugal. Las

  1. Prolapso vaginal e uterino em ovelhas Uterine and vaginal prolapse in ewes

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    Maíra Bianchi R. Alves

    2013-02-01

    Full Text Available O presente trabalho objetivou realizar um estudo retrospectivo sobre os prolapsos vaginal e uterino em ovelhas atendidas no Serviço de Clínica de Bovinos e Pequenos Ruminantes (CBPR da FMVZ/USP no período compreendido entre 2000 a 2010, no qual, foram atendidas 56 ovinos com problemas inerentes ao sistema reprodutivo, dessas, 25 apresentaram prolapso vaginal ou uterino (44,6%. O prolapso vaginal total foi o de maior frequência (72%. As ovelhas acometidas, em sua maioria, possuíam idade superior a quatro anos (64%, eram sem raça definida (44% ou da raça Ile de France (40%. As manifestações clínicas observadas durante a maioria dos atendimentos foram: taquipnéia, taquicardia, mucosas oculares avermelhadas indicando estado de toxemia, decúbito esternal ou lateral, apatia e anorexia. O tratamento instituído para todos os casos foi a limpeza, desinfecção e reintrodução do órgão prolapsado. A sutura de Bühner foi feita em 84% dos casos e a histeropexia em um caso (4%. A evolução foi satisfatória em 80% dos casos atendidos, nos demais casos (20% observou-se óbito da fêmea acometida. Do total de óbitos, os prolapsos vaginais foram responsáveis por 60% (3/5 e os prolapsos uterinos por 40% (2/5. A etiologia dos prolapsos não foi definida nos casos atendidos, sendo esses associados com o período pós-parto em sua maioria (56%, provavelmente associados com quadros de hipocalcemia, altas concentrações séricas de estrógeno e hipertonia uterina. Além disso, a predisposição genética não pode ser descartada.This study aimed to conduct a retrospective study on vaginal and uterine prolapse in sheep seen at the Clinic and Surgery on Cattle and Small Ruminants (CBPR at University of São Paulo, from 2000 to 2010. During this period, 56 sheep were treated with problems of the reproductive system. Of these, 25 ewes had vaginal or uterine prolapse (44.6%. The total vaginal prolapse was the most frequently (72%. The majority of

  2. Ovário-histerectomia vídeo-assistida com único portal em cadelas: estudo retrospectivo de 20 casos Single-port video-assisted ovariohysterectomy in bitches: retrospective study of 20 cases

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    Marco Augusto Machado Silva

    2011-02-01

    Full Text Available O objetivo do presente estudo foi avaliar retrospectivamente as 20 primeiras ovário-histerectomias vídeo-assistidas com único portal (SPVA-OSH, realizadas por um cirurgião não proficiente nessa técnica. Vinte cadelas foram submetidas à laparoscopia para SPVA-OSH, com o auxílio de um endoscópio de 10mm, com canal de trabalho de 5mm, inserido por um trocarte, posicionado na região pré-púbica, e coagulação bipolar. O tempo cirúrgico médio foi de 22,95±5,17 minutos. Os cinco primeiros procedimentos consumiram mais tempo cirúrgico do que os demais. A abordagem aos pedículos ovarianos direito e esquerdo foram as etapas que apresentaram maior tempo de execução. Houve complicação leve ou moderada em seis (30% das 20 cadelas operadas. As complicações foram: hemorragia leve ou moderada em um dos pedículos ovarianos em quatro (20% cadelas e hemorragia grave, devido à punção do baço com agulha de Veress em dois (10% animais. A SPVA-OSH foi realizada em cadelas por um cirurgião no início da curva de aprendizado, sem complicações maiores.The aim of the present study was to evaluate retrospectively the first 20 cases of single-port video-assisted ovariohysterectomy (SPVA-OSH performed by an inexperienced surgeon. Twenty bitches submitted to SPVA-OSH were assessed. A 10mm operative rigid endoscope with one 5 mm working channel and bipolar coagulation was used. The trocar was positioned in the prepubic area of the abdomen. Surgical time and complication rates were assessed descriptively. Mean surgical time was of 22.95±5.17 minutes. Mild or moderate complications were present in six (30% out of 20 bitches that were operated. The first five surgical procedures spent more time to be performed than the others. The longest transoperative momentum time of execution was spent in the approach to the left and right ovarian pedicles. The complications were: mild or moderate hemorrhage from one of the ovarian pedicles in four bitches (20

  3. Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES ovariohysterectomy in bitches: a preliminary feasibility study Ovário-histerectomia transvaginal pura por abordagem endoscópica transluminal por orifícios naturais (NOTES em cadelas: estudo preliminar de factibilidade da técnica

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    Marco Augusto Machado Silva

    2012-07-01

    Full Text Available Natural orifice transluminal endoscopic surgery (NOTES is a relatively new surgical access for minimally invasive surgery, which is being widely studied in human medicine. However, few studies focusing on its applicability in the small animal practice have been performed so far. The aim of the current study was to evaluate the feasibility of pure-NOTES transvaginal ovariohysterectomy in bitches. Five bitches were evaluated. The abdomen was accessed through an 11mm trocar inserted through a vaginal incision. Using a rigid endoscope with working channel, the ovarian pedicles were coagulated and sectioned using bipolar diathermy. The uterine horn was pulled into the trocar and exteriorized along with the cannula. The uterine body and vessels were coagulated or ligated. The uterine stump was replaced into the abdominal cavity and the pneumoperitoneum drained. Pure-NOTES OHE was successfully accomplished in four out of five bitches. In the first try, it was converted to a hybrid-NOTES technique due to instrument failure. Mean surgical time was 52.1 (SD±11.5 minutes for the pure-NOTES technique. Pure-NOTES OHE is feasible in bitches, which may result in no major complications and excellent surgical recovery.Cirurgia endoscópica por orifícios naturais (NOTES constitui um acesso cirúrgico relativamente novo para abordagem minimamente invasiva, a qual vem sendo amplamente estudada na medicina humana. Porém, poucos estudos envolvendo sua aplicação na prática cirúrgica de pequenos animais foram realizados até o momento. O objetivo do presente estudo foi avaliar a factibilidade da ovário-histerectomia transvaginal por NOTES pura em cadelas. Cinco cadelas foram avaliadas. A cavidade abdominal foi acessada por um trocarte de 11mm introduzido por uma incisão vaginal. Empregando-se um endoscópio rígido com canal de trabalho, os pedículos ovarianos foram coagulados e seccionados usando-se diatermia bipolar. O corno uterino foi tracionado para o

  4. Ovário-histerectomia laparoscópica em felinos hígidos: estudo comparativo de três métodos de hemostasia Laparoscopic ovariohysterectomy in healthy felines: comparative study of three hemostatic methods

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    F. Schiochet

    2009-04-01

    Full Text Available Foram avaliadas 24 gatas, hígidas, sem raça definida, distribuídas em três grupos de oito animais. Descreveu-se o acesso laparoscópico para ovariossalpingo-histerectomia (OSH e comparou-se o uso do eletrocautério bipolar (grupo I, do clipe de titânio (grupo II e da ligadura com fio de sutura (grupo III para a oclusão dos vasos ovarianos e uterinos. Hemorragia e enfisema subcutâneo foram as principais complicações observadas no transoperatório e hematoma subcutâneo e deiscência de sutura, as do pós-operatório. O procedimento cirúrgico e a técnica operatória mostraram-se viáveis nos três grupos. O uso do eletrocautério bipolar apresentou vantagens na comparação com os outros métodos de hemostasia.Twenty-four healthy female mongrel cats were submitted to ovaryhisterectomy and distributed into three groups of eight animals each: (I bipolar electrical cautery, (II titanium clips, and (III suture ligature for the occlusion of ovarian and uterine vessels, which were compared. The surgical procedure and the operation technique were viable in all three groups. Hemorrhagia and subcutaneous emphysema were the main intraoperative complications, and hematoma and suture dehiscence in the postoperative. The bipolar electrical cautery procedure is shown to be comparatively successful regarding the other studied methods for hemostasia.

  5. Avaliação da analgesia pós-operatória da metadona, da cetamina ou da sua associação em gatas submetidas a ovariossalpingo-histerectomia

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    V.S. Padilha

    2015-04-01

    Full Text Available A prevenção e o controle da dor são componentes básicos para um procedimento anestésico adequado. Objetivou-se com este estudo avaliar a analgesia pós-operatória da cetamina, em dose subanestésica, da metadona e da associação de ambas pela via intramuscular em felinos. Foram utilizadas 24 gatas, hígidas, submetidas à ovariossalpingo-histerectomia eletiva. No dia anterior ao início do estudo, os animais foram anestesiados para colocação de cateter na veia jugular, para posterior coleta de sangue para mensuração da concentração sérica do cortisol. No dia do experimento, os animais foram alocados aleatoriamente em três grupos (n=oito, os quais receberam cetamina (GC, na dose de 0,5mg/kg; ou metadona (GM, na dose de 0,3mg/kg; ou cetamina e metadona (GCM, nas doses de 0,5mg/kg e 0,3mg/kg, respectivamente, todos pela via intramuscular. Todos os grupos receberam os fármacos 20 minutos antes da indução anestésica, a qual foi realizada com propofol, e a manutenção com isoflurano. Os parâmetros avaliados foram a mensuração do cortisol nos momentos M0 (basal - antes da cirurgia, M1(transoperatório, M2, M3, M4, M8, M12 e M24 (duas, três, quatro, oito, 12 e 24 horas após o término da cirurgia,e a do escore de dor por meio da escala multidimensional de dor aguda em felinos nos momentos M0, M2, M3, M4, M8, M12 e M24. Os valores de cortisol foram maiores no GC em comparação ao GM e ao GCM em M2 e M3. Os escores de dor foram maiores no GC nos momentos M2 e M3 em comparação ao GM e ao GCM, respectivamente. No somatório de pontos, no M2, o GC apresentou valores maiores que o GM e o GCM, e, no M4, o GC obteve valores maiores que o GCM. Em relação ao número de resgates no pós-operatório no GC, 8/8 dos animais necessitaram de resgate, no GM 5/8 e no GCM 3/8. Conclui-se que a associação de metadona e cetamina em gatas submetidas à OSH eletiva promove analgesia pós-operatória adequada e, assim, reduz o requerimento de

  6. Implante de biomateriais e a consolidação óssea em cadelas submetidas à ovariossalpingo-histerectomia Influence of biomaterials on the bony consolidation in spayed female dogs

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    A.I. Roque-Rodriguez

    2009-10-01

    Full Text Available Avaliou-se a hidroxiapatita com alandronato e hidroxiapatita com colágeno na aceleração da consolidação óssea do rádio de cadelas adultas submetidas à ovariossalpingo-histerectomia (OSH. Utilizaram-se 14 cadelas adultas, distribuídas aleatoriamente em dois grupos: grupo-controle e grupo OSH (submetidas à OSH. Quatro meses após a OSH, as cadelas dos dois grupos foram submetidas à cirurgia para produção de uma falha óssea de 4mm de diâmetro nos terços distal e proximal do rádio. No terço distal do membro direito, foi utilizada a hidroxiapatita com alandronato e, no membro esquerdo, a hidroxiapatita com colágeno; no terço proximal, não se utilizou nenhum biomaterial. Houve retardo na consolidação das falhas ósseas nas cadelas submetidas à OSH comparadas com as não submetidas. A hidroxiapatita com alandronato acelerou o processo de reparação e, em todos os animais dos dois grupos, a densidade óssea foi significativamente maior no terço distal onde foi implantada. Os dois biomateriais apresentaram biocompatibilidade, constatada pela ausência de reação inflamatória ou outra reação indesejável.The hydroxyapatite with alendronate and hydroxyapatite with collagen were evaluated in the acceleration of the bony consolidation of adult spayed bitch radius. For that, 14 adult bitches were distributed in two groups (control and spayed. Four months after ovariohysterectomy, the groups were submitted to the surgery for production of a 4mm diameter bony flaw in the distal and proximal third regions of the radius. In the distal region of the right thoracic limb, hydroxyapatite with alendronate was used. In the distal region of the left thoracic limb, hydroxyapatite with collagen was used. Any biomaterial was used in proximal part of the limb. There was a retard in bony flaws consolidation in the spayed bitches. Hydroxyapatite with alendronate showed better result, since the place it was implanted considerably increased the

  7. Anestesia epidural com lidocaína isolada e associada ao fentanil para realização de ováriossalpingo-histerectomia em cadelas Epidural anesthesia with lidocaine and its combination with fentanyl for ovaryhysterectomy in dogs

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    R.N. Cassu

    2008-08-01

    Full Text Available Investigou-se o efeito da lidocaína isolada ou associada ao fentanil na anestesia epidural, para realização de ováriossalpingo-histerectomia. Dezoito cadelas foram tranqüilizadas com acepromazina, seguindo-se indução anestésica com propofol, para a realização da punção lombossacra. Os animais foram distribuídos em dois grupos: o grupo GL recebeu lidocaína (8,5mg/kg e o GLF fentanil (5µg/kg associado à lidocaína (6,5mg/kg. Mensuraram-se as freqüências cardíaca (FC e respiratória (FR, pressão arterial sistólica (PAS, variáveis hemogasométricas, concentração sérica de cortisol, necessidade de complementação anestésica com propofol durante a cirurgia, temperatura retal (T, período de latência e duração do bloqueio anestésico. Foi observada redução na FC, FR e PAS no GL e GLF, porém esses parâmetros mantiveram-se dentro dos limites fisiológicos. Para ambos os grupos, a concentração sérica de cortisol manteve-se estável após a cirurgia. Complementação anestésica foi necessária em 40% e 75% dos animais do GLF e GL, respectivamente. Conclui-se que ambos os protocolos foram suficientes para inibir a elevação sérica do cortisol, e resultaram em alterações mínimas cardiorrespiratórias, e que a complementação anestésica foi necessária.The effects of lidocaine or lidocaine associated with fentanyl for epidural anesthesia in dogs were studied. Eighteen adult healthy bitches were sedated with acepromazine, with subsequent propofol anesthetic induction for the accomplishment of lumbosacral puncture. The animals were alloted in two groups and received: 8.5mg/kg lidocaine (GL group or 5µg/kg fentanyl associated with 6.5mg/kg (GLF group. Heart and respiratory rates, systolic arterial blood pressure, blood gas variables, plasmatic concentration of cortisol, need of complementary doses of propofol for surgery, rectal temperature, and onset and duration of anesthesic block were measured. Mild alterations

  8. Vaginitis

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    ... vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse. Glossary Antibiotics: ... Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info ...

  9. Vaginitis

    Science.gov (United States)

    ... are the symptoms of a yeast infection? What treatments are available for vaginal yeast infection? Should I use an over-the-counter medication to treat a yeast infection? What is bacterial vaginosis? What are the symptoms of bacterial vaginosis? How ...

  10. Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina

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    Silvia Carramão

    Full Text Available OBJETIVO: Comparar os resultados anatômicos pós-operatórios de pacientes portadoras de prolapso uterino tratadas utilizando tela de polipropileno para correção dos defeitos do assoalho pélvico, comparando histerectomia vaginal com a preservação do útero. MÉTODO: Estudo randomizado com 31 mulheres portadoras de prolapso uterino estádio III ou IV (POP-Q divididas em dois grupos: Grupo HV- 15 mulheres submetidas à histerectomia vaginal e reconstrução da anatomia do assoalho pélvico com tela de polipropileno tipo I (Nazca R-Promedon e Grupo HP- 16 mulheres mulheres submetidas à reconstrução da anatomia do assoalho pélvico com tela de polipropileno tipo I (Nazca R-Promedon preservando o útero. Raça, urgência miccional, constipação intestinal, dor sacral, sangramento e tempo de operação foram os parâmetros analisados. RESULTADOS: O tempo de seguimento médio foi de nove meses. Não se observou diferença entre os grupos nas complicações funcionais. O tempo cirúrgico foi 120 minutos para grupo HV versus 58.9 minutos para grupo HP ( p < 0.001 e o volume de perda sanguínea intraoperatória foi 120 mL no grupo HV versus 20 mL para grupo HP ( p < 0.001*. A taxa de sucesso objetivo foi 86.67% para grupo HV e 75% para grupo HP (p = 0,667. A taxa de erosão de tela foi 20% (3/15 de extrusão no grupo HV versus 18,75% (3/16 no grupo HP (p = 1,000. CONCLUSÃO: A correção cirúrgica do assoalho pélvico com telas nas portadoras de prolapso uterino apresentaram similaridade quer sendo ela feita com histeropexia quer com histerectomia. Contudo, o tempo cirúrgico e o volume da perda sanguínea foram significantemente maiores no grupo com histerectromia (HV. Operações vaginais com telas são procedimentos efetivos para a correção do prolapso.

  11. Avaliação da sexualidade em mulheres submetidas à histerectomia para tratamento do leiomioma uterino Sexuality evaluation in women submitted to hysterectomy for the treatment of uterine leiomyoma

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    Imacolada Marino Tozo

    2009-10-01

    Full Text Available OBJETIVO: avaliar o impacto da histerectomia sobre a sexualidade de mulheres portadoras de leiomioma uterino. MÉTODOS: estudo prospectivo, no qual foram incluídas 33 mulheres sexualmente ativas, com idade de 35 a 50 anos, experiência orgástica e parceiro fixo capacitado para o coito. Todas as mulheres foram submetidas a dois instrumentos para avaliação da sexualidade: Quociente Sexual - Versão Feminina (QS-F e Inventário de Satisfação Sexual - Versão Feminina (GRISS. Os mesmos instrumentos foram aplicados pelo mesmo examinador antes da histerectomia e seis meses após o procedimento. RESULTADOS: o QS-F apontou que 39,4% das pacientes apresentaram piora no relacionamento sexual, apesar de não ter sido encontrada associação entre os resultados obtidos no QS-F antes e depois da histerectomia (χ2=10,6; grau de liberdade=12; p=0,05. Os escores médios obtidos após a aplicação do questionário de GRISS mostraram piora significante nos parâmetros "satisfação sexual" (p=0,03; "expressão da sensualidade feminina" (p=0,01; "vaginismo/dispareunia" (p=0,02 e "anorgasmia" (p=0,04. CONCLUSÕES: a histerectomia parece impactar negativamente a vida sexual das mulheres, sendo referida pela diminuição do desejo, da excitação e da capacidade orgásmica.PURPOSE: to evaluate the impact of hysterectomy on the sexuality of women with uterine leiomyoma. METHODS: prospective study including 33 sexually active women, with ages from 35 to 50 years old, with orgasmic experience and with a fit stable partner. All the women were submitted to two instruments for the evaluation or their sexuality: Sexual Quotient - Female Version (SQF and Sexual Satisfaction Inventory - Female Version (SSIF. Both instruments were applied by the same examiner, before and six months after the hysterectomy. RESULTS: the SQF has shown that 39.4% of the patients presented deterioration in the sexual intercourse, even though there has not been found an association between

  12. Estudo retrospectivo de ovariossalpingo-histerectomia em cadelas e gatas atendidas em Hospital Veterinário Escola no período de um ano Retrospective ovariosalpingohisterectomy study in bitches and queens assisted at a Veterinary School Hospital during one year

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    C.P. Balthazar da Silveira

    2013-04-01

    Full Text Available Realizou-se um estudo retrospectivo das indicações de ovariossalpingo-histerectomia - eletiva e terapêutica - no período de um ano. Foram analisados 193 prontuários de cadelas e gatas atendidas em Hospital Veterinário Escola, entre março de 2010 e março de 2011, levando em consideração a espécie, a idade e o uso ou não de anticoncepcional. Constatou-se que a demanda de OSH com caráter terapêutico (78,8% é consideravelmente mais alta que a eletiva (21,2%. Observou-se que as anormalidades reprodutivas detectadas com maior frequência foram piometra (53,36% e complicações obstétricas (25,38% e que o uso de anticoncepcional foi o fator relevante para o delineamento desses quadros.An ovariosalpingohisterectomy procedure indication - elective and therapeutic - retrospective study was conducted during one year. Record files from 193 bitches and queens assisted at a Veterinary School Hospital between March 2010 and March 2011 were analyzed, considering species, age and contraceptive use. It was possible to conclude that the therapeutic OSH demand (78.8% is remarkably superior to the elective OSH request (21.2%. It was also observed that the most frequently detected reproductive abnormalities were pyometra (53.36% and gestational complications (25.38%, and also that the use of contraceptives is a relevant factor for those events.

  13. Colpossacrofixação para correção do prolapso da cúpula vaginal Abdominal sacropexy to repair vaginal vault prolapse

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    Eliana Viana Monteiro Zucchi

    2003-12-01

    Full Text Available OBJETIVO: avaliar o resultado da técnica da colpossacrofixação (CSF para tratamento de pacientes que apresentaram prolapso de cúpula vaginal pós-histerectomia e que foram tratadas no período de 1995 a 2000. MÉTODOS: foram incluídas, retrospectivamente, 21 pacientes com prolapso de cúpula vaginal pós-histerectomia e correção prévia de cistocele e retocele. Foram analisados a idade, paridade, peso e índice de massa corpórea (IMC o intervalo entre a histerectomia e o aparecimento do prolapso. A colpossacrofixação foi realizada em 15 pacientes, das quais se avaliaram o tempo cirúrgico, perda sangüínea e recidiva. As pacientes submeteram-se a CSF com ou sem interposição de prótese de material sintético entre a cúpula vaginal e o sacro. RESULTADOS: para 15 das 21 pacientes acompanhadas em nosso serviço, a técnica de CSF foi a de eleição. Em um caso houve dificuldade técnica intra-operatória e optou-se pela correção a Te Linde. A média de idade das pacientes foi de 63,7 (47 a 95 anos, paridade 4,6 e o IMC 26,9. A CSF foi realizada, em média, 18 anos após histerectomia total abdominal e 3 anos após histerectomia vaginal. O tempo cirúrgico médio foi de 2 horas e 15 minutos, sem necessidade de transfusão sanguínea. Não houve recidiva do prolapso ou dos sintomas pré-operatórios (seguimento de 1 a 5 anos. CONCLUSÕES: o tratamento cirúrgico do prolapso de cúpula vaginal pode ser realizado pela via vaginal (colpocleise ou fixação ao ligamento sacroespinhoso e pela via abdominal (colpossacrofixação. Esta última apresenta a vantagem de restaurar o eixo vaginal preservando sua profundidade, o que, além de melhorar o prolapso, permite o restabelecimento das funções sexuais, intestinal e urinária (principalmente quando associada a colpofixação - Burch. Assim, quando o diagnóstico e tratamento são adequados e a equipe cirúrgica tem pleno conhecimento da anatomia pélvica, podemos afirmar que a CSF atinge

  14. Ovariossalpingo-histerectomia em cadelas: comparação da dor e análises cardiorrespiratória, pressórica e hemogasométrica nas abordagens convencional, por NOTES híbrida e NOTES total

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    P.C. Basso

    2014-10-01

    Full Text Available A cirurgia endoscópica por orifícios naturais (NOTES é um novo conceito de abordagem videocirúrgica, que surge como alternativa à cirurgia convencional, eliminando incisões abdominais e as possíveis complicações relacionadas a ela. A proposta deste artigo foi comparar técnicas de ovariossalpingo-histerectomia (OSH em cadelas, buscando determinar o procedimento que oferece menores alterações hemodinâmicas e menos estímulos dolorosos trans e pós-operatório. Para tanto, foram utilizadas 21 cadelas alocadas em três grupos. No primeiro, os pacientes foram submetidos à OSH por celiotomia (GC, no segundo por meio da técnica de NOTES híbrida (GNH e no terceiro (GNT, utilizando-se a técnica de NOTES total. O tempo cirúrgico do GNH foi significativamente maior que nos demais grupos. Em ambos os grupos de cirurgia NOTES, verificou-se diminuição das pressões arteriais médias e diastólicas no transoperatório. Apenas o grupo GNH desenvolveu acidose severa no transoperatório. Levando-se em consideração as avaliações da dor, apenas o grupo convencional necessitou de analgesia resgate transcirúrgica. No pós-operatório, observou-se que os cães do GC apresentaram índices mais elevados na escala visual analógica e na escala de Melbourne que os animais dos demais grupos, sendo necessária analgesia resgate em 100% deles. Em contraste, no GNT nenhum dos cães requereram complementação analgésica pós-operatória. Conclui-se que a técnica de OSH por NOTES total apresenta parâmetros cardiorrespiratórios e hemogasométricos semelhantes à técnica convencional e mais estáveis que a técnica de NOTES híbrida, bem como resulta em menor dor trans e pós-operatória que a técnica convencional.

  15. Aspectos clínicos, cirúrgicos, histológicos e pós-operatórios de oito cadelas com leiomioma vaginal

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    C.C. Menegassi

    2016-04-01

    Full Text Available O presente trabalho reporta as características clínicas e cirúrgicas de oito casos de cadelas portadoras de leiomioma vaginal, com histórico de aumento de volume na região perineal, aparecimento de massa pela vulva, disquezia, tenesmo e disúria. As pacientes foram submetidas à cirurgia de episiotomia para ressecção da massa neoplásica, e em quatro casos foi necessária a ovariossalpingo-histerectomia. Porém, uma delas apresentou recidiva, e, no segundo procedimento cirúrgico de exérese de neoformação, o histopatológico diagnosticou leiomiossarcoma. A paciente ainda apresentou mais duas recidivas, até o proprietário optar pela eutanásia. Decorridos quatro meses, as sete cadelas diagnosticadas com leiomioma não apresentaram recidiva, e os proprietários relataram ausência de sinais relacionados com a doença descrita. Conclui-se que a episiotomia para ressecção da massa vaginal e a ovariossalpingo-histerectomia nas cadelas inteiras nos casos de tumores vaginais benignos são tratamentos satisfatórios, com bom prognóstico, ao contrário do leiomiossarcoma.

  16. Analgesia preemptiva com S(+cetamina e bupivacaína peridural em histerectomia abdominal Analgesia preemptiva con S(+cetamina y bupivacaína peridural en histerectomía abdominal Preemptive analgesia with epidural bupivacaine and S(+ketamine in abdominal hysterectomy

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    Ferdinand Edson de Castro

    2005-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O presente estudo investiga a capacidade de o antagonista do receptor NMDA, S(+cetamina, associado à injeção peridural de anestésico local (bupivacaína, previamente administrado à incisão promover analgesia preemptiva em pacientes submetidas a histerectomia total abdominal. MÉTODO: Foram avaliadas 30 pacientes, distribuídas aleatoriamente em dois grupos de igual tamanho e estudadas prospectivamente de forma encoberta. Injeção peridural e inserção de cateter foram realizadas entre os interespaços de L1-L2. No grupo I (G1, n = 15, as pacientes receberam, por via peridural, 17 mL de bupivacaína a 0,25%, sem vasoconstritor, associados a 30 mg de S(+cetamina (3 mL, trinta minutos antes da incisão cirúrgica; após 30 minutos da incisão, receberam 20 mL de solução fisiológica a 0,9%. No grupo 2 (G2, n = 15, receberam 20 mL de solução fisiológica, por via peridural, 30 minutos antes da incisão, sendo feita administração de 17 mL de bupivacaína a 0,25% associados a 30 mg de S(+cetamina (3 mL, trinta minutos depois da incisão. Após a injeção peridural, realizou-se anestesia geral com propofol, pancurônio, O2 e isoflurano. Para analgesia pós-operatória foi usada solução peridural em bolus de fentanil associada à bupivacaína, em intervalo mínimo de quatro horas e suplementação com dipirona, se necessária. Avaliou-se a intensidade da dor através de escala numérica e verbal (ao despertar, 6, 12, 18 e 24 horas após o término da operação, o tempo necessário para solicitar pela primeira vez o analgésico e o consumo total de analgésicos. RESULTADOS: Não houve diferença significativa entre os grupos em relação ao tempo para solicitar analgésicos pela primeira vez, ao consumo de analgésicos e aos escores de dor pelas escalas numérica e verbal. CONCLUSÕES: Não foi possível demonstrar efeito preemptivo com a utilização peridural de S(+cetamina e bupivacaína nas doses

  17. Uso de morfina, xilazina e meloxicam para o controle da dor pós-operatória em cadelas submetidas à ovariossalpingo-histerectomia Morphine, xylazine and meloxicam in pain management after ovariosalpingohysterectomy of bitches

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    D.A. Pereira

    2009-04-01

    Full Text Available Foram realizados estudos empregando-se analgésicos por via epidural e subcutânea em cadelas de diferentes raças e idades, submetidas à castração mediante celiotomia. Vinte animais foram tranquilizados e anestesiados com tiletamina-zolazepam, e aleatoriamente distribuídos em quatro grupos (n=5, de acordo com o fármaco e a via de administração. Os do grupo morfina (GM foram submetidos à anestesia epidural no espaço lombossacro, com morfina (0,1mg/kg associada ao cloreto de sódio a 0,9%. Aos do grupo xilazina (GX, foram administrados xilazina (0,2mg/kg e cloreto de sódio a 0,9%. Os do grupo meloxicam (GME receberam 0,2mg/kg do anti-inflamatório meloxicam associado ao cloreto de sódio a 0,9%, injetado pela via subcutânea. Os do grupo-controle (CG receberam apenas cloreto de sódio a 0,9%. O volume final para as injeções epidurais foi padronizado para 0,3mL/kg. A mensuração inicial da concentração de cortisol plasmático, do ritmo cardíaco, da frequência respiratória e os parâmetros comportamentais foram registrados imediatamente antes do procedimento cirúrgico (M1. Registros adicionais foram apresentados às 2, 6, 12 e 24 horas após o procedimento cirúrgico (M2, M3, M4 e M5, respectivamente. As variáveis comportamentais foram avaliadas por meio de sinais clínicos e seus respectivos escores. Em GX foram observadas depressão respiratória, bradicardia e concentração de cortisol mais alta do que o registrado no GM. A analgesia obtida pelo meloxicam foi considerada ineficiente. É possível concluir que a morfina, via epidural, promoveu menor incidência de efeitos colaterais e melhor analgesia e bem-estar animal.The use of analgesics by epidural and subcutaneous way in bitches submitted to surgical sterilization by laparotomy was evaluated. Twenty females dogs of different ages and breeds were sedated and anesthetized with a combination of tiletamine-zolazepam and randomly distributed into four experimental groups of

  18. Vaginal dryness

    Science.gov (United States)

    ... Vaginitis due to reduced estrogen; Atrophic vaginitis; Menopause vaginal dryness ... sexual intercourse more comfortable. It also helps decrease vaginal dryness. If estrogen levels drop off, the vaginal tissue ...

  19. Cotidiano da mulher pós-histerectomia à luz do pensamento de Heidegger Cotidiano de la mujer después de la histerectomia bajo el pensamiento de Heidegger Daily-life of women after hysterectomy supported by Hiedegger's thought

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    Anna Maria de Oliveira Salimena

    2010-04-01

    Full Text Available Este estudo de natureza qualitativa teve como objeto o cotidiano de mulheres após a histerectomia. Neste sentido foi utilizada a abordagem fenomenológica como método de pesquisa e o pensamento de Martin Heidegger como referencial teórico-metodológico. Utilizou-se da entrevista fenomenológica, com 25 mulheres submetidas à histerectomia, no HU/UFJF, em 2006. A compreensão interpretativa desvelou, à luz do pensamento de Heidegger, que o cotidiano da mulher após a histerectomia se expressa num movimento que transita da inautenticidade para o indicativo de propriedades e impropriedades. No cotidiano, após a intervenção, ela se compreende sendo-aí-com-os-outros e se desvela, mostrando-se como ser de possibilidades num mundo próprio. Evidenciou-se que na dinâmica assistencial deve-se considerar a subjetividade da mulher que será submetida à histerectomia.Este estudio de naturaleza calitativa tuvo como objeto el cotidiano de mujeres tras la histerectomia. En este sentido fue utilizada el enfoque fenomenológico como método de investigación y el pensamiento de Martin Heeidegger como referencial teórico metodológico. Fueron testigos 25 mujeres sometidas a la histerectomia siendo que la encuesta fenomenológica, 2006. La comprensión interpretativa, reveló a la luz del pensamiento de Heidegger, que el cotidiano de la mujer, tras la histerectomia se expresa en un movimiento que transita de la inautenticidad para el indicativo de propiedades y impropiedades. Revelaron que en la dinámica asistencial las condiciones de salud la mujer deben ser considerado a partir de la subjetividad de la mujer que será sometida a la histerectomia.This qualitative study had as its object the daily-life of women after being submitted to a histerectomy. Following this sense the phenomenological approach was chosen as methodological framework , supported by Martin Heidegger´ phenomenology. The deponents were twenty five women submitted to a histerectomy

  20. O sentido da sexualidade de mulheres submetidas a histerectomia: uma contribuição da enfermagem para a integralidade da assistência ginecológica El sentido de la sexualidad de mujeres sometidas a histerectomia: una contribución de la enfermería a la integralidad de la asistencia ginecológica The meaning of women´s sexuality that were submited to the histerectomy: a nursing contribution for the completeness of the gynecological assistance

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    Anna Maria de Oliveira Salimena

    2008-12-01

    Full Text Available A histerectomia é um procedimento cirúrgico irreversível, realizado por indicação médica, com a finalidade de restabelecer a saúde ou mesmo salvar a vida da mulher. Ser submetida a esta cirurgia acarreta modificações em seu cotidiano porque as recomendações pertinentes ao pós-operatório de histerectomia impõem implicações em seu mundo-vida. Este estudo de natureza qualitativa teve como objetivo analisar o sentido da sexualidade de mulheres após a histerectomia à luz do pensamento de Martin Heidegger. Foram depoentes 25 mulheres submetidas à retirada total do útero; a entrevista fenomenológica ocorreu num tempo variado, de 4 a 19 meses após o procedimento cirúrgico. A interpretação da estrutura de significação "a atividade sexual foi considerada" desvelou que na dinâmica assistencial, médica e de enfermagem, as rotineiras orientações de abstinência sexual determinadas pelo pós-operatório devem ser consideradas a partir da subjetividade da mulher que será/foi submetida à histerectomia.La histerectomia es un procedimiento quirúrgico irreversible realizado por indicación médica con la finalidad de restablecer la salud o mismo salvar la vida de la mujer. Ser sometida a esta cirurgía acarrea modificaciones en su cotidiano porque las recomendaciones para después de una operación de histerectomia imponen implicaciones en su mundo-vida. Este estudio de naturaleza cualitativa tuvo como objetivo analizar el sentido de la sexualidad de mujeres tras la histerectomia a la luz del pensamiento de Martin Heidegger. Fueron oídas 25 mujeres sometidas a la retirada total de útero siendo que la encuesta fenomenológica ocurrió en un tiempo entre cuatro y diecinueve meses tras el procedimiento quirúrgico. La interpretación de la estructura de la significación "la actividad sexual fue considerada" enseñó que en la dinámica asistencial médica y de enfermería, las orientaciones de rutina de abstinencia sexual

  1. Vaginal Atrophy

    Science.gov (United States)

    Vaginal atrophy Overview Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after ...

  2. Resultados neonatais no parto vaginal espontâneo comparados aos dos partos com fórcipe de Simpson-Braun em primíparas

    OpenAIRE

    Pereira,Belmiro Gonçalves; Camargo, Michel Gardere; Couto,Egle Cristina; Amaral, Eliana; Passini Jr,Renato; Parpinelli, Mary Angela

    2004-01-01

    OBJETIVO: comparar os resultados neonatais dos partos vaginais espontâneos ou assistidos com fórcipe de Simpson-Braun em nulíparas. MÉTODO: em estudo de corte retrospectivo foram avaliados dois grupos de primíparas atendidas no Centro Obstétrico do CAISM/UNICAMP, que tiveram parto vaginal sob analgesia epidural. O grupo fórcipe foi formado por 119 pacientes que tiveram parto a fórcipe de Simpson-Braun, e o grupo normal por 114 casos de parto vaginal espontâneo. Foram estudadas as variáveis ne...

  3. Fatores associados ao parto vaginal em gestantes de alto risco submetidas à indução do parto com misoprostol Factors associated with vaginal delivery in high-risk pregnant women submitted to labor induction with misoprostol

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    Zuleika Studart Sampaio

    2004-02-01

    Full Text Available OBJETIVOS: determinar os principais fatores associados ao parto transpelvino em gestantes de alto-risco submetidas à indução do parto com misoprostol vaginal (50 µg. MÉTODOS: trata-se da análise secundária de um ensaio clínico aberto, não randomizado, incluindo 61 gestantes de alto-risco internadas na Enfermaria de Patologia Obstétrica da Maternidade Escola Assis Chateaubriand, em Fortaleza (CE. Todas tinham idade gestacional de mais de 37 semanas, feto único com boa vitalidade e escores de Bishop menores ou iguais a 7. Utilizou-se a dose de 50 µg de misoprostol via vaginal, repetindo-se a cada seis horas, até o máximo de quatro doses. Realizou-se análise uni e multivariada para determinação da associação entre parto vaginal (variável dependente e variáveis independentes (preditoras, construindo-se curvas ROC para paridade e escores de Bishop. RESULTADOS: encontrou-se associação significativa do parto vaginal com a paridade (um ou mais partos anteriores, escore de Bishop >4 e intervalo entre indução e parto menor que 6 horas, ao passo que a taquissistolia reduziu a chance de parto vaginal. Realizou-se análise de regressão logística múltipla para avaliar cada um desses fatores independentemente, persistindo fortemente associados ao parto vaginal o escore de Bishop >4 (OR = 3,3; IC 95% = 2,15-4,45 e a paridade >1 (OR = 5,41; IC 95% = 4,18-6,64. Pela curva ROC para os escores de Bishop e a paridade como determinantes do parto vaginal, encontrou-se um valor preditivo positivo de 100%, com sensibilidade de 63,2%. A área sob a curva foi de 86,8%, significativamente superior a 50% (p=0,023. CONCLUSÕES: os fatores preditivos mais importantes para parto vaginal após indução com misoprostol foram a paridade (um ou mais partos e escores de Bishop >4. Estes fatores devem ser levados em consideração na escolha de diferentes esquemas e doses de misoprostol, tanto para preparo cervical como indução do parto.PURPOSE: to

  4. Vaginal Atrophy

    Science.gov (United States)

    ... Body in Balance › Vaginal Atrophy Fact Sheet Vaginal Atrophy November, 2011 Download PDFs English Espanol Editors JoAnn ... MD Richard J. Santen, MD What is vaginal atrophy? Vaginal atrophy is a condition in which the ...

  5. Vaginal Diseases

    Science.gov (United States)

    Vaginal problems are some of the most common reasons women go to the doctor. They may have ... that affect the vagina include sexually transmitted diseases, vaginal cancer, and vulvar cancer. Treatment of vaginal problems ...

  6. Vaginal Fistula

    Science.gov (United States)

    Vaginal fistula Overview By Mayo Clinic Staff A vaginal fistula is an abnormal opening that connects your vagina to ... or urine to pass through your vagina. Vaginal fistulas can develop as a result of an injury, ...

  7. Histerectomia e as doenças ginecológicas benignas: o que está sendo praticado na Residência Médica no Brasil? Hysterectomy and benign gynecological diseases: what has been performed in Medical Residency in Brazil?

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    Helena Lúcia Zydan Sória

    2007-02-01

    Full Text Available OBJETIVO: avaliar o ensino e a prática da histerectomia no Brasil nas diferentes regiões do país e compará-las com dados da literatura mundial. MÉTODOS: foram enviados questionários aos 132 Serviços de Residência Médica de Ginecologia e Obstetrícia do Brasil cadastrados pelo Ministério da Educação e Cultura em 2003. O mesmo continha nove questões sobre indicações em casos de doenças benignas, procedimentos operatórios, uso de antibioticoprofilaxia, fios para sutura da cúpula vaginal e complicações. Para a análise dos resultados, foram aplicados os testes de Friedman, Kruskal-Wallis e chi2, conforme a natureza das variáveis. RESULTADOS: nos 48,5% de questionários respondidos ou justificados (não-respostas, houve predomínio da região Sudeste (62%. A via operatória preferencial foi a abdominal, variando de 60 a 100% em média (pPURPOSE: to evaluate the teaching and the practice of hysterectomy in the Brazilian regions and to compare them with data of international literature. METHODS: questionnaires about nine issues on benign hysterectomy indications, surgical procedures, use of antibiotic prophylaxis, suture of the vaginal vault and complications were sent to the 132 Gynecological and Obstetrics Residency Services of Brazil, registered by the Ministry of the Education and Culture in 2003. Data were computed and statically analyzed, with the use of the Friedman's, Kruskal-Wallis's and chi2 tests, according to the characteristics of the variables. RESULTS: 48.5% of the questionnaires were answered or justified when there were no answers, mainly in the Southeastern region (62%. The main surgical hysterectomy procedure was the abdominal, varying from 60 to 100% (p<0.001, followed by the vaginal (10 to 40% and the laparoscopy (6%. In 94% of the cases, laparoscopy was not employed. The main indication for hysterectomy was myomatosis (60.4%; p<0.001, followed by adenomiosis (8.3% and abnormal uterine bleeding (7.5%. First

  8. Fatores associados à violência obstétrica na assistência ao parto vaginal em uma maternidade de alta complexidade em Recife, Pernambuco

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    Priscyla de Oliveira Nascimento Andrade

    2016-03-01

    Full Text Available Resumo Objetivos: analisar os fatores associados à violência obstétrica de acordo com as práticas não recomendadas na assistência ao parto vaginal em uma maternidade escola e de referência da Cidade do Recife. Métodos: estudo transversal, prospectivo, com 603 puérperas, realizado entre agosto a dezembro de 2014. Os dados sociodemográficos, clínicos e de acesso à assistência foram obtidos através dos prontuários e de entrevistas com as pacientes. A prevalência da violência obstétrica foi baseada nas recomendações da Organização Mundial da Saúde sobre as práticas recomendadas para a assistência ao parto vaginal. Para análise dos fatores associados utilizou-se a regressão multivariada de Poisson, considerou-se p<5%. Os dados foram analisados no Stata 12.1 SE. Resultados: a prevalência da violência obstétrica foi de 86,57%. As práticas prejudiciais mais frequentes foram os esforços de puxo (65%, a administração de ocitocina (41% e o uso rotineiro da posição supina/litotomia (39%. Apenas as variáveis não possuir ensino médio completo (p=0,022 e ter sido assistido por um profissional médico (p<0,001 apresentaram associação significante com a violência obstétrica. Conclusões: o grande número de intervenções obstétricas utilizadas consiste em um ato de violência obstétrica e demonstram que apesar do incentivo do Ministério da Saúde para uma assistência humanizada os resultados ainda estão longe do recomendado.

  9. Caracterização fenotípica de leveduras isoladas da mucosa vaginal em mulheres adultas Phenotypic characterization of yeasts isolated from the vaginal mucosa of adult women

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    Paula dos Reis Corrêa

    2009-04-01

    Full Text Available OBJETIVO: caracterizar fenotipicamente leveduras isoladas do conteúdo vaginal de 223 mulheres adultas, sintomáticas (S e assintomáticas (A para vulvovaginite, e determinar os indicadores clínicos que possivelmente levam ao surgimento de sinais e sintomas relacionados ao acometimento da mucosa por essa patologia. MÉTODOS: inicialmente foi aplicado um questionário, com questões abertas e fechadas, sobre dados clínicos epidemiológicos. Logo, ocorreu o diagnóstico micológico com semeadura em meio Chrom Agar Candida, identificação micromorfológica e bioquímica. Métodos específicos para detecção de fatores de virulência, proteinase e fosfolipase foram empregados. A análise estatística das variáveis foi estabelecida utilizando os testes χ2 e χ2 de Pearson. RESULTADOS: Candida albicans foi a espécie mais prevalente (87%, S e 67%, A, seguida de Candida glabrata (4%, S e 17%, A. O número de mulheres que referiram adoção de anticoncepcionais foi mais alto entre as sintomáticas, 77%. Nos dois grupos estudados, em torno de 87% apresentaram ciclos menstruais regulares, 57% das mulheres eram casadas com idade entre 30 a 40 anos. Em relação a práticas sexuais, houve para parte das pacientes, concomitância entre os hábitos, anal, oral e vaginal. Em relação à fosfolipase, apenas Candida albicans produziu este fator de virulência em 37,5%. A proteinase foi detectada em Candida albicans, Candida glabrata e Candida parapsilosis. Esse último fator de virulência esteve associado, principalmente, a isolados de pacientes sintomáticas. CONCLUSÕES: a colonização e infecção da mucosa vaginal por levedura é real com diversas espécies de Candida presentes. No entanto, Candida albicans se destaca como espécie prevalente em mucosa vaginal de mulheres adultas. Fica evidente a emergência de espécies de Candida não albicans, algumas com resistência intrínseca aos azólicos, tais como Candida glabrata, Candida parapsilosis

  10. Fatores prognósticos para o parto transvaginal em pacientes com cesárea anterior Prognostic factors for vaginal delivery after cesarian section

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    Luiz Carlos Santos

    1998-07-01

    Full Text Available O objetivo deste estudo foi determinar os fatores prognósticos para a ultimação do parto por via transpélvica em gestantes com cesárea anterior admitidas em trabalho de parto no CAM-IMIP. Foi realizado um estudo tipo caso-controle, analisando os partos de pacientes com cesárea prévia assistidos no CAM-IMIP no período de janeiro/1991 a dezembro/1994. Foram considerados casos as pacientes com cesárea anterior (n=156 e controles as que tiveram parto transvaginal (n=338. Os critérios de inclusão foram: idade gestacional > 36 semanas, cesárea anterior há pelo menos 1 ano, concepto vivo, trabalho de parto espontâneo e apresentação cefálica fletida. Foram excluídas as gestações de alto risco, os casos de sofrimento fetal anteparto e pacientes com história de parto transpélvico anterior depois da cesárea. A análise estatística foi realizada em Epi-Info 6.0 e Epi-Soft, utilizando-se os testes chi² de associação, teste exato de Fisher e "t" de Student, bem como a odds ratio e seu intervalo de confiança a 95%. Análise de regressão logística múltipla foi efetuada para controle das variáveis confundidoras. O percentual de cesáreas no grupo estudado foi de 31,6%. Os fatores maternos que apresentaram associação significativa com o parto transvaginal foram a idade materna 35 anos (OR = 0,54, IC a 95% = 0,36-0,82, a história de parto vaginal anterior (OR = 1,6, IC a 95% = 1,01-2,55 e a indicação da cesárea anterior por doenças da gestação (OR = 3,67, IC a 95% = 1,19-12,02. Fatores como intervalo entre a cesárea anterior e o parto atual, outras indicações de cesárea e o tipo de histerorrafia não apresentaram associação significativa com o parto transpélvico. No modelo de regressão logística múltipla, persistiram como variáveis associadas significativamente ao parto vaginal a idade materna e a história de parto vaginal anterior. Os autores concluíram que sendo a idade materna Objectives: to determine

  11. Atrophic vaginitis.

    Science.gov (United States)

    Stika, Catherine S

    2010-01-01

    With the loss of estrogen that occurs with menopause, physiologic and structural changes occur within the vulvovaginal mucosa that lead to a condition commonly called atrophic vaginitis. Although mild genital changes occur in most women, 10-47% of postmenopausal women will develop one or more debilitating symptoms that include vulvovaginal dryness, dyspareunia, vulvar itching or pain, recurrent urinary tract infections, as well as abnormal vaginal discharge. Topical estrogen replacement therapies reverse these mucosal changes and are effective treatments for the symptoms of atrophic vaginitis. Vaginal moisturizers and lubricants also provide symptomatic relief for vaginal dryness and dyspareunia, respectively. © 2010 Wiley Periodicals, Inc.

  12. Prevalência e caracterização de espécies de lactobacilos vaginais em mulheres em idade reprodutiva sem vulvovaginites Prevalence and characterization of vaginal lactobacillus species in women at reproductive age without vulvovaginitis

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    Eliane Melo Brolazo

    2009-04-01

    Full Text Available OBJETIVO: identificar espécies de lactobacilos isolados do conteúdo vaginal de mulheres saudáveis e assintomáticas; determinar as espécies mais prevalentes e caracterizá-las fenotipicamente. MÉTODOS: lactobacilos foram isolados em meio seletivo a partir de amostras de conteúdo vaginal de 135 mulheres, sem queixa de corrimento e com diagnóstico laboratorial negativo para infecções vaginais, acompanhadas em um ambulatório de Planejamento Familiar. Os isolados foram identificados por PCR multiplex e, quando necessário, submetidos ao sequenciamento do gene RNAr 16S. Foram também avaliados quanto à acidificação do meio de cultura, à produção de ácido láctico, de H2O2, bacteriocinas e a capacidade de adesão às células epiteliais. RESULTADOS: oitenta e três cepas de lactobacilos foram isoladas e identificadas, sendo as espécies predominantes L. crispatus (30,1%, L. jensenii (26,5%, L. gasseri (22,9% e L. vaginalis (8,4%. Apenas 20 destes isolados não produziram H2O2 em quantidades detectáveis. Das 37 linhagens selecionadas para teste de adesão a células epiteliais, 12 apresentaram adesão entre 50 a 69%, 10 apresentaram 70% ou mais, e as restantes pouca ou nenhuma adesão. Nenhum dos isolados produziu bacteriocinas. CONCLUSÕES: as espécies de lactobacilos mais prevalentes em mulheres sem vulvovaginites, isoladas em meio de cultura seletivo e identificadas por métodos moleculares, foram L. crispatus, L. jensenii e L. gasseri. Além de mais frequentes, tais linhagens também apresentaram melhor produção de H2O2 e atingiram menores valores de pH em meio de cultura.PURPOSE: to identify species of lactobacillus isolated from the vaginal contents of healthy and asymptomatic women, determining the most prevalent species and characterizing them phenotypically. METHODS: lactobacillus have been isolated in selective milieu from samples of the vaginal contents of 135 women without complaints of vaginal secretion, and with

  13. Detecção de DNA de Brucella spp. em amostras de sangue e de suabe vaginal ou prepucial de cães do município de Natal, Rio Grande do Norte, Brasil

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    Annielle Regina da Fonsêca Fernandes

    2013-06-01

    Full Text Available Objetivou-se com este trabalho detectar o DNA de Brucella spp. em amostras de sangue e de suabe vaginal ou prepucial de 80 cães sorologicamente positivos para brucelose pela prova de imunodifusão em gel de ágar (IDGA, no município de Natal, estado do Rio Grande do Norte, Brasil. Amostras de sangue total foram colhidas com anticoagulante (citrato de sódio juntamente com amostras de suabe vaginal e prepucial, para extração de DNA e posterior realização da reação em cadeia da polimerase (PCR empregando-se os primers ITS66 e ITS279. O DNA de Brucella spp. foi amplificado em seis animais, sendo um animal em ambas as amostras, dois cães em amostras de sangue e três em amostras de suabe do trato reprodutivo. Concluiu-se que a infecção por Brucella spp. está presente em cães no município de Natal, e que a detecção de DNA do agente em amostras de suabe do trato reprodutivo podem ser utilizadas como ferramenta suplementar no diagnóstico de brucelose canina.

  14. Vaginal Cancer

    Science.gov (United States)

    Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human ... test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its ...

  15. Vaginal cysts

    Science.gov (United States)

    ... cysts URL of this page: //medlineplus.gov/ency/article/001509.htm Vaginal cysts To use the sharing ... may need a biopsy to rule out vaginal cancer, especially if the mass appears to be solid. If the cyst is located under the bladder or urethra, x-rays may be needed to see if ...

  16. Vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana Vaginal infections in human immunodeficiency virus-infected women

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    Paula Matos Oliveira

    2008-03-01

    Full Text Available OBJETIVO: comparar a freqüência de vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana (HIV com mulheres não infectadas. MÉTODOS: estudo de corte transversal com 64 mulheres infectadas pelo HIV e 76 não infectadas. Foram calculadas as freqüências de vaginose bacteriana, candidíase e tricomoníase, que foram diagnosticadas por critérios de Amsel, cultura e exame a fresco, respectivamente. Para análise dos dados, utilizaram-se o teste do c2, teste exato de Fisher e regressão múltipla para verificar a independência das associações. RESULTADOS: a infecção vaginal foi mais prevalente em pacientes infectadas pelo HIV quando comparadas ao Grupo Controle (59,4 versus 28,9%, pPURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9%, p<0,001; Odds Ratio=2.7, IC95%=1.33-5.83, p=0.007. Bacterial vaginosis occurred in 26.6% of the positive-HIV women; vaginal candidiasis, in 29.7% and trichomoniasis, in 12.5% of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively. CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.

  17. Emphysematous vaginitis.

    Science.gov (United States)

    Lima-Silva, Joana; Vieira-Baptista, Pedro; Cavaco-Gomes, João; Maia, Tiago; Beires, Jorge

    2015-04-01

    Emphysematous vaginitis is a rare condition, characterized by the presence of multiple gas-filled cysts in the vaginal and/or exocervical mucosa. Although its etiology is not completely understood, it is self-limited, with a benign clinical course. Vaginal discharge, sometimes bloody, and pruritus are the most common symptoms. Chronic and acute inflammation can be found, and diseases that impair the immune system and pregnancy have been associated with this condition. A 48-year-old postmenopausal woman, with a history of hysterectomy with several comorbidities, presented with a 4-month history of bloody discharge and vulvar pruritus. Examination showed multiple cystic lesions, 1 to 5 mm, occupying the posterior and right lateral vaginal walls. Speculum examination produced crepitus. Vaginal wet mount was normal, except for diminished lactobacilli; results of Trichomonas vaginalis DNA test and vaginal cultures were negative. Lugol's iodine applied to the vagina was taken up by the intact lesions. Biopsy result showed typical features of emphysematous vaginitis. This is an unusual entity, presenting with common gynecological complaints, and both physicians and pathologists should be aware to prevent misdiagnosis and overtreatment.

  18. Vaginal cancer

    Science.gov (United States)

    Hacker NF. Vulvar and vaginal cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 40. Jhingran ...

  19. Clindamycin Vaginal

    Science.gov (United States)

    ... be used to treat vaginal irritation caused by yeast infections or by sexually transmitted diseases such as ... the lining of all or part of the intestine is swollen, irritated, or has sores) or severe ...

  20. Vaginal Bleeding

    Science.gov (United States)

    Menstruation, or period, is a woman's monthly bleeding.Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, is very heavy, or lasts much ...

  1. Desenvolvimento de primers para identificação e diferenciação de espécies de Candida em secreção vaginal por PCR em tempo real (qPCR

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    Sabine Elisa Jackisch

    2017-01-01

    Full Text Available Infecções fúngicas são cada vez mais frequentes, principalmente relacionadas ao sistema geniturinário e causadas por Candida spp. A PCR mostra-se promissora para o diagnóstico e para sua aplicação faz-se necessário o desenvolvimento de primers. Para isso obteve-se sequências da região ITS do rDNA 18S de 5 espécies de Candida, alinhou-se e verificou-se os tamanhos dos amplicons e as Tms teóricas. Cepas padrão e cepas cultivadas foram utilizadas como referência. Além disso, 67 amostras de DNA de secreção vaginal foram submetidas a qPCR e os resultados foram confirmados em gel de agarose 2%. Os testes in silico demonstraram a capacidade do par de primers em diferenciar as cinco espécies, o que foi confirmado após a amplificação das cepas padrão e de amostras de secreção vaginal, identificadas em 20 amostras. O limite de detecção foi de 58 células/mL para as cepas padrão de C. albicans e C. tropicalis e 29 células/mL para C. parapsilosis. A sensibilidade da qPCR frente ao teste de crescimento microbiológico foi de 68%, com especificidade de 90%. A técnica possui potencial de diagnóstico, porém precisa ser otimizada para testes quantitativos.

  2. Vaginal Microbiota.

    Science.gov (United States)

    Mendling, Werner

    2016-01-01

    The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. Culturing techniques are not suitable any more for determination of a normal or abnormal vaginal microbiota. Non culture-based modern technologies revealed a complex and dynamic system mainly dominated by lactobacilli.The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Several species of lactobacilli per individuum dominate the healthy vagina. They support a defense system together with antibacterial substances, cytokines, defensins and others against dysbiosis, infections and care for an normal pregnancy without preterm birth.The numbers of Lactobacillus (L.) iners increase in the case of dysbiosis.Bacterial vaginosis (BV) - associated bacteria (BVAB), Atopobium vaginae and Clostridiales and one or two of four Gardnerella vaginalis - strains develop in different mixtures and numbers polymicrobial biofilms on the vaginal epithelium, which are not dissolved by antibiotic therapies according to guidelines and, thus, provoke recurrences.Aerobic vaginitis seems to be an immunological disorder of the vagina with influence on the microbiota, which is here dominated by aerobic bacteria (Streptococcus agalactiae, Escherichia coli). Their role in AV is unknown.Vaginal or oral application of lactobacilli is obviously able to improve therapeutic results of BV and dysbiosis.

  3. Descrição de duas novas técnicas cirúrgicas para o tratamento de prolapso vaginal em vacas zebuínas: vaginectomia parcial e vaginopexia dorsal

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    José Abdo de Andrade Hellú

    2015-11-01

    Full Text Available Com o aumento da casuística e o insucesso da aplicação das técnicas convencionais de Caslick, Bühner ou Flessa, na redução do prolapso vaginal não associado à gestação em vacas zebuínas, caracterizada pela elevação significativa da recorrência da afecção, este trabalho teve por objetivo avaliar duas novas técnicas cirúrgicas na correção do prolapso vaginal, denominadas de vaginectomia parcial e vaginopexia dorsal em vacas. O estudo foi conduzido a campo, por um período de quatro anos, utilizando-se 812 vacas zebuínas (Nelore, Gir e Brahman, em idade reprodutiva, alojadas em diversas propriedades. O diagnóstico foi realizado através de anamnese e avaliação dos sinais clínicos e, de acordo com o estágio do prolapso vaginal, foi definida a técnica cirúrgica a ser executada, após procedimentos anestésicos. Os resultados pós-cirúrgicos das duas técnicas indicaram alta porcentagem de recuperação (93,4% para vaginectomia parcial e 96,14% para vaginopexia dorsal, baixo índice de recidivas (6,3% e 3,7%, respectivamente e baixa mortalidade (entre 0,2% e 0,3%. Desse modo, os resultados demonstram que as duas técnicas propostas podem ser indicadas para a redução e solução definitiva de prolapso vaginal em vacas zebuínas

  4. Bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno intravenoso melhora a analgesia após histerectomia abdominal

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    Evren Yucel

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da aplicação intravenosa(IV de dexcetoprofeno trometamol em bloqueio dos nervos ilioinguinal e ílio-hipogástrico na qualidade analgésica e no consumo de morfina após histerectomia abdominal total. MÉTODO: Estudo clínico controlado e randomizado conduzido com 61 pacientes. O estudo foi feito em sala de operação, sala de recuperação pós-anestésica e ambulatório. Os 61 pacientes foram randomicamente alocados em três grupos: grupo controle (Grupo C, grupo bloqueio (Grupo B e grupo bloqueio com dexcetoprofeno (Grupo BD. Antes da incisão cirúrgica feita após a indução da anestesia, fizemos o bloqueio dos nervos ilioinguinal e ilio-hipogástrico (Grupo C recebeu solução salina e grupos B e BD receberam levobupivacaína. Em contraste com os grupos C e B, o Grupo BD recebeu dexcetoprofeno. Administramos morfina a todos os pacientes para analgesia, com o uso do método de analgesia controlada pelo paciente (ACP durante o pós-operatório de 24 horas. Registramos os escores para dor pela escala visual analógica (EVA, os índices de satisfação, o consumo de morfina e os efeitos colaterais durante o pós-operatório de 24 horas. RESULTADOS: Os escores EVA do Grupo BD foram menores do que os dos grupos C e B no pós-operatório (p < 0,05 nos intervalos de 1, 2, 6 e 12 horas. Os escores EVA do Grupo C foram maiores do que os do Grupo B nas primeiras 2 horas de pós-operatório. O tempo até a primeira demanda de ACP foi mais longo, os valores de consumo de morfina mais baixos e os índices de satisfação maiores no Grupo BD do que nos outros dois grupos (p < 0,05. CONCLUSÃO: O bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno IV aumenta a satisfação do paciente e diminui o consumo de opioides e sugere que dexcetoprofeno trometamol é um analgésico anti-inflamatório não esteroide eficaz em analgesia pós-operatória.

  5. Homeopathic treatment of vaginal leiomyoma in a dog: case report Tratamento homeopático de leiomioma vaginal en canino: relato de caso Tratamento homeopático de leiomioma vaginal em cães: relato de caso

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    Luiz Figueira Pinto

    2008-09-01

    Full Text Available The most common vaginal neoplasias in old dogs are leiomyoma and fibroma. Although surgical excision is the indicated treatment, it does not eliminate potential complications that may lead to death or poor quality of life. This paper reports the case of a 9 year-old female Doberman dog with vaginal leiomyoma attended by copious and recidivating colporrhagia homeopathically treated between March and December 2005. Homeopathic approach was the one designed at Homeopathic Unit of the Veterinary Hospital, Rural Federal University of Rio de Janeiro, Brazil. The progress of disease was assessed through clinical evaluation, laboratory exams and ultrasonography. Hemorrhage decreased while the general clinical state of the animal improved. After 7 months of homeopathic treatment, the tumor was spontaneously eliminated through violent abdominal contractions, which was followed by recovery of the animal’s state of health. Keywords:  Homeopathy; Veterinary medicine; Tumors; Leiomyoma; Vaginal; Dogs.   Tratamento homeopático de leiomioma vaginal em cães: relato de caso Resumo As neoplasias vaginais mais comuns em cadelas velhas são o leiomioma e o fibroma. Embora a excisão cirúrgica é o tratamento indicado, não elimina complicações potenciais que podem levar ao óbito ou baixa qualidade de vida. O presente artigo relata o caso de uma cadela Doberman de 9 anos de idade, com leiomioma vaginal, apresentando colporragia copiosa e recidivante, tratada entre março e dezembro de 2005. A abordagem homeopática utilizada foi a desenvolvida na Unidade Homeopática do Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro, Brasil. A evolução da doença foi acompanhada através de avaliação clínica, testes de laboratório e ultrassonografia. A hemorragia diminuiu e o estado

  6. Isolamento e PCR para detecção de Mollicutes em muco vaginal e sua associação com problemas reprodutivos em ovinos criados na região de Piedade, São Paulo, Brasil Mollicutes isolation and PCR on ovine vaginal mucous and its association with reproductive problems in Piedade, SP, Brazil

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    Huber Rizzo

    2011-02-01

    Full Text Available Pesquisou-se Mycoplasma spp, Ureaplasma spp e Acholeplasma laidlawiii em amostras de muco vaginal de 60 ovinos, criados na região de Piedade no Estado de São Paulo, Brasil, que apresentavam ou não vulvovaginite no exame específico do sistema genital. A caracterização desses microrganismos baseou-se no cultivo e detecção do respectivo DNA pela Reação da Polimerase em Cadeia (PCR com os primers para classe Mollicutes (GPO e MGSO, para o gênero Ureaplasma (UGPF e UGPS e a espécie Acholeplasma laidlawii (UNI e ACH3. A presença de micoplasmas não foi associada com distúrbios do trato reprodutivo dos animais, entretanto todos os isolados obtidos de Ureaplasma spp foram provenientes de animais com distúrbios reprodutivos, sugerindo o possível envolvimento desse agente nas enfermidades da reprodução. A PCR para a espécie Acholeplasma laidlawii detectou somente uma amostra positiva.It was evaluated the presence of Mycoplasma spp, Ureaplasma spp and Acholeplasma laidlawiii in 60 samples of ovine vaginal mucous with the presence or absence of vulvovaginitis in the specific exam of the reproductive tract. The microorganisms were characterized based on bacteriological culture and DNA detection by Polymerase Chain Reaction (PCR with specific primers to Mollicutes (GPO and MGSO, Ureaplasma (UGPF and UGPS and Acholeplasma laidlawii (UNI and ACH3. The presence of mycoplasmas could not be associated with reproductive disorders in animals. The PCR to Acholeplasma laidlawii detected only one positive sample. However, all isolations of Ureaplasma spp were from animals presenting reproductive disorders, suggesting a possible involvement of this agent in reproductive diseases.

  7. Distúrbios evacuatórios em primigestas após parto normal: estudo clínico Evacuatory disorders in primigravidae after vaginal delivery: clinical study

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    Maria Auxiliadora Prolungatti Cesar

    2011-06-01

    Full Text Available Introdução: Os distúrbios evacuatórios são descritos na literatura relacionados ao parto normal e episiotomia. Objetivo: Estudar a incidência de distúrbios evacuatórios em primíparas submetidas à episiotomia, durante o parto normal. Métodos: Estudo prospectivo em 32 pacientes primíparas, submetidas à episotomia durante parto vaginal. Para realização do estudo as pacientes reSponderam os questionários com o score de constipação de Agachan e score de incontinência de Jorge e Wexner, em relação ao período pré-gestacional e 90 dias após o parto. Resultados: Não foram encontradas diferenças estatisticamente significantes quando comparados os resultados dos questionários aplicados, em relação ao período pré-gestacional e 90 dias pós-parto. Conclusões: Não observamos alterações da constipação e continência fecal em primigestas após parto normal com episiotomia.Introduction: Evacuatories disturbances are described in the literature related to vaginal delivery and episiotomy. Objective: To study the incidence of evacuatories disturbances in primiparous undergoing episiotomy during vaginal delivery. Methods: Prospective study in 32 primiparous patients submitted to episotomy during vaginal delivery. For the study the patients answered in relation to the period before pregnancy and 90 days postpartum questionnaires with the score of Agachan constipation and incontinence score of Jorge and Wexner. Results: No statistically significant differences were found when comparing the results from the questionnaires in relation to the period before pregnancy and 90 days postpartum. Conclusions: Episiotomy in vaginal delivery in primiparous women with no prior history of intestinal symptoms, caused no disorders of anal continence postpartum in the pacients of this study.

  8. Avaliação do efeito preemptivo da s(+-cetamina por via peridural para histerectomia: concentrações plasmáticas de interleucinas

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    Elismar Paulo Azevedo Silva

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Alguns estudos demonstraram que a cetamina inibe a produção de citocinas. O objetivo deste estudo foi avaliar o efeito analgésico preemptivo e citocinas plasmáticas (IL-6, TNF-α e IL-10 de S(+-cetamina por via peridural em histerectomia. MÉTODO: Foi realizado estudo duplo-encoberto em 29 pacientes. Pacientes do Grupo 1 receberam 13 mL de bupivacaína a 0,25% com 25 mg de S(+-cetamina 30 minutos antes da incisão cirúrgica, e 15 mL de solução salina fisiológica, 30 minutos após, por via peridural. Pacientes do Grupo 2 receberam 15 mL de salina 30 minutos antes da incisão cirúrgica, seguido por 13 mL de bupivacaína 0,25%, mais 25 mg de S (+-cetamina 30 minutos após. A analgesia pós-operatória foi feita com bupivacaína e fentanil por via peridural. Quando necessário, foi utilizado 1 g de dipirona. Foram avaliados: concentração de citocinas, intensidade da dor, o tempo da primeira solicitação de analgésico e a quantidade total de analgésico utilizado. RESULTADOS: O tempo para a primeira solicitação de analgésico foi de 61,5 minutos no Grupo 1 e 69,0 no Grupo 2, sem diferença entre os grupos. Não houve diferença entre os grupos para a dose total de fentanil usada no Grupo 1 (221,4 µg e Grupo 2 (223,3 µg. Foi obtido efeito analgésico semelhante nos grupos, exceto em T12 (Grupo 1 = 2,4 ± 3,2; Grupo 2 = 5,5 ± 3,4. Não foi observada diferença entre os grupos na concentração de citocinas. CONCLUSÕES: A injeção de 25 mg de S(+-cetamina por via peridural antes da incisão reduziu a intensidade da dor apenas 12 horas após a incisão cirúrgica e não alterou a concentração de citocinas.

  9. Cervicovaginal aerobic microflora of women with spontaneous abortion or preterm delivery in Araraquara-Brazil Microbiota aeróbica cérvico-vaginal de mulheres com aborto espontâneo ou prematuridade fetal em Araraquara - Brasil

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    Maria Stella G. Raddi

    1998-10-01

    Full Text Available Microbiological routine exams of endocervix and vaginal specimens of 22 women with clinical history of recent spontaneous abortion or premature rupture of membranes were accomplished. Chlamydia trachomatis, Streptococcus pyogenes, Streptococcus agalactiae, Candida sp and Gardnerella vaginalis were recovered from 54.5% (12 of the women. Ureaplasma urealyticum was frequently isolated (45.5% but 5 out of 22 had U. urealyticum only. Our report stands for the importance of quantitative as well as qualitative investigation on genital microflora in pregnant women, since it is likely to influence on pregnancy outcome.Rotina bacteriológica do conteúdo vaginal e cervical de 22 mulheres com histórico de aborto recente ou ruptura precoce das membranas foi realizada. Chlamydia trachomatis, Streptococcus pyogenes, Streptococcus agalactiae, Candida sp e Gardnerella vaginalis foram isolados em 54,5% (12 das pacientes. Apesar de Ureaplasma urealyticum ter sido frequentemente encontrado (45,5%, somente em 5 das 22 mulheres foi o único microrganismo presente nos materiais analisados. Esses resultados chamam a atenção para a importância de investigação quantitativa bem como qualitativa da microbiota genital em gestantes, tendo em vista ter consequências na gestação.

  10. Quadro citológico vaginal, concentração plasmática de progesterona durante a gestação e medidas fetais em paca (Cuniculus paca Linnaeus, 1766 Vaginal citology, serum progesterone concentration during pregnancy and fetal measurements in paca (Cuniculus paca, Linnaeus 1766

    Directory of Open Access Journals (Sweden)

    Vânia Maria França Ribeiro

    2012-09-01

    Full Text Available Em 27 pacas (Cuniculus paca Linnaeus, 1766 objetivou-se descrever aos 30, 60 e 90 dias (D de prenhez diagnosticada por ultrassonografia (US, os tipos celulares do epitélio vaginal em esfregaços vaginais, relatar as condições de abertura da vulva e as características do muco vaginal, determinar a concentração plasmática de progesterona (P4 por radioimunoensaio, e ainda, mensurar por ultrassonografia (US o diâmetro biparietal (DBP fetal aos 60 e 90 dias de prenhez. No D30, 40% das amostras exibiram células (com características estrogênicas superficiais e presença de núcleos nus. Nos D60 e D90, células parabasais, intermediárias, superficiais e naviculares estavam presentes nas mesmas proporções, mas células endocervicais foram descritas em apenas 73,9% e 69% das amostras daqueles dias, respectivamente. No D30 a maior proporção de células naviculares e superficiais diferiu (p The objective of this work was to describe in 27 pacas (Cuniculus paca Linnaeus, 1766 at 30, 60 and 90 days (D of pregnancy diagnosed by ultrasonography (U.S. the cell types of the vaginal epithelium by vaginal smears, to report the vulva opening condition and the characteristics of vaginal mucus, to determine the progesterone (P4 serum concentration by radioimmunoassay, and also measure by ultrasound (U.S. the fetuses biparietal diameter (BPD at 60 and 90 days of pregnancy. At D30, 40% of the smears exhibited surface cells (with estrogenic characteristics and of naked nuclei. At D60 and D90, parabasal, intermediate, superficial, and navicular cells were present in the same proportions, but endocervical cells were described in only 73.9% and 69% of those day's smears, respectively. At D30 the highest proportion of navicular and surface cells differed (p < 0.05 compared with other cell types. The vaginal mucus was crystalline and fluid in 100% and 70% of females at D30 and D60, respectively. It was observed the vaginal vestibule open in around 50% of

  11. Vaginal dryness alternative treatments

    Science.gov (United States)

    Alternative treatments for vaginal dryness ... Question: Is there a drug-free treatment for vaginal dryness? Answer: There are many causes of vaginal dryness . It may be caused by reduced estrogen level, infection, medicines, and ...

  12. Corrimento vaginal referido entre gestantes em localidade urbana no Sul do Brasil: prevalência e fatores associados Self-reported vaginal discharge among pregnant women in an urban area in Southern Brazil: prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Tânia M. V. da Fonseca

    2008-03-01

    Full Text Available Por intermédio de delineamento transversal, buscou-se determinar a prevalência e identificar fatores associados à ocorrência de corrimento vaginal referido entre gestantes da cidade de Rio Grande, Rio Grande do Sul, Brasil. Utilizando-se de questionário padrão, foram investigadas características sócio-econômicas, demográficas, reprodutivas, condições de moradia, assistência recebida e ocorrência de corrimento vaginal referido entre estas gestantes. Para as comparações entre proporções utilizou-se teste do qui-quadrado e para análise multivariada regressão de Poisson. Dentre as 339 gestantes estudadas, 51,6% referiram corrimento vaginal na gestação. As seguintes variáveis mostraram-se significativamente associadas à ocorrência de corrimento vaginal referido: idade (razão de prevalências: RP= 1,49, estado civil (RP = 1,31, ocorrência de infecção urinária (RP = 1,56, hiperglicemia na gestação atual (RP = 1,48, uso de dispositivo intra-uterino (RP = 2,35, ocorrência prévia de parto prematuro (RP = 1,37 e utilização de anticoncepcional oral como fator de proteção (RP = 0,79. Este estudo mostrou prevalência elevada de corrimento vaginal referido entre as gestantes estudadas e permitiu identificar aquelas com maior risco de adoecer por esta causa, o que pode contribuir para a adoção de medidas preventivas.The purpose of this study was to determine the prevalence and risk factors associated with self-reported vaginal discharge among pregnant women in the city of Rio Grande, South Brazil. Using a cross-sectional design, a standard interview was applied to pregnant women at home by previously trained interviewers, covering the following: demographic, reproductive, and socioeconomic data, household conditions, health care, and illnesses during pregnancy, including vaginal discharge. The chi-square test was used to compare proportions, and Poisson regression was used in the multivariate analysis. Among the 339

  13. Avaliação proteômica do conteúdo vaginal em resposta ao tratamento da vaginose bacteriana

    OpenAIRE

    Ferreira,Carolina Sanitá Tafner

    2015-01-01

    Bacterial vaginosis is the most common type of abnormal vaginal flora and defined by the depletion of vaginal lactobacilli. This condition increases the risk of premature labor and acquisition of several sexually transmitted infections. Short-term efficacy of bacterial vaginosis metronidazole treatment is low. Thus, we aimed to characterize the cervicovaginal fluid proteome of women with bacterial vaginosis and to compare the proteomic profile between women who were successfully treated with ...

  14. Ovarian remnant syndrome in small animalsSíndrome do ovário remanescente em pequenos animais

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    Gilson Hélio Toniollo

    2012-04-01

    êmea acometida, dosagem sérica de estrógeno e progesterona e/ou por meio do teste provocativo com administração de GnRH ou hCG. Contudo, citologia vaginal constitui a opção de melhor custo-benefício para o diagnóstico. Atualmente, o tratamento de escolha é cirúrgico por meio de laparotomia exploratória ou laparoscopia, seguido pela remoção do ovário remanescente. O tratamento cirúrgico tem maiores taxas de sucesso quando realizado com o animal em diestro (i.e., entre 15 e 60 dias após detectada a atração dos machos. Ademais, a realização de um procedimento cirúrgico preciso, auxiliado por técnicas avançadas de visualização durante a ovário-histerectomia ou ovariectomia constitui a melhor forma de prevenção SOR em animais de companhia.

  15. Vaginal Cancer Overview

    Science.gov (United States)

    ... are here Home > Types of Cancer > Vaginal Cancer Vaginal Cancer This is Cancer.Net’s Guide to Vaginal Cancer. Use the menu below to choose the Overview/ ... social workers, and patient advocates. Cancer.Net Guide Vaginal Cancer Introduction Statistics Medical Illustrations Risk Factors and Prevention ...

  16. Resultados neonatais no parto vaginal espontâneo comparados aos dos partos com fórcipe de Simpson-Braun em primíparas Neonatal outcome of spontaneous deliveries as compared to Simpson-Braun forceps deliveries in nulliparous women

    OpenAIRE

    Belmiro Gonçalves Pereira; Michel Gardere Camargo; Egle Cristina Couto; Eliana Amaral; Renato Passini Jr; Mary Angela Parpinelli

    2004-01-01

    OBJETIVO: comparar os resultados neonatais dos partos vaginais espontâneos ou assistidos com fórcipe de Simpson-Braun em nulíparas. MÉTODO: em estudo de corte retrospectivo foram avaliados dois grupos de primíparas atendidas no Centro Obstétrico do CAISM/UNICAMP, que tiveram parto vaginal sob analgesia epidural. O grupo fórcipe foi formado por 119 pacientes que tiveram parto a fórcipe de Simpson-Braun, e o grupo normal por 114 casos de parto vaginal espontâneo. Foram estudadas as variáveis ne...

  17. Desquamative inflammatory vaginitis.

    Science.gov (United States)

    Reichman, Orna; Sobel, Jack

    2014-10-01

    Desquamative inflammatory vaginitis (DIV) is an uncommon form of chronic purulent vaginitis. It occurs mainly in Caucasians with a peak occurrence in the perimenopause. Symptoms and signs are nonspecific; DIV is a diagnosis of exclusion, and other causes of purulent vaginitis should be excluded. The main symptoms include purulent discharge, vestibulo-vaginal irritation, and dyspareunia. Examination of vaginal walls shows signs of inflammation with increased erythema and petechiae. Through microscopy (wet mount) of the vaginal secretions, DIV is defined by an increase in inflammatory cells and parabasal epithelial cells (immature squamous cells). Vaginal flora is abnormal and pH is always elevated above 4.5. Although etiology and pathogenesis remain unknown, the favorable response to anti-inflammatory agents suggests that the etiology is immune mediated. Either local vaginal clindamycin or vaginal corticosteroids are adequate treatment. As a chronic condition, maintenance treatment should be considered as relapse is common. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Identificação das bactérias envolvidas na sepse grave de fêmeas caninas com piometra submetidas a ovário-histerectomia terapêutica

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    Tabatha do Amaral Kalenski

    2012-04-01

    Full Text Available A piometra é uma afecção reprodutiva comum que acomete fêmeas caninas, podendo se agravar e progredir para o quadro de sepse grave e choque séptico. A precocidade da instituição da antibioticoterapia é determinante para um melhor prognóstico. O objetivo deste estudo foi avaliar os principais microrganismos envolvidos nos casos de sepse grave em cadelas acometidas por piometra e submetidas à ovário-histerectomia terapêutica, por meio de realização de hemocultura e cultura da secreção uterina e antibiograma. Foram avaliadas 33 fêmeas caninas e o principal agente envolvido com a sepse grave secundária à piometra foi a Escherichia coli, identificada em 57,57% dos casos. Também foram identificados Staphylococcus sp., com incidência de 9,09%, Citrobacter koseri, Enterobacter cloacae, Enterobacter faecalis, Eduardsiella sp., Klebsiella pneumoniae e Streptococcus sp., com 3,03% de frequência cada. Após a realização do antibiograma pelo método de difusão, os antimicrobianos que apresentaram maior eficácia contra as cepas de Escherichia coli foram a gentamicina, a enrofloxacina, a cefalexina e a associação de amoxicilina com ácido clavulânico, nesta ordem. A cultura da secreção uterina foi mais sensível que a hemocultura para identificação do agente microbiano (p<0,0001. A identificação bacteriana é útil para direcionar a antibioticoterapia empírica mais específica, de acordo com o perfil de sensibilidade, minimizando assim o desenvolvimento de resistência, o custo do tratamento e o risco de reações adversas aos antimicrobianos utilizados.

  19. Prevalência da colonização vaginal e anorretal por estreptococo do grupo B em gestantes do terceiro trimestre Prevalence of vaginal and anorectal colonization by group B streptococcus in pregnant women in the last three months of gestation

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    Cláudio Beraldo

    2004-08-01

    Full Text Available OBJETIVOS: estudar a prevalência da colonização por estreptococo do grupo B em gestantes do terceiro trimestre, atendidas em um hospital regional, e avaliar a associação da colonização com as variáveis maternas demográficas e clínicas. MÉTODOS: no período de 8 de outubro de 2002 a 26 de março de 2003, foi realizado um estudo transversal (de prevalência com 309 gestantes no terceiro trimestre. Amostras de secreção vaginal e anorretal foram coletadas e testadas para identificação presuntiva do estreptococo do grupo B. Foram incluídas as gestantes com gestação maior ou igual a 36 semanas datadas por ultra-sonografia e excluídas as que se recusaram a participar, as em uso de antibioticoterapia e as que haviam sido submetidas a exame ginecológico pelo período mínimo de 24 horas antes da coleta. As gestantes foram caracterizadas por variáveis demográficas (raça, idade, grau de escolaridade, renda familiar e número de gestações e clínicas (idade gestacional, ocorrência de infecção urinária durante a gestação atual, ruptura prematura de membranas e tempo de bolsa rota, febre materna intraparto, corioamnionite, líquido amniótico com mecônio, via de parto utilizada, febre materna pós-parto e endometrite. RESULTADOS: das gestantes, 46 estavam colonizadas pelo estreptococo do grupo B, sendo que 26 (56,5% tiveram a cultura vaginal positiva, 8 (17,4% a cultura anorretal positiva e 12 (26,5% tiveram tanto a cultura vaginal como a retal positivas. Nenhuma das variáveis analisadas neste estudo foi estatisticamente significativa quanto à colonização pelo estreptococo do grupo B. Os resultados obtidos foram submetidos à análise bivariada pelo teste do chi2 e teste exato de Fisher quando apropriado. CONCLUSÃO: a taxa de prevalência da colonização vaginal e anorretal pelo estreptococo do grupo B em gestantes no terceiro trimestre, foi de 14,9%. Não houve associação entre fatores de risco (primigestação, idade

  20. Apresentação pélvica na gestação de termo em pacientes com partos vaginais prévios Breech presentation in term pregnancy in patients with previous vaginal deliveries

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    José Mauro Madi

    2004-12-01

    Full Text Available OBJETIVO: avaliar os resultados obstétricos e perinatais em casos de fetos em apresentação pélvica, de termo, nascidos de pacientes com partos vaginais prévios, comparando-os a fetos de termo, em apresentação cefálica. PACIENTES E MÉTODOS: foram analisados retrospectivamente 8.350 nascimentos ocorridos no período de março de 1998 a julho de 2003. Ocorreram 419 partos (5,1% em apresentação pélvica, dos quais selecionaram-se 58 casos (grupo pélvico, que deveriam ter as seguintes características: antecedentes de um ou mais filhos nascidos pela via transpélvica, idade gestacional igual ou superior a 37 semanas, ausência de malformações fetais, inexistência de intercorrências durante a gestação, peso do recém-nascido no nascimento igual ou superior a 2.500 g e inferior a 3.750 g, e sem cesárea anterior. Esse grupo foi comparado a outro formado por 1.327 fetos com características semelhantes, em apresentação cefálica, de gestantes sem cesárea prévia (grupo cefálico. Analisaram-se a idade materna, paridade, idade gestacional, via de parto, peso do recém-nascido, presença de mecônio, índice de Apgar no primeiro e quinto minutos, necessidade de internação na unidade de tratamento intensivo neonatal e ocorrência de recém-nascidos pequenos e grandes para a idade gestacional. Os dados obstétricos e perinatais foram analisados pelo chi² e teste t de Student. Considerou-se como significante pPURPOSE: to assess the obstetric and perinatal outcomes in cases of term newborns in breech presentation, in patients with previous vaginal deliveries, comparing them to term newborns in vertex presentation. METHODS: 8,350 deliveries retrospectively from March 1998 to July 2003 were analysed. Of 419 deliveries (5.1% in breech presentation, 58 cases were selected for the study (breech group, according to the following criteria: patients who had had one or more babies through vaginal delivery, gestational age ³37 weeks, no fetal

  1. Fatores de Risco para Infecção Pós-histerectomia Total Abdominal Risk Factors for Infection after Total Abdominal Hysterectomy

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    Melania Maria Ramos de Amorim

    2000-08-01

    Full Text Available Objetivos: determinar os principais fatores associados à ocorrência de infecção do sítio cirúrgico em pacientes submetidas a histerectomia total abdominal (HTA no Instituto Materno ¾ Infantil de Pernambuco (IMIP. Métodos: realizou-se um estudo de corte transversal incluindo todas as pacientes submetidas a histerectomia total abdominal no IMIP no período de janeiro de 1995 a dezembro de 1998, desde que tivessem retornado no 7º e no 30º dia pós-operatório para controle de infecção (n = 414. A freqüência de infecção do sítio cirúrgico (definida pelos critérios do CDC, 1998 foi de 10% (42 casos. Calculou-se o risco de prevalência (RP de infecção do sítio cirúrgico e seu intervalo de confiança (IC a 95% para as seguintes variáveis: idade, obesidade, hipertensão, diabetes, doença maligna, tipo de incisão, tempo cirúrgico e antibioticoprofilaxia. Realizou-se análise de regressão logística múltipla para determinação do risco ajustado de infecção. Resultados: encontrou-se aumento significativo do risco de infecção do sítio cirúrgico para as seguintes variáveis: idade >60 anos (RP = 2,39; IC-95% = 1,15-4,94, obesidade (RP = 3,2; IC-95% = 1,83-5,59, duração da cirurgia >2 horas (RP = 2,36; IC-95% = 1,32-4,21 e associação com diabetes (RP = 6,0; IC-95% = 3,41-10,57. Por outro lado, o risco de infecção esteve significativamente diminuído quando utilizou-se antibiótico profilático (RP = 0,38; IC-95% = 0,21-0,68. Não se encontrou associação estatisticamente significativa de infecção com o tipo de incisão, a indicação da cirurgia por patologia maligna e a presença de hipertensão. Conclusões: os fatores associados a risco aumentado de infecção do sítio cirúrgico pós-HTA no IMIP foram: idade >60 anos, obesidade, diabetes e duração da cirurgia >2 horas. A antibioticoprofilaxia apresentou efeito protetor, com diminuição do risco de infecção.Purpose: to determine the main factors associated

  2. Vaginal birth - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100198.htm Vaginal birth - series—Normal anatomy To use the sharing features ... vaginal delivery. Please keep in mind that every birth is unique, and your labor and delivery may ...

  3. Assisted Vaginal Delivery

    Science.gov (United States)

    ... be needed. What are the risks for my baby if I have assisted vaginal delivery? Although the overall rate of injury to the baby as a result of assisted vaginal delivery is low, there still is a risk of ...

  4. Vaginitis test - wet mount

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003916.htm Vaginitis test - wet mount To use the sharing features on this page, please enable JavaScript. The vaginitis wet mount test is a test to detect ...

  5. Neglected vaginal pessary

    Directory of Open Access Journals (Sweden)

    Meenu Jain

    2014-02-01

    Full Text Available Vaginal pessary may be opted for management of uterine prolapse as a safe option, but to avoid complications regular follow-up is a must. We are reporting a case of neglected vaginal pessary in a 72 year old female which got embedded in vaginal mucosa and required excision of vaginal band for its removal. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 291-292

  6. Vaginitis: diagnosis and management.

    Science.gov (United States)

    Quan, Martin

    2010-11-01

    Vaginitis is one of the most common ambulatory problems to occur in women. It is a disorder responsible for > 10% of visits made to providers of women's health care. Although vaginal infections are the most common cause, other considerations include cervicitis, a normal vaginal discharge, foreign-body vaginitis, contact vaginitis, atrophic vaginitis, and desquamative inflammatory vaginitis. The medical history and examination are an important source of clues to the underlying diagnosis. However, making a definitive diagnosis requires skillful performance of office laboratory procedures, including the vaginal pool wet mount examination, determination of the vaginal pH, and the whiff test. Vaginal and cervical cultures, nucleic acid tests, and point-of-care tests are available and may be required in selected patients. Once a specific diagnosis is made, effective therapy can be prescribed. Candida vaginitis is generally treated with either the vaginal administration of an imidazole or triazole antifungal agent or the prescription of oral fluconazole. Oral nitroimidazole agents, metronidazole or tinidazole, are the only effective treatments for trichomoniasis in the United States. Bacterial vaginosis, which has been linked to important gynecologic and pregnancy complications, can be treated with an available oral or topical agent containing either a nitroimidazole or clindamycin.

  7. Microbiological and functional evaluation of an alternative device (OB® for estrous synchronization in ewes Avaliação microbiológica e funcional de um dispositivo vaginal alternativo (OB® para sincronização de cio em ovelhas

    Directory of Open Access Journals (Sweden)

    Leonardo Tondello Martins

    2010-02-01

    Full Text Available The use of synthetic progestagens released by vaginal devices is an important tool to overcome the reproductive seasonality in sheep, but cost and/or subsequent vaginitis are limiting factors for their use. To identify economic, simple and innocuous alternative vaginal devices for estrous synchronization/induction protocols in sheep, this study aimed to evaluate the microbiological and functional viability of the human vaginal tampons (OB® impregnated with medroxyprogesterone acetate (MAP on reproductive performance of ewes. The study compared them with commercial vaginal inserts (CIDR® and polyurethane sponges impregnated with MAP. In Experiment 1, the device loss rate, the degree of vaginitis during the device removal, the count and identification of bacterial colonies at the device insertion and removal, and efficiency in estrous synchronization and estrus temporal distribution were evaluated. Pubertal ewes at the beginning of the breeding season were randomly allocated to three experimental groups: CIDR®, PSP (polyurethane sponge and OB®. No device losses occurred in any group, but the use of OB® caused milder signs of vaginitis than polyurethane sponges, with a similar vaginal bacterial growth and microbiota than the CIDR group. The estrus distribution was more disperse in the CIDR than PSP or OB groups. In Experiment 2, pregnancy rates using CIDR® or OB® devices were compared, with estrus manifestation (85.4% and 89.8% and pregnancy rates (58.3% and 49.0% being similar between groups (P>0.05, respectively. In conclusion, the use of human intra-vaginal tampons (OB® impregnated with MAP was proven highly hygienic, practical and effective as a low-cost alternative for estrous synchronization and AI in sheep.O uso de progestágeno sintético liberado por pessários vaginais é uma importante ferramenta para suplantar a sazonalidade reprodutiva em ovelhas. Todavia, seu uso é limitado pelo custo ou pelas subsequentes vaginites. Na busca

  8. Vaginal bleeding between periods

    Science.gov (United States)

    ... may cause occasional spotting) Ectopic pregnancy Miscarriage Other pregnancy complications Vaginal dryness due to lack of estrogen after menopause Stress Stopping and starting birth control pills or estrogens ...

  9. Achado incidental de glândula sebácea em colo uterino: provavelmente um processo metaplásico An incidental finding of sebaceous glands in the uterine cervix: a probable metaplastic process

    Directory of Open Access Journals (Sweden)

    Daniel Cury Ogata

    2012-06-01

    Full Text Available As glândulas sebáceas ectópicas são achados muito infrequentes no trato genital feminino. Descrevemos um caso que ocorreu em paciente de 42 anos de idade, submetida à histerectomia total, devido à leiomiomatose e ao prolapso uterino.The ectopic sebaceous glands have been extremely rare findings in female genital system. We describe the case of 42 years-old patient with total hysterectomy due to leiomyomatosis and uterine prolapsed.

  10. Desquamative Inflammatory Vaginitis: The Unknown

    National Research Council Canada - National Science Library

    María Trinidad Alumbreros Andújar; Ana González López; Celia Pérez Parra; Rafael López Pérez; Carmen Céspedes Casas; María Mercedes Ramírez Gómez; Castor Martin Francisco; Francisco Javier Haya Palazuelos

    2015-01-01

    Introduction: Desquamative inflammatory vaginitis (DIV) is a chronic inflammatory process of unknown etiology, characterized by genital pain and profuse vaginal discharge, mainly affecting perimenopausal women...

  11. MANAGEMENT OF VAGINAL DISCHARGE

    African Journals Online (AJOL)

    Enrique

    Vaginal infection is one of the top 25 reasons for women to consult doctors in the. USA. The 3 most common ... VAGINAL DISCHARGE IN POSTMENOPAUSAL WOMEN. In this age group, the .... More than one host fac- tor may be involved and ...

  12. Vaginal infections update.

    Science.gov (United States)

    Mashburn, Jane

    2012-01-01

    Vaginal symptoms are one of the leading reasons that women visit their health care providers. Women often self-diagnose and may treat themselves inappropriately. This article describes the etiology, risk factors, symptoms, diagnosis, and treatment of the 3 most common vaginal infections: bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis.

  13. Management of persistent vaginitis.

    Science.gov (United States)

    Nyirjesy, Paul

    2014-12-01

    With vaginitis remaining a common condition that leads women to seek care, it is not surprising that some women develop chronic vulvovaginal problems that are difficult to diagnose and treat. With a differential diagnosis that encompasses vulvar disorders and infectious and noninfectious causes of vaginitis, accurate diagnosis is the cornerstone of choosing effective therapy. Evaluation should include a symptom-specific history, careful vulvar and vaginal examination, and office-based tests (vaginal pH, amine test, saline and 10% potassium hydroxide microscopy). Ancillary tests, especially yeast culture with speciation, are frequently crucial to obtaining a correct diagnosis. A heavy but normal physiologic discharge can be determined by excluding other causes. With vulvovaginal candidiasis, differentiating between Candida albicans and non-albicans Candida infection has important treatment ramifications. Most patients with C albicans infections can be successfully treated with maintenance antifungal therapy, usually with fluconazole. Although many non-albicans Candida, particularly Candida glabrata, may at times be innocent bystanders, vaginal boric acid therapy is an effective first choice for many true non-albicans Candida infections. Recurrent bacterial vaginosis, a difficult therapeutic challenge, can often be controlled with maintenance therapy. Multiple options, especially high-dose tinidazole, have been used for metronidazole-resistant trichomoniasis. With the aging of the U.S. population, atrophic vaginitis and desquamative inflammatory vaginitis, both associated with hypoestrogenism, are encountered frequently in women with persistent vaginitis.

  14. The contraceptive vaginal ring.

    Science.gov (United States)

    Edwardson, Jill; Jamshidi, Roxanne

    2010-03-01

    The contraceptive vaginal ring offers effective contraception that is self-administered, requires less frequent dosing than many other forms of contraception, and provides low doses of hormones. NuvaRing (Organon, Oss, The Netherlands), the only contraceptive vaginal ring approved for use in the United States, contains etonogestrel and ethinyl estradiol. It is inserted into the vagina for 3 weeks, followed by a 1-week ring-free period, and works by inhibiting ovulation. Most women note a beneficial effect on bleeding profiles and are satisfied with NuvaRing. Commonly reported adverse events include vaginitis, leukorrhea, headaches, and device-related events such as discomfort. Serious adverse events are rare. In Chile and Peru, progesterone-only vaginal contraceptive rings are available for nursing women. Studies are ongoing examining new formulations of vaginal contraceptive rings.

  15. Management of Vaginal Cancer.

    Science.gov (United States)

    Shrivastava, S B L; Agrawal, Gaurav; Mittal, Megha; Mishra, Priyanshi

    2015-01-01

    Vaginal cancer is a rare gynecologic cancer with very little documentation. Literature search to have useful information for the management of vaginal cancer and share. We have searched the PUBMED database, Google search engine and other database. A total of 26 references were taken into account. Once spread from primary other cancers or vulva is ruled out, vaginal cancer is designated to be primary in origin. It was revealed that majority of vaginal cancers reported are squamous cell carcinomas. The most common risk factors implicated are Human Papiloma Virus, age. Most common presenting symptoms were abnormal vaginal bleeding,. Diagnosis requires pathological confirmation. Management depends on staging work-up. Vaginal cancer is staged by FIGO system of staging and TNM staging. There are many prognostic factors influencing the choice of treatment. Lymph node metastasis is one of the important prognostic factors, others to mention are histology, size, age. In a recent SEER analysis of over 2000 patients, the 5 year disease specific survival was 84% for stage 1, 75% for stage II and 57% for advanced tumors. Early carcinomas are generally treated with either surgery or radiation therapy. Advanced cancers are treated with radiation therapy with simultaneous administration of combined chemotherapy. Preventive strategies include safe sex and HPV vaccination. Primary vaginal cancer is a rare entity, if there is no history of cancer cervix or vulva in past or absence of cervical squamous cell carcinoma or vulvar carcinoma within 5 years is usually considered as primary vaginal cancer. Though early stage vaginal cancers have better outcome treated with surgery or radiotherapy or surgery followed by radiotherapy, radiotherapy alone is preferred mode of treatment in vaginal cancers.

  16. Vaginal toxic shock reaction triggering desquamative inflammatory vaginitis.

    Science.gov (United States)

    Pereira, Nigel; Edlind, Thomas D; Schlievert, Patrick M; Nyirjesy, Paul

    2013-01-01

    The study aimed to report 2 cases of desquamative inflammatory vaginitis associated with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus strains. Case report of 2 patients, 1 with an acute and 1 with a chronic presentation, diagnosed with desquamative inflammatory vaginitis on the basis of clinical findings and wet mount microscopy. Pretreatment and posttreatment vaginal bacterial and yeast cultures were obtained. Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial culture results after oral antibiotic therapy were negative. Desquamative inflammatory vaginitis may be triggered through TSST-1-mediated vaginal toxic shock reaction.

  17. Densidade Mineral Óssea de Mulheres na Pós-menopausa com e sem Antecedente de Histerectomia com Conservação Ovariana Bilateral Bone Mineral Density in Postmenopausal Women with and without Previous Hysterectomy with Bilateral Ovarian Conservation

    Directory of Open Access Journals (Sweden)

    João Daniel Hobeika

    2000-09-01

    Full Text Available Objetivo: avaliar a densidade mineral óssea de mulheres na pós-menopausa com o antecedente cirúrgico de histerectomia com conservação ovariana bilateral, realizada no menacme, comparadas a um grupo de mulheres com menopausa natural, não-histerectomizadas. Métodos: tratou-se de um estudo de corte transversal, com 30 mulheres histerectomizadas no menacme, avaliadas na pós-menopausa, comparadas a 102 mulheres menopausadas naturalmente, sendo realizado a densitometria óssea (Lunar DPX. Resultados: as médias etárias, índice de massa corporal, cor da pele, tabagismo, escolaridade, menarca, paridade e antecedente de laqueadura tubária foram semelhantes nos grupos estudados. A comparação das médias da densidade mineral óssea e do T-score dos três locais do fêmur, utilizando o teste de Bonferroni, não apresentou diferenças estatisticamente significativas. As médias da densidade mineral óssea e do T-score da coluna lombar foram analisadas pelo teste t de Student e também não mostraram diferenças estatísticas. Conclusão: estes resultados sugerem que a histerectomia com conservação ovariana bilateral, realizada em mulheres no menacme, não parece ocasionar redução adicional da massa óssea, quando avaliadas na pós-menopausa.Purpose: to evaluate the bone mineral density of postmenopausal women with previous hysterectomy and with bilateral ovarian conservation compared to a group of nonhysterectomized naturally menopausal women. Methods: this is a cross-sectional study of bone densitometry (Lunar DPX in 30 menopausal women hysterectomized when in the premenopause compared with 102 naturally postmenopausal women. Results: the mean age, body mass index, color of the skin, smoking habits, educational level, menarche, parity and previous tubal ligation were similar in the studied groups. Bone mineral density average and the T-score of the three femural sites analyzed by the Bonferroni test did not show significant differences. The

  18. Can Vaginitis Be Prevented?

    Science.gov (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications Can vaginitis be prevented? Skip sharing on social media links Share this: Page Content These steps can ...

  19. How Is Vaginitis Treated?

    Science.gov (United States)

    ... to learn the specific type of vaginitis. 1 Bacterial Vaginosis Bacterial vaginosis (BV) is treated with an antibiotic that gets ... diagnosed? Are there complications? » Related A-Z Topics Bacterial Vaginosis Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...

  20. Anterior vaginal wall repair

    Science.gov (United States)

    ... may have you: Learn pelvic floor muscle exercises ( Kegel exercises ) Use estrogen cream in your vagina Try ... Urinary incontinence - vaginal sling procedures Vagina Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  1. What Is Vaginal Cancer?

    Science.gov (United States)

    ... or epithelial lining ) because it is formed by epithelial cells. The vaginal wall underneath the epithelium is made up of connective tissue, muscle tissue, lymph vessels, and nerves. The vagina ...

  2. Representações e experiências das mulheres sobre a assistência ao parto vaginal e cesárea em maternidades pública e privada Women's representations and experiences with vaginal and cesarean delivery in public and private maternity hospitals

    Directory of Open Access Journals (Sweden)

    Andréa de Sousa Gama

    2009-11-01

    Full Text Available Este estudo analisa as diferentes representações e experiências quanto ao parto vaginal e cesárea de mulheres de diferentes estratos sócio-econômicos, bem como a natureza das relações profissionais de saúde/usuárias no contexto institucional em que estão inseridas. A pesquisa de natureza qualitativa foi desenvolvida em três maternidades do Município do Rio de Janeiro, Brasil, sendo uma pública, uma conveniada com o SUS e uma particular, com mulheres que tiveram os dois tipos de parto. Os resultados revelam que o modelo de organização dos serviços público e privado apresentam variações que produzem diferentes tipos de assistência e de relação entre os profissionais de saúde e as usuárias, dando forma a experiências distintas entre as mulheres pesquisadas. Todavia, ao empreendermos uma crítica assentada nas relações de gênero, podemos verificar que o modelo de assistência ao parto permanece submetendo quem deve ser sujeito e reproduzindo o projeto da medicalização - mesmo que este processo se manifeste de formas diferenciadas entre os grupos estudados -, o que reduz o campo da assistência e inviabiliza um lugar de poder diferenciado das usuárias.This study analyzes the different representations and experiences of women from different social classes, including issues related to their relations with hospital staff in different institutional settings. This qualitative study focused on women who had experienced both types of delivery, in three maternity hospitals in Rio de Janeiro, Brazil (one public, one fully private, and another private under an outsourcing agreement with the public health system. The study showed that variations in public and private service models result in different types of delivery care and different relations with staff, and are reflected in different birthing experiences for the women. However, a critical gender perspective shows that in both cases, the service models reproduce the

  3. Menopause and the vaginal microbiome.

    Science.gov (United States)

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

    2016-09-01

    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis.

  4. Resultados neonatais no parto vaginal espontâneo comparados aos dos partos com fórcipe de Simpson-Braun em primíparas Neonatal outcome of spontaneous deliveries as compared to Simpson-Braun forceps deliveries in nulliparous women

    Directory of Open Access Journals (Sweden)

    Belmiro Gonçalves Pereira

    2004-02-01

    Full Text Available OBJETIVO: comparar os resultados neonatais dos partos vaginais espontâneos ou assistidos com fórcipe de Simpson-Braun em nulíparas. MÉTODO: em estudo de corte retrospectivo foram avaliados dois grupos de primíparas atendidas no Centro Obstétrico do CAISM/UNICAMP, que tiveram parto vaginal sob analgesia epidural. O grupo fórcipe foi formado por 119 pacientes que tiveram parto a fórcipe de Simpson-Braun, e o grupo normal por 114 casos de parto vaginal espontâneo. Foram estudadas as variáveis neonatais imediatas como o estado do líquido amniótico e os índices de Apgar, assim como a evolução neonatal nos primeiros dias de vida. Para análise estatística foram utilizados os testes c², exato de Fisher e t de Student para comparação de médias e considerada significativa a diferença correspondente a pPURPOSE: to compare maternal and neonatal outcomes between spontaneous vaginal and Simpson-Braun forceps deliveries in nulliparous women. METHOD: a retrospective study including two groups of nulliparous women, who had vaginal delivery under peridural anesthesia in the obstetric unit of the CAISM-UNICAMP: the forceps group included 119 women who had Simpson-Braun forceps delivery, and the normal group included 114 women who delivered spontaneously. Neonatal outcomes, such as Apgar score and the evolution in the first days of life, were studied. Data were compared in both groups and, for statistical analysis, c² test, Fisher exact, and Student t tests were used. The differences were considered significant when p<0.05. RESULTS: the indications for Simpson-Braun forceps delivery were maternal-fetal relief (90 cases and abbreviation of the expulsive period (29 cases. In the forceps group there were 8 cases (6.7% of vaginal injuries; a similar result was observed in the normal group. The number of hospitalization days for the parturient and the newborns was identical, 2.4 days. The newborns in the two groups had similar Apgar scores

  5. Severe atrophic vaginitis causing vaginal synechiae and hematocolpos at menopause.

    Science.gov (United States)

    Segal, Saya; Harvie, Heidi S; Siegelman, Evan; Arya, Lily A

    2011-03-01

    Vaginal atrophy caused by decreased levels of ovarian estrogen production is common at menopause. Atrophic vaginitis severe enough to result in vaginal stricture of the upper two thirds of the vagina and subsequent hematocolpos is unusual. A 53-year-old woman presented with nonvisualization of the cervix at the time of her annual examination. Pelvic ultrasound reported a "vaginal cyst," and the final diagnosis of hematocolpos was made by magnetic resonance imaging. The woman was managed with surgical excision of vaginal synechiae followed by local vaginal estrogen therapy and dilators, with satisfactory results. Untreated severe atrophic vaginitis at menopause can result in a shortened vagina and hematocolpos. Magnetic resonance imaging is useful to characterize vaginal pathology in postmenopausal women.

  6. Vaginal itching and discharge - child

    Science.gov (United States)

    ... vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... To prevent and treat vaginal irritation, your child should: Avoid colored or perfumed toilet tissue and bubble bath. Use plain, unscented soap. Limit bath time to 15 minutes or less. Ask ...

  7. General Information about Vaginal Cancer

    Science.gov (United States)

    ... Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer Go to Health Professional ... the vagina (also called the birth canal). Enlarge Anatomy of the female reproductive system. The organs in ...

  8. Vaginal metastasis of pancreatic cancer.

    Science.gov (United States)

    Benhayoune, Khadija; El Fatemi, Hinde; El Ghaouti, Meryem; Bannani, Abdelaziz; Melhouf, Abdelilah; Harmouch, Taoufik

    2015-01-01

    Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic adenocarcinoma discovered of symptoms from a vaginal metastasis.

  9. Vaginal and Vulvar Cancer

    Science.gov (United States)

    ... is passed from one person to another during sex. There is a vaccine that protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. It is recommended for preteens (both boys and girls) aged 11 to 12 ...

  10. Staging for vaginal cancer.

    Science.gov (United States)

    Rajaram, Shalini; Maheshwari, Amita; Srivastava, Astha

    2015-08-01

    Vaginal cancer is a rare cancer comprising about 3% of all gynecologic cancers. Primary vaginal cancer should be carefully assigned as spread from cervix, vulva, and other metastatic tumors to vagina can occur. Although vaginal cancer traditionally occurs in older postmenopausal women, the incidence of high-risk human papillomavirus (HPV)-induced cancers is increasing in younger women. Squamous cell carcinoma is still the most common histopathologic type followed by adenocarcinoma. With decreasing use of diethylstilbestrol in pregnancy, non-diethylstilbestrol-associated cancers are described. The Federation Internationale de Gynecologie et d'Obstetrique (FIGO) staging of vaginal cancer (2009) follows the same rules as cervical cancer; it is clinically staged and allows the use of routine investigative modalities for staging. Although FIGO encourages the use of advanced imaging modalities, such as computed tomography, magnetic resonance imaging (MRI), and positron emission tomography (PET), to guide therapy, the imaging findings may not be used to change or reassign the stage. TNM staging is the pathologic staging system proposed by the American Joint Committee on Cancer, and information available from examination of the resected specimen, including pelvic and inguinal lymph nodes, may be used for staging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief?

    Science.gov (United States)

    Stute, Petra

    2013-12-01

    In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0

  12. Newly developed vaginal atrophy symptoms II and vaginal pH: a better correlation in vaginal atrophy?

    Science.gov (United States)

    Tuntiviriyapun, P; Panyakhamlerd, K; Triratanachat, S; Chatsuwan, T; Chaikittisilpa, S; Jaisamrarn, U; Taechakraichana, N

    2015-04-01

    The primary objective of this study was to evaluate the correlation among symptoms, signs, and the number of lactobacilli in postmenopausal vaginal atrophy. The secondary objective was to develop a new parameter to improve the correlation. A cross-sectional descriptive study. Naturally postmenopausal women aged 45-70 years with at least one clinical symptom of vaginal atrophy of moderate to severe intensity were included in this study. All of the objective parameters (vaginal atrophy score, vaginal pH, the number of lactobacilli, vaginal maturation index, and vaginal maturation value) were evaluated and correlated with vaginal atrophy symptoms. A new parameter of vaginal atrophy, vaginal atrophy symptoms II, was developed and consists of the two most bothersome symptoms (vaginal dryness and dyspareunia). Vaginal atrophy symptoms II was analyzed for correlation with the objective parameters. A total of 132 naturally postmenopausal women were recruited for analysis. Vaginal pH was the only objective parameter found to have a weak correlation with vaginal atrophy symptoms (r = 0.273, p = 0.002). The newly developed vaginal atrophy symptoms II parameter showed moderate correlation with vaginal pH (r = 0.356, p atrophy score (r = 0.230, p atrophy symptoms and the objective parameters. Vaginal pH was significantly correlated with vaginal atrophy symptoms. The newly developed vaginal atrophy symptoms II was associated with a better correlation. The vaginal atrophy symptoms II and vaginal pH may be better tools for clinical evaluation and future study of the vaginal ecosystem.

  13. Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.

    Science.gov (United States)

    Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

    2012-12-01

    Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour.

  14. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  15. Steroidal contraceptive vaginal rings.

    Science.gov (United States)

    Sarkar, N N

    2003-06-01

    The development of steroid-releasing vaginal rings over the past three decades is reviewed to illustrate the role of this device as an effective hormonal contraceptive for women. Vaginal rings are made of polysiloxane rubber or ethylene-vinyl-acetate copolymer with an outer diameter of 54-60 mm and a cross-sectional diameter of 4-9.5 mm and contain progestogen only or a combination of progestogen and oestrogen. The soft flexible combined ring is inserted in the vagina for three weeks and removed for seven days to allow withdrawal bleeding. Progesterone/progestogen-only rings are kept in for varying periods and replaced without a ring-free period. Rings are in various stages of research and development but a few, such as NuvaRing, have reached the market in some countries. Women find this method easy to use, effective, well tolerated and acceptable with no serious side-effects. Though the contraceptive efficacy of these vaginal rings is high, acceptability is yet to be established.

  16. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest......, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...

  17. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    , pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC......The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest...

  18. CLINICAL COMPLICATIONS IN NELORE OOCYTE DONERS CAUSED BY VAGINAL ULTRASOUND GUIDED FOLLICULAR ASPIRATION COMPLICAÇÕES CLÍNICAS EM VACAS NELORE DOADORAS DE OÓCITOS DECORRENTES DA ASPIRAÇÃO FOLICULAR TRANSVAGINAL GUIADA POR ULTRA-SOM

    Directory of Open Access Journals (Sweden)

    Renata Gebara Sampaio Dória

    2008-10-01

    Full Text Available

    In the last few years the vaginal ultrasound guided follicular aspiration or OPU (<em>ovum pick upem> in bovine oocyte doners has become a very difunded technique. It has been used in females with highly zootechnical valuable. The complications of this technique, despite exceptional, assume great importance and might be of the veterinarian and owner’s knowledge. The purpose of this study is to describe the possible complications of the follicular aspiration considering the Veterinarian Hospital ";Governador Laudo Natel"; of the Faculdade de Ciências Agrárias e Veterinárias UNESP-Jaboticabal 2003-2005 casuistic. In a total number of 16 animals was possible to observe peritonitis, absence of labor signals, offspring death and peritonitis, distocic delivery with premature fetus, genital lesions, presence of vaginal wall abnormal masses and ovarian adhesions.

    KEY WORDS: Clinical complications, follicular aspiratiorn, Nelore cow.

    Nos últimos anos, a aspiração folicular transvaginal guiada pela ultra-sonografia ou OPU (<em>ovum pick upem>, em fêmeas bovinas doadoras de oócitos, tem se tornado uma prática muito difundida e vem sendo utilizada na multiplicação de fêmeas de elevado valor zootécnico. As complicações dessa técnica, mesmo que de ocorrência excepcional, assumem grande importância e devem ser de conhecimento do veterinário e, também, do proprietário. O propósito deste trabalho é descrever as possíveis complicações da aspiração folicular, considerando a casuística do Hospital Veterinário Governador Laudo Natel, da Faculdade de Ciências Agrárias e Veterinárias da UNESP, Jaboticabal, durante os anos de 2003 a 2005. Em um total de dezesseis animais recebidos, verificaram-se a presença de peritonite, a ausência de sinais de parto, morte fetal, parto distócico com feto prematuro, lesões de órgãos genitais

  19. Treatment Options by Stage (Vaginal Cancer)

    Science.gov (United States)

    ... Health Professional Vaginal Cancer Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  20. Vaginal contraceptives still evolving.

    Science.gov (United States)

    Pearson, R M

    1986-01-01

    The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future.

  1. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest......, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...... was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities....

  2. Neoplasia vaginal intraepitelial

    OpenAIRE

    Baquedano M.,Laura; Lamarca B,Marta; José G,Yasmina; Rubio C,Patricia; Ruiz C,Miguel Ángel

    2013-01-01

    Objetivo: Actualizar los conocimientos disponibles sobre la neoplasia vaginal intraepitelial (VAIN) especialmente en el diagnóstico y tratamiento. Métodos: Revisión de la literatura en Pubmed de los últimos 20 años, especialmente de los publicados desde 2005 hasta la actualidad y considerando sobre todo los ensayos clínicos aleatorizados. Resultados: Su prevalencia real es desconocida, aunque es una patología rara generalmente en mujeres posmenopaúsicas. Su fisiopatología es similar a la neop...

  3. Associação entre via de parto e complicações maternas em hospital público da Grande São Paulo, Brasil Association between mode of delivery and maternal complications in a public hospital in Greater Metropolitan São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Luís Carlos Machado Junior

    2009-01-01

    Full Text Available O estudo objetivou avaliar associação entre via de parto e complicações maternas. Realizou-se coorte retrospectiva com partos ocorridos durante o ano de 2003, em um hospital público. As complicações avaliadas foram: infecção, hemorragia, histerectomia, rotura uterina, lesão de órgão contíguo, trombose venosa profunda e embolia pulmonar. Utilizou-se a odds ratio (OR e os testes de qui-quadrado de Pearson e de Fisher, além da regressão logística. Estabeleceu-se o nível de 0,05 como significante. Foram encontradas 15 complicações. Tomando-se o parto vaginal como referência, encontrou-se associação entre cesárea e as complicações tomadas em conjunto. Analisando-se variáveis confundidoras, encontrou-se associação das complicações com hipertensão, soropositividade para HIV, placenta prévia e descolamento prematuro de placenta. Após controle para estas quatro variáveis, manteve-se a associação entre cesárea e complicações (OR = 9,7; p = 0,04. Encontrou-se também associação entre complicações e cesárea eletiva comparada ao parto vaginal (OR = 4,7; p = 0,02, e maior proporção de complicações, no limite da significância estatística, nas cesáreas eletivas comparadas à "tentativa de parto vaginal" (OR = 3; p = 0,058. Conclui-se que a cesárea associa-se a complicações maternas, mesmo após a realização de vários ajustes.The purpose of this study was to assess the relationship between mode of delivery and maternal complications, based on a retrospective cohort of all births at a public hospital in 2003. Complications included: infection, hemorrhage, hysterectomy, uterine rupture, lesions in adjacent organs, deep venous thrombosis, and pulmonary embolism. The analysis used odds ratio (OR, chi-squared test, and Fisher's exact test, besides logistic regression. Fifteen complications were identified. Taking vaginal delivery as the reference, an association was found between cesarean section and overall

  4. Vaginal wind: A literature review.

    Science.gov (United States)

    Neels, Hedwig; Mortiers, Xavier; de Graaf, Sybrich; Tjalma, Wiebren A A; De Wachter, Stefan; Vermandel, Alexandra

    2017-07-01

    In the medical literature, there is little known about vaginal wind, though from clinical expertise, it turns out to be a consistent and underreported problem. The aim of this review was to collect the available literature about the different aspects of vaginal wind. A systematic literature search was conducted using three databases until December 2015. The search strategy was built using relevant synonyms of vaginal wind. Study characteristics were extracted. Risk of bias, the quality of the relevant studies and the level of evidence was judged. Eleven studies met the inclusion criteria. Vaginal wind occurs on random movements and during or after coitus. The prevalence ranges from one to 69%. The pathophysiology is unclear and the incidence unknown. Known risk factors are vaginal delivery and urinary incontinence. Provoking factors are coitus, digital stimulation, cunnilingus and exercising. Female sexual function is decreased. The sexual function of male partners with vaginal wind is not influenced. Overall vaginal wind leads to a decrease in the quality of live and can have cause social isolation. The treatment is related to the cause and mainly not successful. Tampons can be used for treatment as well as prevention. Vaginal wind is an underestimated health issue with a severe impact on sexual functioning. Adequate research is needed regarding the influence of sexual activity, weight, age, parity, the underlying pathophysiological mechanisms, prevention and treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Azubuike Uzoma

    2009-01-01

    Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.

  6. Vaginal haemangioendothelioma: an unusual tumour.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.

  7. El significado de la histerectomía para un grupo de hombres chilenos parejas de histerectomizadas O significado da histerectomia para um grupo de homens chilenos parceiros de histerectomizadas The meaning of hysterectomy for a group of chilean men partners of women who have undergone hysterectomy

    Directory of Open Access Journals (Sweden)

    Alejandra Araya Gutiérrez

    2012-12-01

    Full Text Available Se objetivó conocer el significado de la histerectomía para un grupo de hombres chilenos, parejas de mujeres histerectomizadas (HPMH. Estudio cualitativo, con entrevistas en profundidad realizadas a 15 hombres, parejas de mujeres histerectomizadas, entre Mayo y Septiembre del 2010, previa aprobación de dos Comités de Ética. Para el análisis de los datos se utilizó la perspectiva fenomenológica descrita por Giorgi, y se realizó el análisis de contenido según Krippendorff. Los criterios de Creswell fueron utilizados para evaluar la credibilidad del análisis y asegurar la validez descriptiva. Emergieron cinco dimensiones que representan aspectos únicos del significado de la histerectomía para los hombres parejas de mujeres histerectomizadas: síntomas, comentarios, atributos del útero, preocupaciones, y cambios en la sexualidad. Educar los hombres parejas de mujeres histerectomizadas es una acción fundamental para apoyar a las mujeres que serán sometidas a una histerectomía, siendo necesaria su incorporación en el plan de cuidados de ellas.O objetivo deste estudo foi conhecer o significado da histerectomia para um grupo de homens chilenos, parceiros de mulheres histerectomizadas (HPMH. A pesquisa qualitativa foi realizada com entrevistas em profundidade, realizada com um total de quinze homens parceiros de mulheres histerectomizadas, entre maio e setembro de 2010, com aprovação prévia dos Comitês de Ética. Para a análise dos dados foi utilizada a perspectiva fenomenológica descrita por Giorgi e realizada a análise de conteúdo de acordo com Krippendorff. Os critérios de Crestwell foram utilizados para avaliar a credibilidade da análise e garantir a validez descritiva. Surgiram cinco dimensões que representam aspectos únicos do significado da extração do útero para os homens parceiros de mulheres histerectomizadas: sintomas, comentários, atribuições do útero, preocupações e mudanças na sexualidade. Educar os

  8. Vaginal microbicides: An overview

    Directory of Open Access Journals (Sweden)

    Hany Abdel-Aleem

    2011-03-01

    Full Text Available It is estimated that more than 340 million new cases of curable sexually transmitted infections occur every year throughout the world in men and women age (15–49years. Women bear an increasing burden of the epidemic as both caregivers for the ill and because of their heightened risk of infection due to biological, economic and social vulnerabilities. There is an urgent need for new prevention strategies that women can use themselves and initiate. A vaginal microbicide defined as substances intended to reduce or prevent transmission of HIV and/or other sexually transmitted infections (STIs when applied topically to genital mucosal surfaces, provides a woman-controlled method applied before sex that could kill, neutralize, or block HIV and other sexually transmitted diseases.

  9. Squamous cell carcinoma in vaginal fundus in a Brahman cow

    Directory of Open Access Journals (Sweden)

    A. Pimenta-Oliveira

    2011-06-01

    Full Text Available É descrito o carcinoma de células escamosas (CCE no fundo vaginal de uma vaca. O diagnóstico de CCE moderadamente diferenciado foi confirmado através do exame histopatológico. Os testes imunoistoquímicos com os marcadores p53 e Ki67 realizados em amostras do tumor confirmaram a mutação na p53 e aumento da proliferação celular.

  10. Farmacocinética do tramadol administrado pela via intravenosa e intramuscular em cadelas submetidas a ovário - salpingo - histerectomia

    Directory of Open Access Journals (Sweden)

    Altamir Benedito de Sousa

    2008-06-01

    Full Text Available The objective of the present study was to implant a method using a sensitive and specific system, and validate the whole analytical method to obtain an efficient tool for analyses of tramadol in plasma dogs, and to evaluate the pharmacokinetics of tramadol following intravenous (i.v. and intramuscular (i.m. administration of this drug in females dogs submitted to castration. The pharmacokinetics of tramadol were examined following i.v. or i.m. tramadol administration to five female dogs in each group submitted to ovariohysterectomy (dosage=2 mg/kg. In relation to intravenous administration, the half-time for the distribution process (t1/2d = 0.18 ± 0.12 h; the total body clearance was 0.60 ± 0.50 L/h/kg, half-life of elimination (t1/2² was 1.24 ± 0.69 h. Statistically differences between parameters obtained after i.v. and i.m. was significant only to AUC0[i: 3362.07 ± 1008 and 1604.55 ± 960.02 (ng.h/mL, respectively. The F was 48.00 ± 43.30%. The assay for tramadol described has been demonstrated to meet all requirements for clinical PK studies. In particular, the method has satisfactory specificity, linearity, accuracy and precision range over the concentration examined.

  11. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    There are many causes of abnormal vaginal bleeding. HORMONES Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB) . DUB is more ...

  12. How Is Vaginal Cancer Diagnosed?

    Science.gov (United States)

    ... light is inserted into the bladder through the urethra. If suspicious areas or growths are seen, a biopsy will be done. Cystoscopy may be recommended if a vaginal cancer is large and/or located in the front ...

  13. Drugs Approved for Vaginal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  14. Vaginal bleeding in late pregnancy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000627.htm Vaginal bleeding in late pregnancy To use the sharing features ... the blood from soaking your clothes. What Causes Bleeding Later in Pregnancy? When labor begins, the cervix ...

  15. A universal combination treatment for vaginitis.

    Science.gov (United States)

    Bornstein, Jacob; Zarfati, Doron

    2008-01-01

    We compared a novel vaginal tablet consisting of 100 mg of clotrimazole and 100 mg of metronidazole ('Clo-Met') to a 100-mg clotrimazole tablet in the treatment of vaginitis. A multicenter, double-blind, randomized controlled study. Women with vaginal discharge and diagnosed as suffering from vaginitis caused by Trichomonas vaginalis, bacterial vaginosis or Candida albicans, or any combination of the three, and who had not received treatment for vaginitis during the previous month, were studied. 165 patients were enrolled into the study--84 into the combined therapy group, and 81 into the clotrimazole group. In women with Candida vaginitis, Clo-Met was more effective than clotrimazole treatment (p vaginal tablet consisting of clotrimazole and metronidazole is therapeutically effective in candidal vaginitis. The effectiveness of Clo-Met on bacterial vaginosis, T. vaginalis infection as well as on vaginal infections due to a combination of these microorganisms should be studied further.

  16. MICROBIOLOGICAL PROFILE OF VAGINAL SWABS.

    Directory of Open Access Journals (Sweden)

    Sevitha

    2012-10-01

    Full Text Available ABSTRACT: BACKGROUND/OBJECTIVES: Bacterial vaginosis (BV, an alteration of vaginal flora involving a decrease in Lactobacilli and predo minance of anaerobic bacteria, is the most common cause of vaginal complaints for women of chil dbearing age .Causative agents include Gardnerella vaginalis, facultative lactobacilli, My coplasma hominis, Viridans streptococci & anaerobic bacteria. The most frequent manifestation s of genitourinary candidiasis is vulvovaginal candidiasis & is diagnosed in 40 % of women with vaginal complaints. The present study was undertaken to study the occurrence of Bac terial vaginosis & Vulvovaginal candidiasis in women with vaginal complaints. MATERIALS AND METHODS: The study included 100 High vaginal swabs with H/O white discharge per vaginum f or a period of 6 months from June 2011.Swabs were stained by Grams method & were cult ured. RESULTS: Out of 100 samples, in 35(35%Gram smear findings were normal & no growth in culture. 26(26%samples had polymorphs with Gardnerella morphotype, gram negative c urved rods, fusiforms & Lactobacilli were absent/present in low numbers(1 to 2+, the sme ar was interpreted as consistent with BV. 15 samples (15% had the growth of Candida spp. In the remaining 24 samples, the Gram stain findings had only vaginal epithelial cells with Lactobacilli, but the culture had the growth o f Group B Streptococcus 10(10%, E. coli & coliforms 10(10%,Enterococcus spp 14(14%which could just be colonisers. CONCLUSION: Bacterial vaginosis is the predominant cause of leuc orrhoea (26% followed by vulvovaginal candidiasis accounting for 15 % of the cases. Detection of intrapartum vaginal colonisation of Group B Streptococci, E. coli & colif orms & Enterococcus spp. in pregnant women is of significance as it can get transmitted to the neonate & cause sepsis

  17. The vaginal contraceptive sponge.

    Science.gov (United States)

    Edelman, D A

    1984-06-01

    The vaginal contraceptive sponge, approved on April 1, 1983 by the US Food Administration (FDA) for sale in the US as a single use, disposable, over-the-counter contraceptive, is made of polyurethane and designed to be biocompatible with the vaginal environment. The sponge is available in a single size, is round, and about 5.5 cm in diameter and 2.5 cm thick. An indentation on 1 side helps to ensure the sponge's correct placement against the cervix. A polyester retrieval loop attached to the sponge facilitates removal. Postcoital tests of the sponge without the spermicide indicated that it was ineffective in preventing sperm from entering the cervical canal. Before insertion, the contraceptive sponge is moistened with tap water to activate the spermicide and is inserted into the vagina with the indentation placed against the cervis. The sponge has been designed to provide continuous protection against pregnancy for at least 24 hours after insertion. Following a successful phase ii clinical trail of the sponge, in 1979 comparative phase iii clinical trials were initiated by Family Health International. The following trials were conducted: sponge versus the diaphragm (arcing-spring) used with a spermicide (nonoxynol-9) at 13 clinics in the US (1439 subjects) and at 2 clinics in Canada and the UK (502 subjects); sponge versus a foaming spermicidal (menfegol) suppository at 5 clinics in Yugoslavia, Taiwan, and Bangladesh (1386) subjects); and sponge versus spermicidal (nonoxynol-9) foam at 2 clinics in Israel and Thailand (366 subjects). In all trials the contraceptive methods were raondomly assigned. Clinics were required to follow up subjects for 1 year. Only the US study has been completed. In the comparative trials of the sponge and diaphragm (both US based and overseas) the pregnancy rates were significantly higher for the sponge. In the comparative trials of the sponge and foaming suppositories or spermicidal foam there were no significant differences between the

  18. Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis.

    Science.gov (United States)

    Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

    2013-12-01

    Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. anamnesis, clinical, gynecological and microbiological examination of vaginal smear. The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.

  19. [The etiologic diversity of vaginitis].

    Science.gov (United States)

    Bohbot, J-M; Sednaoui, P; Verriere, F; Achhammer, I

    2012-10-01

    To establish the different etiologies of vaginitis and, especially, assess the distribution of responsible pathogens through a prospective study. One hundred and sixty-nine women aged between 18 and 65 years (average age: 33.7 years old), consulting a physician for symptoms of vaginitis, were examined in 21 centers of gynaecology or infectious diseases. The clinical evaluation was completed by bacteriological sample that was tested for infections (including sexually transmitted infections (STIs)). One hundred and eighteen patients (69.8%) had one or several infectious etiologies distributed as follows: 79 (46.7%) candidiasis (3 of which were caused by non albicans Candida), 37 (21.9%) bacterial vaginitis and 16 (9.5%) bacterial vaginosis. To be noticed that there were 38 cases of mixed etiologies out of the 118 infectious etiologies (32.2%), 3 of them were STIs. Although candidiasis was the most common etiology in this study, it only represented less than 1 out of every two patients. Among the infectious etiologies, 1 out of 3 women presented a bacterial or mixed vaginitis. The etiological diversity of vaginitis leads to consider broad-spectrum treatment as first-line therapy and to prescribe a microbiological analysis in case of failure. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  20. Contraceptive vaginal rings: a review.

    Science.gov (United States)

    Brache, Vivian; Faundes, Anibal

    2010-11-01

    Development efforts on contraceptive vaginal rings were initiated over 40 years ago based on two principles: the capacity of the vaginal epithelium to absorb steroids and the capacity of elastomers to release these hormones at a nearly constant rate. Numerous models of contraceptive vaginal rings (CVRs) have been studied, but only two have reached the market: NuvaRing, a combined ring that releases etonogestrel (ENG) and ethinylestradiol (EE), and Progering, a progesterone-releasing ring for use in lactating women. The main advantages of CVRs are their effectiveness (similar to or slightly better than the pill), ease of use without the need of remembering a daily routine, user's ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring. The main disadvantages are related to the mode of delivery; CVRs may cause vaginal discharge and complaints, ring expulsion is not uncommon, the ring may be felt during coitus and vaginal insertion may be unpleasant for some women. The studies reviewed in this article provide evidence that CVRs are safe, effective and highly acceptable to women. There is no doubt that CVRs offer a new, effective contraceptive option to women, expanding their available choices of hormonal contraception.

  1. Citología Vaginal

    OpenAIRE

    Arrunategui, Ana María; Fundación Valle de Lili

    2001-01-01

    ¿Qué es una neoplasia?/ ¿Qué grupo de mujeres tiene un mayor riesgo de desarrollar cáncer del cuello de la matriz?/ ¿Cuáles son los síntomas más frecuentes del cáncer del cuello de la matriz?/ Anatomía de los órganos genitales femeninos/¿Cómo se realiza la prueba de la citología vaginal?/¿Cómo se interpretan los resultados de la citología vaginal?/ ¿Toda citología anormal es cáncer?/ ¿Qué otras utilidades tiene la citología vaginal?/ ¿Desde qué edad, hasta que edad y con qué frecuencia debe t...

  2. Vaginitis: current microbiologic and clinical concepts.

    Science.gov (United States)

    Hill, L V; Embil, J A

    1986-01-01

    Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID:3510698

  3. Predictors of vaginal delivery in nulliparous mothers

    African Journals Online (AJOL)

    study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had ..... Table 2: Logistic regression of factors influencing vaginal delivery in primigravidae ... times higher risk of emergency caesarean section.

  4. The effect of vaginal cream containing ginger in users of clotrimazole vaginal cream on vaginal candidiasis.

    Science.gov (United States)

    Shabanian, Sheida; Khalili, Sima; Lorigooini, Zahra; Malekpour, Afsaneh; Heidari-Soureshjani, Saeid

    2017-01-01

    Vulvovaginal candidiasis is one of the most common infections of the genital tract in women that causes many complications. Therefore, we examined the clinical effect of ginger cream along with clotrimazole compared to vaginal clotrimazole alone in this study. This double-blind clinical trial was conducted on 67 women admitted to the Gynecology Clinic of Hajar Hospital with vaginal candidiasis. The patients were divided randomly into two groups of 33 and 34 people. The diagnosis was made according to clinical symptoms, wet smear, and culture. Ginger-clotrimazole vaginal cream 1% and clotrimazole vaginal cream 1% were administered to groups 1 and 2, respectively, once a day for 7 days and therapeutic effects and symptoms were evaluated in readmission. Data analysis was performed using SPSS version 22, t-test and Chi-square. The mean value of variables itching (P > 0.05), burning (P > 0.05), and cheesy secretion (P cream containing ginger and clotrimazole 1% was more effective and may be more useful than the clotrimazole to treat vaginal candidiasis.

  5. Vaginal radical trachelectomy: an update.

    Science.gov (United States)

    Plante, Marie

    2008-11-01

    The vaginal radical trachelectomy has emerged as a valuable fertility-preserving treatment option for young women with early-stage disease. Cancer-related infertility is associated with feelings of depression, grief, stress, and sexual dysfunction. Data have shown that the overall oncological outcome is safe and that the obstetrical outcome is promising. In this article, we analyze the data on the vaginal radical trachelectomy published over the last 10 years in the context of what we have learned, what issues remain unclear, and what the future holds.

  6. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  7. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  8. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  9. Effects of vaginal prolapse surgery and ageing on vaginal vascularization

    NARCIS (Netherlands)

    Weber, M.A.

    2016-01-01

    Ageing affects pelvic floor anatomy and function, resulting in several disorders like pelvic organ prolapse (POP), lower urinary tract symptoms and vaginal atrophy (VA). In this thesis we searched for methods to link the function of pelvic organs to physiological changes. The effects of POP and vagi

  10. A New Method to Measure Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, M. M. E.; Laan, E.; Vaart, C. H.; Roovers, J. P.

    2010-01-01

    Introduction: Vaginal surgery may affect sexual function both positively and negatively. Possibly, negative consequences of surgical interventions on sexuality may be caused by reduced sensibility of the vaginal wall. Aims: To develop a new method to measure vaginal sensibility. Methods: We develope

  11. Atrophic vaginitis: signs, symptoms, and better outcomes.

    Science.gov (United States)

    Reimer, Annabelle; Johnson, Laura

    2011-01-01

    Atrophic vaginitis is a common finding in women with low estrogen states. Many women believe their symptoms are expected signs of aging. NPs can provide therapeutic options to improve vaginal health and quality of life. This article reviews physiology, clinical manifestations, signs, symptoms, and treatment methods for atrophic vaginitis.

  12. Optical clearing of vaginal tissues

    Science.gov (United States)

    Chang, Chun-Hung; Myers, Erinn M.; Kennelly, Michael J.; Fried, Nathaniel M.

    2017-02-01

    Near-IR laser energy in conjunction with applied tissue cooling is being investigated for thermal remodeling of endopelvic fascia during minimally invasive treatment of female stress urinary incontinence. Previous simulations of light transport, heat transfer, and tissue thermal damage have shown that a transvaginal approach is more feasible than a transurethral approach. However, undesirable thermal insult to vaginal wall was predicted. This study explores whether an optical clearing agent (OCA) can improve optical penetration depth and completely preserve vaginal wall during subsurface treatment of endopelvic fascia. Several OCA mixtures were tested, and 100% glycerol was found to be optimal. Optical transmission studies, optical coherence tomography, reflection spectroscopy, and computer simulations of thermal damage to tissue using glycerol were performed. The OCA produced a 61% increase in optical transmission through porcine vaginal wall at 37 °C after 30 min. Monte Carlo (MC) light transport, heat transfer, and Arrhenius integral thermal damage simulations were performed. MC model showed improved energy deposition in endopelvic fascia using OCA. Without OCA, 62, 37, and 1% of energy was deposited in vaginal wall, endopelvic fascia, and urethral wall, compared with 50, 49, and 1% with OCA. Use of OCA also yielded 0.5 mm increase in treatment depth, allowing potential thermal tissue remodeling at 3 mm depth.

  13. Vaginal leiomyoma: MRI features with pathologic correlation

    Directory of Open Access Journals (Sweden)

    Avantika Gupta

    2015-06-01

    Full Text Available We present a rare case of vaginal leiomyoma presenting as prolapsed vaginal mass in a 45 years old woman. The leiomyoma was found to arise from the right lateral vaginal fornix with a vascular stalk. MRI showed homogenous hypointense signals on T1W1 and iso to hyperintense signals on T2W1 images with moderate heterogenous enhancement on post contrast images. It was enucleated via vaginal route and the histopathological examination confirmed the diagnosis of vaginal leiomyoma.

  14. Cistopexia videoassistida em cadela com cistocele após prolapso uterino: relato de caso

    Directory of Open Access Journals (Sweden)

    T. Krebs

    2015-04-01

    Full Text Available O prolapso de vesícula urinária associado ao prolapso uterino é condição rara em cães e gatos. O tratamento preconizado para essa afecção é o reposicionamento anatômico das estruturas afetadas. No presente relato é descrito o manejo por meio de ovariossalpingo-histerectomia por celiotomia e, após dois dias, cistopexia videoassistida. Essa condição, conforme o conhecimento dos autores, não havia sido previamente descrita. A operação apresentou-se como possibilidade viável de tratamento, sem complicações pós-operatórias.

  15. Novos conhecimentos sobre a flora bacteriana vaginal Vaginal bacterial flora: up to date

    Directory of Open Access Journals (Sweden)

    Iara Moreno Linhares

    2010-01-01

    Full Text Available O objetivo desta revisão foi apresentar os novos conhecimentos sobre o ecossistema vaginal, enfatizando os métodos não cultiváveis de identificação microbiana (amplificação de genes, as várias espécies de Lactobacillus que podem compor a flora vaginal e a interação desta com os mecanismos locais de imunidade inata e adquirida, dependentes dos constituintes genéticos. Foram pesquisados no Medline (Pubmed os artigos relacionados ao tema publicados entre 1997 e 2009, selecionando-se apenas os considerados relevantes. A utilização de técnicas não cultiváveis (técnicas de amplificação de genes tem possibilitado o melhor conhecimento sobre a composição do ecossistema vaginal. Na maioria das mulheres no menacme predominam na vagina uma ou mais espécies de Lactobacillus: L. crispatus, . L. inners e L gasseri. Entretanto, em outras mulheres aparentemente saudáveis pode haver deficiência ou mesmo ausência de Lactobacillus, que são substituídos por outras bactérias produtoras de ácido lático: espécies de Atopobium, Megasphaera e/ou Leptotrichia. A infecção e/ou a proliferação de bactérias patogênicas na vagina são suprimidas pela produção de ácido lático, por produtos gerados pelas bactérias e pela atividade local das imunidades inata e adquirida. As células epiteliais vaginais produzem diversos componentes com atividade antimicrobiana. Tais células ainda possuem receptores de membrana ("Toll-like receptors" que reconhecem padrões moleculares associados aos patógenos. O reconhecimento leva à produção de citocinas proinflamatórias e à estimulação da imunidade antigenoespecífica. A produção de anticorpos IgG e IgA também pode ser iniciada na endocérvice e na vagina em resposta à infecção. Conclui-se que a composição da flora vaginal e os mecanismos de imunidade representam importantes mecanismos de defesa. Os critérios de "flora normal" e "flora anormal" devem ser revistos; os polimorfismos

  16. Antigonococcal effects of vaginal tampons.

    Science.gov (United States)

    Arko, R J; Wong, K H; Smith, S J; Finley-Price, K G

    1983-01-01

    Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae. Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections. Strains from patients with pelvic inflammatory disease were moderately sensitive. Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice. Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice. These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes. PMID:6403199

  17. Evaluation and Management of Vaginitis

    Science.gov (United States)

    Carr, Phyllis L; Felsenstein, Donna; Friedman, Robert H

    1998-01-01

    OBJECTIVE To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections, and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting. DATA SOURCES Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997 were reviewed. DATA SYNTHESIS Techniques that enable the identification of the various strains of candida have helped lead to a better understanding of the mechanisms of recurrent candida infection. From this information a rationale for the treatment of recurrent disease can be developed. Bacterial vaginosis has been associated with complications, including upper genital tract infection, preterm delivery, and wound infection. Women undergoing pelvic surgery, procedures in pregnancy, or pregnant women at risk of preterm delivery should be evaluated for bacterial vaginosis to decrease the rate of complications associated with this condition. New, more standardized criteria for the diagnosis of bacterial vaginosis may improve diagnostic consistency among clinicians and comparability of study results. Use of topical therapies in the treatment of bacterial vaginosis are effective and associated with fewer side effects than systemic medication. Trichomonas vaginalis, although decreasing in incidence, has been associated with upper genital tract infection. Therapy of T. vaginalis infection has been complicated by an increasing incidence of resistance to metronidazole. CONCLUSIONS Vaginitis is a common medical problem in women that is associated with significant morbidity and previously unrecognized complications. Research in recent years has improved diagnostic tools as well as treatment modalities for all forms of vaginitis. PMID:9613891

  18. Vaginal birth after cesarean section

    Directory of Open Access Journals (Sweden)

    Vidyadhar B Bangal

    2013-01-01

    Full Text Available Background: The rate of primary cesarean section (CS is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC in selected cases of one previous lower segment CS (LSCS. Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

  19. Antifungal resistance in yeast vaginitis.

    Science.gov (United States)

    Dun, E.

    1999-01-01

    The increased number of vaginal yeast infections in the past few years has been a disturbing trend, and the scientific community has been searching for its etiology. Several theories have been put forth to explain the apparent increase. First, the recent widespread availability of low-dosage, azole-based over-the-counter antifungal medications for vaginal yeast infections encourages women to self-diagnose and treat, and women may be misdiagnosing themselves. Their vaginitis may be caused by bacteria, parasites or may be a symptom of another underlying health condition. As a result, they may be unnecessarily and chronically expose themselves to antifungal medications and encourage fungal resistance. Second, medical technology has increased the life span of seriously immune compromised individuals, yet these individuals are frequently plagued by opportunistic fungal infections. Long-term and intense azole-based antifungal treatment has been linked to an increase in resistant Candida and non-Candida species. Thus, the future of limiting antifungal resistance lies in identifying the factors promoting resistance and implementing policies to prevent it. PMID:10907778

  20. Lactobacillus for Vaginal Microflora Correction

    Directory of Open Access Journals (Sweden)

    Saule Saduakhasova

    2014-12-01

    Full Text Available Introduction. Despite the significant progress made in prevention, diagnosis, and treatment, there is still a high rate of vaginal dysbiosis in Kazakh women. The use of antibiotics in the treatment of vaginal dysbiosis contributes to the elimination of pathogens as well as microflora, which can lead to a decrease in local immunity and more favorable conditions for infection spread. The most physiologically safe and promising method for the restoration of vaginal biocenosis is the use of probiotics administered by a vaginal route.Methods. We have allocated 64 of cultures of Lactobacillus from the vaginal epithelium of healthy women of reproductive age and women with diagnosed bacterial vaginosis (BV. Identification of cultures was performed by PCR analysis of 16S ribosomal RNA.  Evaluation of biological significance was determined by the following criteria: high antagonistic activity against Candida albicans, Escherichia coli, Serratia marcescens, Proteus mirabilis, Klebsiella ozaenae, and Staphylococcus aureus; and production of hydrogen peroxide, resistance to antibiotics, adhesive activity. We studied the symbiotic relationship of selected biologically active of cultures to each other and received options for consortiums with  properties of  probiotics through co-cultivation.Results. Results of genotyping  showed that the isolated lactobacilli belong to the seven species: L. fermentum, L. salivarius, L. gasseri, L. crispatus, L. jensenii, L. plantarum, and L. delbrueskii. L. fermentum, L. salivarius, L. gasseri, and L. jensenii occur in women with suspected BV. The highest percentage of occurrence in the vagina of healthy women was L. fermentum (28%. Most strains of lactobacilli possess high inhibitory activity for all test-strains, except Candida albicans (37.5%. 56% of studied cultures revealed high adhesion to human erythrocytes. All lactobacillus strains were resistant to metronidazole, 80% to kanamycin, 57%  to vancomycin, and

  1. Concurrent chemoradiation for vaginal cancer.

    Directory of Open Access Journals (Sweden)

    David T Miyamoto

    Full Text Available BACKGROUND: It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT or concurrent chemoradiation therapy (CRT. METHODS: Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS and disease-free survival (DFS rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. RESULTS: The median age at diagnosis was 61 years (range, 18-92 years and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011. Twenty-three patients (45% in the RT group had a relapse at any site compared to 3 (15% in the CRT group (p = 0.027. With regard to the sites of first relapse, 10 patients (14% had local only, 4 (6% had local and regional, 9 (13% had regional only, 1 (1% had regional and distant, and 2 (3% had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10-0.97; p = 0.04. CONCLUSIONS: Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.

  2. Adhesion of vaginal microorganisms to epithelial cells and its association with Bacterial Vaginosis

    OpenAIRE

    Castro, Joana Isabel Reis

    2012-01-01

    Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Engenharia Clínica) A vaginose bacteriana (VB) é um distúrbio da flora vaginal normal e um importante problema de saúde pública em mulheres de idade reprodutiva. A VB é caracterizada pela substituição de lactobacilos vaginais por microrganismos, predominantemente, anaeróbios. Desconhecendo-se a etiologia da VB, duas hipóteses tentam explicar esta condição: a hipótese polimicrobiana, que infere...

  3. Plexopatia lombar após histerectomia abdominal: relato de caso Plexopatía lumbar después de la histerectomía abdominal: relato de caso Lumbar plexopathy after abdominal hysterectomy: case report

    Directory of Open Access Journals (Sweden)

    Elizabeth Vaz da Silva

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As lesões neurológicas diagnosticadas no período pós-operatório muitas vezes são atribuídas ao ato anestésico, embora possam também decorrer do ato cirúrgico. O objetivo deste relato foi apresentar o caso de uma paciente submetida à intervenção cirúrgica pélvica que evoluiu com quadro de plexopatia lombar e discutir as possíveis causas. RELATO DO CASO: Paciente do sexo feminino, 38 anos, 58 kg, 1,63 m de altura, estado físico ASA I, internada para tratamento de leiomiomatose uterina, com indicação de histerectomia total abdominal. A monitorização inicial incluiu oxímetro de pulso, pressão arterial não-invasiva, eletrocardioscópio e diurese. Após punção venosa no membro superior esquerdo com cateter 18G, foram administrados, por via venosa, cefazolina (2 g, dipirona (2 g, dexametasona (10 mg e metoclopramida (10 mg. A anestesia peridural foi realizada com agulha Tuohy 16G, no espaço L3-L4, na linha mediana com a paciente em decúbito lateral esquerdo. Foram administrados 15 mL de ropivacaína a 0,75% e 2 mg de morfina, a seguir posicionado cateter para analgesia pós-operatória. A intervenção cirúrgica não teve intercorrência, mantendo-se a paciente estável sob o ponto de vista cardiovascular. Na visita pós-anestésica, oito horas após o procedimento, a paciente não deambulava e apresentava monoparesia no membro inferior esquerdo. Após investigações clínicas e radiológicas foi descartada a hipótese diagnóstica de síndrome radicular. Como não houve regressão do quadro, 30 dias após foi realizada eletroneuromiografia que foi compatível com plexopatia lombar de possível origem traumática. CONCLUSÕES: O anestesiologista deve estar atento às complicações neurológicas que podem surgir no pós-operatório, participando da elucidação das causas, do tratamento e da sua evolução.JUSTIFICATIVA Y OBJETIVOS: Las lesiones neurológicas diagnosticadas en el per

  4. Vaginal rejuvenation using energy-based devices

    Directory of Open Access Journals (Sweden)

    Cheryl Karcher, MD

    2016-09-01

    Full Text Available Physiologic changes in a woman’s life, such as childbirth, weight fluctuations, and hormonal changes due to aging and menopause, may alter the laxity of the vaginal canal, damage the pelvic floor, and devitalize the mucosal tone of the vaginal wall. These events often lead to the development of genitourinary conditions such as stress urinary incontinence; vaginal atrophy; dryness; and physiologic distress affecting a woman’s quality of life, self-confidence, and sexuality. Various treatment modalities are currently available to manage these indications, varying from invasive vaginal surgery to more benign treatments like topical vaginal hormonal gels or hormone-replacement therapy. A new trend gaining momentum is the advent of energy-based devices for vaginal rejuvenation that apply thermal or nonthermal energy to the various layers of the vaginal tissue, stimulating collagen regeneration contracture of elastin fibers, neovascularization, and improved vaginal lubrication. This review aims to present the available technologies offering vaginal rejuvenation and the scientific evidence that underlines their safety and efficacy for this indication.

  5. Dynamic Clinical Measurements of Voluntary Vaginal Contractions and Autonomic Vaginal Reflexes

    NARCIS (Netherlands)

    Broens, Paul M. A.; Spoelstra, Symen K.; Weijmar Schultz, Willibrord C. M.

    2014-01-01

    IntroductionThe vaginal canal is an active and responsive canal. It has pressure variations along its length and shows reflex activity. At present, the prevailing idea is that the vaginal canal does not have a sphincter mechanism. It is hypothesized that an active vaginal muscular mechanism exists a

  6. Premenstrual vaginal colonization of Candida and symptoms of vaginitis.

    Science.gov (United States)

    Watson, Cathy J; Grando, Danilla; Garland, Suzanne M; Myers, Stephen; Fairley, Christopher K; Pirotta, Marie

    2012-11-01

    Although premenstrual exacerbation of vulvovaginal symptoms attributed to Candida spp. is well documented, the causation of these symptoms is not well understood. This study describes the daily vaginal colonization of Candida in three women. A single pilot study was designed to test the methodology of the proposed randomized controlled trial, Garlic and Candida. This study reports the colonization of Candida spp. in three women. Ten women aged 18-50 who reported at least one episode of vulvovaginal candidiasis were recruited by the University of Melbourne. Each participant took daily vaginal swabs for 2 weeks during the luteal phase of their menstrual cycle, which were analysed for quantitative colony counts of Candida spp. Of these, three women were colonized with Candida spp. For the first time, to our knowledge, daily colonization of Candida during the luteal phase of the menstrual cycle is described in three women, demonstrating an increase in the colony count preceding symptom development. This small study demonstrated the colonization of Candida spp. during the luteal phase of the menstrual cycle in three women. Candida colonization is poorly understood, yet investigating the relevance of the link between symptom exacerbation and the menstrual cycle in those women who experience recurrent episodes of vulvovaginal candidiasis may influence the management of this condition.

  7. Efficacy and Tolerability of Fitostimoline (Vaginal Cream, Ovules, and Vaginal Washing) and of Benzydamine Hydrochloride (Tantum Rosa Vaginal Cream and Vaginal Washing) in the Topical Treatment of Symptoms of Bacterial Vaginosis

    OpenAIRE

    Papa, R; Ascione, L.; Rullo, V.; Campedelli, A; Muzi, M.; Petrella, E.; Boselli, F.; Saponati, G.

    2012-01-01

    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0–3) were evaluated at baseline and at the end of treatment; the total symptoms sc...

  8. Long-retained vaginal foreign body causing chronic vaginitis in a bulldog.

    Science.gov (United States)

    Snead, Elisabeth C; Pharr, John W; Ringwood, Brendon P; Beckwith, Jennifer

    2010-01-01

    A vaginal foreign body consisting of a piece of retained calvarium from a macerated fetus was identified and removed using vaginoscopy in a 4-year-old, spayed female bulldog. The dog had a 12-month history of chronic mucopurulent vaginitis. Vaginal foreign bodies, although uncommon, are a differential diagnosis for recurrent mucopurulent or hemorrhagic chronic vaginal discharge. A case of chronic vaginitis caused by a long-retained intravaginal foreign body in a dog is described and compared to four other canine cases reported in the literature.

  9. Clinical implementation of MR‐guided vaginal cylinder brachytherapy

    National Research Council Canada - National Science Library

    Owrangi, Amir M; Jolly, Shruti; Balter, James M; Cao, Yue; Maturen, Katherine E; Young, Lisa; Zhu, Tong; Prisciandaro, Joann I

    2015-01-01

    ...)‐guided vaginal brachytherapy using commercially available solid applicator models. To test the fidelity of solid applicator models to digitize vaginal cylinder applicators, three datasets were evaluated...

  10. Treatment of postmenopausal vaginal atrophy with 10-μg estradiol vaginal tablets.

    Science.gov (United States)

    Panay, Nick; Maamari, Ricardo

    2012-03-01

    Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-µg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-µg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg.

  11. Treatment of Vaginal Atrophy with Vaginal Estrogen Cream in Menopausal Indian Women

    Science.gov (United States)

    Shah, Maitri; Karena, Zalak; Patel, Sangita V.; Parmar, Niyati; Singh, Pawan K.; Sharma, Atul

    2017-01-01

    Objectives To measure the effect of vaginal estrogen cream in the treatment of vaginal atrophy in menopausal Indian women. Methods A total of 50 menopausal women aged between 40 and 80 years old with symptoms of vaginal atrophy were selected and treated with 0.5 g vaginal estrogen cream, twice weekly for 12 weeks. The women were followed-up monthly where symptom score, Genital Health Clinical Evaluation (GHCE) score, vaginal pH, and vaginal maturation index (VMI) were assessed and compared to baseline data. Any adverse events were recorded. Results There was a significant improvement (p cream causes symptomatic relief in women of menopausal age in India suffering from vaginal atrophy. PMID:28042397

  12. Use of vaginal estrogen in Danish women

    DEFF Research Database (Denmark)

    Meaidi, Amani; Goukasian, Irina; Lidegaard, Oejvind

    2016-01-01

    INTRODUCTION: We know little about the use of vaginal estrogen in perimenopausal and postmenopausal women. We aimed to assess the prevalence of vaginal estrogen use in Denmark. MATERIAL AND METHODS: The study was designed as a nationwide cross-sectional study of all Danish women aged 40-79 years,...

  13. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Bergholt, Thomas; Nikolajsen, Sys

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  14. VULVO-VAGINAL CANDIDIASIS ASSOCIATED WITH ACITRETIN

    NARCIS (Netherlands)

    STURKENBOOM, MCJM; MIDDELBEEK, A; VANDENBERG, LTWD; VANDENBERG, PB; STRICKER, BHC; WESSELING, H

    The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years

  15. VULVO-VAGINAL CANDIDIASIS ASSOCIATED WITH ACITRETIN

    NARCIS (Netherlands)

    STURKENBOOM, MCJM; MIDDELBEEK, A; VANDENBERG, LTWD; VANDENBERG, PB; STRICKER, BHC; WESSELING, H

    1995-01-01

    The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years

  16. 21 CFR 884.3900 - Vaginal stent.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or...

  17. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  18. Use of vaginal hysterectomy in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Sidsel Lykke; Daugbjerg, Signe B; Gimbel, Helga

    2011-01-01

    To describe the use of vaginal, abdominal and laparoscopic hysterectomy in Denmark from 1999 to 2008, the influence of national guidelines and the patient and procedure-related characteristics associated with the choice of vaginal hysterectomy. Design. Nationwide register-based cohort study....

  19. Estrogen receptors in human vaginal tissue

    NARCIS (Netherlands)

    Wiegerinck, M.A.H.M.; Poortman, J.; Agema, A.R.; Thijssen, J.H.H.

    1980-01-01

    The presence of specific estrogen receptors could be demonstrated in vaginal tissue, obtained during operation from 38 women, age 27–75 yr. In 23 premenopausal women the receptor concentration in the vaginal tissue varied between 12 and 91 fmol/mg protein, no significant difference in the receptor

  20. PERFIL CITOLÓGICO VAGINAL DE OVELHAS DA RAÇA SANTA INÊS NO ACOMPANHAMENTO DO CICLO ESTRAL VAGINAL CYTOLOGY PROFILE FOR ACCOMPANIMENT TO ESTROUS CYCLE IN BREED SANTA INÊS EWES

    Directory of Open Access Journals (Sweden)

    José Adamir Torres de Souza

    2007-09-01

    Full Text Available

    O objetivo deste trabalho foi investigar o perfil citológico vaginal em ovelhas da raça Santa Inês, durante um ciclo estral completo. Selecionaram-se cinco fêmeas cíclicas criadas em sistema semi-intensivo, na Fazenda Pe-dras Santa em Araguaína, TO. Prepararam-se os esfregaços vaginais diariamente nas ovelhas cujo estro foi detectado por um rufião. Confeccionou-se um esfregaço vaginal por fêmea, em lâminas de vidro secas à temperatura ambiente e fixadas em álcool a 95%. Em seguida, foram coradas pelo método panótico rápido. As lâminas foram observadas ao microscópio óptico de luz com aumentos de 10 x e 40 x para contagem de 100 células por lâmina. Analisaram-se as características morfológicas e tintoriais das células epiteliais ao longo do ciclo estral, levando em consideração tanto as variáveis de cada fase do ciclo estral – proestro, estro, metaestro e diestro –, bem como os tipos celulares encon-trados – basal, parabasal, intermediária e anucleada. Os valores foram estudados por meio de ANOVA, ao nível de probabilidade de 5% pelo teste de Tukey. Na fase de estro, notou-se uma diferença do tipo celular superficial anucleada sobre os demais tipos (P<0,05. Concluiu-se que, através da citologia vaginal esfoliativa, podem-se diferenciar as fases do ciclo estral em ovelhas da raça Santa Inês.

    PALAVRAS-CHAVES: Ciclo estral, citologia vaginal, epitélio vaginal, ovelhas.

    The objective of this work was to establish a vaginal cytological profile in ewe of the Race Saint Inês, during a complete estrous cycle. Five created cyclical females in half-intensive system had been selected, in the Farm Rocks Saint, Araguaína, TO. The vaginal smears had been made daily during the estrous cycle, detected for a ruffian. One was confectioned vaginal smears for female, in dry glass slides to the ambient temperature and settled in alcohol 95% and in followed. They had been staining by the fast panótico method

  1. Value of bacterial culture of vaginal swabs in diagnosis of vaginal infections

    Directory of Open Access Journals (Sweden)

    Nenadić Dane

    2015-01-01

    Full Text Available Bacground/Aim. Vaginal and cervical swab culture is still very common procedure in our country’s everyday practice whereas simple and rapid diagnostic methods have been very rarely used. The aim of this study was to show that the employment of simple and rapid diagnostic tools [vaginal fluid wet mount microscopy (VFWMM, vaginal pH and potassium hydroxide (KOH test] offers better assessment of vaginal environment than standard microbiologic culture commonly used in Serbia. Methods. This prospective study included 505 asymptomatic pregnant women undergoing VFWMM, test with 10% KOH, determination of vaginal pH and standard culture of cervicovaginal swabs. Combining findings from the procedures was used to make diagnoses of bacterial vaginosis (BV and vaginitis. In addition, the number of polymorphonuclear leukocytes (PMN was determined in each sample and analyzed along with other findings. Infections with Candida albicans and Trichomonas vaginalis were confirmed or excluded by microscopic examination. Results. In 36 (6% patients cervicovaginal swab cultures retrieved several aerobes and facultative anaerobes, whereas in 52 (11% women Candida albicans was isolated. Based on VFWMM findings and clinical criteria 96 (19% women had BV, 19 (4% vaginitis, and 72 (14% candidiasis. Of 115 women with BV and vaginitis, pH 4.5 was found in 5, and of 390 with normal findings 83 (21% had vaginal pH 4.5. Elevated numbers of PMN were found in 154 (30% women - in 83 (54% of them VFWMM was normal. Specificity and sensitivity of KOH test and vaginal pH determination in defining pathological vaginal flora were 95% and 81%, and 79% and 91%, respectively. Conclusion. Cervicovaginal swab culture is expensive but almost non-informative test in clinical practice. The use of simpler and rapid methods as vaginal fluid wet mount microscopy, KOH test and vaginal pH offers better results in diagnosis, and probably in the treatment and prevention of sequels of vaginal

  2. Dermatologic causes of vaginitis: a clinical review.

    Science.gov (United States)

    Edwards, Libby

    2010-10-01

    The concept of vaginitis is widely accepted. Most physicians assume that vaginitis represents an infection, with nearly all vaginal complaints diagnosed as Candidiasis, bacterial vaginosis, or trichomonas. However, like the mouth, the vagina is covered with squamous epithelium, and therefore affected by various dermatoses. Some dermatoses prominently affect mucous membranes, such as lichen planus, pemphigus vulgaris, cicatricial pemphigoid, and blistering forms of erythema multiforme. In addition, some dermatoses affect only the vagina, including desquamative inflammatory vaginitis and atrophic vaginitis. The diagnosis and management of these diseases are hampered by the difficulty of visualizing the vagina, and the lack of medications other than antimicrobials available for use in the vagina. Copyright © 2010. Published by Elsevier Inc.

  3. Influência da freqüência de coitos vaginais e da prática de duchas higiênicas sobre o equilíbrio da microbiota vaginal Influence of frequency of vaginal intercourses and the use of doushing on vaginal microbiota

    Directory of Open Access Journals (Sweden)

    Paulo César Giraldo

    2005-05-01

    Full Text Available OBJETIVO: verificar se alta freqüência de coitos vaginais e o uso de duchas higiênicas interferem com a microbiota vaginal. MÉTODOS: noventa e sete mulheres atendidas em centro de saúde localizado em zona de prostituição na cidade de Campinas foram avaliadas em estudo prospectivo de corte transversal. A anamnese determinou as freqüências de coitos vaginais e do uso de duchas higiênicas nas 44 profissionais do sexo e nas 53 não-profissionais do sexo estudadas. O conteúdo vaginal foi coletado com swab estéril de Dacron, da parede vaginal direita, e disposto em duas lâminas de vidro. A microbiota vaginal foi estudada em microscopia óptica com lente de imersão em esfregaço corado pela técnica de Gram. Os dados foram analisados pelo teste exato de Fisher. As mulheres profissionais e não profissionais do sexo apresentaram, respectivamente, média de idade de 24,9 (± 6,4 e 31,5 (± 9,7 anos, hábito de fumar em 52,2 e 24,5%, prática do uso de lubrificantes vaginais em 56,8 e 0% e prática de uso de condom em 100 e 41,5% dos casos respectivamente. RESULTADOS: apenas 1,8% das mulheres do grupo controle tinham sete ou mais relações sexuais por semana, em evidente contraste com as profissionais do sexo (97,7%. Não houve diferenças significativas quanto à raça, escolaridade e paridade. A vaginose bacteriana e a flora vaginal anormal foram mais observadas nas profissionais do sexo do que no grupo controle (p=0,02 e 0,001 e associou-se à alta freqüência (sete ou mais vezes de coitos vaginais semanais (p=0,04 e 0,001. O diagnóstico de vaginose citolítica foi mais freqüente nas mulheres não-profissionais do sexo (p=0,04 e com menor freqüência de relações sexuais (p=0,04. O uso de duchas higiênicas foi mais comum nas profissionais do sexo (p=0,002. Entretanto, esta prática não esteve associada aos distúrbios da microbiota vaginal e nem à presença de vulvovagintes. CONCLUSÕES: profissionais do sexo com sete ou mais

  4. A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012

    Directory of Open Access Journals (Sweden)

    Pardis Hosseinzadeh

    2015-01-01

    Full Text Available Background: Atrophic vaginitis is a disease, which affects up to 50% of postmenopausal women. This study compared the effectiveness and user-friendliness of Vagifem (an estradiol vaginal tablet and vaginal estrogen cream in the treatment of atrophic vaginitis. Materials and Methods: One hundred and sixty postmenopausal women with symptoms of atrophic vaginitis were randomly divided into two groups of treatment with Vagifem or with vaginal estrogen cream for 12 weeks. Patients used the medication daily for the first 2 weeks of the study, and twice weekly. Severity of vaginal atrophy and four main symptoms of atrophic vaginitis including dysuria, dyspareunia, vaginal itching, and dryness were evaluated and compared before and after treatment. In addition, patients were asked regarding user-friendliness and hygienic issues of medications. Results: Both vaginal estrogen cream and Vagifem significantly improved symptoms of atrophic vaginitis but in terms of effectiveness for the treatment symptoms of atrophic vaginitis, there was no significant difference between the two medications. Vagifem compared to estrogen cream resulted in significantly lower rate of hygienic problems (0% versus 23%, P < 0.001, and was reported by the patients as a significantly easier method of treatment (90% versus 55%, P < 0.0001. Conclusion: This investigation showed that Vagifem is an appropriate medication for the treatment of atrophic vaginitis, which is as effective as vaginal estrogen creams and is more user-friendly.

  5. A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem) in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012.

    Science.gov (United States)

    Hosseinzadeh, Pardis; Ghahiri, Atallah; Daneshmand, Freshteh; Ghasemi, Mojdeh

    2015-12-01

    Atrophic vaginitis is a disease, which affects up to 50% of postmenopausal women. This study compared the effectiveness and user-friendliness of Vagifem (an estradiol vaginal tablet) and vaginal estrogen cream in the treatment of atrophic vaginitis. One hundred and sixty postmenopausal women with symptoms of atrophic vaginitis were randomly divided into two groups of treatment with Vagifem or with vaginal estrogen cream for 12 weeks. Patients used the medication daily for the first 2 weeks of the study, and twice weekly. Severity of vaginal atrophy and four main symptoms of atrophic vaginitis including dysuria, dyspareunia, vaginal itching, and dryness were evaluated and compared before and after treatment. In addition, patients were asked regarding user-friendliness and hygienic issues of medications. Both vaginal estrogen cream and Vagifem significantly improved symptoms of atrophic vaginitis but in terms of effectiveness for the treatment symptoms of atrophic vaginitis, there was no significant difference between the two medications. Vagifem compared to estrogen cream resulted in significantly lower rate of hygienic problems (0% versus 23%, P vaginitis, which is as effective as vaginal estrogen creams and is more user-friendly.

  6. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  7. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  8. Pyometra and complete vaginal adhesion in a miniature horse

    Science.gov (United States)

    Cozens, Elizabeth R.W.

    2009-01-01

    A 4-year-old miniature horse experienced intermittent episodes of pyrexia, lethargy, and purulent vaginal discharge following dsytocia. Vaginal endoscopy and transrectal ultrasonography revealed a blind-ending vaginal cavity and distended uterus. Surgical treatment was declined and the mare was euthanized. Post-mortem examination confirmed the diagnosis of pyometra and vaginal adhesions. PMID:19949560

  9. Proinflammatory Cytokines as Regulators of Vaginal Microbiota.

    Science.gov (United States)

    Kremleva, E A; Sgibnev, A V

    2016-11-01

    It was shown that IL-1β, IL-8, and IL-6 in concentrations similar to those in the vagina of healthy women stimulated the growth of normal microflora (Lactobacillus spp.) and suppressed the growth and biofilm production by S. aureus and E. coli. On the contrary, these cytokines in higher concentrations typical of vaginal dysbiosis suppressed normal microflora and stimulated the growth of opportunistic microorganisms. TGF-β1 in both doses produced a stimulating effects on study vaginal microsymbionts. It is hypothesized that pro-inflammatory cytokines serve as the molecules of interspecies communication coordinating the interactions of all components of the vaginal symbiotic system.

  10. Bilateral hydronephrosis caused by vaginal prolapse

    Directory of Open Access Journals (Sweden)

    Helio Begliomini

    2003-06-01

    Full Text Available INTRODUCTION: Even though it is uncommon, uterine prolapse can cause compression of ureters and bilateral hydronephrosis, predisposing to arterial hypertension and renal failure. Hydronephrosis consequent to cystocele and to vaginal prolapse is even rarer. CASE REPORT: This paper reports on a 59 year-old patient, Caucasian, obese and hysterectomized who presented complete vaginal prolapse with bilateral hydronephrosis and slight alteration in serum urea and creatinine. Patient underwent correction of vaginal prolapse by endoscopic suspension technique with improvement of hydronephrosis and normalization of renal function. This work emphasizes the rarity of such case and the requirement of surgical approach.

  11. Pudendal nerve block for vaginal birth.

    Science.gov (United States)

    Anderson, Deborah

    2014-01-01

    Pudendal nerve block is a safe and effective pain relief method for vaginal birth. Providing analgesia to the vulva and anus, it is used for operative vaginal birth and subsequent repair, late second stage pain relief with spontaneous vaginal birth, repair of complex lacerations, or repair of lacerations in women who are unable to achieve adequate or satisfactory pain relief during perineal repair with local anesthesia. Key to its efficacy is the knowledge of pudendal nerve anatomy, the optimal point of infiltration of local anesthetic, and an understanding of the amount of time necessary to effect adequate analgesia.

  12. Surgical removal of a large vaginal calculus formed after a tension-free vaginal tape procedure.

    Science.gov (United States)

    Zilberlicht, Ariel; Feiner, Benjamin; Haya, Nir; Auslender, Ron; Abramov, Yoram

    2016-11-01

    Vaginal calculus is a rare disorder which has been reported in association with urethral diverticulum, urogenital sinus anomaly, bladder exstrophy and the tension-free vaginal tape (TVT) procedure. We report a 42-year-old woman who presented with persistent, intractable urinary tract infection (UTI) following a TVT procedure. Cystoscopy demonstrated an eroded tape with the formation of a bladder calculus, and the patient underwent laser cystolithotripsy and cystoscopic resection of the tape. Following this procedure, her UTI completely resolved and she remained asymptomatic for several years. Seven years later she presented with a solid vaginal mass. Pelvic examination followed by transvaginal ultrasonography and magnetic resonance imaging demonstrated a large vaginal calculus located at the lower third of the anterior vaginal wall adjacent to the bladder neck. This video presents the transvaginal excision and removal of the vaginal calculus.

  13. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure.

    Science.gov (United States)

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P

    2016-01-01

    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.

  14. Vaginal atrophy in breast cancer survivors: role of vaginal estrogen therapy.

    Science.gov (United States)

    Mariani, Luciano; Gadducci, Angiolo; Vizza, Enrico; Tomao, Silverio; Vici, Patrizia

    2013-01-01

    Early menopause and related vaginal atrophy is a well known side-effect of hormone adjuvant treatment in breast cancer patients, particularly during aromatase-inhibitors therapy. Due to estrogens contra-indication, proper therapy for such symptom remains often an inadequately addressed clinical problem. After an accurate assessment of the risk/benefit ratio, vaginal low-dose estrogen treatment (better with estriol) [corrected] may have a role in controlling vaginal atrophy in selected and informed breast cancer women.

  15. MOIST VAGINAL PACKING FOR UTERO-VAGINAL PROLAPSE-A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Manidip

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND : Utero-vaginal prolapse is a common condition in ag ed women and often they come to us with decubitus ulcer. Prolong ed vaginal packing not only will heal the decubitus ulcer but also it may help in returning th e normal rugosity of the vaginal skin. AIMS: To assess the role of prolonged moist vaginal packing in utero-vaginal prolpase. SETTINGS & DESIGN: It was an OPD based prospective study conducted at t he gynecology OPD of College of Medicine & JNM Hospital, WBUHS, Kalyani, Nadia, West Bengal and Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal, Manipur. METHODS & MATERIAL: Hundred (100 patients of utero-vaginal prolapse with decubitus ulce r were studied. After initial staging (POP- Q staging, daily moist (5% povidone-iodine solution soaked gauze vaginal packing at home was advised. After 2 weeks, re-examination done for decubitus ulcer healing. Packing continued till operation (interval 1- 1½ month. Preoperative s taging and modification of operation were noted. On follow up complication (mainly recurrence was noted. RESULTS: Initial staging was stage 3 - 39%, stage 4 - 61%. Preoperative scoring r evealed stage 3 became stage 2 in 54% cases and stage 4 became stage 3 in 49% cases. This improv ement helped us to avoid excessive excision of vaginal mucosa. CONCLUSION: Prolonged pre-operative moist gauze vaginal packing may improve the outcome of the disease.

  16. Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis

    OpenAIRE

    Razzak, Mohammad Sabri A.; Alaa H. Al-Charrakh; Bara Hamid AL-Greitty

    2011-01-01

    Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effec...

  17. DO CHANGES IN ANAL SPHINCTER ANATOMY CORRELATE WITH ANAL FUNCTION IN WOMEN WITH A HISTORY OF VAGINAL DELIVERY?

    Directory of Open Access Journals (Sweden)

    Sthela Maria MURAD-REGADAS

    2014-09-01

    Full Text Available Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner’s score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS, the anterior and posterior internal anal sphincter (IAS, the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal.

  18. After vaginal delivery - in the hospital

    Science.gov (United States)

    ... patientinstructions/000629.htm After vaginal delivery - in the hospital To use the sharing features on this page, ... enable JavaScript. Most women will remain in the hospital for 24 hours after delivery. This is important ...

  19. Place of Schauta's radical vaginal hysterectomy.

    Science.gov (United States)

    Roy, Michel; Plante, Marie

    2011-04-01

    Women affected by early stage invasive cancer of the cervix are usually treated by surgery. Radical abdominal hysterectomy with pelvic lymphadenectomy is the most widely used technique. Because the morbidity of the abdominal approach can be important, the radical vaginal hysterectomy has gained acceptance in gynaecologic oncology. New instrumentation in laparoscopy also opens the possibility of treating cervical cancer by laparoscopically assisted vaginal radical hysterectomy and also total laparoscopic radical hysterectomy. Before these techniques become widely accepted, it has to be shown that safety and efficacy are comparable with the 'standard' abdominal approach. In this chapter, we review the technique of radical vaginal hysterectomy with pelvic lymphadenectomy and evaluate results of published studies, comparing the abdominal, vaginal and laparoscopic approaches.

  20. Vaginal birth after C-section

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000589.htm Vaginal birth after C-section To use the sharing features ... please enable JavaScript. If you had a cesarean birth (C-section) before, it does not mean that ...

  1. Vaginal itching and discharge - Adult and adolescent

    Science.gov (United States)

    ... spread during sexual contact. These include chlamydia, gonorrhea (GC), and trichomoniasis. Vaginal yeast infection, caused by a ... fitting clothes and not wearing panty hose. Wearing cotton underwear (rather than synthetic), or underwear that has ...

  2. What Are the Symptoms of Vaginitis?

    Science.gov (United States)

    ... the type of vaginitis a woman has 1 : Bacterial vaginosis often causes a thin, milky discharge from the ... How is it diagnosed? » Related A-Z Topics Bacterial Vaginosis Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...

  3. Vaginitis: MedlinePlus Health Topic

    Science.gov (United States)

    ... sprays Use a condom when having sex Avoid clothes that hold in heat and moisture Wear cotton underwear ... Institute of Child Health and Human Development) What Are the Symptoms of Vaginitis? (National ...

  4. Short convalescence after vaginal prolapse surgery

    DEFF Research Database (Denmark)

    Ottesen, Marianne; Sørensen, Mette; Kehlet, Henrik

    2003-01-01

    OBJECTIVE: Retrospectively to describe the recommended convalescence according to patients who had undergone vaginal prolapse surgery in 1996-98, and prospectively to describe the need for and limiting factors for convalescence after vaginal prolapse surgery in 1999-2000 at a Danish University...... Hospital. METHODS: The retrospective study included a validated, postal, questionnaire and review of patient files. In the prospective study, we followed consecutive women after vaginal surgery in a fast-track setting using a multimodal rehabilitation model with well-defined recommendations...... exceeding 10 kg. Limiting factors were fatigue and pain. The 1-year subjective recurrence rate was 17%. CONCLUSION: Traditionally, recommended convalescence has been median 6 weeks after vaginal prolapse surgery. Convalescence has been shortened to 1-3 weeks with a multimodal rehabilitation model...

  5. Nursing considerations in patients with vaginitis.

    Science.gov (United States)

    Holloway, Debra

    Vaginitis is defined as an inflammation of the vagina. It can result in symptoms of any or all of the following: discharge, itching and pain, and often irritation or infection of the vulva. There is no specific cause for vaginitis, and many other conditions can cause the symptoms. Vaginitis is a distressing condition that affects many women of reproductive age and beyond, and encompasses candidiasis (also known as thrush), bacterial vaginosis, and trichomoniasis. It can occur in a single episode, or recur throughout a woman's lifetime. Some women will seek medical help, but many more self-treat with over-the-counter medications, suspecting the recurrence of Candida in particular. This article aims to explore the causes, signs and symptoms, and treatments of vaginitis to provide nurses with the necessary background information to feel more confident in dealing with women's health issues.

  6. vaginal histological changes of the baboon

    African Journals Online (AJOL)

    2009-04-04

    Apr 4, 2009 ... baboon is a good model for investigating possible effects of hormonal contraceptives on vaginal epithelium .... folding. The placard and rosette arrangement of cells remained high. .... A randomized, double-blind trial. Mauritas.

  7. The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial.

    Science.gov (United States)

    Ekin, Murat; Yaşar, Levent; Savan, Kadir; Temur, Muzaffer; Uhri, Mehmet; Gencer, Işıl; Kıvanç, Esra

    2011-03-01

    To compare the effectiveness of the vaginal tablets of hyaluronic acid and estrodiol for the treatment of atrophic vaginitis. Forty-two postmenopausal women with symptoms of atrophic vaginitis were randomized to take vaginal tablets of 25 μg estradiol (n = 21) (group I) or 5 mg hyaluronic acid sodium salt (n = 21) (group II) for 8 weeks. The symptoms of atrophic vaginitis were evaluated by a self-assessed 4-point scale of composite score and the degree of epithelial atrophy was determined as, none, mild, moderate and severe. Vaginal pH and maturation index were measured and compared in both the groups. The symptoms were relieved significantly in both the groups (P vaginal pH were detected in both the groups (P vaginal maturation values were also significantly improved at both study groups (P vaginal symptoms, improved epithelial atrophy, decreased vaginal pH, and increased maturation of the vaginal epithelium. Those improvements were greater in group I. Hyaluronic acid vaginal tablets can be used in patients with atrophic vaginitis who do not want to or can not take local estrogen treatment.

  8. Induced vaginal birth after previous caesarean section

    OpenAIRE

    Akylbek Tussupkaliyev; Andrey Gayday; Bibigul Karimsakova; Saule Bermagambetova; Lunara Uteniyazova; Guldana Iztleuova; Gulkhanym Kusherbayeva; Meruyert Konakbayeva; Assylzada Merekeyeva; Zamira Imangaliyeva

    2016-01-01

    Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC) remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administra...

  9. Vaginal Rejuvenation with Gore-Mycromesh.

    Science.gov (United States)

    Park, Tae Hwan; Whang, Kwi Whan

    2015-08-01

    Recently, we introduced functional vaginal rejuvenation with elastic silicone threads. However, some patients with specific indications need other biocompatible materials for rejuvenation of the vagina. Gore-Mycromesh is one of the most commonly used materials in plastic and reconstructive surgical fields and it is composed of expanded poly-tetrafluroethylene. In this study, we introduced our clinical experience with static vaginal rejuvenation using Gore-Mycromesh to specifically assess the overall patient satisfaction (Female Sexual Function Index, FSFI). This study included 50 patients who underwent vaginal rejuvenation with a Gore-Mycromesh between 2010 and 2012. After marking two incisions at the inner side of the vaginal inlet and posterior wall, respectively, we performed submucosal dissection at the posterior vaginal wall and then grafted and secured a Gore-Mycromesh to the dissected area (muscle/fascia). Overall the FSFI improved as time progressed up to a year postoperatively. This is especially prominent in the FSFI satisfaction subscore. All but eight patients (42/50, 84 %) were "very satisfied (5)" or "satisfied (4)" with the outcomes after the vaginal rejuvenation. The overall complication rate was 8 %. Based on our clinical experience with the 50 cases, we think that vaginal rejuvenation with Gore-Mycromesh significantly improved postoperative outcomes, resulting in improved sexual function with a focus on improving the FSFI satisfaction subscore in mid-term follow-up. Elderly patients experience better outcomes using gore mycromesh rather than silicone thread because we can plicate the vaginal posterior wall with senile changes simultaneously using an open technique. However, further studies would be warranted for better positioning and adherence of grafted implants to surrounding tissue and for increasing the tightening effect of the implant and its sufficient longevity.

  10. Vaginal Health During Breast Cancer Treatment.

    Science.gov (United States)

    Falk, Sandy J; Bober, Sharon

    2016-05-01

    There are increasing numbers of breast cancer survivors. Chemotherapy or endocrine therapy result in effects on vaginal health that may affect quality of life. These effects may impact sexual function, daily comfort, or the ability to perform a pelvic examination. Vulvovaginal atrophy, or genitourinary syndrome of menopause, may be treated with nonhormonal or hormonal measures. Breast cancer survivors who are menopausal and/or on endocrine therapy should be screened for issues with vaginal health and counseled about treatment options.

  11. Effect of vaginal estrogen on pessary use

    Science.gov (United States)

    Dessie, Sybil G.; Armstrong, Katherine; Modest, Anna M.; Hacker, Michele R.

    2016-01-01

    Introduction and hypothesis Many providers recommend concurrent estrogen therapy with pessary use to limit complications; however, limited data exist to support this practice. We hypothesized that vaginal estrogen supplementation decreases incidence of pessary-related complications and discontinuation. Methods We performed a retrospective cohort study of women who underwent a pessary fitting from 1 January 2007 through 1 September 2013 at one institution; participants were identified by billing code and were eligible if they were post-menopausal and had at least 3 months of pessary use and 6 months of follow-up. All tests were two sided, and P values < 0.05 were considered statistically significant. Results Data from 199 women were included; 134 used vaginal estrogen and 65 did not. Women who used vaginal estrogen had a longer median follow-up time (29.5 months) compared with women who did not (15.4 months) and were more likely to have at least one pessary check (98.5 % vs 86.2 %, P < 0.001). Those in the estrogen group were less likely to discontinue using their pessary (30.6 % vs 58.5 %, P < 0.001) and less likely to develop increased vaginal discharge than women who did not [hazard ratio (HR) 0.31, 95 % confidence interval (CI) 0.17–0.58]. Vaginal estrogen was not protective against erosions (HR 0.93, 95 % CI 0.54–1.6) or vaginal bleeding (HR 0.78, 95 % CI 0.36–1.7). Conclusions Women who used vaginal estrogen exhibited a higher incidence of continued pessary use and lower incidence of increased vaginal discharge than women who did not. PMID:26992727

  12. Twin vaginal delivery: innovate or abdicate.

    Science.gov (United States)

    Easter, Sarah Rae; Taouk, Laura; Schulkin, Jay; Robinson, Julian N

    2017-02-07

    Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins, particularly in the case of the noncephalic second twin. Yet, the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raises concerns about the availability of providers who are skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin. Among 107 responding providers, only 57% would deliver a noncephalic second twin by breech extraction. Providers who preferred breech extraction had a higher rate of maternal-fetal medicine subspecialty training (26.2% vs 4.3%; P30 sets of twins annually (57.4% vs 34.8%; P=.02). Most providers (54.2%) were familiar with the findings from the recent randomized trial that demonstrated the safety of twin vaginal birth. However, knowledge of the trial was not associated statistically with a preference for breech extraction (62.3% vs 43.5%; P=.05). Providers who preferred breech extraction were more likely to agree with recent society guidelines that encourage the vaginal birth of twins (86.9% vs 63.0%; Pinnovation. Without novel provider-focused strategies, we may relinquish passively the requisite skills for not only our patients but also for future generations of obstetricians.

  13. UTERINE PROLAPSE IN QUEEN AND UTERINE PROLAPSO UTERINO EM GATA E RETROFLEXÃO UTERINA EM CADELA

    Directory of Open Access Journals (Sweden)

    Giuliano Queiroz Mostachio

    2008-10-01

    Full Text Available

    Obstetrical emergencies are problem in veterinary clinics and hospital. So, the aim of this report is to describe the clinical-surgical aspect of one of them, the uterine prolapse. Complete protrusion and retroflexion of uterus had been diagnosed in a queen and female dog, respectively. After the stabilization of the animals and reduction of the prolapses followed by ovary-hysterectomy, one of the animals came to death due to septicemia and hypovolemic shock. Rapid assessment and intensive treatments are required to sustain the life of the animal.

    KEY WORDS: Cat, dog, uterine prolapse, uterine retroflexion.

    Emergências obstétricas, como o prolapso uterino, constituem um problema em clínicas e hospitais veterinários. Neste relato descreve-se o aspecto clínico-cirúrgico do prolapso uterino. Diagnosticaram-se, em uma gata e em uma cadela, protrusão completa e retroflexão uterina, respectivamente. Após a estabilização dos animais e redução dos prolapsos seguidos de ovário-histerectomia, um dos animais veio a óbito, em decorrência de septicemia e choque hipovolêmico. Portanto, a rápida avaliação e tratamentos intensivos são requeridos para assegurar a vida do animal.

     

    PALAVRAS-CHAVES: Cão, gato, prolapso uterino, retroflexão uterina

  14. Local join therapy of vaginal infections by nifuratel-nistatin

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    Amra Habibović,

    2010-02-01

    Full Text Available A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiologycal examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiologycal examination of vaginal and cervical smears. An analiysis of vaginalsecretion found bacterial flora in 34 smears (65%, fungus (Candida albicans in 15 (24%and Trichomonas vaginalis in 7 (11%. Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients,vaginitis caused by Candida albicans was successly treated in 14 (93% patients. Bacterial vaginitis was cured in 29 (71% patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.

  15. Resection of the vaginal vault for vaginal recurrence of cervical cancer after hysterectomy and brachytherapy.

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    Abe, Akiko; Matoda, Maki; Okamoto, Sanshiro; Kondo, Eiji; Kato, Kazuyoshi; Omatsu, Kohei; Umayahara, Kenji; Utsugi, Kuniko; Takeshima, Nobuhiro

    2015-04-02

    We describe our experiences with vaginal vault resection for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. After operative treatment, the rate of vaginal vault recurrence of uterine cervical cancer is reported to be about 5%. There is no consensus regarding the treatment for these cases. Between 2004 and 2012, eight patients with vaginal vault recurrence underwent removal of the vaginal wall via laparotomy after hysterectomy and radiotherapy. The median patient age was 45 years (range 35 to 70 years). The median operation time was 244.5 min (range 172 to 590 min), the median estimated blood loss was 362.5 mL (range 49 to 1,890 mL), and the median duration of hospitalization was 24.5 days (range 11 to 50 days). Two patients had intraoperative complications: a grade 1 bowel injury and a grade 1 bladder injury. The following postoperative complications were observed: one patient had vaginal vault bleeding, three patients developed vesicovaginal fistulae, and one patient had repeated ileus. Two patients needed clean intermittent catheterization. Local control was achieved in five of the eight cases. Vaginal vault resection is an effective treatment for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. However, complications of this procedure can be expected to reduce quality of life. Therefore, this operation should be selected with great care.

  16. Misoprostol sublingual versus vaginal para indução do parto a termo Sublingual versus vaginal misoprostol for labor induction of term pregnancies

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    Olímpio Barbosa de Moraes Filho

    2005-01-01

    Full Text Available OBJETIVO: comparar efetividade e segurança de uso de comprimido sublingual de 25 µg de misoprostol com o comprimido vaginal de 25 µg do misoprostol na indução do parto com idade gestacional e > 37 semanas e colo uterino desfavorável. MÉTODOS: realizou-se ensaio clínico controlado e aleatorizado, não cego, na Maternidade Monteiro de Morais (CISAM-UPE, em Recife, no período de outubro de 2003 a fevereiro de 2004. Participaram do estudo 123 gestantes com idade gestacional e > 37 semanas, índice de Bishop PURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg versus vaginal misoprostol (25 µg (Prostokos® for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE, in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22, or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11. The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95, meconium incidence (5.2 vs 4.8%, p=0.74, Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98 and other adverse effects. CONCLUSION: twenty-five micrograms of

  17. Semaphorin 4D induces vaginal epithelial cell apoptosis to control mouse postnatal vaginal tissue remodeling.

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    Ito, Takuji; Bai, Tao; Tanaka, Tetsuji; Yoshida, Kenji; Ueyama, Takashi; Miyajima, Masayasu; Negishi, Takayuki; Kawasaki, Takahiko; Takamatsu, Hyota; Kikutani, Hitoshi; Kumanogoh, Atsushi; Yukawa, Kazunori

    2015-02-01

    The opening of the mouse vaginal cavity to the skin is a postnatal tissue remodeling process that occurs at approximately five weeks of age for the completion of female genital tract maturation at puberty. The tissue remodeling process is primarily composed of a hormonally triggered apoptotic process predominantly occurring in the epithelium of the distal section of the vaginal cavity. However, the detailed mechanism underlying the apoptotic induction remains to be elucidated. In the present study, it was observed that the majority of BALB/c mice lacking the class 4 semaphorin, semaphorin 4D (Sema4D), developed imperforate vagina and hydrometrocolpos resulting in a perpetually unopened vaginal cavity regardless of a normal estrogen level comparable with that in wild‑type (WT) mice. Administration of β‑estradiol to infant Sema4D‑deficient (Sema4D‑/‑) mice did not induce precocious vaginal opening, which was observed in WT mice subjected to the same β‑estradiol administration, excluding the possibility that the closed vaginal phenotype was due to insufficient estrogen secretion at the time of vaginal opening. In order to assess the role of Sema4D in the postnatal vaginal tissue remodeling process, the expression of Sema4D and its receptor, plexin‑B1, was examined as well as the level of apoptosis in the vaginal epithelia of five‑week‑old WT and Sema4D‑/‑ mice. Immunohistochemical analyses confirmed the localization of Sema4D and plexin‑B1 in the mouse vaginal epithelia. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay and immunohistochemistry detecting activated caspase‑3 revealed significantly fewer apoptotic cells in situ in the vaginal mucosa of five‑week‑old Sema4D‑/‑ mice compared with WT mice. The addition of recombinant Sema4D to Sema4D‑/‑ vaginal epithelial cells in culture significantly enhanced apoptosis of the vaginal epithelial cells, demonstrating the apoptosis‑inducing activity of Sema4D. The

  18. Efficacy and safety of vaginal estriol and progesterone in postmenopausal women with atrophic vaginitis.

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    Chollet, Janet A; Carter, Gloria; Meyn, Leslie A; Mermelstein, Fred; Balk, Judith L

    2009-01-01

    The aim of this study was to assess the efficacy and safety of intravaginal estriol and progesterone on atrophic vaginitis in postmenopausal women. Under a physician-sponsored Investigational New Drug application, 19 healthy postmenopausal women with atrophic vaginitis received vaginal suppositories containing estriol (1 mg) and progesterone (30 mg). The participants were instructed to insert one suppository intravaginally once daily for 2 weeks and thrice weekly for a total of 6 months. Vaginal pH, Vaginal Maturation Index, urinalysis, self-reported vaginal dryness, menopausal quality of life, and serum estriol and progesterone levels were measured at enrollment and after 3 and 6 months of suppository use. Endometrial biopsies were obtained at enrollment and at 6 months. After 2 weeks of therapy, six participants had serum estriol and progesterone measured. The Vaginal Maturation Index, vaginal pH, and vaginal dryness rating improved significantly at 3 and 6 months compared with baseline. Menopausal quality of life scores improved significantly in all domains, with the sexual subscale showing the most improvement. There were no cases of endometrial hyperplasia after 6 months of suppository use. Serum preinsertion estriol at week 2 and months 3 and 6 were similar to baseline levels. Serum preinsertion progesterone increased but returned to baseline preinsertion levels at month 6, and preinsertion levels were significantly less at month 6 compared with month 3. Intravaginal administration of a combination estriol and progesterone agent to women with atrophic vaginitis may represent a safe and effective alternative to systemic hormone replacement, although this study was not adequate to provide proof of efficacy given that it was uncontrolled.

  19. Vaginal parity and pelvic organ prolapse.

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    Quiroz, Lieschen H; Muñoz, Alvaro; Shippey, Stuart H; Gutman, Robert E; Handa, Victoria L

    2010-01-01

    To investigate whether the odds of pelvic organ prolapse vary significantly with the number of vaginal births and whether cesarean birth is associated with prolapse. In this cross-sectional study of women over the age of 40, pelvic organ prolapse was defined as descent to or beyond the hymen. Logistic regression was used to estimate the relative odds of pelvic organ prolapse for each vaginal birth or cesarean birth, controlling for confounders. Two hundred ninety women underwent a pelvic organ prolapse quantification POPQ examination, and 72 were found to have pelvic organ prolapse. A single vaginal birth significantly increased the odds of prolapse (OR 9.73, 95% CI 2.68-35.35). Additional vaginal births were not associated with a significant increase in the odds of prolapse. Cesarean births were not associated with prolapse (OR 1.31, 95% CI 0.49-3.54). The odds of pelvic organ prolapse were almost 10 times higher after a single vaginal birth. The marginal impact of additional births on this association was small.

  20. Diagnostic and therapeutic advancements for aerobic vaginitis.

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    Han, Cha; Wu, Wenjuan; Fan, Aiping; Wang, Yingmei; Zhang, Huiying; Chu, Zanjun; Wang, Chen; Xue, Fengxia

    2015-02-01

    Aerobic vaginitis (AV) is a newly defined clinical entity that is distinct from candidiasis, trichomoniasis and bacterial vaginosis (BV). Because of the poor recognition of AV, this condition can lead to treatment failures and is associated with severe complications, such as pelvic inflammatory disease, infertility, preterm birth and foetal infections. This review describes the diagnosis and treatment of AV and the relationship between AV and pregnancy. The characteristics of AV include severely depressed levels of lactobacilli, increased levels of aerobic bacteria and an inflamed vagina. The diagnosis is made by microscopy on wet mounts of fresh vaginal fluid, and some distinct clinical features are recognized. Vaginal suppositories that contain kanamycin or clindamycin have shown curative effects in nonpregnant women. Additionally, the application of topical probiotics can restore the vaginal flora and reduce the recurrence of AV. Clindamycin vaginal suppositories and probiotics may be a better choice for gravida with AV than metronidazole. AV requires prompt attention, and the early diagnosis and treatment of AV during pregnancy significantly improves perinatal outcomes. Further research is needed to define the pathogenesis, diagnostic criteria and standard treatment guidelines for AV.

  1. A comprehensive review of vaginitis phytotherapy.

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    Azimi, Hanieh; Fallah-Tafti, Mehrnaz; Karimi-Darmiyan, Maliheh; Abdollahi, Mohammad

    2011-11-01

    To overview phytotherapy of vaginitis in order to identify new approaches for new pharmacological treatments. All related literature databases were searched for herbal medicinal treatment in vaginitis. The search terms were plant, herb, herbal therapy, phytotherapy, vaginitis, vaginal, anti-candida, anti-bacterial and anti-trichomonas. All of the human, animal and in vitro studies were included. Anti-candida, anti-bacterial and anti-trichomonas effects were the key outcomes. The plants including carvacrol, 1,8-cineole, geranial, germacrene-D, limonene, linalool, menthol, terpinen-4-ol and thymol exhibited anti-candida effects. A very low concentration of geranium oil and geraniol blocked mycelial growth, but not yeast. Tea tree oil including terpinen-4-ol, alpha-terpinene, gamma-terpinene and alpha-terpineol showed anti-bacterial, anti-fungal and anti-protozoal properties against trichomonas. Allium hirtifolium (persian shallot) comparable to metronidazole exhibited anti-trichomonas activity due to its components such as allicin, ajoene and other organosulfides. The plants having beneficial effects on vaginitis encompass essential oils that clear the pathway that future studies should be focused to standardize theses herbs.

  2. Screening of mucoadhesive vaginal gel formulations

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    Ana Ochoa Andrade

    2014-12-01

    Full Text Available Rational design of vaginal drug delivery formulations requires special attention to vehicle properties that optimize vaginal coating and retention. The aim of the present work was to perform a screening of mucoadhesive vaginal gels formulated with carbomer or carrageenan in binary combination with a second polymer (carbomer, guar or xanthan gum. The gels were characterised using in vitroadhesion, spreadability and leakage potential studies, as well as rheological measurements (stress and frequency sweep tests and the effect of dilution with simulated vaginal fluid (SVF on spreadability. Results were analysed using analysis of variance and multiple factor analysis. The combination of polymers enhanced adhesion of both primary gelling agents, carbomer and carrageenan. From the rheological point of view all formulations presented a similar behaviour, prevalently elastic and characterised by loss tangent values well below 1. No correlation between rheological and adhesion behaviour was found. Carbomer and carrageenan gels containing the highest percentage of xanthan gum displayed good in vitro mucoadhesion and spreadability, minimal leakage potential and high resistance to dilution. The positive results obtained with carrageenan-xanthan gum-based gels can encourage the use of natural biocompatible adjuvants in the composition of vaginal products, a formulation field that is currently under the synthetic domain.

  3. The vaginal microbiota and susceptibility to HIV.

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    Buve, Anne; Jespers, Vicky; Crucitti, Tania; Fichorova, Raina N

    2014-10-23

    There is some evidence that the risk of HIV infection per heterosexual act is higher in low-income countries than in high-income countries. We hypothesize that variations in per sex-act transmission probability of HIV may in part be attributed to differences in the composition and function of the vaginal microbiota between different populations. This paper presents data that are in support of this hypothesis. Experimental and clinical studies have provided evidence that the normal vaginal microbiota plays a protective role against acquisition of HIV and other sexually transmitted infections. Epidemiological studies have convincingly shown that disturbances of the vaginal microbiome, namely intermediate flora and bacterial vaginosis, increase the risk of acquisition of HIV infection. A review of the literature found large differences in prevalence of bacterial vaginosis between different populations, with the highest prevalence rates found in black populations. Possible explanations for these differences are presented including data suggesting that there are ethnic differences in the composition of the normal vaginal microbiota. Lastly, interventions are discussed to restore and maintain a healthy vaginal environment. 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

  4. Reviewing the options for local estrogen treatment of vaginal atrophy

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    Lindahl SH

    2014-03-01

    Full Text Available Sarah H Lindahl Sutter East Bay Medical Foundation, SEBMF – Diablo Division, Castro Valley, CA, USA Background: Vaginal atrophy is a chronic condition with symptoms that include vaginal dryness, pain during sex, itching, irritation, burning, and discharge, as well as various urinary problems. Up to 45% of postmenopausal women may be affected, but it often remains underreported and undertreated. This article aims to review the current recommendations for treatment of vaginal atrophy, and current data on the effectiveness and safety of local vaginal estrogen therapies. Methods: Literature regarding vaginal atrophy (2007–2012 was retrieved from PubMed and summarized, with emphasis on data related to the treatment of vaginal atrophy with local vaginal estrogen therapy. Results: Published data support the effectiveness and endometrial safety of low-dose local estrogen therapies. These results further support the general recommendation by the North American Menopause Society that a progestogen is not needed for endometrial protection in patients using low-dose local vaginal estrogen. Benefits of long-term therapy for vaginal atrophy include sustained relief of symptoms as well as physiological improvements (eg, decreased vaginal pH and increased blood flow, epithelial thickness, secretions. Conclusion: 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. Keywords: menopause, estrogen, local estrogen therapy, vaginal atrophy

  5. [Clinical characteristics of aerobic vaginitis and its mixed infections].

    Science.gov (United States)

    Fan, Ai-Ping; Xue, Feng-Xia

    2010-12-01

    To investigate clinical characteristics of aerobic vaginitis (AV) and its mixed infections for diagnosis efficiently. From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonal vaginitis (TV), and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. Among 516 cases, AV cases were found in 14.7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30%, 13/44), and mixed with TV (25%, 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4.5 (84%, 27/32). Vaginal cleanliness mainly was grade III - IV (88%, 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV.

  6. A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn

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    Osman Köse

    2013-01-01

    Full Text Available Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD, which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1 cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST, Pelvic Organ Prolapse Quantification (POP-Q evaluation, Incontinence Impact Questionnaire (IIQ-7, and Urogenital Distress Inventory (UDI-6 scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

  7. Vaginal Biogenic Amines: Biomarkers of Bacterial Vaginosis or Precursors to Vaginal Dysbiosis?

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    Tiffanie Maree Nelson

    2015-09-01

    Full Text Available Bacterial vaginosis (BV is the most common vaginal disorder among reproductive age women. One clinical indicator of BV is a ‘fishy’ odor. This odor has been associated with increases in several biogenic amines (BAs that may serve as important biomarkers. Within the vagina, BA production has been linked to various vaginal taxa, yet their genetic capability to synthesize BAs is unknown. Using a bioinformatics approach, we show that relatively few vaginal taxa are predicted to be capable of producing BAs. Many of these taxa (Dialister, Prevotella, Parvimonas, Megasphaera, Peptostreptococcus, and Veillonella spp. are more abundant in the vaginal microbial community state type (CST IV, which is depleted in lactobacilli. Several of the major Lactobacillus species (L. crispatus, L. jensenii, and L. gasseri were identified as possessing gene sequences for proteins predicted to be capable of putrescine production. Finally, we show in a small cross sectional study of 37 women that the BAs putrescine, cadaverine and tyramine are significantly higher in CST IV over CSTs I and III. These data support the hypothesis that BA production is conducted by few vaginal taxa and may be important to the outgrowth of BV-associated (vaginal dysbiosis vaginal bacteria.

  8. Vaginal biogenic amines: biomarkers of bacterial vaginosis or precursors to vaginal dysbiosis?

    Science.gov (United States)

    Nelson, Tiffanie M.; Borgogna, Joanna-Lynn C.; Brotman, Rebecca M.; Ravel, Jacques; Walk, Seth T.; Yeoman, Carl J.

    2015-01-01

    Bacterial vaginosis (BV) is the most common vaginal disorder among reproductive age women. One clinical indicator of BV is a “fishy” odor. This odor has been associated with increases in several biogenic amines (BAs) that may serve as important biomarkers. Within the vagina, BA production has been linked to various vaginal taxa, yet their genetic capability to synthesize BAs is unknown. Using a bioinformatics approach, we show that relatively few vaginal taxa are predicted to be capable of producing BAs. Many of these taxa (Dialister, Prevotella, Parvimonas, Megasphaera, Peptostreptococcus, and Veillonella spp.) are more abundant in the vaginal microbial community state type (CST) IV, which is depleted in lactobacilli. Several of the major Lactobacillus species (L. crispatus, L. jensenii, and L. gasseri) were identified as possessing gene sequences for proteins predicted to be capable of putrescine production. Finally, we show in a small cross sectional study of 37 women that the BAs putrescine, cadaverine and tyramine are significantly higher in CST IV over CSTs I and III. These data support the hypothesis that BA production is conducted by few vaginal taxa and may be important to the outgrowth of BV-associated (vaginal dysbiosis) vaginal bacteria. PMID:26483694

  9. Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis.

    Science.gov (United States)

    Shen, Jian; Song, Ning; Williams, Christopher J; Brown, Celeste J; Yan, Zheng; Xu, Chen; Forney, Larry J

    2016-01-01

    Atrophic vaginitis (AV) is common in postmenopausal women, but its causes are not well understood. The symptoms, which include vaginal itching, burning, dryness, irritation, and dyspareunia, can usually be alleviated by low doses of estrogen given orally or locally. Regrettably, the composition of vaginal bacterial communities in women with AV have not been fully characterized and little is known as to how these communities change over time in response to hormonal therapy. In the present intervention study we determined the response of vaginal bacterial communities in postmenopausal women with AV to low-dose estrogen therapy. The changes in community composition in response to hormonal therapy were rapid and typified by significant increases in the relative abundance of Lactobacillus spp. that were mirrored by a decreased relative abundance of Gardnerella. These changes were paralleled by a significant four-fold increase in serum estradiol levels and decreased vaginal pH, as well as nearly a two-fold increase in the Vaginal Maturation Index (VMI). The results suggest that after menopause a vaginal microbiota dominated by species of Lactobacillus may have a beneficial role in the maintenance of health and these findings that could lead to new strategies to protect postmenopausal women from AV.

  10. Postmenopausal Vaginal Bleeding after Infesting with Leeches

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    Roghaieh Rahmani-Bilandi

    2012-04-01

    Full Text Available Diagnosis and therapeutic measures are immediately taken for abnormal postmenopausal vaginal bleeding, because its causes range from atrophic endometrium to malignancy. In this paper, abnormal bleeding is reported due to leech infection. The patient is a 69-year-old woman who has reached menopause for 12 years and has visited a physician because of vaginal bleeding. The patient had no history of abnormal bleeding or medication. The patient first refused to get hospitalized and continue medical care, but she finally accepted to take diagnostic and therapeutic procedures after a few times of visit and increased bleeding. During general anesthesia and upon opening vagina, a large hemorrhagic and moving mass was observed at the upper posterior vaginal wall which was removed with surgical forceps. Surprisingly, this mass was a leech. Bleeding at the leech’s junction was stopped after half an hour using sterile gas and the patient was discharged on the next day.

  11. Nonbarrier contraceptives and vaginitis and vaginosis.

    Science.gov (United States)

    Roy, S

    1991-10-01

    Within the limitations of the available data, it has been reported that oral contraceptive use versus other contraceptive methods is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of chlamydia trachomatis, and a reduced frequency of bacterial vaginosis and trichomoniasis. The impact of contraceptive steroids on cellular and humoral immunologic factors may explain these observations. Intrauterine contraceptive device use is reported to be associated with an increased rate of bacterial vaginosis and anaerobic organism recovery from the vagina regardless of symptoms. Patients having a contraceptive vaginal ring were found to have the same number and types of vaginal organisms as oral contraceptive users. Levonorgestrel-releasing subdermal implant (Norplant, Wyeth-Ayerst, Philadelphia, Pa.) users have been reported to have approximately half the rate of vaginitis and vaginosis compared with that of Copper T-200 intrauterine device users.

  12. The Effectiveness of Vaginal Contraceptive Sponge

    Institute of Scientific and Technical Information of China (English)

    金毓翠; 丁家佩; 董吟秋; 董炳麟; 许雪芬

    1994-01-01

    The vaginal contraceptive sponge is made of polyurethane containing 1 g of nonoxynot-9, The gross cumulative twelve month life table pregnancy rate of 352 cases using vaginal contraceptive sponge was 5.7/ 100 women and the method pregnancy rate was 2. 3/ 100 women. The gross cumulative continuation rate per 100 women was 74. Only 2 patients (1,0/ 100 women) suffering from vaginitis and itching of vulva no longer wished to continue in the stud). Over the course of the study no significant changes were observed in any of the laboratory parameters such as vagina & cervix smear etc. that had been monitored. This modality associated with few side effects and its effectiveness rate and also indicated a protection from the risk of acquring of sex-transmitted diseases.

  13. Monitoramento do ciclo estral de cutias (Dasyprocta leporina Lichtenstein, 1823 através de citologia esfoliativa vaginal e ultrassonografia

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    Lívia B. Campos

    2015-02-01

    Full Text Available O objetivo deste estudo foi monitorar o ciclo estral em cutias (Dasyprocta leporina criadas em cativeiro no semiárido brasileiro. Durante 70 dias, cinco cutias foram diariamente submetidas a citologia esfoliativa vaginal, e o monitoramento ultrassonográfico ovariano foi realizado a cada três dias. Um total de 8 ciclos estrais foi completamente monitorado, com duração de 28,2±0,7 dias, variando de 24 a 31 dias. Pela citologia esfoliativa vaginal, houve uma predominância de células superficiais nas fases de proestro e estro (P0,05. Os folículos foram identificados durante as fases estrogênicas (proestro e estro, com diâmetro médio de 1±0,5mm. Em apenas 12,5% das fases luteais, corpos lúteos medindo 1,4±0,9mm foram identificados. Conclui-se que a associação da citologia vaginal e da ultrassonografia ovariana constitui uma alternativa viável para o monitoramento de ciclos estrais e identificação das fases estrogênicas em cutias da espécie Dasyprocta leporina

  14. Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis.

    Science.gov (United States)

    Boselli, F; Petrella, E; Campedelli, A; Muzi, M; Rullo, V; Ascione, L; Papa, R; Saponati, G

    2012-01-01

    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0-3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV.

  15. Pregnancy's stronghold on the vaginal microbiome.

    Directory of Open Access Journals (Sweden)

    Marina R S Walther-António

    Full Text Available OBJECTIVE: To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. METHODS: Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8-12, 17-21, 27-31, and 36-38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3-V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. RESULTS: Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n = 8, the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. CONCLUSION: Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for

  16. Surgery for women with apical vaginal prolapse.

    Science.gov (United States)

    Maher, Christopher; Feiner, Benjamin; Baessler, Kaven; Christmann-Schmid, Corina; Haya, Nir; Brown, Julie

    2016-10-01

    Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched July 2015) and ClinicalTrials.gov (searched January 2016). We included randomised controlled trials (RCTs). We used Cochrane methods. Our primary outcomes were awareness of prolapse, repeat surgery and recurrent prolapse (any site). We included 30 RCTs (3414 women) comparing surgical procedures for apical vaginal prolapse. Evidence quality ranged from low to moderate. Limitations included imprecision, poor methodological reporting and inconsistency. Vaginal procedures versus sacral colpopexy (six RCTs, n = 583; one to four-year review). Awareness of prolapse was more common after vaginal procedures (risk ratio (RR) 2.11, 95% confidence interval (CI) 1.06 to 4.21, 3 RCTs, n = 277, I(2) = 0%, moderate-quality evidence). If 7% of women are aware of prolapse after sacral colpopexy, 14% (7% to 27%) are likely to be aware after vaginal procedures. Repeat surgery for prolapse was more common after vaginal procedures (RR 2.28, 95% CI 1.20 to 4.32; 4 RCTs, n = 383, I(2) = 0%, moderate-quality evidence). The confidence interval suggests that if 4% of women require repeat prolapse surgery after sacral colpopexy, between 5% and 18% would require it after vaginal procedures.We found no conclusive evidence that vaginal procedures increaserepeat surgery for stress urinary incontinence (SUI) (RR 1.87, 95% CI 0.72 to 4.86; 4 RCTs, n = 395; I(2) = 0%, moderate

  17. Novos conhecimentos sobre a flora bacteriana vaginal

    OpenAIRE

    Iara Moreno Linhares; Paulo Cesar Giraldo; Edmund Chada Baracat

    2010-01-01

    O objetivo desta revisão foi apresentar os novos conhecimentos sobre o ecossistema vaginal, enfatizando os métodos não cultiváveis de identificação microbiana (amplificação de genes), as várias espécies de Lactobacillus que podem compor a flora vaginal e a interação desta com os mecanismos locais de imunidade inata e adquirida, dependentes dos constituintes genéticos. Foram pesquisados no Medline (Pubmed) os artigos relacionados ao tema publicados entre 1997 e 2009, selecionando-se apenas os ...

  18. Parto vaginal tras cesárea

    OpenAIRE

    San Martín Bragado, María

    2016-01-01

    Cuando una mujer ha sido sometida a una cesárea previa existen dos opciones para ella en el caso de que se quede embarazada: repetir cesárea o intentar un parto vaginal. A pesar de los riesgos, el parto vaginal después de una cesárea es una situación atractiva para muchas pacientes y dará lugar a un resultado exitoso en un alto porcentaje de casos. Se ha de tener en cuenta que la realización de una cesárea electiva no está exenta de riesgos Grado en Medicina

  19. MRSA as a rare cause of vaginitis.

    Science.gov (United States)

    de Bree, L C J; van Rijen, M M L; Coertjens, H P M; van Wijngaarden, P

    2015-12-01

    We describe a 26-year-old otherwise healthy woman with MRSA vaginitis. Traditional MRSA risk factors were absent and additional screening sites were negative. Patient was treated successfully with oral antibiotics combined with topical lactic acid emulsion. Because her partner appeared to have solitary MRSA carriage on the glans, a suggestion of sexual transmission was made. He was treated successfully with topical mupirocin ointment. Although solitary vaginal MRSA carriage and infection seems to be rare and its clinical impact is yet undefined, clinicians should consider adding the genitourinary tract to traditional screening sites in case of recurrent MRSA infections.

  20. Parto vaginal tras cesárea

    OpenAIRE

    San Martín Bragado, María

    2016-01-01

    Cuando una mujer ha sido sometida a una cesárea previa existen dos opciones para ella en el caso de que se quede embarazada: repetir cesárea o intentar un parto vaginal. A pesar de los riesgos, el parto vaginal después de una cesárea es una situación atractiva para muchas pacientes y dará lugar a un resultado exitoso en un alto porcentaje de casos. Se ha de tener en cuenta que la realización de una cesárea electiva no está exenta de riesgos Grado en Medicina

  1. Plasma estrogen concentrations after oral and vaginal estrogen administration in women with atrophic vaginitis.

    Science.gov (United States)

    Dorr, Mary Beth; Nelson, Anita L; Mayer, Philip R; Ranganath, Radhika P; Norris, Paul M; Helzner, Eileen C; Preston, Richard A

    2010-11-01

    In this open-label, randomized, multiple-dose, two-treatment crossover study, 24 postmenopausal women with moderate to severe atrophic vaginitis received 0.3 mg conjugated estrogens daily for 14 days: 7 days orally (0.3 mg tablet) and 7 days vaginally (0.5 g cream). Steady-state plasma concentrations of E2 and estrone were one-third lower after vaginal versus oral administration of conjugated estrogens. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Directed shift of vaginal microbiota induced by vaginal application of sucrose gel in rhesus macaques.

    Science.gov (United States)

    Hu, Kai-tao; Zheng, Jin-xin; Yu, Zhi-jian; Chen, Zhong; Cheng, Hang; Pan, Wei-guang; Yang, Wei-zhi; Wang, Hong-yan; Deng, Qi-wen; Zeng, Zhong-ming

    2015-04-01

    Sucrose gel was used to treat bacterial vaginosis in a phase III clinical trial. However, the changes of vaginal flora after treatment were only examined by Nugent score in that clinical trial, While the vaginal microbiota of rhesus macaques is characterized by anaerobic, Gram-negative bacteria, few lactobacilli, and pH levels above 4.6, similar to the microbiota of patients with bacterial vaginosis. This study is aimed to investigate the change of the vaginal microbiota of rehsus macaques after topical use of sucrose gel to reveal more precisely the bacterial population shift after the topical application of sucrose gel. Sixteen rhesus macaques were treated with 0.5 g sucrose gel vaginally and three with 0.5 g of placebo gel. Vaginal swabs were collected daily following treatment. Vaginal pH levels and Nugent scores were recorded. The composition of the vaginal micotbiota was tested by V3∼V4 16S rDNA metagenomic sequencing. Dynamic changes in the Lactobacillus genus were analyzed by qPCR. The vaginal microbiota of rhesus macaques are dominated by anaerobic Gram-negative bacteria, with few lactobacilli and high pH levels above 4.6. After five days' treatment with topical sucrose gel, the component percentage of Lactobacillus in vaginal microbiota increased from 1.31% to 81.59%, while the component percentage of Porphyromonas decreased from 18.60% to 0.43%, Sneathia decreased from 15.09% to 0.89%, Mobiluncus decreased from 8.23% to 0.12%, etc.. The average vaginal pH values of 16 rhesus macaques of the sucrose gel group decreased from 5.4 to 3.89. There were no significant changes in microbiota and vaginal pH observed in the placebo group. Rhesus macaques can be used as animal models of bacterial vaginosis to develop drugs and test treatment efficacy. Furthermore, the topical application of sucrose gel induced the shifting of vaginal flora of rhesus macaques from a BV kind of flora to a lactobacilli-dominating flora. Copyright © 2015 The Authors. Published by

  3. Vulvar and Vaginal Cancer, Vulvar Intraepithelial Neoplasia 3 and Vaginal Intraepithelial Neoplasia 3: Experience of a Referral Institute

    National Research Council Canada - National Science Library

    Siegler, Efraim; Segev, Yakir; Mackuli, Lena; Auslender, Ron; Shiner, Mayan; Lavie, Ofer

    2016-01-01

    ...: human papillomavirus (HPV) induced or non-HPV induced. To evaluate the demographic and clinical characteristics associated with vulvar or vaginal cancer and vulvar and vaginal intraepithelial neoplasia 3 (VIN3, VAIN3...

  4. Prepubertal vaginal discharge: Vaginoscopy to rule out foreign body.

    Science.gov (United States)

    Ekinci, Saniye; Karnak, İbrahim; Tanyel, Feridun Cahit; Çiftçi, Arbay Özden

    2016-01-01

    Medical records of all prepubertal patients who underwent vaginoscopy to rule out vaginal foreign body between 2004 and 2013 were reviewed retrospectively. All patients were evaluated by pediatricians prior to surgical consultation. Vaginoscopy is performed in the operating room under general anesthesia. During the study period, 20 girls with persistent vaginal discharge with a mean age of 6.8 years (1-13 years) underwent vaginoscopy to rule out vaginal foreign body. Six patients had bloody vaginal discharge and 4 had recurrent vaginal bleeding lasting for more than one month. Ten patients had purulent vaginal discharge lasting for 1-7 months. None of vaginal cultures revealed pathological bacteria or candida species. Preoperative imaging techniques revealed vaginal foreign body in one patient only. Vaginoscopy demonstrated vaginal foreign bodies in four patients. Foreign bodies were grass inflorescence, safety pin and undefined brownish particles (n=2), which may be pieces of toilet paper or feces. There was no complication related to vaginoscopy and removal of foreign body. Hymen integrity was preserved in all patients. Persistent or recurrent vaginal discharge in prepubertal girls should raise the suspect of vaginal foreign body. Continuous flow vaginoscopy is mandatory to detect and remove any vaginal foreign body. Early diagnosis would prevent complications secondary to long-standing foreign bodies.

  5. Detection of protozoal Trichomonas vaginalis and abnormal vaginal flora in high vaginal smear

    Directory of Open Access Journals (Sweden)

    Wills G. Sheela

    2017-01-01

    Conclusions: This study reflects on our responsibility to create awareness among women regarding abnormal vaginal discharge through proper health education routine screening targeted treatment to envisage healthy quality life.

  6. Vaginal vault drainage after complicated single-port access laparoscopic-assisted vaginal hysterectomy

    Directory of Open Access Journals (Sweden)

    Soo-Jeong Lee

    2017-05-01

    Conclusion: Vaginal vault drainage could be a safe alternative that allows for the management of postoperative morbidity and retains the advantages of minimally invasive surgery after complicated SPA-LAVH.

  7. Lactobacilli Dominance and Vaginal pH: Why is the Human Vaginal Microbiome Unique?

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Miller

    2016-12-01

    Full Text Available The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N=21 mammals for pH and 14 mammals for lactobacilli abundance. We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4 to 7.8. Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99. Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

  8. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

    Science.gov (United States)

    Miller, Elizabeth A; Beasley, DeAnna E; Dunn, Robert R; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N = 21 mammals for pH and 14 mammals for lactobacilli relative abundance). We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4-7.8). Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli relative abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99). Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non

  9. Vaginal plethysmography in women with dyspareunia

    NARCIS (Netherlands)

    Wouda, JC; Hartman, PM; Bakker, RM; Bakker, JO; van de Wiel, HBM; Schultz, WCMW

    1998-01-01

    We investigated by means of vaginal plethysmography the extent to which the genital reactions of women with dyspareunia (N = 18) differed from those of women without dyspareunia (N = 16) during sexual arousal. In addition, we used questionnaires to investigate whether the genital reaction was correl

  10. Vaginal Lacerations from Consensual Intercourse in Adolescents

    Science.gov (United States)

    Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

    2011-01-01

    Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

  11. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media links Share this: Page Content To find out ...

  12. An isolated vaginal metastasis from rectal cancer

    Directory of Open Access Journals (Sweden)

    Ai Sadatomo

    2016-02-01

    Conclusion: We should keep the vagina within the field of view of pelvic MRI, which is one of the preoperative diagnostic tools for colorectal cancer. If female patients show gynecological symptoms, gynecological examination should be recommended. Isolated vaginal metastases are an indication for surgical resection, and adjuvant chemotherapy is also recommended.

  13. VAGINAL HYSTERECTOMY - CEFUROXIME, METRONIDAZOLE OR BOTH

    NARCIS (Netherlands)

    KAUER, FM; WIJMA, J; MANSON, WL

    1990-01-01

    A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients). I

  14. VAGINAL HYSTERECTOMY - CEFUROXIME, METRONIDAZOLE OR BOTH

    NARCIS (Netherlands)

    KAUER, FM; WIJMA, J; MANSON, WL

    1990-01-01

    A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients).

  15. VULVO VAGINAL CANDIDIASIS : IMPORTANCE OF SPECIES IDENTIFICATION

    Directory of Open Access Journals (Sweden)

    Swarajya Lakshmi

    2014-01-01

    Full Text Available OBJECTIVES : Vulvo Vaginal Candidiasis is a common nagging problem faced by 75% of women in reproductive age group. Present study was undertaken to determine the prevalence of Candida in patients suffering from vaginitis , to assess predisposing factors and correlate the symptoms with gram stain for presumptive diagnosis of Candidiasis. METHODS : A prospective study of the laboratory diagnosis of vulvovaginal candidiasis (VVC was carried out in 100 women presenting with symptoms suggestive of vaginosis in the reproductive age group. Investigation s included microscopy and culture for yeast. Candida is identified, based on growth on SDA, corn meal agar and Saba raud’s Triphenyl tetrazolium agar, and assimilation and fermentation of sugars. RESULTS : Candida was isolated in 33% of women. Clue cells on gram stain suggestive of bacterial vaginosis was seen in equal number of women, whereas mixed infection was found in 9%. Candida albicans accounted for 15% and nonalbicans species for 85% . O f the non albicans species, Candida glabrata was the commonest (4 2%. Pruritus with or without vaginal discharge and vaginal erythema were the most common symptoms and signs in women with positive Candida culture. CONCLUSION : On comparing the significance of gram stain and culture for presumptive diagnosis of candidiasi s, culture was more significant than gram stain alone. In present study, the rate of culture positivity was 33% and C. glabrata was the predominant species. VVC cannot be diagnosed by clinical criteria alone and requires confirmation by culture including i dentification of species.

  16. Lactobacilli Dominance and Vaginal pH: Why is the Human Vaginal Microbiome Unique?

    OpenAIRE

    Miller, Elizabeth A.; Beasley, DeAnna E.; Dunn, Robert R.; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain hu...

  17. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

    OpenAIRE

    Miller, Elizabeth A.; Beasley, DeAnna E.; Dunn, Robert R.; Archie, Elizabeth A

    2016-01-01

    The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain hu...

  18. In Vitro Activity of Tea Tree Oil Vaginal Suppositories against Candida spp. and Probiotic Vaginal Microbiota.

    Science.gov (United States)

    Di Vito, Maura; Mattarelli, Paola; Modesto, Monica; Girolamo, Antonietta; Ballardini, Milva; Tamburro, Annunziata; Meledandri, Marcello; Mondello, Francesca

    2015-10-01

    The aim of this work is to evaluate the in vitro microbicidal activity of vaginal suppositories (VS) containing tea tree oil (TTO-VS) towards Candida spp. and vaginal probiotics. A total of 20 Candida spp. strains, taken from patients with vaginitis and from an established type collection, including reference strains, were analysed by using the CLSI microdilution method. To study the action of VS towards the beneficial vaginal microbiota, the sensitivity of Bifidobacterium animalis subsp. lactis (DSM 10140) and Lactobacillus spp. (Lactobacillus casei R-215 and Lactobacillus acidophilus R-52) was tested. Both TTO-VS and TTO showed fungicidal activity against all strains of Candida spp. whereas placebo-VS or the Aloe gel used as controls were ineffective. The study of fractional fungicidal concentrations (FFC) showed synergistic interaction with the association between Amphotericin B and TTO (0.25 to 0.08 µg/ml, respectively) against Candida albicans. Instead, the probiotics were only affected by TTO concentration ≥ 4% v/v, while, at concentrations < 2% v/v, they remained viable. TTO-VS exhibits, in vitro, a selective fungicidal action, slightly affecting only the Bifidobacteriun animalis strain growth belonging to the vaginal microbiota. In vivo studies are needed to confirm the efficacy to prevent acute or recurrent vaginal candidiasis.

  19. [Improvement of vaginal relaxation by vaginal narrowing technique with double suturing].

    Science.gov (United States)

    Liu, Sanhu; Cen, Ying; Liu, Quan

    2009-12-01

    To investigate the surgical procedures and outcomes of curing the mild and medium vaginal relaxation by double suturing vaginal muscularis. From May 2005 to November 2008, 8 patients (aged 30-45 years old) with mild and medium vaginal relaxation were treated. All the patients were married and had reproductive history of natural childbirth. The double semiring suture was performed in the region 4 cm and 0.5 cm away from the vaginal orifice, respectively, forming the first and the second semicircle to make vagina outside 1/3 segments and vagina muscles tighten. The time of operation was 20-30 minutes (average 25 minutes). There was no obvious bleeding and injury of the rectum and urethra during operation. All the incisions healed by first intention. The vagina accommodated 2 fingers without scar on its mucosa 1-2 months after operation. Eight patients were followed up for 6-24 months and the patients resumed their sexual life 4-8 weeks after operation with satisfied improvement. The technique of double suturing vaginal muscularis is easy and simple to perform with mild injury, fast postoperative recovery, and less postoperative complications. It is one of the effective methods to treat mild and medium vaginal relaxation.

  20. Laparoscopic repair of vaginal evisceration: a case report.

    Science.gov (United States)

    Lledó, Jose Bueno; Roig, Manuel Planells; Serra, Alfonso Serralta; Astaburuaga, Carmen Rodero; Giménez, Fernando Dobón

    2002-12-01

    Vaginal evisceration, although rare, is usually present in postmenopausal women with a history of vaginal surgery and high-grade pelvic floor dysfunction. Operative management is directed toward resecting any compromised bowel, repairing vaginal defect, and correcting the defect in the pelvic floor, which is associated with most cases, either in the same intervention or in a second procedure. Laparoscopy allows for assessment of the viability of the compromised bowel and the vaginal defect suture with advantages common to minimally invasive techniques. We report the first case in the international literature of vaginal evisceration managed by laparoscopy.

  1. The vaginal microflora in relation to gingivitis

    Directory of Open Access Journals (Sweden)

    Weibel Marianne

    2009-01-01

    Full Text Available Abstract Background Gingivitis has been linked to adverse pregnancy outcome (APO. Bacterial vaginosis (BV has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty. Methods Vaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range: 18 to 46, and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species. BV was defined by Gram stain (Nugent criteria. Gingivitis was defined as bleeding on probing at ≥ 20% of tooth sites. Results A Nugent score of 0–3 (normal vaginal microflora was found in 83 women (46.1%, and a score of > 7 (BV in 49 women (27.2%. Gingivitis was diagnosed in 114 women (63.3%. Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01. Independent of gingival conditions, vaginal bacterial counts were higher (p Prevotella bivia (p Prevotella disiens (p P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p 1.0 × 104 cells and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p P. disiens (95%CI: 1.8–7.5, p P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p Conclusion Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.

  2. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    Directory of Open Access Journals (Sweden)

    Joanne Lester

    2015-03-01

    Full Text Available Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

  3. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    Science.gov (United States)

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors. PMID:25815692

  4. Descubriendo las prácticas de cuidado de adolescentes gestantes con infección vaginal Descobrindo as práticas de cuidado de adolescentes gestantes com infecção vaginal Discovering care practices of pregnant adolescents with vaginal infection

    Directory of Open Access Journals (Sweden)

    MARY LUZ MONROY RUBIANO

    qualitativo, de tipo etnográfico, baseado na etnoenfermagem da teoria transcultural de Leininger. A técnica de pesquisa esteve baseada no uso do questionário e analise etnográfica de Spradley, com uma média de três entrevistas a cada uma das sete participantes, até que houve suficiente informação. A amostra esteve caracterizada pela qualidade da informação fornecida. A partir da análise em profundidade se construíram três domínios e taxonomias: 1. Conhecimento da infecção vaginal, 2. Ações de proteção, 3. Conselhos recebidos. O estudo revelou que as adolescentes gestantes sabiam sobre a infecção vaginal, conheciam as causas e conseqüências relacionadas e estabeleciam medidas de proteção dirigidas a cuidar da infecção e evitar a reinfecção, tomando um tratamento baseado mais em conselhos informais que formais. O cuidado durante infecções vaginais entre adolescentes gestantes evidenciou a posta em prática dos conselhos recebidos das fontes informais e formais para o desaparecimento da infecção vaginal e a fim de evitar a reinfecção e as complicações para elas e para o filho. Verificaramse também as diferentes formas em que conheciam e estabeleciam práticas de cuidado durante a infecção vaginal e salientouse a ausência de conselhos formais do profissional em enfermagem.The study was aimed at discovering the meaning of care from the perspective of cultural beliefs and customs of pregnant adolescents with vaginal infection diagnosis who had prenatal control at the ESE Hospital San Rafael of the city of Girardot during the first quarter of 2007. Qualitative ethnographic design, based on ethnonursing of Leininger's transcultural theory. Interviews and Spradley's ethnographic analysis were used and an average of three interviews was applied to each one of the 7 participants, until saturation of information was achieved. The sample's representativeness was based on the quality of the information offered. From the in depth analysis, three

  5. [Total laparoscopic hysterectomy: retrospective analysis of 262 cases].

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    Nogueira-Silva, Cristina; Santos-Ribeiro, Samuel; Barata, Sónia; Alho, Conceição; Osório, Filipa; Calhaz-Jorge, Carlos

    2014-01-01

    Introdução: A histerectomia é a cirurgia ginecológica major mais frequentemente realizada nos países desenvolvidos, considerando-se três principais vias de abordagem: vaginal, abdominal e laparoscópica. Apesar de múltiplas vantagens, a histerectomia totalmente laparoscópica tem-se associado a controvérsia relativamente à taxa de complicações.Objectivos: Análise da nossa casuística de histerectomia totalmente laparoscópica e avaliação da taxa de complicações.Material e Métodos: Análise retrospetiva dos processos clínicos das doentes submetidas a histerectomia totalmente laparoscópica no nosso departamento, pela mesma equipa cirúrgica, entre abril de 2009 e março de 2013 (n = 262).Resultados: As doentes tinham em média 48,9 ± 9 anos e 49,2% tinha antecedentes de cirurgia abdomino-pélvica. O índice de massa corporal médio era 26,5 ± 4,5 kg/m2, sendo que 42% eram obesas ou tinham excesso de peso. O tempo operatório médio para realização da histerectomia totalmente laparoscópica foi 77,7 ± 27,5 minutos, diminuindo significativamente com o aumento da experiência da equipa cirúrgica. O peso médio da peça operatória foi 241 ± 168,4g e a duração média do internamento após a cirurgia foi 1,49 ±0,9 dias. A diferença entre a hemoglobina pré e pós-operatória foi 1,5 ± 0,8g/dL. A morbilidade major foi 1,5% (n = 4) e a minor 11,5% (n = 30). Salienta-se um caso de conversão para laparotomia e dois casos de deiscência da cúpula vaginal. Não ocorreu nenhuma lesão urinária ou gastrointestinal grave.Conclusões: Esta série demonstra que, se realizada por uma equipa cirúrgica adequadamente treinada, a histerectomia totalmente laparoscópica é segura e associada a baixa taxa de complicações.

  6. Complete vaginal outlet stenosis in a patient with Sheehan's syndrome.

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    Choo, Minji; Park, Hana; Yi, Kyong Wook

    2016-11-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

  7. Prevalência e fatores associados à percepção de ocorrência de corrimento vaginal patológico entre gestantes Prevalence of self-reported vaginal discharge and associated factors in pregnant women

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    Juraci A. Cesar

    2009-12-01

    Full Text Available Este estudo teve por objetivo medir a prevalência e identificar fatores associados à percepção de corrimento vaginal patológico por gestantes residentes em Rio Grande, Rio Grande do Sul, Brasil. Aplicou-se questionário padronizado a todas as parturientes nas maternidades do município em 2007. Utilizou-se teste do qui-quadrado para comparar proporções e análise multivariável por regressão de Poisson. A prevalência de corrimento vaginal foi de 40%. Análise ajustada mostrou as seguintes razões de prevalência: 1,6 (1,4-1,8 para adolescentes; 1,3 (1,1-1,6 para aquelas com até oito anos de escolaridade; 1,3 (1,1-1,5 para aquelas que ingeriram álcool; 2,0 (1,8-2,2 para aquelas que referiram corrimento vaginal em gestação anterior; 1,4 (1,3-1,6 para infecção urinária na gestação atual; prematuridade em gestação anterior mostrou-se protetor com RP = 0,8 (0,7-0,9. Os serviços de saúde deveriam priorizar diagnóstico e tratamento de corrimento vaginal entre gestantes adolescentes, de baixa renda familiar e escolaridade, com história prévia de corrimento em gravidez anterior e infecção urinária na gravidez atual.This study aims to determine the prevalence self-reported abnormal vaginal discharge and to identify associated risk factors in pregnant women in the municipality of Rio Grande, Rio Grande do Sul State, Brazil. A standardized questionnaire was applied to all pregnant women admitted for delivery in local maternity hospitals. The chi-square test was used to compare proportions, and Poisson regression was applied using multivariate analysis. Prevalence of vaginal discharge was 40%. Adjusted analysis showed the following prevalence ratios for vaginal discharge: 1.6 (1.4-1.8 for adolescents; 1.3 (1.1-1.6 for 8 years of schooling or less; 1.3 (1.1-1.5 for alcohol consumption; 2.0 (1.8-2.2 for vaginal discharge in the previous pregnancy; 1.4 (1.3-1.6 for urinary tract infection in the current pregnancy; and 0.8 (0

  8. Secretory Aspartyl Proteinases Cause Vaginitis and Can Mediate Vaginitis Caused by Candida albicans in Mice.

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    Pericolini, Eva; Gabrielli, Elena; Amacker, Mario; Kasper, Lydia; Roselletti, Elena; Luciano, Eugenio; Sabbatini, Samuele; Kaeser, Matthias; Moser, Christian; Hube, Bernhard; Vecchiarelli, Anna; Cassone, Antonio

    2015-06-02

    Vaginal inflammation (vaginitis) is the most common disease caused by the human-pathogenic fungus Candida albicans. Secretory aspartyl proteinases (Sap) are major virulence traits of C. albicans that have been suggested to play a role in vaginitis. To dissect the mechanisms by which Sap play this role, Sap2, a dominantly expressed member of the Sap family and a putative constituent of an anti-Candida vaccine, was used. Injection of full-length Sap2 into the mouse vagina caused local neutrophil influx and accumulation of the inflammasome-dependent interleukin-1β (IL-1β) but not of inflammasome-independent tumor necrosis factor alpha. Sap2 could be replaced by other Sap, while no inflammation was induced by the vaccine antigen, the N-terminal-truncated, enzymatically inactive tSap2. Anti-Sap2 antibodies, in particular Fab from a human combinatorial antibody library, inhibited or abolished the inflammatory response, provided the antibodies were able, like the Sap inhibitor Pepstatin A, to inhibit Sap enzyme activity. The same antibodies and Pepstatin A also inhibited neutrophil influx and cytokine production stimulated by C. albicans intravaginal injection, and a mutant strain lacking SAP1, SAP2, and SAP3 was unable to cause vaginal inflammation. Sap2 induced expression of activated caspase-1 in murine and human vaginal epithelial cells. Caspase-1 inhibition downregulated IL-1β and IL-18 production by vaginal epithelial cells, and blockade of the IL-1β receptor strongly reduced neutrophil influx. Overall, the data suggest that some Sap, particularly Sap2, are proinflammatory proteins in vivo and can mediate the inflammasome-dependent, acute inflammatory response of vaginal epithelial cells to C. albicans. These findings support the notion that vaccine-induced or passively administered anti-Sap antibodies could contribute to control vaginitis. Candidal vaginitis is an acute inflammatory disease that affects many women of fertile age, with no definitive cure and, in

  9. Association of vaginal dysbiosis and biofilm with contraceptive vaginal ring biomass in African women.

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    Hardy, Liselotte; Jespers, Vicky; De Baetselier, Irith; Buyze, Jozefien; Mwambarangwe, Lambert; Musengamana, Viateur; van de Wijgert, Janneke; Crucitti, Tania

    2017-01-01

    We investigated the presence, density and bacterial composition of contraceptive vaginal ring biomass and its association with the vaginal microbiome. Of 415 rings worn by 120 Rwandese women for three weeks, the biomass density was assessed with crystal violet and the bacterial composition of biomass eluates was assessed with quantitative polymerase chain reaction (qPCR). The biomass was visualised after fluorescence in situ hybridisation (FISH) and with scanning electron microscopy (SEM). The vaginal microbiome was assessed with Nugent scoring and vaginal biofilm was visualised after FISH. All vaginal rings were covered with biomass (mean optical density (OD) of 3.36; standard deviation (SD) 0.64). Lactobacilli were present on 93% of the rings, Gardnerella vaginalis on 57%, and Atopobium vaginae on 37%. The ring biomass density was associated with the concentration of A. vaginae (OD +0.03; 95% confidence interval (CI) 0.01-0.05 for one log increase; p = 0.002) and of G. vaginalis (OD +0.03; (95% CI 0.01-0.05; p = 0.013). The density also correlated with Nugent score: rings worn by women with a BV Nugent score (mean OD +0.26), and intermediate score (mean OD +0.09) had a denser biomass compared to rings worn by participants with a normal score (p = 0.002). Furthermore, presence of vaginal biofilm containing G. vaginalis (p = 0.001) and A. vaginae (p = 0.005) correlated with a denser ring biomass (mean OD +0.24 and +0.22 respectively). With SEM we observed either a loose network of elongated bacteria or a dense biofilm. We found a correlation between vaginal dysbiosis and the density and composition of the ring biomass, and further research is needed to determine if these relationships are causal. As multipurpose vaginal rings to prevent pregnancy, HIV, and other sexually transmitted diseases are being developed, the potential impact of ring biomass on the vaginal microbiota and the release of active pharmaceutical ingredients should be researched in depth.

  10. Instrumental vaginal delivery--back to basics.

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    Keriakos, R; Sugumar, S; Hilal, N

    2013-11-01

    Assisted vaginal delivery using forceps or a vacuum extractor is an essential part of obstetric practice. Operative vaginal delivery rates in the UK have remained stable between 10% and 15%, yielding safe and satisfactory outcomes for the majority of mothers and their babies. However, there has been an increase in medico-legal cases due to an increasing awareness of the potential morbidity for both the mother and the baby. There are many factors that can play a part in both the maternal and fetal complications resulting from instrumental deliveries. The aim of this educational review is to address these factors and identify measures to reduce them by adherence to the basics and relevant evidence.

  11. Vaginal Evisceration: An Unexpected Complication of Conization

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    Ali Ghassani

    2014-01-01

    Full Text Available Background. Large loop excision of the transformation zone (LLETZ is routinely performed for the management of high grade intracervical neoplasia (CIN. Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management. Case. A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair. Conclusions. Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management.

  12. [Vaginal metastasis of renal carcinoma (author's transl)].

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    Carl, P; Marx, F J

    1977-11-01

    Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear.

  13. Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

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    Vanessa S. Pereira

    2014-10-01

    Full Text Available Background: The proper evaluation of the pelvic floor muscles (PFM is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05. Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90. In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively. Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.

  14. Ultra-low-dose vaginal estrogen tablets for the treatment of postmenopausal vaginal atrophy.

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    Simon, J A; Maamari, R V

    2013-08-01

    Vaginal atrophy is a common chronic condition affecting up to 57% of postmenopausal women. The decrease in estrogen following cessation of menses can lead to bothersome symptoms that include vaginal dryness and irritation, pain and burning during urination (dysuria), urinary tract infections, and pain (dyspareunia) and bleeding during sexual activities. These symptoms can be safely and effectively managed with the use of local estrogen therapy, which reduces the risks associated with long-term systemic hormone therapy. The ultra-low-dose 10 μg estradiol vaginal tablet is the lowest approved dose available and has an annual estradiol exposure of only 1.14 mg. Its development addresses recommendations from regulatory agencies and women's health societies regarding the use of the lowest hormonal dose. The 10 μg vaginal tablet displays minimal estradiol absorption, causes no increased risk of endometrial hyperplasia or carcinoma, and provides significant symptom relief. The clinical evidence presented here may offer greater reassurance to health-care professionals and postmenopausal women that vaginal atrophy can be treated safely and effectively.

  15. Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections.

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    Alam, Mohd Aftab; Ahmad, Farhan Jalees; Khan, Zeenat Iqbal; Khar, Roop Krishen; Ali, Mushir

    2007-12-14

    An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4), which is an attribute of a healthy vagina. The effervescent mixture (citric acid and sodium bicarbonate) along with a superdisintegrant (Ac-Di-sol) was used to enhance the swellability of the bioadhesive tablet. The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as an antibacterial) were used in the formulation along with Lactobacillus acidophilus spores to treat mixed vaginal infections. From the ex vivo retention study it was found that the bioadhesive polymers hold the tablet for more than 24 hours inside the vaginal tube. The hardness of the acid-buffering bioadhesive vaginal tablet was optimized, at 4 to 5 kg hardness the swelling was found to be good and the cumulative release profile of the developed tablet was matched with a marketed conventional tablet (Infa-V). The in vitro spreadability of the swelled tablet was comparable to the marketed gel. In the in vitro antimicrobial study it was found that the acid-buffering bioadhesive tablet produces better antimicrobial action than marketed intravaginal drug delivery systems (Infa-V, Candid-V and Canesten 1).

  16. Pregnancy and Vaginal Delivery after Sacrohysteropexy

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    Deniz Balsak

    2015-01-01

    Full Text Available Pregnancy and birth after a Pelvic Organ Prolapse (POP surgery is a rare condition and less is known about the method for delivery. A 31-year-old women with gravida 3 para 3 underwent abdominal sacrohysteropexy and transobturatuar tape (TOT procedures for stage III prolapse who delivered via vaginal birth and showed no relapse. Sacrohysteropexy is a good option for women with POP who desire fertility with a long term follow-up period.

  17. [Saforelle - a new approach to treat vaginitis].

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    Karamisheva, V; Nachev, A

    2015-01-01

    Infections of the vulva and vagina are one of the most common gynecological diseases. They can be determined by a variety of physical, chemical and biological factors. The main risk factors contributing to vaginitis are aerobic and anaerobic bacterias, fungal and viral infections, and irritants. Subjective complaints are pruritus, vulvar and/or perivulvar erytema and different in volume and characterization discharge. Excepting etiological treatment in most cases it is necessary to use additional agents, for example Saforelle.

  18. Mesenteric venous thrombosis following vaginal delivery

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    Roopa Sachidananda

    2013-01-01

    Full Text Available Acute abdomen following an uneventful vaginal delivery is a rare occurrence. Diagnosis may be delayed due to pregnancy related comorbid conditions such as preeclampsia, hemolysis elevated, liver enzymes, low platelet (HELLP count syndrome, acute fatty liver of pregnancy (AFLP, etc. We describe a 21-year-old woman with pre-eclampsia, HELLP syndrome and AFLP with acute abdomen that was managed successfully in our intensive care unit.

  19. Vaginal agenesis: Experience with sigmoid colon neovaginoplasty

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    Rawat Jiledar

    2010-01-01

    Full Text Available Aim: Objective of this study is to report our experience with sigmoid vaginoplasty in adolescents. Materials and Methods: A retrospective study of children with vaginal atresia and Mayer-Rokitansky-Kuster-Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the cases. Results: Eight children were studied over a period of 7 years. The postoperative complications were ileus in 2, mucosal prolapse of the neovagina in 1, and minor wound infection in 1 patient. Seven patients are on regular follow-up. All the neovaginas were patent and functional. One patient had unacceptable perineal appearance, that is, badly scarred perineum as a late complication. None of the patients had vaginal stenosis or excessive mucus discharge, during follow-up visits. Out of the 7 patients, 2 patients are sexually active and satisfied. Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, and short recovery time.

  20. Comparison of detection methods for vaginal lactobacilli.

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    Smidt, I; Kiiker, R; Oopkaup, H; Lapp, E; Rööp, T; Truusalu, K; Štšepetova, J; Truu, J; Mändar, R

    2015-01-01

    Vaginal lactobacilli offer protection against microbiota imbalance and genitourinary tract infections. We compared vaginal lactobacilli in 50 Estonian women of child-bearing age applying culture-based methods, quantitative PCR and next-generation sequencing (NGS). The culture-based methods found three different lactobacilli: Lactobacillus crispatus, Lactobacillus jensenii and Lactobacillus gasseri. Using NGS revealed the presence of L. crispatus in 76%, Lactobacillus iners in 52%, L. jensenii in 47% and L. gasseri in 33% of the samples. According to qPCR, L. iners was present in 67% and L. crispatus in 64% of the samples. The proportions of L. crispatus revealed by qPCR and NGS were in good correlation (R=0.79, P0.05). Good concordance for L. crispatus was also found between the results of the culture-based method and qPCR. Finally, good overlap between the results of the culture-based method and NGS was revealed: in case of a positive NGS result for L. crispatus, the same species was isolated in 95% of samples. The corresponding percentages were 82% for L. jensenii and 86% for L. gasseri. Our data indicate fairly general concordance of the three methods for detecting vaginal lactobacilli, except for L. iners. This points out the importance of standardisation of techniques, and the respective studies should involve cultures applying a medium suitable for the fastidious L. iners.

  1. Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli

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    Virginia Ocaña

    2006-01-01

    Full Text Available Objective. To study the antimicrobial susceptibility of six vaginal probiotic lactobacilli. Methods. The disc diffusion method in Müeller Hinton, LAPTg and MRS agars by the NCCLS (National Committee for Clinical Laboratory Standards procedure was performed. Due to the absence of a Lactobacillus reference strains, the results were compared to those of Staphylococcus aureus ATCC29213. Minimal Inhibitory Concentration (MIC with 21 different antibiotics in LAPTg agar and broth was also determined. Results. LAPTg and MRS agars are suitable media to study antimicrobial susceptibility of lactobacilli. However, the NCCLS procedure needs to be standardized for this genus. The MICs have shown that all Lactobacillus strains grew at concentrations above 10 μg/mL of chloramphenicol, aztreonam, norfloxacin, ciprofloxacin, ceftazidime, ceftriaxone, streptomycin and kanamycin. Four lactobacilli were sensitive to 1 μg/mL vancomycin and all of them were resistant to 1000 μg/mL of metronidazole. Sensitivity to other antibiotics depended on each particular strain. Conclusions. The NCCLS method needs to be standardized in an appropriate medium to determine the antimicrobial susceptibility of Lactobacillus. Vaginal probiotic lactobacilli do not display uniform susceptibility to antibiotics. Resistance to high concentrations of metronidazole suggests that lactobacilli could be simultaneously used with a bacterial vaginosis treatment to restore the vaginal normal flora.

  2. An innovative approach to treating vaginal mesh exposure after abdominal sacral colpopexy: endoscopic resection of mesh and platelet-rich plasma; initial experience in three women.

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    Castellani, Daniele; Valloni, Alessandra; Piccirilli, Angela; Paradiso Galatioto, Giuseppe; Vicentini, Carlo

    2017-02-01

    Polypropylene mesh exposure is uncommon after abdominal sacral colpopexy (ASC), but in case of symptomatic vaginal mesh exposure, surgery is needed. When treating it, care must be taken to completely remove the exposed mesh (EM), saving as much vaginal tissue as possible to avoid a subsequent shortened and narrowed vagina. In this video, we present a minimally invasive technique for treating EM after ASC using endoscopic mesh resection and autologous platelet-rich plasma (PRP) technology. Three women were referred to our outpatient clinic for vaginal vault mesh exposure after laparoscopic ASC with concomitant hysterectomy. All women underwent endoscopic bipolar PlasmaKinetic resection (BPR) of EM, and PRP gel was delivered in the surgical site to cover the gap left by the resection. Mean operative time was 39.6 min. Surgery was uneventful in all cases. All women recovered sexual function, and nobody experienced relapsed pelvic organ prolapse at 1-year follow-up. Our preliminary results show that BPR and PRP are safe, effective, and feasible for treating vaginal mesh exposure with conservation of anatomy and sexual function.

  3. Effect of Vaginal or Systemic Estrogen on Dynamics of Collagen Assembly in the Rat Vaginal Wall1

    Science.gov (United States)

    Montoya, T. Ignacio; Maldonado, P. Antonio; Acevedo, Jesus F.; Word, R. Ann

    2014-01-01

    ABSTRACT The objective of this study was to compare the effects of systemic and local estrogen treatment on collagen assembly and biomechanical properties of the vaginal wall. Ovariectomized nulliparous rats were treated with estradiol or conjugated equine estrogens (CEEs) either systemically, vaginal CEE, or vaginal placebo cream for 4 wk. Low-dose local CEE treatment resulted in increased vaginal epithelial thickness and significant vaginal growth without uterine hyperplasia. Furthermore, vaginal wall distensibility increased without compromise of maximal force at failure. Systemic estradiol resulted in modest increases in collagen type I with no change in collagen type III mRNA. Low-dose vaginal treatment, however, resulted in dramatic increases in both collagen subtypes whereas moderate and high dose local therapies were less effective. Consistent with the mRNA results, low-dose vaginal estrogen resulted in increased total and cross-linked collagen content. The inverse relationship between vaginal dose and collagen expression may be explained in part by progressive downregulation of estrogen receptor-alpha mRNA with increasing estrogen dose. We conclude that, in this menopausal rat model, local estrogen treatment increased total and cross-linked collagen content and markedly stimulated collagen mRNA expression in an inverse dose-effect relationship. High-dose vaginal estrogen resulted in downregulation of estrogen receptor-alpha and loss of estrogen-induced increases in vaginal collagen. These results may have important clinical implications regarding the use of local vaginal estrogen therapy and its role as an adjunctive treatment in women with loss of vaginal support. PMID:25537371

  4. Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer

    Science.gov (United States)

    2014-04-21

    Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

  5. Urinary tract infection in vaginitis: a condition often overlooked.

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    Amatya, R; Bhattarai, S; Mandal, P K; Tuladhar, H; Karki, B M S

    2013-03-01

    Despite the differences between the organisms that cause vaginitis and urinary tract infections (UTI), it is possible that women with vaginitis develop UTI. The main objective of the study was to find the association of the common types of infectious vaginitis with UTI. Cross sectional study was conducted for six months in a referral hospital at Lalitpur, Nepal. Three hundred and sixmid-stream urine samples and high vaginal swabs (HVS) collected from non pregnant women were investigated by standard microbiological techniques. Among the women with bacterial vaginosis (BV), 75% also had UTI. Similarly, 46% and 13% of those with vaginal candidiasis and trichomoniasis respectively had concurrent UTI. Considering this strong association of UTI and vaginitis, women with either of these conditions should be tested for the other.

  6. Isolated Vaginal Neurofibroma Presenting as Vaginal Wall Cyst: A Rare Case Report With Review of Literature

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    Sarita Nibhoria

    2016-05-01

    Full Text Available Neurofibromas commonly involve peripheral nervous system. Isolated neurofibroma of vagina is very rare tumor and usually associated with Von Recklinghausen’s disease. Vulva is the most frequent location of neurofibroma of genital tract followed by clitoris and labia. We present a rare case of neurofibroma of vaginal wall presented as vaginal cyst in a 52 year old female with no history of any other symptoms related to Recklinghausen’s disease. Excision biopsy was done and on the histopathological examination non-encapsulated, well circumscribed mass composed of spindle shaped cells with wavy nuclei and bland nuclear chromatin was noted. Immunohistochemistry revealed strong positivity with S-100.

  7. Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis

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    Razzak, Mohammad Sabri A.; Al-Charrakh, Alaa H.; AL-Greitty, Bara Hamid

    2011-01-01

    Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effects of some antibiotics on Lactobacilli isolates. Materials and Methods: In this study (110) vaginal swabs were obtained from women suffering from vaginitis who admitted to Babylon Hospital of Maternity and Paediatrics in Babylon province, Iraq. The study involved the role of intrauterine device among married women with vaginitis and also involved isolation of opportunistic bacterial isolates among pregnant and non pregnant women. This study also involved studying probiotic role of Lactobacilli by production of some defense factors like hydrogen peroxide, bacteriocin, and lactic acid. Results: Results revealed that a total of 130 bacterial isolates were obtained. Intrauterine device was a predisposing factor for vaginitis. The most common opportunistic bacterial isolates were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Klebsiella pneumoniae. All Lactobacilli were hydrogen peroxide producers while some isolates were bacteriocin producers that inhibited some of opportunistic pathogens (S. aureus, E. coli). Lactobacilli were sensitive to erythromycin while 93.3% of them were resistant to ciprofloxacin and (40%, 53.3%) of them were resistant to amoxicillin and gentamycin respectively. Results revealed that there was an inverse relationship between Lactobacilli presence and organisms causing vaginitis. This may be attributed to the production of defense factors by Lactobacilli. Conclusion: The types of antibiotics used to treat vaginitis must be very

  8. Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis.

    Science.gov (United States)

    Razzak, Mohammad Sabri A; Al-Charrakh, Alaa H; Al-Greitty, Bara Hamid

    2011-04-01

    Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effects of some antibiotics on Lactobacilli isolates. In this study (110) vaginal swabs were obtained from women suffering from vaginitis who admitted to Babylon Hospital of Maternity and Paediatrics in Babylon province, Iraq. The study involved the role of intrauterine device among married women with vaginitis and also involved isolation of opportunistic bacterial isolates among pregnant and non pregnant women. This study also involved studying probiotic role of Lactobacilli by production of some defense factors like hydrogen peroxide, bacteriocin, and lactic acid. Results revealed that a total of 130 bacterial isolates were obtained. Intrauterine device was a predisposing factor for vaginitis. The most common opportunistic bacterial isolates were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Klebsiella pneumoniae. All Lactobacilli were hydrogen peroxide producers while some isolates were bacteriocin producers that inhibited some of opportunistic pathogens (S. aureus, E. coli). Lactobacilli were sensitive to erythromycin while 93.3% of them were resistant to ciprofloxacin and (40%, 53.3%) of them were resistant to amoxicillin and gentamycin respectively. Results revealed that there was an inverse relationship between Lactobacilli presence and organisms causing vaginitis. This may be attributed to the production of defense factors by Lactobacilli. The types of antibiotics used to treat vaginitis must be very selective in order not to kill the beneficial bacteria

  9. The treatment of postmenopausal vaginal atrophy with ovestin

    NARCIS (Netherlands)

    Kicovic, P.M.; Cortesprieto, J.; Milojevic, S.; Haspels, A.A.; Aljinovic, A.

    1980-01-01

    Seventy-four postmenopausal women presenting with vaginal atrophy were treated with either Ovestin® vaginal cream (Group A, 23 women: 1 mg/day E3; Group B, 30 women: 0.5 mg/day E3) or vaginal suppositories (Group C, 21 women: 0.5 mg/day E3), applied daily for 3 wk (A and B) or 2 wk (C) before

  10. Treatment of vaginal stenosis with fasciocutaneous Singapore flap.

    Science.gov (United States)

    Clifton, Marisa M; Gurunluoglu, Raffi; Pizarro-Berdichevsky, Javier; Baker, Todd; Vasavada, Sandip P

    2017-03-01

    Vaginal stenosis is an unfortunate complication that can occur after pelvic radiation therapy for gynecologic or colorectal malignancies. Treatment is challenging and can require significant reconstructive surgery. The objective of this video is to present a case of vaginal stenosis after radiation and describe vaginal reconstruction with a fasciocutaneous Singapore flap. We describe the case of a 42-year-old woman with a history of stage 3 colorectal cancer who underwent partial colectomy, chemotherapy, and pelvic radiation. She subsequently developed a rectovaginal fistula requiring repair with a right-sided gracilis flap. When her stenosis recurred, she underwent vaginal reconstruction with a medial thigh flap. The Singapore flap is a pudendal thigh flap centered on the labial crural fold with a base at the perineal body. As the cutaneous innervation is spared, this flap is sensate. This technique is one option for patients with complex vaginal stenosis who have failed conservative management. However, it is imperative the patient perform vaginal dilation postoperatively and maintain close follow-up with her surgeon, as vaginal stenosis can recur. Postradiation vaginal stenosis is a complex condition to treat; however, vaginal reconstruction with a thigh flap can provide excellent cosmetic and functional results.

  11. Vaginal pH-balanced gel for the control of atrophic vaginitis among breast cancer survivors: a randomized controlled trial.

    Science.gov (United States)

    Lee, Yoo-Kyung; Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh-Hyun; Song, Yong-Sang; Kang, Soon-Beom

    2011-04-01

    To estimate the effects of vaginal pH-balanced gel on vaginal symptoms and atrophy in breast cancer survivors treated with chemotherapy or endocrine therapy. This was a randomized, double-blind, placebo-controlled study. Breast cancer survivors who experienced menopause after chemotherapy or endocrine therapy were voluntarily enrolled and randomly administered vaginal topical pH-balanced gel or placebo three times per week for 12 weeks. Vaginal dryness and dyspareunia were measured by visual analog scale, vaginal health index, and vaginal pH. The endometrium and ovary were evaluated by transvaginal ultrasonography. Among 98 enrolled women, 86 completed the treatment (n=44 and n=42 for the pH-balanced gel group and placebo group, respectively). Vaginal dryness and dyspareunia improved more in the pH-balanced gel group than in the placebo group (baseline mean 8.20 compared with end-point mean 4.23 [P=.001] and 8.23 compared with 5.48 [P=.040], respectively). Vaginal pH-balanced gel reduced the vaginal pH (gel: baseline mean 6.49 compared with end-point mean 5.00; placebo: 6.22 compared with 5.69 [Pvaginal maturation index (gel: 45.5 compared with 51.2; placebo: 46.4 compared with 47.9 [Pvaginal health index (gel: 15.8 compared with 21.1; placebo 14.3 compared with 16.98 [P=.002]). There was no significant difference in adverse effects between the two groups except for mild irritation at the early time of pH-balanced gel administration. Vaginal pH-balanced gel could relieve vaginal symptoms and improve vaginal health in breast cancer survivors who have experienced menopause after cancer treatment. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00607295. I.

  12. 78 FR 19271 - Draft Guidance for Industry on Bioequivalence Recommendations for Metronidazole Vaginal Gel...

    Science.gov (United States)

    2013-03-29

    ... Recommendations for Metronidazole Vaginal Gel; Availability AGENCY: Food and Drug Administration, HHS. ACTION... guidance for industry entitled ``Bioequivalence Recommendations for Metronidazole Vaginal Gel.'' The... abbreviated new drug applications (ANDAs) for metronidazole vaginal gel. DATES: Although you can comment...

  13. Vaginal fold histology reduces the variability introduced by vaginal exfoliative cytology in the classification of mouse estrous cycle stages.

    Science.gov (United States)

    Gal, Arnon; Lin, Po-Ching; Barger, Anne M; MacNeill, Amy L; Ko, CheMyong

    2014-12-01

    Vaginal exfoliative cytology is commonly used in biomedical and toxicological research to classify the stages of the rodent estrous cycle. However, mouse vaginal exfoliative cytology is commonly used as a stand-alone tool and has not been evaluated in reference to vaginal histology and serum sex hormone levels. In this study, the direct and Giemsa-stained methods of vaginal exfoliative cytology were compared in reference to vaginal fold histology and serum sex hormone levels. Both methods predicted the estrous stages similarly with mean discordance rates of 55%, 77%, 46%, and 31%, for diestrus, proestrus, estrus, and metestrus, respectively. From these results, we conclude that vaginal exfoliative cytology may be used as a general guide to determine the desired estrous stage end point and that a definitive confirmation of the estrous stage should be obtained from evaluation of vaginal fold histology. Confirmation of the stage of the estrous cycle by vaginal fold histology will decrease the variability otherwise introduced by misclassification of estrous cycle stages with vaginal exfoliative cytology. © 2014 by The Author(s).

  14. Adenocarcinoma arising from vaginal stump: unusual vaginal carcinogenesis 7 years after hysterectomy due to cervical intraepithelial neoplasia.

    Science.gov (United States)

    Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya

    2013-11-01

    Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.

  15. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study.

    Science.gov (United States)

    Biglia, Nicoletta; Peano, Elisa; Sgandurra, Paola; Moggio, Giulia; Panuccio, Enrico; Migliardi, Marco; Ravarino, Nicoletta; Ponzone, Riccardo; Sismondi, Piero

    2010-06-01

    The study aim is to evaluate the efficacy and safety of two low-dose vaginal estrogen treatments (ETs) and of a non-hormonal vaginal moisturizer in postmenopausal breast cancer survivors with urogenital atrophy. Eighteen patients receiving estriol cream 0.25 mg (n = 10) or estradiol tablets 12.5 microg (n = 8) twice/week for 12 weeks were evaluated and compared with eight patients treated with polycarbophil-based moisturizer 2.5 g twice/week. Severity of vaginal atrophy was assessed using subjective [Vaginal Symptoms Score (VSS), Profile of Female Sexual Function (PFSF)] and objective [Vaginal Health Index (VHI), Karyopycnotic Index (KI)] evaluations, while safety by measuring endometrial thickness and serum sex hormones levels. After 4 weeks, VSS and VHI were significantly improved by both vaginal ETs, with further improvement after 12 weeks. PFSF improved significantly only in estriol group (p = 0.02). Safety measurements did not significantly change. Vaginal moisturizer improved VSS at week 4 (p = 0.01), but score returned to pre-treatment values at week 12; no significant modification of VHI, KI, PFSF was recorded. Both low-dose vaginal ET are effective for relieving urogenital atrophy, while non-hormonal moisturizer only provides transient benefit. The increase of serum estrogens levels during treatment with vaginal estrogen at these dosages is minimal.

  16. Vaginal seeding or vaginal microbial transfer from the mother to the cesarean born neonate

    DEFF Research Database (Denmark)

    Haahr, Thor; Glavind, Julie; Axelsson, Paul

    2017-01-01

    Recent evidence suggests cesarean delivery (CD) to be a risk factor for inflammatory and metabolic diseases such as asthma, allergies and other chronic immune disorders in the child. One hypothetical pathogenesis of these associations has been proposed to be a disruption of the neonatal colonizat...... to children delivered vaginally. This article is protected by copyright. All rights reserved....

  17. Ovestin vaginal cream and suppositories for the treatment of menopausal vaginal atrophy.

    Science.gov (United States)

    Trevoux, R; van der Velden, W H; Popović, D

    1982-01-01

    Eighty-two postmenopausal women with vaginal atrophy and associated symptoms were treated with either Ovestin vaginal cream (54 women) or vaginal suppositories (28 women) containing 0.5 mg of E3/dose, daily for 3 weeks. A maintenance dose of 0.5 mg of E3 twice weekly was applied by all patients for 5 weeks, and by 27 of them for up to 16 weeks. Variables studied were clinical and colposcopic findings, the Maturation Index (MI) and Maturation Value (MV), cervical mucus ferning (F) and spinnbarkeit (S) and endometrial biopsies (obtained pretreatment and after 3 weeks in 15 of the patients). Furthermore, the bio-availability of circulating unconjugated E3 for up to 8 hours following a single dose of Ovestin cream was studied in 10 of the patients. Clinical and colposcopic findings indicated that the treatment had a very favourable effect in all patients. This was reflected in the pronounced change in vaginal smears, indicating a strong oestrogenic effect. There was a slight to moderate effect on cervical mucus. Endometrial biopsies showed that endometrium remained atrophic in all 15 patients in whom biopsies were obtained. A maintenance dose of 0.5 mg of E3 twice weekly appeared to be sufficient to maintain the beneficial effect. Tolerance was good, and patients commented favourably on the treatment.

  18. Directed shift of vaginal microbiota induced by vaginal application of sucrose gel in rhesus macaques

    Directory of Open Access Journals (Sweden)

    Kai-tao Hu

    2015-04-01

    Conclusions: Rhesus macaques can be used as animal models of bacterial vaginosis to develop drugs and test treatment efficacy. Furthermore, the topical application of sucrose gel induced the shifting of vaginal flora of rhesus macaques from a BV kind of flora to a lactobacilli-dominating flora.

  19. Induced vaginal birth after previous caesarean section

    Directory of Open Access Journals (Sweden)

    Akylbek Tussupkaliyev

    2016-11-01

    Full Text Available Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administration of E1 prostaglandin (Misoprostol, and intravenous infusion of Oxytocin-Richter. The assessment of rediness of parturient canals was conducted by Bishop’s score; the labour course was assessed by a partogram. The effectiveness of labour induction techniques was assessed by the number of administered doses, the time of onset of regular labour, the course of labour and the postpartum period and the presence of complications, and the course of the early neonatal period, which implied the assessment of the child’s condition, described in the newborn development record. The foetus was assessed by medical ultrasound and antenatal and intranatal cardiotocography (CTG. Obtained results were analysed with SAS statistical processing software. Results The overall percentage of successful births with intravaginal administration of Misoprostol was 93 per cent (83 of cases. This percentage was higher than in the amniotomy group (relative risk (RR 11.7 and was similar to the oxytocin group (RR 0.83. Amniotomy was effective in 54 per cent (39 of cases, when it induced regular labour. Intravenous oxytocin infusion was effective in 94 per cent (89 of cases. This percentage was higher than that with amniotomy (RR 12.5. Conclusions The success of vaginal delivery after previous Caesarean section can be achieved in almost 70 per cent of cases. At that, labour induction does not decrease this indicator and remains within population boundaries.

  20. Syndromic Diagnosis in Evaluation of Women with Symptoms of Vaginitis.

    Science.gov (United States)

    Nwankwo, Theophilus Ogochukwu; Aniebue, Uzochukwu Uzoma; Umeh, Uchenna Anthony

    2017-01-01

    This review aims to determine the effectiveness of the use of syndrome diagnosis in the evaluation of vaginitis and to make suggestions based on the review findings. Vaginal discharge as the main symptom of vaginitis is unspecific. A randomized study of symptom-based diagnosis and treatment of vaginitis in the USA favored symptoms used for treatment; however, this was only a pilot study. Hence, a population-based study is necessary to validate these findings. Most of the study that assessed treatment of vaginitis in pregnancy reported low diagnostic sensitivity and specificity for bacterial vaginosis and vaginal candidiasis and a wide range for trichomonas vaginalis reflecting ineffectiveness of syndrome-based treatment in pregnancy. A systematic review of the web for relevant literature was made, and appropriate articles were extracted and reviewed. Sensitivity, specificity, and positive values were used, where applicable to determine effectiveness. Forty-three full articles and abstracts were reviewed. Studies that validated or applied WHO algorithm for treatment of vaginitis reported high sensitivity (91.5-100%) but moderate to low specificity (0-27.5%) among women with vaginal symptoms. Studies that focused on symptoms for diagnosis of the three main etiologic agents of vaginitis reported low sensitivity and specificity, while such studies in pregnancy reported sensitivity and specificity ranging from 35.4 to 54% for TV, 11 to 100% for BV, and 0 to 56.2% for trichomonas vaginalis, bacterial vaginosis, and vaginal candidiasis, respectively. Studies that added point of care test reported higher sensitivity and specificity and positive predictive value. The use of WHO syndrome-based algorithm or its modification for treatment of vaginitis though moderately effective has the potential for overtreatment and physician error. Point of care testing and laboratory investigation are essential for productive intervention especially in pregnancy.

  1. Simple strategies for vaginal health promotion in cancer survivors.

    Science.gov (United States)

    Carter, Jeanne; Goldfrank, Deborah; Schover, Leslie R

    2011-02-01

    With the population of cancer survivors nearing 12 million, an ever-increasing number of women will face vaginal health issues related to their disease and/or treatment. Abrupt menopause triggered by cancer treatment, for example, can cause intense and prolonged estrogen deprivation symptoms, including vaginal dryness and discomfort. Simple strategies to promote vaginal health are available. To provide a comprehensive overview of vaginal health issues caused by estrogen deprivation in female cancer patients/survivors and provide recommendations to identify, treat, and promote vaginal health. We describe a treatment algorithm, based on scientific literature and supported by clinical experience, found to be effective in treating these patients at two major cancer centers. We also provide examples of handouts for patient education on vaginal health promotion. Evidence-based medicine and psychosocial literature, in addition to clinical experience at two major cancer centers. Simple, non-hormonal interventions for sexual dysfunction are often overlooked. Several studies show that education on vaginal lubricants, moisturizers, and dilator use (as needed) can decrease the morbidity of vaginal atrophy. These studies also provide support for our clinical treatment recommendations. Our goal in this article is to increase awareness of these strategies and to provide assistance to general gynecologists and oncologists caring for cancer patients and survivors. Dedicating a small amount of time to educate female cancer survivors about methods to promote vaginal health can result in the reduction or elimination of vaginal discomfort. Non-hormonal vaginal health strategies often appear sufficient to remedy these issues. However, large randomized trials are needed, varying the format and components of the treatment program and exploring efficacy in various groups of female cancer survivors. © 2010 International Society for Sexual Medicine.

  2. Factors Influencing Selection of Vaginal, Open Abdominal, or Robotic Surgery to Treat Apical Vaginal Vault Prolapse

    Science.gov (United States)

    Anand, Mallika; Weaver, Amy L.; Fruth, Kristin M.; Gebhart, John B.

    2016-01-01

    Objectives To determine factors influencing selection of Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), or robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery between January 1, 2000, and June 30, 2012, at our institution. Baseline characteristics and explicit selection factors were abstracted from the electronic medical records. Factors were compared between groups using χ2 tests for categorical variables, ANOVA for continuous variables, and Kruskal-Wallis tests for ordinal variables. Results Among the 512 patients identified who met inclusion criteria, the MMC group (n=174) had more patients who were older, American Society of Anesthesiologists class 3+ or greater, had anterior vaginal prolapse grade 3+, desired to avoid abdominal surgery, and did not desire a functional vagina. Patients in the ASC (n=237) and RSC (n=101) groups had more failed prolapse surgeries, suspected abdominopelvic pathologic processes, and chronic pain. Advanced prolapse was more frequently cited as an explicit selection factor for ASC than for either MMC or RSC. Conclusions The most common factors that influenced the type of apical vaginal vault prolapse surgery overlapped with characteristics that differed at baseline. In general, MMC was chosen for advanced anterior vaginal prolapse and baseline characteristics that increased surgical risks, ASC for advanced apical prolapse, and ASC or RSC for recurrent prolapse, suspected abdominal pathology, and patients with chronic pain or lifestyles including heavy lifting. Thus, efforts should be made to attempt to control for selection bias when comparing these procedures. PMID:26945273

  3. Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors.

    Science.gov (United States)

    Mendez, Lucas C; Paudel, Moti; Wronski, Matt; Ravi, Ananth; Barbera, Lisa; Leung, Eric

    2017-05-18

    To evaluate the dosimetric performance of multi-channel vaginal cylinder (MCVC) against interstitial brachytherapy (ISBT) for the treatment of vaginal tumors. Vaginal tumors with extension of > 0.5 cm and ≤ 2 cm from the lateral vaginal wall and/or ≤ 1 cm in height above the vaginal vault were retrospectively selected from a ISBT registry trial database. The selected patients were treated with ISBT and targets included the intermediate (IRCTV) or high-risk (HRCTV) clinical target volumes. For technique comparison, a 35 mm MCVC was registered with the interstitial intra-vaginal cylinder. Bladder and rectum contours were transferred from the ISBT to the MCVC-BT plans. Vaginal mucosa was achieved by 3 mm uniform expansion from cylinder surface. Both the ISBT and MCVC-BT plans were optimized using the Inverse Planning Simulated Annealing optimization algorithm. After normalizing target D90 to 700 cGy, dose to organs at risk were measured and compared between ISBT and MCVC plans. Six interstitial patient plans met the inclusion criteria for this study. Four patients had vaginal primaries and two recurrent cancers in the vagina. Lower doses to bladder and rectum were seen with ISBT plans. In half of the MCVC plans, the rectal dose met the recommended constraints. For plans in which the rectal constraint was not met, the target volumes were abutting the rectum and had a cranial-caudal length ≥ 5 cm. Dose to vaginal mucosa was lower in ISBT plans directed to the HRCTVs, although no difference was seen in circumferential IRCTVs. Overall, ISBT results in decreased dose to OARs as compared to MCVC. However, MCVC BT results in acceptable doses to OARs with possible improvement in vaginal doses for circumferential targets. Careful consideration to tumor geometry and location may help guide optimal techniques in vaginal tumor brachytherapy.

  4. [Vaginal ecology, climate, landscapes and populations (xenoecies and facies)].

    Science.gov (United States)

    Nicoli, J M; Nourrit, J; Michel-Nguyen, A; Sempe, M; Nicoli, R M

    1994-06-01

    Brief study of vaginal populations, the human vagina being considered as a biotopic cavity. Allusion to dynamic aspects ("vaginal climate", "landscapes") and to various bacterial populations. Introduction of the concept of xenoecies and of facies. This study is preceded by essential definitions of terms widely used in ecology.

  5. The use of supersaturation for the vaginal application of microbicides

    DEFF Research Database (Denmark)

    Grammen, Carolien; Plum, Jakob; Van Den Brande, Jeroen;

    2014-01-01

    In this study, we investigated the potential of supersaturation for the formulation of the poorly water-soluble microbicide dapivirine (DPV) in an aqueous vaginal gel in order to enhance its vaginal tissue uptake. Different excipients such as hydroxypropylmethylcellulose, polyethylene glycol 1000...

  6. Genome Sequences of 11 Human Vaginal Actinobacteria Strains

    Science.gov (United States)

    Deitzler, Grace E.; Ruiz, Maria J.; Weimer, Cory; Park, SoEun; Robinson, Lloyd S.; Hallsworth-Pepin, Kymberlie; Wollam, Aye; Mitreva, Makedonka

    2016-01-01

    The composition of the vaginal microbiota is an important health determinant. Several members of the phylum Actinobacteria have been implicated in bacterial vaginosis, a condition associated with many negative health outcomes. Here, we present 11 strains of vaginal Actinobacteria (now available through BEI Resources) along with draft genome sequences. PMID:27688328

  7. PHARMACOKINETIC AND PHARMACODYNAMIC STUDIES ON VAGINALLY ADMINISTERED LEVONORGESTREL

    Institute of Scientific and Technical Information of China (English)

    HEChang-Hai; XUJian-Qiu; ZHUYue-Hua; SHIYong-En

    1989-01-01

    Comparative studies on pharmacokinetics of vaginally and orally administered levonorgestrel (LNG) tablet (Postinor) in one single dose containing 0,75mg LNG were performed. The pharmacokinetics of LNG and its effects on ovarian functions werealso studied after repeated vaginal administration.

  8. Alternative therapies in women with chronic vaginitis.

    Science.gov (United States)

    Nyirjesy, Paul; Robinson, Jennifer; Mathew, Leny; Lev-Sagie, Ahinoam; Reyes, Ingrid; Culhane, Jennifer F

    2011-04-01

    To describe the use of complementary alternative medicines in women with chronic vaginitis and to evaluate epidemiologic factors associated with these treatments. In this prospective cohort study, patients with chronic vaginitis completed a questionnaire about past diagnoses and treatments. Information regarding demographics, medical and social history, perceived mental and emotional stress, and current symptoms was collected. All patients underwent a standard physical examination and laboratory testing and were assigned a specific diagnosis. A total of 481 women were enrolled; 64.9% used complementary alternative medicines. The most common treatments were yogurt and acidophilus pills. In univariate analysis, compared with nonusers, users of complementary alternative medicines were younger (83.4% younger than 50 compared with 73.1%; P=.032), not African American (11.9% compared with 21.3%; P=.018), had increased measures of perceived stress (P=.008), and reported that their symptoms interfered with both work (59.1% compared with 40.6%; P=.001) and social lives (57.9% compared with 40.2%; P=.001). Patients using complementary alternative medicines had seen more doctors (median 2 compared with 1; Pvaginitis, particularly in those who are young, have more disruptive symptoms, and report greater stress. II.

  9. Transabdominal sonography to measure the total vaginal and mucosal thicknesses.

    Science.gov (United States)

    Balica, Adrian; Schertz, Katherine; Wald-Spielman, Daniella; Egan, Susan; Bachmann, Gloria

    2017-10-01

    Transabdominal and transvaginal sonography are used to measure bladder wall and detrusor thickness. Only transvaginal sonography has been used to measure the vaginal wall thickness. We describe the use of transabdominal sonography to measure the total vaginal wall thickness and total vaginal mucosal thickness at the bladder trigone. The mean bladder wall thickness and SD from published data were within the 95% confidence interval of our data. Total vaginal and mucosal thicknesses are reliable measurements, which require specific evaluation in a postmenopausal population. They could be used to quantify vaginal atrophy and could correlate to symptoms of atrophy and response to treatment. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:461-464, 2017. © 2017 Wiley Periodicals, Inc.

  10. Mucoadhesive and thermogelling systems for vaginal drug delivery.

    Science.gov (United States)

    Caramella, Carla M; Rossi, Silvia; Ferrari, Franca; Bonferoni, Maria Cristina; Sandri, Giuseppina

    2015-09-15

    This review focuses on two formulation approaches, mucoadhesion and thermogelling, intended for prolonging residence time on vaginal mucosa of medical devices or drug delivery systems, thus improving their efficacy. The review, after a brief description of the vaginal environment and, in particular, of the vaginal secretions that strongly affect in vivo performance of vaginal formulations, deals with the above delivery systems. As for mucoadhesive systems, conventional formulations (gels, tablets, suppositories and emulsions) and novel drug delivery systems (micro-, nano-particles) intended for vaginal administration to achieve either local or systemic effect are reviewed. As for thermogelling systems, poly(ethylene oxide-propylene oxide-ethylene oxide) copolymer-based and chitosan-based formulations are discussed as thermogelling systems. The methods employed for functional characterization of both mucoadhesive and thermogelling drug delivery systems are also briefly described.

  11. Vaginal hysterectomy as a primary route for morbidly obese women.

    Science.gov (United States)

    Sheth, Shirish S

    2010-07-01

    Vaginal hysterectomy is a least invasive and the choicest route when hysterectomy is possible by recourse to all the three available techniques. However in obese women, the common method is by the more invasive abdominal or laparoscopic route, with attendant morbidity. Vaginal hysterectomy was reviewed in 102 morbidly obese women (body mass index, BMI > or = 40) and compared with 50 comparable morbidly obese women who underwent abdominal hysterectomy and with vaginal hysterectomy in 200 normal weight women (BMI hysterectomy was slightly but significantly longer in the morbidly obese compared to those of normal weight, while the abdominal approach was significantly longer in the morbidly obese. Hospital stay was significantly longer for the abdominal operations in the obese. Surgical and anesthetic complications did not differ. In the absence of specific contraindications for vaginal hysterectomy it is recommended that the surgeon should perform hysterectomy vaginally and consider obesity as a contraindication for taking the abdominal route.

  12. [Vaginal birth after cesarean section in light of international opinions].

    Science.gov (United States)

    Németh, Gábor; Molnár, András

    2017-07-01

    The tendency of increasing cesarean section rate has drawn worldwide attention. The vaginal birth after cesarean section is a useful method to decrease cesarean section rate at defined cases. Retrospective overview of factors resulting successful vaginal birth, labor/induction's condition, criterias, short and long term benefits and consequences. Overview recommendations of international guidelines and publications' results concerned vaginal birth after cesarean section in "PubMed", "MEDLINE", "Cochrane" databases from 1996 to 2016. Reviewing results of recommendations and publications we can declare that statements are inconsistent, however the option of vaginal birth after cesarean section is appropriate for decrease complications and trend of increasing cesarean section rate. It would be important in our country to define a uniform recommendation regarding vaginal birth after cesarean section, with supporting evidence in obstetrical and gynecological practice. Orv Hetil. 2017; 158(30): 1168-1174.

  13. The role of fomites in the transmission of vaginitis.

    Science.gov (United States)

    Andrew, D. E.; Bumstead, E.; Kempton, A. G.

    1975-01-01

    A role for fomites such as toilet seats in the transmission of vaginitis has never been proved or disproved. A compilation of clinical data from a university community showed that the organisms found in vaginal cultures of patients with vaginitis were, in order of frequency. Candida albicans, Escherichia coli, beta-hemolytic streptococci, Hemophilus vaginalis and Trichomonas vaginalis. In a concurrent bacteriologic survey of washroom fixtures, staphylococci and other micrococci were isolated most frequently. The overt pathogens associated with vaginitis were never found, and gram-negative organisms appeared to be suppressed by the disinfectant used by the cleaning staff. It is clear that fomites are not an important mode of transmission in vaginitis, although a search for specific pathogens on toilets is to be continued. PMID:1092449

  14. Recurrence of vaginal prolapse after total vaginal hysterectomy with concurrent vaginal uterosacral ligament suspension: comparison between normal-weight and overweight women.

    Science.gov (United States)

    Rappa, Carlo; Saccone, Gabriele

    2016-11-01

    Obesity is one of the most important risk factors for the development and progression of the pelvic organ prolapse. However, data regarding whether obesity is a risk factor for recurrence after pelvic organ prolapse surgery are controversial. The aim of this study was to estimate the risk of recurrent prolapse in any vaginal compartment after total vaginal hysterectomy with concurrent uterosacral ligament vaginal vault suspension among normal-weight women compared with either overweight or obese women. This is a 5-year retrospective cohort study of women who underwent total vaginal hysterectomy with concurrent vaginal uterosacral ligament suspension at one referral center for pelvic organ prolapse in Italy from January 2010 to January 2015. All women who underwent total vaginal hysterectomy with concurrent uterosacral ligament suspension were included in the analysis. Laparoscopic approach was excluded. Women were classified according to the body mass index of 2 groups: (1) normal weight (body mass index, 18.5-24.9 kg/m(2)) and (2) either overweight (body mass index, 25.0-29.9 kg/m(2)) or obese (body mass index, ≥30.0 kg/m(2)). The primary outcome was the incidence of recurrent prolapse in any vaginal compartment (anterior, posterior, or apical). Recurrent prolapse was defined as prolapse extending beyond the hymen with straining (pelvic organ prolapse quantification points Ba, C, Bp ≥0) or repeat treatment for prolapse with either pessary or surgery. Uterosacral ligament suspensions were performed with a vaginal approach with the use of sutures placed in the intermediate uterosacral ligament, at or above the ischial spine, and affixed to the vaginal apex. Delayed absorbable sutures were used, with 2 sutures per side. Three hundred sixty women who underwent total vaginal hysterectomy with concurrent uterosacral ligament suspension with at least 6 months of follow up after surgery were included in the study. The overall incidence of recurrent prolapse in any

  15. [Safety of promestriene capsule used in postmenopausal atrophic vaginitis].

    Science.gov (United States)

    Sun, Ai-jun; Lin, Shou-qing; Jing, Lian-hong; Wang, Zi-yi; Ye, Jia-lin; Zhang, Ying

    2009-08-01

    To investigate the safety and efficacy of promestriene capsule used in the treatment of postmenopausal atrophic vaginitis. Fifty-three women at age of 45 - 75 years (more than one year history of menopause) diagnosed with postmenopausal atrophic vaginitis were enrolled in self-control study. They all had typicalsymptoms of postmenopausal vaginitis. Promestriene was given by continuous therapy for 20 days, then maintenance therapy for for 8 weeks (1 pill two times per week used). The level of follicle stimulation hormone (FSH) and estradiol (E(2)) in serum was and thickness of endometrium were detected before and after treatment. The routine biochemical test was used as index to monitoring the safety. The vaginal mature index (VMI), the atrophic vaginitis evaluating score and vaginal healthy evaluating score were evaluated for therapeutic effect. In the mean time, adverse effect was recorded. (1) SAFETY: during promestriene treatment, no case with adverse effect was observed. Before treatment, the mean level of FSH and E(2) was (71 +/- 3) U/L and (41 +/- 18) pmol/L, the mean thickness of endometrium was (2.4 +/- 0.9) mm. After treatment, the mean level of FSH and E(2) was (67 +/- 22) U/L and (43 +/- 37) pmol/L, the mean thickness of endometrium was (2.5 +/- 1.3) mm. No significant difference was observed (P > 0.05). (2) Therapeutic effect: VMI were 42 +/- 15 before and 54 +/- 8 after treatment. The atrophic vaginitis evaluating score were 3.4 +/- 1.7 before and 1.5 +/- 1.4 after treatment. Vaginal healthy evaluating score were 7.8 +/- 2.4 before and 12.0 +/- 2.4 after treatment. They all showed significant difference (P vaginal bleeding, 3 cases with breast nodules and 1 case with cervical polyp was observed, however, it was uncertain whether those events were associated with promestriene use. The premestriene capsule was safe and effective in the treatment of postmenopausal atrophic vaginitis.

  16. Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse.

    NARCIS (Netherlands)

    Milani, A.L.; Withagen, M.I.J.; Vierhout, M.E.

    2009-01-01

    INTRODUCTION AND HYPOTHESIS: The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh. METHODS: We conducted a pro

  17. Prevalência e susceptibilidade de leveduras vaginais Prevalence and susceptibility of vaginal yeast

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    Leonilda Chiari Galle

    2004-08-01

    Full Text Available Entre as vulvovaginites, a candidíase é apontada como a causa mais freqüente em mulheres na idade fértil. Atualmente, várias pesquisas mostram aumento na freqüência das espécies não-albicans e grande preocupação com episódios de repetição, assim como sua relação com a resistência ao tratamento. OBJETIVO: O presente estudo teve como objetivo verificar a distribuição de gêneros e espécies de leveduras causadoras de vaginite e analisar o perfil de sensibilidade das leveduras frente às drogas antifúngicas. MATERIAL E MÉTODO: Foram colhidas amostras de fluido vaginal de 250 pacientes para cultura, realizados identificação e antifungigrama dos isolados. RESULTADOS: Leveduras do gênero Candida estavam presentes em 27,6% das amostras. Candida albicans foi a levedura mais isolada em 74% dos casos, seguida de Candida glabrata, em 14,5%; Candida tropicalis, em 7,3%; e Candida parapsilosis, em 4,3%. Todos os isolados Candida albicans foram sensíveis à anfotericina B, e apenas um isolado da espécie não-albicans apresentou concentração inibitória mínima (CIM mais elevada (2µg/ml. Em Candida albicans, 5,9% das amostras mostraram-se sensíveis, dependendo da dose de fluconazol, e 9,8%, resistentes. Apenas um isolado mostrou-se resistente, com CIM de 8µg/ml, para itraconazol. Nas espécies não-albicans, 11,7% dos isolados foram considerados resistentes ao fluconazol e 23,5, ao itraconazol. CONCLUSÃO: Candida albicans foi a espécie mais freqüentemente encontrada na microbiota vaginal; no entanto, outras espécies foram também comuns nessa população. Porcentual importante de isolados de Candida albicans e não-albicans foi resistente a fluconazol e itraconazol, mostrando a importância de realização de testes de identificação e antifungigrama para os episódios de candidíase vaginal.Among the vulvovaginitis, candidiasis is the most frequent cause in women at reprodutive age of and several researches have shownd an

  18. Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy

    Directory of Open Access Journals (Sweden)

    SA Kingsberg

    2009-08-01

    Full Text Available SA Kingsberg¹, S Kellogg², M Krychman³1University Hospitals Case Medical Center, Case Western Reserve University Cleveland OH, USA; 2The Pelvic and Sexual Health Institute of Philadelphia, Drexel University College of Medicine, Philadelphia, USA; 3Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USAAbstract: Vulvovaginal atrophy (VVA and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms.Keywords: dyspareunia, postmenopausal vulvovaginal atrophy, vaginal estrogen therapy

  19. Mucus-penetrating nanoparticles for vaginal and gastrointestinal drug delivery

    Science.gov (United States)

    Ensign-Hodges, Laura

    A method that could provide more uniform and longer-lasting drug delivery to mucosal surfaces holds the potential to greatly improve the effectiveness of prophylactic and therapeutic approaches for numerous diseases and conditions, including sexually transmitted infections and inflammatory bowel disease. However, the body's natural defenses, including adhesive, rapidly cleared mucus linings coating nearly all entry points to the body not covered by skin, has limited the effectiveness of drug and gene delivery by nanoscale delivery systems. Here, we investigate the use of muco-inert mucus-penetrating nanoparticles (MPP) for improving vaginal and gastrointestinal drug delivery. Conventional hydrophobic nanoparticles strongly adhere to mucus, facilitating rapid clearance from the body. Here, we demonstrate that mucoadhesive polystyrene nanoparticles (conventional nanoparticles, CP) become mucus-penetrating in human cervicovaginal mucus (CVM) after pretreatment with sufficient concentrations of Pluronic F127. Importantly, the diffusion rate of large MPP did not change in F127 pretreated CVM, implying there is no affect on the native pore structure of CVM. Additionally, there was no increase in inflammatory cytokine release in the vaginal tract of mice after daily application of 1% F127 for one week. Importantly, HSV virus remains adherent in F127-pretreated CVM. Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that hypotonically-induced fluid uptake could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We evaluated hypotonic formulations for delivering water-soluble drugs and for drug delivery with MPP. Hypotonic formulations markedly increased the rate at which drugs and MPP reached the epithelial surface. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that isotonic formulations

  20. Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification

    Science.gov (United States)

    McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

    2012-01-01

    A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-β-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

  1. Parturition Pit: The Bony Imprint of Vaginal Birth

    Science.gov (United States)

    Meyer, Isuzu; Jackson, Bradford; Pitt, Michael J.; Larrison, Matthew C.

    2017-01-01

    Purpose To retrospectively evaluate for pits along the dorsum of the pubic body in females and compare the presence/absence of these pits to vaginal birth data. Materials and Methods We retrospectively reviewed females with vaginal birth data who underwent pelvic CT. The presence of pits along the dorsum of the pubic body, pit grade (0 = not present; 1 = faintly imperceptible; 2 = present; 3 = prominent), and the presence of osteitis condensans ilii, preauricular sulcus, and sacroiliac joint vacuum phenomenon were assessed on imaging. Musculoskeletal radiologists who were blinded to the birth data evaluated the CTs. 48 males were also evaluated for the presence of pits. Results 482 female patients underwent CT pelvis and 171 were excluded due to lack of vaginal birth data. Of the 311 study patients, 262 had prior vaginal birth(s) and 194 had pits on CT. Only 7 of the 49 patients without prior vaginal birth had pits. There was a statistically significant association between vaginal birth and presence of pits (pbirths. As vaginal deliveries increased, the odds of having parturition pits greatly increased, adjusting for age and race at CT (pbirth and should be considered a characteristic of the female pelvis. The lytic appearance of prominent pits on imaging can simulate disease and create a diagnostic dilemma for interpreting radiologists. PMID:27270921

  2. A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

    Science.gov (United States)

    Agnaeber, K; Bodalal, Z

    2013-08-01

    We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.

  3. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis.

    Science.gov (United States)

    Mitchell, Leia; King, Michelle; Brillhart, Heather; Goldstein, Andrew

    2017-09-01

    Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman with a 4-year history of profuse yellowish discharge and dyspareunia. Upon presentation, her symptoms and laboratory results met the criteria for desquamative inflammatory vaginitis, but the standard treatments did not provide long-lasting relief. As a last resort, cryotherapy (cryosurgery) of her cervix was performed for treatment of her cervical ectropion, which provided complete resolution of her symptoms. Mitchell L, King M, Brillhart H, Goldstein A. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sex Med 2017;5:e212-e214. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Unraveling the Dynamics of the Human Vaginal Microbiome

    Science.gov (United States)

    Nunn, Kenetta L.; Forney, Larry J.

    2016-01-01

    Four Lactobacillus species, namely L. crispatus, L. iners, L. gasseri, and L. jensenii, commonly dominate the vaginal communities of most reproductive-age women. It is unclear why these particular species, and not others, are so prevalent. Historically, estrogen-induced glycogen production by the vaginal epithelium has been proffered as being key to supporting the proliferation of vaginal lactobacilli. However, the ‘fly in the ointment’ (that has been largely ignored) is that the species of Lactobacillus commonly found in the human vagina cannot directly metabolize glycogen. It would appear that this riddle has been solved as studies have demonstrated that vaginal lactobacilli can metabolize the products of glycogen depolymerization by α-amylase, and fortunately, amylase activity is found in vaginal secretions. These amylases are presumed to be host-derived, but we suggest that other bacterial populations in vaginal communities could also be sources of amylase in addition to (or instead of) the host. Here we briefly review what is known about human vaginal bacterial communities and discuss how glycogen-derived resources and resource competition might shape the composition and structure of these communities. PMID:27698617

  5. Vaginal Testosterone Cream vs Estradiol Vaginal Ring for Vaginal Dryness or Decreased Libido in Women Receiving Aromatase Inhibitors for Early-Stage Breast Cancer: A Randomized Clinical Trial.

    Science.gov (United States)

    Melisko, Michelle E; Goldman, Mindy E; Hwang, Jimmy; De Luca, Amy; Fang, Sally; Esserman, Laura J; Chien, Amy J; Park, John W; Rugo, Hope S

    2017-03-01

    Aromatase inhibitors (AI) are associated with significant urogenital atrophy, affecting quality of life and drug compliance. To evaluate safety of intravaginal testosterone cream (IVT) or an estradiol-releasing vaginal ring (7.5 μg/d) in patients with early-stage breast cancer (BC) receiving an AI. Intervention was considered unsafe if more than 25% of patients had persistent elevation in estradiol (E2), defined as E2 greater than 10 pg/mL (to convert to pmol/L, multiply by 3.671) and at least 10 pg/mL above baseline after treatment initiation on 2 consecutive tests at least 2 weeks apart. Postmenopausal (PM) women with hormone receptor (HR)-positive stage I to III BC taking AIs with self-reported vaginal dryness, dyspareunia, or decreased libido were randomized to 12 weeks of IVT or an estradiol vaginal ring. Estradiol was measured at baseline and weeks 4 and 12 using a commercially available liquid chromatography and tandem mass spectrometry assay; follicle-stimulating hormone levels were measured at baseline and week 4. Gynecologic examinations and sexual quality-of-life questionnaires were completed at baseline and week 12. This randomized noncomparative design allowed safety evaluation of 2 interventions concurrently in the same population of patients, reducing the possibility of E2 assay variability over time and between the 2 interventions. The primary objective of this trial was to evaluate safety of IVT or an estradiol vaginal ring in patients with early-stage BC receiving an AI; secondary objectives included evaluation of adverse events, changes in sexual quality of life using the Cancer Rehabilitation Evaluation System sexuality subscales, changes in vaginal atrophy using a validated 4-point scale, and comparison of E2 levels. Overall, 76 women signed consent (mean [range] age, 56 [37-78] years), 75 started treatment, and 69 completed 12 weeks of treatment. Mean (range) baseline E2 was 20 (10 pg/mL) in 28 of 76 women (37%). Persistent E2 elevation was

  6. Effects of a One Year Reusable Contraceptive Vaginal Ring on Vaginal Microflora and the Risk of Vaginal Infection: An Open-Label Prospective Evaluation.

    Directory of Open Access Journals (Sweden)

    Yongmei Huang

    Full Text Available A contraceptive vaginal ring (CVR containing Nestorone® (NES and ethinyl estradiol (EE that is reusable for 1- year (13 cycles is under development. This study assessed effects of this investigational CVR on the incidence of vaginal infections and change in vaginal microflora.There were 120 women enrolled into a NES/EE CVR Phase III trial and a microbiology sub-study for up to 1- year of cyclic product use. Gynecological examinations were conducted at baseline, the first week of cycle 6 and last week of cycle 13 (or during early discontinuation visits. Vaginal swabs were obtained for wet mount microscopy, Gram stain and culture. The CVR was removed from the vagina at the last study visit and cultured. Semi-quantitative cultures for Lactobacillus, Gardnerella vaginalis, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, anaerobic gram negative rods (GNRs, Candida albicans and other yeasts were performed on vaginal and CVR samples. Vaginal infections were documented throughout the study.Over 1- year of use, 3.3% of subjects were clinically diagnosed with bacterial vaginosis, 15.0% with vulvovaginal candidiasis, and 0.8% with trichomoniasis. The detection rate of these three infections did not change significantly from baseline to either Cycle 6 or 13. Nugent scores remained stable. H2O2-positive Lactobacillus dominated vaginal flora with a non-significant prevalence increase from 76.7% at baseline to 82.7% at cycle 6 and 90.2% at cycle 13, and a median concentration of 107 colony forming units (cfu per gram. Although anaerobic GNRs prevalence increased significantly, the median concentration decreased slightly (104 to 103cfu per gram. There were no significant changes in frequency or concentrations of other pathogens. High levels of agreement between vaginal and ring surface microbiota were observed.Sustained use of the NES/EE CVR did not increase the risk of vaginal infection and was not disruptive to the vaginal ecosystem

  7. A STUDY OF VAGINAL BIRTH AFTER CAESAREAN

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    Ratana

    2015-06-01

    Full Text Available OBJECTIVE : To evaluate the efficacy and safety of attempted VBAC with a view to decrease the incidence of caesarean section . METHOD S : A prospective study is carried out on women with one previous LSCS for a non - recurrent cause attending ANC & labour room of RIMS for 2 years from 1 st Aug 2007 to 31 st July 2009. RESULTS : 100 eligible PCS women agreed to undergo trial of labour. Of these 50 delivered vaginally and the remaining 50 had to undergo emergency repeat caesarean section due to fetal distress, scar tenderness o r non - progress of labour resulting in a VBAC rate of 50%. CONCLUSION : A trial of labour in cases of previous caesarean section is the way to reduce the overall caesarean section rate. Physicians need to discuss the risks and benefits of VBAC following tria l of labour or elective repeat caesarean section with patients and patients’ choices must be considered.

  8. Prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal anormal en el Hospital Nacional Arzobispo Loayza

    Directory of Open Access Journals (Sweden)

    Ruth Medina

    1999-10-01

    Full Text Available Objetivo: Determinar la prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal y su asociación con características clínicas y de laboratorio. Material y métodos: Se llevó a cabo un estudio transversal. Se estudiaron 370 pacientes que acudieron a la consulta ginecológica del Hospital Nacional Arzobispo Loayza de enero a marzo de 1998. A todas las pacientes se les tomó muestras de flujo vaginal para la medición del pH, del test de amina y la identificación microscópica de "células clave", Trichomonas vaginalis, levaduras e hifas. Resultados: La prevalencia de infección vaginal fue de 42.2%; siendo vaginosis bacteriana la infección más frecuente (23.24%, seguido de candidiasis vaginal (16.2% y tricomoniasis vaginal (7.8%. Vaginosis bacteriana estuvo asociada a mal olor postcoital, ausencia de signos inflamatorios en vagina, flujo vaginal blanquecino, lechoso, homogéneo y fétido. La candidiasis vaginal estuvo asociada a prurito, ardor vulvovaginal, eritema vulvar y vaginal, flujo vaginal amarillento, grumoso sin olor, test de amina negativo; así como ausencia de relaciones sexuales, ningún compañero sexual en el último año, ninguna gestación, una vida sexual menor de dos años y paridad de ninguno a un hijo. La tricomoniasis vaginal estuvo asociada a eritema vaginal, flujo vaginal amarillo verdoso, espumoso, homogéneo y fétido y test de amina positivo. Conclusión: Un diagnóstico correcto y oportuno de las infecciones vaginales no debe basarse sólo en las características clínicas sino en la confirmación con métodos sencillos de laboratorio. ( Rev Med Hered 1999; 10:144-150 .

  9. Magnitude of Interfractional Vaginal Cuff Movement: Implications for External Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Daniel J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Michaletz-Lorenz, Martha [Department of Education and Training, Elekta, Maryland Heights, MO (United States); Goddu, S. Murty [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

    2012-03-15

    Purpose: To quantify the extent of interfractional vaginal cuff movement in patients receiving postoperative irradiation for cervical or endometrial cancer in the absence of bowel/bladder instruction. Methods and Materials: Eleven consecutive patients with cervical or endometrial cancer underwent placement of three gold seed fiducial markers in the vaginal cuff apex as part of standard of care before simulation. Patients subsequently underwent external irradiation and brachytherapy treatment based on institutional guidelines. Daily megavoltage CT imaging was performed during each external radiation treatment fraction. The daily positions of the vaginal apex fiducial markers were subsequently compared with the original position of the fiducial markers on the simulation CT. Composite dose-volume histograms were also created by summing daily target positions. Results: The average ({+-} standard deviation) vaginal cuff movement throughout daily pelvic external radiotherapy when referenced to the simulation position was 16.2 {+-} 8.3 mm. The maximum vaginal cuff movement for any patient during treatment was 34.5 mm. In the axial plane the mean vaginal cuff movement was 12.9 {+-} 6.7 mm. The maximum vaginal cuff axial movement was 30.7 mm. In the craniocaudal axis the mean movement was 10.3 {+-} 7.6 mm, with a maximum movement of 27.0 mm. Probability of cuff excursion outside of the clinical target volume steadily dropped as margin size increased (53%, 26%, 4.2%, and 1.4% for 1.0, 1.5, 2.0, and 2.5 cm, respectively.) However, rectal and bladder doses steadily increased with larger margin sizes. Conclusions: The magnitude of vaginal cuff movement is highly patient specific and can impact target coverage in patients without bowel/bladder instructions at simulation. The use of vaginal cuff fiducials can help identify patients at risk for target volume excursion.

  10. Sentinel lymph node mapping with indocyanine green in vaginal cancer.

    Science.gov (United States)

    Lee, In Ok; Lee, Jung Yun; Kim, Sunghoon; Kim, Sang Wun; Kim, Young Tae; Nam, Eun Ji

    2017-07-01

    Sentinel lymph node (SLN) mapping is being adapted to gynecologic cancer. Higher SLN mapping rates were reported with indocyanine green (ICG) compared to other dyes. The aim of this film is to share our experience of SLN mapping with ICG in vaginal cancer. A 40 year-old woman was diagnosed with squamous cell vaginal cancer. About 1.5 cm-sized tumor was located on the posterior vaginal fornix. Preoperatively she was assumed to be stage I vaginal cancer. Beginning of surgery, we performed SLN mapping by ICG injection into 3- and 9-o'clock positions of the vaginal tumor. Concentrated in 1.25 mg/mL, 1 mL of ICG solution was injected into deep stroma and another 1 mL submucosally in both sides. Bilateral SLN identification and lymphadenectomy were done. Afterward, laparoscopic Type C1 Querleu-Morrow radical hysterectomy with vaginectomy was done. A fluorescence endoscope produced by KARL STORZ (Tuttlingen, Germany) was used for ICG detection. To our knowledge, this is the first film report performing SLN mapping with ICG in vaginal cancer. The mapping was successful and we were able to recognize SLN of vaginal cancer. SLNs were located in the bilateral obturator fossa. According to the pathologic diagnosis, the mass size was 15 mm and invasion depth was 1 mm. Subvaginal tissue involvement and pelvic wall extension were absent. Resection margin of the vagina was free from carcinoma. No lymph node metastasis was reported including the bilateral SLNs. For vaginal cancer, SLN mapping can be applied by injecting ICG into the bilateral sides of the vaginal tumor.

  11. Endometrial safety of ultra-low-dose Vagifem 10 microg in postmenopausal women with vaginal atrophy

    DEFF Research Database (Denmark)

    Ulrich, L S G; Naessen, T; Elia, D

    2010-01-01

    The objective of the study was to evaluate the endometrial safety of a 10 microg estradiol vaginal tablet in the treatment of vaginal atrophy in postmenopausal women.......The objective of the study was to evaluate the endometrial safety of a 10 microg estradiol vaginal tablet in the treatment of vaginal atrophy in postmenopausal women....

  12. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  13. Colostrum in menopause effects on vaginal cytology/symptoms.

    Science.gov (United States)

    Tucci, S; Mancini, R; De Vitis, C; Noto, A; Marra, E; Lukic, A; Giovagnoli, M R; Moscarini, M

    2013-01-01

    The aim of this study was to assess the effects of three weeks of daily colostrum cream on vaginal cytology and local symptoms related to menopause. Genito-urinary symptoms and cell morphology were analyzed at time 0 (T0) and after three weeks (16 +/- days since the end of treatment) at time 1 (T1). Dyspareunia, vaginal dryness, and maturation index (MI) reached a statistically significant difference between T0 and T1. The results proved to be an alternative treatment for vaginal distress caused by lack of hormones in patients in which hormonal treatment is contraindicated.

  14. Vulvar and Vaginal Atrophy: Physiology, Clinical Presentation, and Treatment Considerations.

    Science.gov (United States)

    Lev-Sagie, Ahinoam

    2015-09-01

    Vulvovaginal atrophy is a common condition associated with decreased estrogenization of the vaginal tissue. Symptoms include vaginal dryness, irritation, itching, soreness, burning, dyspareunia, discharge, urinary frequency, and urgency. It can occur at any time in a woman's life cycle, although more commonly in the postmenopausal phase, during which the prevalence is approximately 50%. Despite the high prevalence and the substantial effect on quality of life, vulvovaginal atrophy often remains underreported and undertreated. This article aims to review the physiology, clinical presentation, assessment, and current recommendations for treatment, including aspects of effectiveness and safety of local vaginal estrogen therapies.

  15. Vaginitis Caused by Corynebacterium amycolatum in a Prepubescent Girl.

    Science.gov (United States)

    Chen, Xiao; Zhao, Xiaofeng; Chen, Lifeng; Zeng, Wenjie; Xu, Haiou

    2015-12-01

    Vaginal discharge is the most common gynecological symptom in prepubescent girls. We report a case of vaginitis caused by Corynebacterium amycolatum in a prepubescent girl and successful treatment with targeted antibiotics. Vaginal discharge is most commonly attributed to poor hygiene or nonspecific irritants; however, some patients have recurrent vulvovaginitis that is primarily caused by a variety of bacteria. For these patients, identifying the associated pathogens is critical for treatment. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Beneficial effects of a Coriolus versicolor-based vaginal gel on cervical epithelization, vaginal microbiota and vaginal health: a pilot study in asymptomatic women.

    Science.gov (United States)

    Palacios, Santiago; Losa, Fernando; Dexeus, Damián; Cortés, Javier

    2017-03-16

    To assess the effect of a 12-day treatment using a vaginal gel based on niosomes containing hyaluronic acid, ß-glucan, alpha-glucan oligosaccharide, Coriolus versicolor, Asian centella, Azadirachta indica and Aloe vera on vaginal microbiota, cervical epithelization and vaginal health. Open-label, prospective pilot study conducted in asymptomatic women in daily practice. Cervical epithelization was evaluated by colposcopy using an ectopy epithelization score (from 5: no ectopy to 1: severe ectopy and bleeding), vaginal microbiota using the VaginaStatus-Diagnostic test (Instiüt für Mikroökologie, Herborn, Germany) and further rated by the investigator using a 5-point Liker scale (from 5: normal to 1: very severe deterioration in which all evaluated species were altered), and vaginal health using the Vaginal Health Index. In 21 women, a positive effect to improve epithelization of the cervical mucosa, with a mean score of 4.42 at the final visit as compared to 3.09 at baseline (P microbiota status, with a mean score of 4.0 at the final visit vs. 3.3 at baseline (P = NS) (21.2% improvement). In 11 women, the Vaginal Health Index increased from 19.0 at baseline to 22.3 at the final visit (P = 0.007). The concentration of Lactobacillus spp. increased 54.5% of women and pH decreased from 4.32 to 4.09. These encouraging preliminary results provide the basis for designing a randomized controlled study, and for potential use in human papilloma virus infection. ISRCTN77955077 . Registration date: February 15, 2017. Retrospectively registered.

  17. Characterization of Human Vaginal Mucosa Cells for Autologous In Vitro Cultured Vaginal Tissue Transplantation in Patients with MRKH Syndrome

    Directory of Open Access Journals (Sweden)

    Cristina Nodale

    2014-01-01

    Full Text Available Mayer-Rokitansky-Küster-Hauser (MRKH is a rare syndrome characterized by congenital aplasia of the uterus and vagina. The most common procedure used for surgical reconstruction of the neovagina is the McIndoe vaginoplasty, which consists in creation of a vaginal canal covered with a full-thickness skin graft. Here we characterized the autologous in vitro cultured vaginal tissue proposed as alternative material in our developed modified McIndoe vaginoplasty in order to underlie its importance in autologous total vaginal replacement. To this aim human vaginal mucosa cells (HVMs were isolated from vaginal mucosa of patients affected by MRKH syndrome and characterized with respect to growth kinetics, morphology, PAS staining, and expression of specific epithelial markers by immunofluorescence, Western blot, and qRT-PCR analyses. The presence of specific epithelial markers along with the morphology and the presence of mucified cells demonstrated the epithelial nature of HMVs, important for an efficient epithelialization of the neovagina walls and for creating a functional vaginal cavity. Moreover, these cells presented characteristics of effective proliferation as demonstrated by growth kinetics assay. Therefore, the autologous in vitro cultured vaginal tissue might represent a highly promising and valid material for McIndoe vaginoplasty.

  18. Giant primary vaginal calculus secondary to vesicovaginal fistula with partial vaginal outlet obstruction in a 12-year-old girl.

    Science.gov (United States)

    Chen, Shushang; Ge, Rong; Zhu, Lingfeng; Yang, Shunliang; Wu, Weizhen; Yang, Yin; Tan, Jianming

    2011-10-01

    A vesicovaginal fistula with vagina obstruction associated with vaginal calculi is an extremely rare medical condition. We report a giant primary vaginal calculus resulting from vesicovaginal fistula with partial vaginal outlet obstruction secondary to perineum trauma and surgery in a 12-year-old girl. Episiotomy was performed and the adhesive labia minora was split. After the removal of a giant calculus in the vagina, approximately 8 cm in diameter, the fistula tract was completely excised, followed by the repair of the vesicovagina fistula and the vagina. The patient was symptom-free at 6-month follow-up examination.

  19. Antibiotic Administration and Factors Influencing the Vaginal Microbiota during Pregnancy

    DEFF Research Database (Denmark)

    Stokholm, Jakob

    2012-01-01

    The commensal flora consists of non-pathogenic microbiota found on all body surfaces maintaining a well-balanced host-microbial symbiotic state. The vaginal microbiota represents a microbial ecosystem. A low pH level is maintained by acid producing bacteria, most often dominated by Lactobacillus....... The low pH level is together with the host immunity responsible for protection of the vagina. A vast number of other bacterial species are represented in the vaginal commensal microbiota and among these both Staphylococcus and E. coli are often found. Skewing of the vaginal commensal flora...... with a following increase in pH level can lead to an overgrowth of certain microbiota resulting in bacterial vaginosis or vaginal candidiasis. Humans are continuously exposed to a large amount of environmental factors providing a possible influence on their microbial ecology. Antibiotic administration is one...

  20. WHO to concentrate HIV strategy on vaginal microbicide.

    Science.gov (United States)

    Cookson, C

    1993-11-27

    The World Health Organization (WHO), at a meeting in Geneva in November 1993, launched a campaign that will coordinate efforts of the pharmaceutical industry, academic research institutes, and drug regulatory bodies to find a vaginal antiviral agent that will either inactivate the human immunodeficiency virus (HIV) or prevent its attachment to vaginal cells, without harming the genital tract or killing sperm. Spermicides, such as nonoxynol 9, which kill HIV in test tubes may increase HIV transmission by harming the vaginal lining. However, this may be due to the carrier substance. Clinical research, using a protocol designed by the WHO and international regulatory authorities, will begin examining existing vaginal microbicides. Other candidates include sulphated polysaccharides and reverse transcriptase inhibitors. Included are comments by Dr. Michael Merson and Prof. Don Jefferies. The meeting was organized by the United Kingdom's Medical Research Council and Department of Health.

  1. Sigmoid-vaginal fistula during bevacizumab treatment diagnosed by fistulography.

    Science.gov (United States)

    Hayashi, C; Takada, S; Kasuga, A; Shinya, K; Watanabe, M; Kano, H; Takayama, T

    2016-12-01

    There have been several reports describing rectovaginal fistula development after bevacizumab treatment, and these fistulas were diagnosed by CT scan or colonoscopy. We report a case of sigmoid-vaginal fistula diagnosed by fistulography. The case is a 53-year-old woman who was treated for chronic myelogenous leukaemia and gynaecological cancers 8 years previously. At 52 years of age, she was diagnosed with colon cancer and had a partial colectomy performed. One year after surgery, colon cancer recurred, and she was treated with anticancer agents, including bevacizumab. During chemotherapy, she complained of a foul smelling discharge from the vagina. Fistulography revealed a sigmoid-vaginal fistula. This is the first report of vaginal fistulography performed on a patient who was treated with bevacizumab. Fistulography may be useful for detecting sigmoid-vaginal fistula. © 2016 John Wiley & Sons Ltd.

  2. Fetal Acidosis from Obstetric Interventions During the First Vaginal Delivery

    Directory of Open Access Journals (Sweden)

    Chi-Feng Su

    2008-12-01

    Conclusion: Oxytocin augmentation and vacuum extraction were significantly related to low cord arterial pH values (pH < 7.20, but there were no adverse effects to the newborns of first vaginal deliveries.

  3. Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?

    Science.gov (United States)

    Hormone replacement therapy: Can it cause vaginal bleeding? I'm taking hormone therapy for menopause symptoms, and my monthly menstrual periods have returned. Is this normal? Answers from Shannon K. Laughlin- ...

  4. Recommendations for the management of postmenopausal vaginal atrophy

    DEFF Research Database (Denmark)

    Sturdee, D W; Panay, N; Ulrich, Lian

    2010-01-01

    for hormone replacement therapy (HRT) over recent years that has suggested an increased risk of breast cancer, heart disease and stroke. But, regardless of whether these scares are justified, local treatment of vaginal atrophy is not associated with these possible risks of systemic HRT. Other reasons......Unlike hot flushes and night sweats which resolve spontaneously in time, atrophic symptoms affecting the vagina and lower urinary tract are often progressive and frequently require treatment. The prevalence of vaginal dryness increases as a woman advances through the postmenopausal years, causing...... for the continued suffering in silence may be cultural and an understandable reluctance to discuss such matters, particularly with a male doctor, but the medical profession must also take much of the blame for failing to enquire of all postmenopausal women about the possibility of vaginal atrophic symptoms. Vaginal...

  5. Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision

    Directory of Open Access Journals (Sweden)

    Ridhima Gupta

    2015-01-01

    Full Text Available Background. A transverse vaginal septum (TVS is a rare obstructing anomaly, caused due to improper fusion of Müllerian ducts and urogenital sinus during embryogenesis. Case. A 15-year-old girl presented with primary amenorrhea. She had multiple congenital anomalies. Initial examination and imaging investigation revealed the presence of a unicornuate uterus and a TVS. The TVS was excised; however the patient was unable to perform vaginal dilation postoperatively leading to recurrent stricture formation. She underwent multiple surgeries for excision of the stricture. The patient was eventually evaluated every day in the clinic until she was able to demonstrate successful vaginal dilatation in the presence of a clinician. Summary and Conclusion. Properly guided regular and intensive vaginal dilation after TVS excision may decrease the need of reoperations due to recurrent stricture formation.

  6. Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision.

    Science.gov (United States)

    Gupta, Ridhima; Bozzay, Joseph D; Williams, David L; DePond, Robert T; Gantt, Pickens A

    2015-01-01

    Background. A transverse vaginal septum (TVS) is a rare obstructing anomaly, caused due to improper fusion of Müllerian ducts and urogenital sinus during embryogenesis. Case. A 15-year-old girl presented with primary amenorrhea. She had multiple congenital anomalies. Initial examination and imaging investigation revealed the presence of a unicornuate uterus and a TVS. The TVS was excised; however the patient was unable to perform vaginal dilation postoperatively leading to recurrent stricture formation. She underwent multiple surgeries for excision of the stricture. The patient was eventually evaluated every day in the clinic until she was able to demonstrate successful vaginal dilatation in the presence of a clinician. Summary and Conclusion. Properly guided regular and intensive vaginal dilation after TVS excision may decrease the need of reoperations due to recurrent stricture formation.

  7. Pregnancy outcome in asymptomatic women with abnormal vaginal ...

    African Journals Online (AJOL)

    Patients with symptomatic vaginal infections, obvious risk factors for preterm delivery ... many of them were not willing to return for frequent visits. .... SD = standard deviation; GA = gestational age; BV = bacterial vaginosis. Table 2. Adverse ...

  8. Clinical Validation of a Test for the Diagnosis of Vaginitis.

    Science.gov (United States)

    Gaydos, Charlotte A; Beqaj, Sajo; Schwebke, Jane R; Lebed, Joel; Smith, Bonnie; Davis, Thomas E; Fife, Kenneth H; Nyirjesy, Paul; Spurrell, Timothy; Furgerson, Dorothy; Coleman, Jenell; Paradis, Sonia; Cooper, Charles K

    2017-07-01

    Vaginitis may be diagnosed as bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, or coinfection. A new molecular test assays the vaginal microbiome and organisms that cause three common infections. The objective of the trial was to evaluate the clinical accuracy of the investigational test for vaginal swabs collected by patients (self) or clinicians. The primary and secondary outcomes were to compare the investigational test with reference methods for the three most common causes of vaginitis and compare clinician-collected with self-collected swabs. We conducted a cross-sectional study in which women with symptoms of vaginitis were recruited at ten clinical centers and consented to the investigation between May and September 2015. The woman collected a vaginal swab, sheathed, and then handed it to the clinician. These swabs were to evaluate how self-collected swabs compared with clinician-collected swabs. The clinician collected an investigational test swab and reference test swabs. From 1,740 symptomatic patients, clinician-collected and self-collected vaginal swabs were evaluated by the molecular test and six tests. The reference methods for bacterial vaginosis were Nugent's score and Amsel's criteria for intermediate Nugent results. The reference methods for Candida infection were isolation of any potential Candida microorganisms from inoculation of two culture media: chromogenic and Sabouraud agar and sequencing. The reference methods for trichomoniasis were wet mount and culture. For clinician-collected swabs, by reference methods, bacterial vaginosis was diagnosed in 56.5%, vaginal candidiasis in 32.8%, trichomoniasis in 8%, and none of the three infections in 24% with a coinfection rate of 20%. The investigational test sensitivity was 90.5% (95% confidence interval [CI] 88.3-92.2%) and specificity was 85.8% (95% CI 83.0-88.3%) for bacterial vaginosis. The investigational test sensitivity was 90.9% (95% CI 88.1-93.1%) and specificity was 94

  9. The performance of the vaginal discharge syndromic management in treating vaginal and cervical infection : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Zemouri, C.; Wi, T.E.; Kiarie, J.; Seuc, A.; Mogasale, V.; Latif, A.; Broutet, N.

    2016-01-01

    Background This review aimed to synthesize and analyze the diagnostic accuracy and the likelihood of providing correct treatment of the syndromic approach Vaginal Discharge Flowchart in managing cervical infections caused by Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), and vaginal

  10. Desquamative inflammatory vaginitis: differential diagnosis and alternate diagnostic criteria.

    Science.gov (United States)

    Bradford, Jennifer; Fischer, Gayle

    2010-10-01

    To describe alternate diagnostic protocols and describe the differential diagnosis for desquamative inflammatory vaginitis (DIV). One hundred one cases of DIV were audited retrospectively. All patients were seen exclusively by the authors in their private practices using diagnostic criteria applicable to local practice limitations. Other potential etiologies (infection, contact irritant vaginitis, fixed drug eruptions, immunobullous diseases, estrogen hypersensitivity vulvovaginitis, and graft-vs-host disease) were excluded by history, examination, and focused trials of treatment. Historical triggers in the study cohort and a control group of 75 women with lichen planus also drawn from the authors' private practice were compared. Patients were treated with 4 to 6 weeks of topical vaginal antibiotics, 94% with clindamycin, and response to treatment was recorded at subsequent follow-up. All patients were white. Of 101 patients, 57 (56%) had historical triggers, most frequently diarrhea or antibiotic treatment. Of the 75 women in the control group with vaginal lichen planus, 11 had historical triggers (15%, p vaginitis, which were ongoing, were cured when their triggers were finally controlled or cured, leaving 35 patients who required long-term maintenance therapy. Desquamative inflammatory vaginitis seems to be a distinct entity of vaginitis that, in an office setting, can be distinguished from other diagnostic possibilities by careful clinical evaluation and focused trials of treatment. The majority of women responded promptly to intravaginal antibiotics, with approximately 35% of cases requiring maintenance therapy. More than half the cases have an historical trigger. We postulate that DIV occurs when a trigger causes shifts in vaginal homeostasis, resulting in an inflammatory response associated with increased epithelial cell turnover.

  11. Viability of lactobacillus acidophilus in various vaginal tablet formulations

    OpenAIRE

    Fazeli M.R.; Toliyat T.; Samadi N.; Hajjaran S.; Jamalifar H.

    2006-01-01

    The lactobacilli which are present in vaginal fluids play an important role in prevention of vaginosis and there are considerable interests in formulation of these friendly bacteria into suitable pharmaceutical dosage forms. Formulating these microorganisms for vaginal application is a critical issue as the products should retain viability of lactobacilli during formulation and also storage. The aim of this study was to examine the viability and release of Lactobacillus acidophilus from slow-...

  12. Deep sequencing of the vaginal microbiota of women with HIV

    OpenAIRE

    Ruben Hummelen; Andrew D. Fernandes; Macklaim, Jean M.; Dickson, Russell J.; John Changalucha; Gloor, Gregory B.; Gregor Reid

    2010-01-01

    textabstractBackground:Women living with HIV and co-infected with bacterial vaginosis (BV) are at higher risk for transmitting HIV to a partner or newborn. It is poorly understood which bacterial communities constitute BV or the normal vaginal microbiota among this population and how the microbiota associated with BV responds to antibiotic treatment. Methods and Findings: The vaginal microbiota of 132 HIV positive Tanzanian women, including 39 who received metronidazole treatment for BV, were...

  13. Eosinofilia no sangue periférico de mulheres com candidiase vaginal recorrente

    OpenAIRE

    Queiroz Filho,José; Gonçalves,Ana Katherine; Cavalcante Júnior,Geraldo Barroso; Pessoa,Daliana Caldas; Eleutério Júnior,José; Giraldo, Paulo César; Sales, Valéria Soraya de Farias

    2013-01-01

    OBJETIVO: Quantificar o número de células de defesa e os níveis de imunoglobulina E (IgE) no sangue periférico em amostra de mulheres com candidíase vaginal recorrente. MÉTODOS: Estudo de corte transversal com 60 mulheres, 40 com candidíase vulvovaginal e 20 do grupo controle (sem doença). As células de defesa foram identificadas utilizando um sistema de impedância combinada com a citometria de fluxo, os níveis de IgE total e específica foram medidos por meio de técnicas de quimiluminescência...

  14. Isolation of Candida spp from vaginal microbiota of healthy canine females during estrous cycle Isolamento de Candida spp da microbiota vaginal de fêmeas caninas hígidas durante o ciclo estral

    Directory of Open Access Journals (Sweden)

    Marlete Brum Cleff

    2005-06-01

    Full Text Available Yeasts are commensal organisms found in the skin, genital and gastrointestinal tracts, and other mucosa in mammalians. Candida spp has been frequently isolated from domestic and sylvan animals. Yeast isolation from vaginal mucus is frequent in women, especially of Candida genus. In canine females, however, studies about vaginal fungal microbiota are rare and the connection with estrous cycle is unknown. The purpose of this study was to isolate yeast 5 of Candida genus from healthy canine females and identify the isolated species, establishing their connection with estrous cycle phases. Two hundred twenty-four samples taken from vaginal mucus of 14 canine females were analyzed in this study. Candida spp was observed in 83 (37% from these samples; nine samples were taken in proestrus, 14 in oestrus, 31 in dioestrus, 24 in anoestrus and five samples were obtained during pregnancy. Candida parapsilosis the most frequently isolated specie (21.7%, followed by C. guillermondii (8.4%, C. kefir (6% and C. albicans (4.8%. We concluded that Candida spp is a commion component of healthy canine females' vaginal microbiota, and isolation varies according to the estrous cycle phase.As leveduras são organismos comensais da pele, trato genital e gastrointestinal, e de outras mucosas de mamíferos. O gênero Candida vem sendo isolado freqüentemente de animais domésticos e silvestres. O isolamento de Candida spp da mucosa vaginal de mulheres é freqüente, porém na espécie canina são escassos os estudos referentes à microbiota fúngica vaginal, especialmente do gênero candida, não se tendo conhecimento de sua relação com o ciclo reprodutivo. O presente trabalho teve como objetivo isolar leveduras do gênero Candida em fêmeas caninas hígidas e identificar as espécies isoladas, relacionando-as com as diferentes fases do ciclo estral. Foram analisadas 224 amostras obtidas da mucosa vaginal de 14 fêmeas caninas. Candida spp foi observada em 83 (37

  15. Tratamento cirúrgico e conservador da agenesia vaginal: análise de uma série de casos Surgical and non-surgical treatment of vaginal agenesis: analysis of a series of cases

    Directory of Open Access Journals (Sweden)

    Juliana Straehl Marin

    2012-06-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento da agenesia vaginal pela técnica cirúrgica de McIndoe-Bannister modificada e pela técnica de Frank. MÉTODOS: Este estudo retrospectivo foi conduzido com uma amostra de conveniência de 25 mulheres portadoras de agenesia vaginal em seguimento no Ambulatório de Ginecologia Infanto Puberal. Quinze mulheres foram submetidas à cirúrgica modificada de McIndoe-Bannister Grupo Cirúrgico e 10 fora tratadas com a técnica de Frank Grupo Frank. Para a análise comparativa entre essas duas amostras, foram considerados os seguintes parâmentros: vaginometria final, efeitos adversos e satisfação sexual após o tratamento. Esses dados foram obtidos por meio dos registros nos prontuários médicos. A satisfação sexual foi aferida por questão simples: como está sua vida sexual? RESULTADOS: Houve diferença em relação ao comprimento da vagina tanto naquelas submetidas à técnica de Frank (comprimento inicial 2,4±2,0 cm, após o tratamento 6,9±1,1 cm, pPURPOSE: This study aimed to evaluate the results of neovaginoplasty by a modified McIndoe-Bannister technique and by the non-surgical Frank technique. METHODS: This retrospective study was conducted on a convenience sample of 25 women with vaginal agenesis undergoing surgical or conservative treatment at an Infant-Pubertal Gynecology Outpatient Clinic. Data were obtained from the medical records. Fifteen women underwent the surgical McIndoe-Bannister modified technique Surgical Group, and 10 women underwent the non-surgical Frank technique Frank Group. The following parameters were considered for comparative analysis between the two samples: vaginometry, surgical and non-surgical complications, and sexual satisfaction after treatment. Sexual satisfaction was assessed by a simple question: How is your sex life? RESULTS: There were differences related to vaginal length before and after performing exercises in both Frank Group (initial vaginal length 2

  16. [Vulvovaginitis: vaginal pH changes and associated microflora].

    Science.gov (United States)

    Saturnino, Ana Conceiçáo Ribeiro Dantas; Sisenando, Herbert Ary Arzabe Anteza Costa Nóbrega; Pereira, Alessandra Ramalho; Vale, Ana Patrícia Medeiros; Pires, Leila Monte; de Araújo, Jarine Torres; Ramos, Eleni Souto Nóbrega

    2005-01-01

    To establish a correlation between pH vaginal and the microflora associated in carriers of vulvovaginites. In the present study, the cytopathological examination and the vaginal flow in a group of 65 sexually active women had been carried through, 20 and 72 years, taken care of in the Laboratório de Citologia Clínica do Departamento de Análises Clínicas e Toxicológicas da Universidade Federal do Rio Grande do Norte, for determination of microorganisms in cervicovaginal sample and of pH in the vaginal flow. Associating pH vaginal with the presence of vulvovaginitis, it was evidenced that the Candida sp. occurred more frequently in pH 4.0, Trichomonas vaginalis in pH 6.0, Gardnerella vaginalis in pH 5.0, coconuts in pH 5.0, bacilli in pH 4.0 and cocos/bacilos in pH 6.0. It was observed that all the patients had presented at least one type of ethiological agent of vulvovaginiti and an associated microflora. The joint accomplishment of the cytological examinations and the determination of pH revealed important for directing the microflora associated with the vulvovaginiti, suggesting, of this form, that pH vaginal plays preponderant role how much to the presence of the infectious agents in the vaginal ecosystem.

  17. Posthysterectomy vault prolapse of vaginal walls: Choice of operating procedure

    Directory of Open Access Journals (Sweden)

    Argirović Rajka

    2012-01-01

    Full Text Available Post-hysterectomy vaginal vault prolapse is a common complication following different types of hysterectomy with a negative impact on the woman’s quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanisms for the uterus and vagina is important in order to make the right choice of the corrective procedure and also to minimize the risk of posthysterectomy occurrence of vault prolapse. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced in hysterectomy to prevent vault prolapse. Vaginal vault repair can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures. The vaginal approach for vault prolapse is superior to the abdominal approach in terms of complication rates, blood loss, postoperative discomfort, length of hospital stay and costeffectiveness. Moreover, it allows the simultaneous repair of all coexistent pelvic floor defects, such as cystocele, enterocele and rectocele. Abdominal sacrocolpopexy is associated with a lower rate of recurrent vault prolapse and dyspareunia than the vaginal sacrospinous colpopexy. Other less commonly performed procedures include uterosacral ligament suspension and illeococcygeal fixation with a high risk of ureteric injury. Surgical mesh of non-absorbent material is gaining in popularity and preliminary data from vaginal mesh procedures is encouraging.

  18. Vaginitis in pregnancy is related to adverse perinatal outcome.

    Science.gov (United States)

    Xu, Fengqiu; Du, Xiaodong; Xie, Lili

    2015-01-01

    To determine whether education level and occupation are risk factors of vaginitis in pregnant women and to investigate relationship between vaginitis occurrence during pregnancy and perinatal mortality rates. A total of 319 women of early pregnancy or mid-pregnancy were enrolled. Six specimens were collected from posterior fornix of each pregnant woman and then cultured for identification of Neisseria gonorrhoeae, intestinal bacteria, general bacteria, fungi, mycoplasma, and chlamydia, respectively. The pregnant women in the "elementary school or below" group and the "middle school" group had significantly higher incidences of vaginitis compared with the pregnant women in the groups of "high school", "skill education", and "college or above". The pregnant women in the groups of "Worker", "Government employee", "Company employee", and "Professionals" had significantly lower vaginitis incidences. The women with infections of Neisseria gonorrhoeae, intestinal bacteria, and general bacteria had higher perinatal mortalities (0.063 ± 0.011, 0.052 ± 0.012, and 0.017 ± 0.008, respectively) than women with infections of fungi, mycoplasma, and Chlamydia (0.002 ± 0.007, 0.003 ± 0.004, and 0.001 ± 0.001, respectively). Education level and occupation are risk factors related to incidences of vaginitis in pregnant women. The bacteria-related vaginitis is a major reason of perinatal mortality.

  19. The aetiology of vaginal symptoms in rural Haiti.

    Science.gov (United States)

    Bristow, Claire C; Desgrottes, Tania; Cutler, Lauren; Cutler, David; Devarajan, Karthika; Ocheretina, Oksana; Pape, Jean William; Klausner, Jeffrey D

    2014-08-01

    Vaginal symptoms are a common chief complaint amongst women visiting outpatient clinics in rural Haiti. A systematic sample of 206 consecutive women over age 18 with gynaecological symptoms underwent gynaecologic examination and laboratory testing for chlamydia, gonorrhoea, syphilis, HIV infection, trichomoniasis, candidiasis, and bacterial vaginosis. Among 206 women, 174 (84%) presented with vaginal discharge, 165 (80%) with vaginal itching, 123 (60%) with vaginal pain or dysuria, and 18 (9%) with non-traumatic vaginal sores or boils. Laboratory results were positive forChlamydia trachomatisin 5.4% (11/203), syphilis in 3.5% (7/202), HIV in 1.0% (2/200), andNeisseria gonorrhoeaein 1.0% (2/203). Among those that had microscopy, hyphae suggestive of candidiasis were visualized in 2.2% (1/45) and no cases of trichomoniasis were diagnosed 0% (0/45). Bacterial vaginosis was diagnosed in 28.3% (13/46). The prevalence of chlamydia was 4.9 (95% CI: 1.3-17.7) times greater among those 25 years of age and under (10.8%) than those older (2.3%). Chlamydia and bacterial vaginosis were the most common sexually transmitted infection and vaginal condition, respectively, in this study of rural Haitian adult women. The higher risk of chlamydia in younger women suggests education and screening programmes in young women should be considered.

  20. Intravaginally applied oxytocin improves post-menopausal vaginal atrophy.

    Science.gov (United States)

    Al-Saqi, Shahla H; Uvnäs-Moberg, Kerstin; Jonasson, Aino F

    2015-09-01

    To explore the efficacy of local oxytocin for the treatment of post-menopausal vaginal atrophy. Double-blinded randomised controlled trial. Healthy post-menopausal women in Stockholm, Sweden. Sixty four post-menopausal women between February and June 2012 at the Karolinska University Hospital Huddinge/Sweden. The efficacy of oxytocin for treatment of vaginal atrophy after seven weeks and cytological evaluation. The percentage of superficial cells in the vaginal smears and the maturation values were significantly increased after seven weeks of treatment with vagitocin 400 IU (p = 0.0288 and p = 0.0002, respectively). The vaginal pH decreased significantly after seven weeks of treatment with vagitocin 100 IU (p = 0.02). The scores of vaginal atrophy, according to the histological evaluation, were significantly reduced after administration of vagitocin 100 IU (p = 0.03). The thickness of the endometrium did not differ between the treatment and placebo groups after seven weeks of treatment. The symptom experienced as the most bothersome was significantly reduced after seven weeks of treatment in the women receiving vagitocin 400 IU compared to women in the placebo group (p = 0.0089). Treatment with intravaginally applied oxytocin could be an alternative to local estrogen treatment in women with post-menopausal vaginal atrophy. © The Author(s) 2015.

  1. Endogenous or exogenous origin of vaginal candidiasis in Polish women?

    Science.gov (United States)

    Mnichowska-Polanowskai, Magdalena; Wojciechowska-Koszko, Iwona; Klimowicz, Bogumia; Szymaniak, Ludmia; Krasnodebska-Szponder, Barbara; Szych, Zbigniew; Giedrys-Kalemba, Stefania

    2013-01-01

    Vaginal candidiasis is a common problem of clinical practice. Many studies have been conducted to explain its origin but only a few have included Polish women. The aim of the study was to determine the prevalence and similarity of oral, anal and vaginal Candida albicans strains isolated from Polish women with vaginal candidiasis. The study involved 20 from 37 recruited women. Swab samples were collected from their vagina, anus, and oral cavity at two-month intervals. All the women were treated with nystatin. Yeast were recovered and identified by the germ-tube test, API /Vitek system, typed by API ZYM and RAPD-PCR. Chi-square test was used to analyze the data. A total of 170 Candida albicans isolates were recovered from 180 samples collected 3 times from 3 sites of 20 women. Positive yeast vaginal cultures were found in all patients before administration of nystatin. Vaginal yeast recovery rate was decreased statistically significant in both follow-up visits (p= 0.001; p= 0.003). The same and different genotypes/biotypes were found concomitantly in a few body sites and/ or repeatedly at time interval from the same body site. The results support the concept of dynamic exchange of yeast within one woman and endogenous or exogenous origin of vaginal candidiasis.

  2. Impedance pattern of vaginal and vestibular mucosa in cyclic goats

    Directory of Open Access Journals (Sweden)

    Ivo Křivánek

    2008-01-01

    Full Text Available The changes of vaginal and vestibular impedance during the oestrous cycle in goats were examined. The onset of oestrus was teased with a buck once a day during the experiment. Impedance was mea­sured by a four-terminal method. The vaginal impedance was recorded under slight pressure of electrodes to the vaginal dorsal wall at the cervix. The vestibular impedance was recorded under slight pressure of electrodes to the vestibular dorsal wall 5 cm from the vulva and at the vulva. The im­pe­dan­ce was measured once a day from 4 days before the expected oestrus to 6 days after onset of oestrus. The vaginal impedance at the cervix decreased during pro-oestrus (P < 0.01 and increased du­ring oestrus (P < 0.01. The vestibular impedance 5 cm from the vulva decreased during pro-oestrus (P < 0.01 and increased after oestrus (P < 0.01. The decrease of vaginal impedance during peri-oestrus was nearly twofold in comparison with the vestibular impedance 5 cm from the vulva. No sig­ni­fi­cant decrease of the vestibular impedance at the vulva was found during the oestrous cycle. The results indicate that the vaginal impedance at the cervix and vestibular impedance 5 cm from the vulva measured by means of a four-terminal method during the oestrous cycle display cyclic changes that are closely related to the oestrous behaviour of goats.

  3. Sexual Absorption of Vaginal Progesterone: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Kathryn S. Merriam

    2015-01-01

    Full Text Available Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P=0.0075. Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P=0.0008. Conclusion(s. Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464.

  4. Analysis of the Oxidative Stress Status in Nonspecific Vaginitis and Its Role in Vaginal Epithelial Cells Apoptosis

    Science.gov (United States)

    Chen, Zhaojie; Zhang, Zhen; Zhang, Haiyan; Xie, Beibei

    2015-01-01

    Nonspecific vaginitis (NSV), also named bacterial vaginosis, is one of the most common genital system diseases in women during their reproductive years. The specific pathogenic mechanism of NSV is not clear yet. Upon the balance alteration, large amount of reactive oxidant species (ROS) is generated and accumulated in the genital tract, and thus resulting in oxidative stress, which has been reported to be an important trigger of mitochondrial pathway cell apoptosis. In this study, the antioxidant secretion level and antioxidant enzyme activity in the vaginal discharge were evaluated to analyze the oxidative status in the vaginal tract of NSV patients. The effect of oxidative stress on the vaginal mucosa epithelial cell apoptosis was then studied. The role of oxidative stress on NSV development was uncovered; thus open new direction for the prevention and treatment of NSV by providing antiradical agents was revealed. PMID:26558281

  5. Analysis of the Oxidative Stress Status in Nonspecific Vaginitis and Its Role in Vaginal Epithelial Cells Apoptosis

    Directory of Open Access Journals (Sweden)

    Zhaojie Chen

    2015-01-01

    Full Text Available Nonspecific vaginitis (NSV, also named bacterial vaginosis, is one of the most common genital system diseases in women during their reproductive years. The specific pathogenic mechanism of NSV is not clear yet. Upon the balance alteration, large amount of reactive oxidant species (ROS is generated and accumulated in the genital tract, and thus resulting in oxidative stress, which has been reported to be an important trigger of mitochondrial pathway cell apoptosis. In this study, the antioxidant secretion level and antioxidant enzyme activity in the vaginal discharge were evaluated to analyze the oxidative status in the vaginal tract of NSV patients. The effect of oxidative stress on the vaginal mucosa epithelial cell apoptosis was then studied. The role of oxidative stress on NSV development was uncovered; thus open new direction for the prevention and treatment of NSV by providing antiradical agents was revealed.

  6. Preparation and characterisation of fluconazole vaginal films for the treatment of vaginal Candidiasis

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    L Kumar

    2013-01-01

    Full Text Available Objective of the present study was to develop and evaluate vaginal films with essential in vitro studies. Films were developed using hydroxypropyl methylcellulose as a polymer and formulations were coded. The developed films were evaluated with Fourier transform infrared spectroscopy, drug content, viscosity, surface pH, thickness, mechanical characterisation and in vitro drug release study. Fourier transform infrared spectroscopy results confirmed that there is no chemical interaction between drug and stabilisers/excipients. The batch variation was not more than 5% for average thickness and weight of the films. The drug content for the prepared formulation was in the range of 72.32±0.18% to 94.48±0.54%. Viscosity of the formulations increased with the increase in concentration of polymer. Mechanical characterisation revealed that tensile strength and percentage elongation of the films improved as there is increase in degree of substitution of the polymer, but the values of modulus decreased which confirmed that all the prepared films are soft in nature. The in vitro study indicated that 1 and 2% concentrations of polymer are the least concentrations to control the release of drug whereas the 4% concentration of polymer is a good and more effective concentration to control the release. Only one prepared formulation released the drug by following anomalous transport whereas other film formulations released the fluconazole by following Fickian diffusion mechanism. Prepared vaginal films may be an important alternative for the treatment of vaginal candidiasis, because these prepared films suggest the benefits of controlled release of fluconazole at the site of absorption.

  7. Uterus preserving vaginal surgery versus vaginal hysterectomy for correction of female pelvic organ prolapse.

    Science.gov (United States)

    Iliev, Vasil N; Andonova, Irena T

    2014-01-01

    The objective of this study is to evaluate uterus preserving vaginal procedure of cervical amputation with uterosacral ligament plication (modified Manchester operation) and compare it to vaginal hysterectomy regard recurrence rate, duration of surgery, blood loses, intra and post-operative complications, duration of hospital stay. Consecutive women with pelvic organ prolapse who underwent either vaginal hyste-rectomy or a modified Manchester procedure were included. Assessments were made preoperatively and at 1-year follow-up, including physical examination with pelvic organ prolapse quantification standardized questionnaires. 66 patients were included in the study with a one year follow-up. We found no significant difference in: recurrence of POP and reintervention (recurrence with required treatment n (%): 3(10) vs. 5(15), p=0.28) and hospital stay (mean±SD days: 5±2 vs. 7±2, p=0.97). Significant less blood loses (250±210 ml. vs. 360±230 ml.) and shorter operation time (67±20 min. vs 102±22 min.) in modified Manchester group, but significant more urinary retention (cases: 8 vs 6) in modified Manchester group. The overall functional outcome was acceptable for both procedures. We found an excellent performance of both procedures regarding recurrences and intra and post-operative complications. A high degree of acceptance-satisfaction shows the modified Manchester operation and is good option for the treatment of uterine prolapse in younger women who wish to keep their uterus and in all cases of genital prolapse with elongation of uterine cervix (when there is not other uterine pathology). Shorter operation time and lower blood lose are another factors for stronger recommendation of the modified Manchester operation for patients with concomitant diseases and/or older age patients with elevated risk from anesthesia and/or surgery.

  8. Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs. Cesarean Section.

    Science.gov (United States)

    Barbara, Giussy; Pifarotti, Paola; Facchin, Federica; Cortinovis, Ivan; Dridi, Dhohua; Ronchetti, Camilla; Calzolari, Luca; Vercellini, Paolo

    2016-03-01

    Several studies have explored the association between modes of delivery and postpartum female sexual functioning, although with inconsistent findings. To investigate the impact of mode of delivery on female postpartum sexual functioning by comparing spontaneous vaginal delivery, operative vaginal delivery, and cesarean section. One hundred thirty-two primiparous women who had a spontaneous vaginal delivery, 45 who had an operative vaginal delivery, and 92 who underwent a cesarean section were included in the study (N = 269). Postpartum sexual functioning was evaluated 6 months after childbirth using the Female Sexual Function Index. Time to resumption of sexual intercourse, postpartum depression, and current breastfeeding also were assessed 6 months after delivery. Female Sexual Function Index total and domain scores and time to resumption of sexual intercourse at 6 months after childbirth. Women who underwent an operative vaginal delivery had poorer scores on arousal, lubrication, orgasm, and global sexual functioning compared with the cesarean section group and lower orgasm scores compared with the spontaneous vaginal delivery group (P < .05). The mode of delivery did not significantly affect time to resumption of sexual intercourse. Women who were currently breastfeeding had lower lubrication, more pain at intercourse, and longer time to resumption of sexual activity. Operative vaginal delivery might be associated with poorer sexual functioning, but no conclusions can be drawn from this study regarding the impact of pelvic floor trauma (perineal laceration or episiotomy) on sexual functioning because of the high rate of episiotomies. Overall, obstetric algorithms currently in use should be refined to decrease further the risk of operative vaginal delivery. Copyright © 2016. Published by Elsevier Inc.

  9. Sexual functioning and vaginal changes after radical vaginal trachelectomy in early stage cervical cancer patients: a longitudinal study

    DEFF Research Database (Denmark)

    Froeding, LP; Ottesen, C; Rung-Hansen, H

    2014-01-01

    Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce.......Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce....

  10. Partial vaginal expulsion of a leiomyosarcoma

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    Kaori Yokochi

    2013-06-01

    Full Text Available Uterine sarcomas are an uncommon and heterogeneous group of tumors that account for 3-7% of the malignant neoplasms of the uterus and approximately 1% of all malignant tumors of the female genital system. The main clinical manifestations are abnormal uterine bleeding in pre- or postmenopausal women. Pelvic pain, abdominal distension, urinary urgency, and profuse and fetid leukorrhea are other frequent complaints. The authors present a case of a 48-year-old patient that was in amenorrhea for 2 years, who sought treatment for vaginal bleeding. On physical examination, the abdomen was distended, painful in the hypogastrium and upon examination of the external genitalia, it was observed the exteriorization of an amorphous “mass”. The patient was submitted to uterine curettage. The results of the histological examination revealed leiomyosarcoma. Staging workup showed an enlarged uterus with endometrial lesion, and non-calcified pulmonary nodules. The patient underwent a pan-hysterectomy and chemotherapy, and is under oncologic treatment. The authors call attention for the unusual form of presentation of this entity.

  11. Improving Vaginal Examinations Performed by Midwives

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    Rhoda S. Muliira

    2013-06-01

    Full Text Available A vaginal examination (VE is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant,embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management ofpain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE.

  12. Tela de polipropileno versus correção sítio-especifica no tratamento do prolapso de parede vaginal anterior: resultados preliminares de ensaio clínico randômico

    OpenAIRE

    Jacqueline Leme Lunardelli; Antonio Pedro Flores Auge; Nucélio Luiz de Barros Moreira Lemos; Silvia da Silva Carramão; André Lima de Oliveira; Eliana Duarte; Tsutomu Aoki

    2009-01-01

    OBJETIVO: Comparar o uso de tela de polipropileno e correção sitio-específica no tratamento cirúrgico do prolapso vaginal anterior. MÉTODOS: Estudo prospectivo randômico comparativo em que foram operadas 32 pacientes com idades entre 50 e 75 anos, que apresentavam prolapso vaginal anterior estádio III ou IV, ou recidivado. A estática pélvica foi avaliada segundo as recomendações da International Continence Society (ICS), o sistema POP-Q e pelo Índice de Quantificação de Prolapso (POP-Q-I) Abs...

  13. Vaginal and pelvic recurrence rates based on vaginal cuff length in patients with cervical cancer who underwent radical hysterectomies.

    Science.gov (United States)

    Kim, K; Cho, S Y; Park, S I; Kim, B J; Kim, M H; Choi, S C; Ryu, S Y; Lee, E D

    2011-09-01

    The objective of this study was to determine the association of vaginal cuff length (VCL) with vaginal and pelvic recurrence rates in patients with cervical cancer who underwent radical hysterectomies. The clinicopathologic characteristics were collected from the medical records of 280 patients with cervical cancer who underwent radical hysterectomies. The association of VCL with 3-year vaginal and pelvic recurrence rates was determined using a Z-test. The association of VCL with other clinicopathologic characteristics was also determined. The VCL was not associated with 3-year vaginal and pelvic recurrence rates. The 3-year vaginal recurrence rate was 0%-2% and the 3-year pelvic recurrence rate was 7%-8%, independent of VCL. The VCL and the age of patients had an inverse relationship. However, the VCL was not associated with histologic type, FIGO stage, clinical tumor size, tumor size in the surgical specimen, depth of invasion, lymphovascular space invasion, parametrial involvement, lymph node involvement, and adjuvant therapy. One-hundred ninety of 280 patients (68%) underwent adjuvant therapies following radical hysterectomies. Although it is limited by the high rate of adjuvant therapy, the current study suggested that the VCL following radical hysterectomy in patients with cervical cancer was not associated with vaginal and pelvic recurrence rates. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. THE PROFILE OF VAGINAL TEMPERATURE AND CYTOLOGY OF VAGINAL SMEAR IN BALI CATTLE DURING ESTRUS CYCLE PHASE

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    Indira P.N.

    2015-09-01

    Full Text Available The objective of the study was to evaluate physiological condition of Bali cattle during estrus. Ninecattles were used in the research. The method of the research was descriptive analysis. The measurementof vaginal temperature was conducted by using digital thermometer and cytology of vaginal smear wasdone by using cotton bud swabbed on object glass. It was washed by methanol and was stained withGiemsa staining and was observed by microscope. The results indicated that vaginal temperature were38.39 ± 0.29 oC; 38.05 ± 0.15 oC; 37.4 ± 0.74 oC; 37.86 ± 0.3 oC at estrus, metestrus, diestrus, proestrusphase, respectively. On the basis of the cytology of vaginal smear, estrus phase had more superficialcornification and intermediate cells causing estrogen concentration increased. In conclusion, the profileof vaginal temperature showed that each kind of estrus cycle phase had characteristic within estrus. Thecytology of vaginal smear showed various types of cells preferences in different phase of estrus cycle.

  15. Early pregnancy vaginal microbiome trends and preterm birth.

    Science.gov (United States)

    Stout, Molly J; Zhou, Yanjiao; Wylie, Kristine M; Tarr, Phillip I; Macones, George A; Tuuli, Methodius G

    2017-09-01

    Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Nonculture 16S ribosomal RNA gene sequencing suggests important racial differences and pregnancy specific changes in the vaginal microbial communities. A recent study examining the association of the vaginal microbiome and preterm birth documented important findings but was performed in a predominantly white cohort. Given the important racial differences in bacterial communities within the vagina as well as persistent racial disparities in preterm birth, it is important to examine cohorts with varied demographic compositions. To characterize vaginal microbial community characteristics in a large, predominantly African-American, longitudinal cohort of pregnant women and test whether particular vaginal microbial community characteristics are associated with the risk for subsequent preterm birth. This is a nested case-control study within a prospective cohort study of women with singleton pregnancies, not on supplemental progesterone, and without cervical cerclage in situ. Serial mid-vaginal swabs were obtained by speculum exam at their routine prenatal visits. Sequencing of the V1V3 region of the 16S rRNA gene was performed on the Roche 454 platform. Alpha diversity community characteristics including richness, Shannon diversity, and evenness as well as beta diversity metrics including Bray Curtis Dissimilarity and specific taxon abundance were compared longitudinally in women who delivered preterm to those who delivered at term. A total of 77 subjects contributed 149 vaginal swabs longitudinally across pregnancy. Participants were predominantly African-American (69%) and had a preterm birth rate of 31%. In subjects with subsequent term delivery, the vaginal microbiome demonstrated stable community richness and Shannon diversity, whereas subjects with subsequent preterm delivery had significantly decreased vaginal richness

  16. Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa

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    Bailey Robin

    2005-03-01

    Full Text Available Abstract Background Bacterial vaginosis (BV – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS in The Gambia, West Africa. Methods We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire. Results BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 – 47.6 and anaerobes (P = 0.001 [OR] could not be calculated, but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 – 0.15, and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 – 0.28. Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12

  17. Vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy for enlarged myomatous uterus: a randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    Fan Rong; Zhu Lan; Lang Jing-he; Shi Hong-hui; Gong Xiao-ming

    2011-01-01

    Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy (VH) and laparoscopic assisted vaginal hysterectomy (LAVH) for enlarged myomatous uterus.Methods:Fifty patients from Peking Union Medical College Hospital (PUMCH) were randomly assigned to two treatment groups:VH (n=23) and LAVH (n=27).All procedures were performed by a single senior surgeon to maintain homogeneity.Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH (76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH (6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion.Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.

  18. Vaginal suppositories containing Lactobacillus acidophilus: development and characterization.

    Science.gov (United States)

    Rodrigues, Francisca; Maia, Maria João; das Neves, José; Sarmento, Bruno; Amaral, Maria Helena; Oliveira, Maria Beatriz P P

    2015-01-01

    The aim of this study was to develop and characterize suppositories for vaginal delivery of Lactobacillus acidophilus. Formulations were performed in order to select suitable excipients based on suppository formation feasibility and cytotoxicity. Solid body and hollow-type suppositories were prepared by melting and molding using poly(ethylene glycol) (PEG) 400 and 4000 or Witepsol (WIT) H12 as excipients. L. acidophilus was incorporated in the molten mass before molding solid body suppositories or added as suspension into the cavity of hollow-type suppositories and sealed molten excipients. Cytotoxicity of the selected excipients was evaluated by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium and lactate dehydrogenase assays against VK2/E6E7, HEC-1-A and HeLa cells. Suppositories were characterized regarding organoleptic characteristics, mass uniformity, disintegration, breaking strength and L. acidophilus in vitro release. PEG 400, PEG 4000 and WIT H12 showed the absence of toxicity when tested using three different vaginal cell lines. Obtained vaginal suppositories presented uniform and mild texture, a content of about 1 × 10(8) colony-forming units, completely disintegrated in simulated vaginal environment in less than 60 min and provided sustained in vitro release of L. acidophilus. Release studies further demonstrated that incorporation of freeze-dried bacteria did not result in significant loss of viable bacteria, thus supporting that vaginal suppositories may possess good properties to promote the replacement of the vaginal flora in situations of urinary tract infection. Hollow-type suppositories showed to be promising delivery vehicles for vaginal delivery of probiotics.

  19. Study of Candida Albicans Vaginitis Model in Kunming Mice

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhuo; KONG Xiaofeng

    2007-01-01

    The model of vaginal candidiasis in Kunming mice was constructed in order to search for the optima construction conditions and provide an economic animal model of Candida albicans (C.albicans) vaginitis. Estrogen benzoate (E2) was given to mice at different concentrations ranging from 0.0 to 0.05 mg/mouse (4 levels) beginning 72 h prior to vaginal inoculation, then mice were inoculated intravaginally with various concentrations of stationary-phase C. albicans blastoconidia (ATCC90028) (5 levels) in 20 μL of phosphate-buffered saline (PBS) in each F2 level. General state,scores of genital pathology, the hyphae and vaginal fungal burden (CFU) in vaginal lavage fluid, the hydrops rate of uterus and vaginal tissues for pathological section in mice were observed and obtained at day 2, 4, 7, 14 and 21 after inoculation. The results showed the infection rate in mice was related to the dosage of E2 and concentration of C. albicans blastoconidia. Additionally there was better cross-effect between the two treated factors. The infection rate was about 80% on the day 4,and could reach 100% on the day 7 until the end of experiment after inoculated intravaginally in groups of E2I3, E2 0.025 mg/mouse injected hypodermically and inoculated intravaginally with 5×104 C. albicans blastoconidia, and large amount of hyphae and blastoconidia could be observe in superficial layer tissue and canal of vaginal by PAS. From the results in our experiment it was concluded that E2I3 was the optima construction condition in kunming mice.

  20. Microbiota cérvico-vaginal de ovelhas mestiças e sua susceptibilidade aos antibióticos

    Directory of Open Access Journals (Sweden)

    Valdenice F. Silva

    2011-07-01

    Full Text Available A criação de ovinos tem se desenvolvido nas últimas décadas, entretanto ainda são escassas informações sobre a composição e potencial patogênico da microbiota cérvico-vaginal de ovelhas. O presente estudo teve como objetivo conhecer os microrganismos constituintes da microbiota cérvico-vaginal de ovelhas, bem como sua susceptibilidade aos antimicrobianos. Foram realizadas coletas em 60 animais sadios, pertencentes a rebanhos de Petrolina e região. Foi realizado o isolamento bacteriano em ágar sangue e ágar MacConkey, sendo os microrganismos identificados de acordo com características morfológicas, tintoriais e bioquímicas. As amostras foram submetidas ao teste de difusão em disco para determinar o perfil de sensibilidade aos antimicrobianos: sulfametazina, enrofloxacina, doxiciclina, tetraciclina, penicilina, amoxicilina, cefalotina e lincomicina. Foram obtidos 94 isolados, sendo constatada uma maior frequência de Staphylococcus spp. (32,97%, Escherichia coli e Micrococcus spp., sendo observado ainda, isolados de Acinetobacter spp., Shigella spp., Enterobacter spp., Klebsiella spp. e Streptococcus spp. Os isolados apresentaram alta sensibilidade aos antimicrobianos testados sendo observado o menor percentual de sensibilidade para lincomicina. A presença de microrganismos oportunistas de potencial patogênico, na microbiota, como Staphylococcus spp e Escherichia coli, remete a uma análise criteriosa em relação ao diagnóstico de infecções genitais. Os isolados bacterianos obtidos neste estudo são sensíveis à maioria dos grupos de drogas antimicrobianas testadas, demonstrando o potencial de utilização desses princípios ativos, além da disponibilidade de escolha, visto a ausência de multirresistência.

  1. Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

    1983-06-01

    Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery.

  2. OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES IN REFERRED CASES

    Directory of Open Access Journals (Sweden)

    Prameela

    2015-03-01

    Full Text Available INTRODUCTION: Instrumental vaginal deliveries are important procedures. Performed in indicated cases and attending to the well laid criterias will reduce the fetal and maternal morbidity. These assisted instrumental vaginal deliveries help in reducing the caesarean sec tion rate. AIMS AND OBJECTIVES: To determine the incidence and indications of instrumental vaginal deliveries. To know the maternal and fetal outcome in ventouse (vaccum assisted vaginal delivery and forceps deliveries. MATERIAL AND METHOD: This was a retrospective study carried between 01/06/2014 to 31/08/2014 at Cheluvamba Hospital, Mysore Medical College and Research Institute. The hospital records of all the referred patients who had ventouse (vaccum assisted vaginal delivery and forcep s deliveries were obtained and data on age, parity, referral and type of procedure performed, APGAR score and complications were entered into a proforma and analyzed. RESULT: During the period under review there were total of 3385 deliveries, LSCS 843 case s(24.9%, Total instrumental vaginal deliveries 110 cases(3.2%. 33 Ventouse (vaccum assisted vaginal delivery deliveries(0.9%, 57 Low forceps deliveries(1.68% and 20 Outlet forceps deliveries(0.59%.Most common indication for instrumental deliveries be ing fetal distress(62 cases , Prolonged second stage of labour and maternal exhaustion (36 cases.Cut short 2 nd stage of labour - previous LSCS(8cases and Eclampsia(2cases, RHD(1case, Sickle cell anemia with avascular necrosis femur neck(1case.Number of alive babies(103 babies, Perinatal mortality 7cases(0.20%, 8 babies required NICU admission for 3 - 4 days, 1 baby had subdural hematoma, 2 babies had forceps mark. Complications like vaginal tear (4 cases, episiotomy extension (18 cases. CONCLUSION: Ve ntouse and forceps remains appropriate tool in the armamentarium of the modern obstetrician. The major factor which determines the safety of the instrument is the operator rather than the

  3. Vaginal biological and sexual health--the unmet needs.

    Science.gov (United States)

    Graziottin, A

    2015-01-01

    The vagina is a most neglected organ. It is usually clinically considered with a minimalistic view, as a 'connecting tube' for a number of physiologic functions: passage of menstrual blood, intercourse, natural conception and delivery. Unmet needs include, but are not limited to, respect of vaginal physiologic biofilms; diagnosis and care of the optimal tone of the levator ani, which surrounds and partly support it; care of its anatomic integrity at and after delivery and at pelvic/vaginal surgery; care of long-term consequences of pelvic radiotherapy; long-term care of the atrophic changes it will undergo after the menopause, unless appropriate, at least local, estrogen therapy is used; appreciation and respect of its erotic meaning, as a loving, receptive, 'bonding' organ for the couple. The vaginal erotic value is key as a non-visible powerful center of femininity and sexuality, deeply and secretly attractive in terms of taste, scent (together with the vulva), touch and proprioception. The most welcoming when lubrication, softness and vaginal orgasm award the woman and the partner with the best of pleasures. Prevention of sexual/vaginal abuse is a very neglected unmet need, as well. Who cares?

  4. Successful treatment of vaginal malakoplakia in a young cat

    Directory of Open Access Journals (Sweden)

    Ryan P Cattin

    2016-10-01

    Full Text Available Case summary A 3-year-old, female, spayed, domestic shorthair cat presented for dysuria and haematuria, unresponsive to antibiotic treatment. A small, fleshy, erythematous mass protruded from the vaginal vault. Ultrasound identified a vaginal mass effect with mixed echogenicity measuring in excess of 3 cm. Vaginoscopy confirmed an extensive, fleshy, irregular mass that was characterised histologically as pyogranulomatous vaginitis, with periodic acid–Schiff-positive macrophages containing gram-negative bacteria. Fluorescence in situ hybridisation analysis demonstrated invasive intracellular Escherichia coli. Vaginal malakoplakia was diagnosed. Tissue culture and antimicrobial susceptibility of E coli was used to guide treatment. A 6 week course of enrofloxacin 5 mg/kg q24h resulted in complete resolution of the mass and clinical signs. Relevance and novel information Malakoplakia is a rare chronic inflammatory condition that has been previously reported in the bladder of two cats. The pathogenesis of malakoplakia is thought to involve ineffective killing of bacteria (eg. E coli, similar to granulomatous colitis in Boxers and French Bulldogs. The literature on malakoplakia in cats is sparse. This is the first reported feline case with vaginal involvement, intracellular E coli and successful treatment with a fluoroquinolone. Malakoplakia is an important, non-neoplastic differential diagnosis when a mass is identified in the urogenital system of a young cat.

  5. Susceptibility to Vaginal Candidiasis under Different Conditions in Mice

    Institute of Scientific and Technical Information of China (English)

    TAN Juan; LI Jiawen; CHEN Shanjuan; WU Yan; QIN Fang; DING Juan; CAO Fei; ZHANG Shaoru

    2005-01-01

    In order to study the susceptibility of murine vaginal mucosa to Candida albicans under different conditions, vaginal lavage fluid and vaginal tissue of mice were observed and compared be tween murine models with normal immune system (estrogen-treated mice) and immunosuppressed murine model, and between primary infection model of vaginal candidiasis and secondary infection one. The average level of colony forming unit (CFU) from the immuosuppressed group was higher than that from estrogen-treated group at each time point and the peak time was delayed. The differences between the two groups were statistically significant (P<0.05) from the fourth day after in oculation. A significant difference existed in the average level of CFU between the control group and the estrogen-treated group (P<0.05), and between the control group and the immuosuppressed group (P<0.01). It was concluded that the vaginal mucosa from the immunosuppressed mice is more susceptible to Candida albicans and no difference is found in susceptibility between mice with primary infection and secondary infection.

  6. Neovaginal construction in vaginal aplasia and sex-reassignment surgery.

    Science.gov (United States)

    Siemssen, P A; Matzen, S H

    1997-03-01

    During the period 1984-1994 33 patients were admitted to the department of plastic surgery for the purpose of neovaginal construction. They comprised 22 patients with vaginal agenesis or aplasia and 11 transsexual men. In most cases neovaginal construction was done by blunt dissection and lining with a split thickness skin graft from the thigh, and in the cases of sex-reassignment surgery genital skin was also used. The two groups differed as the patients with vaginal agenesis or aplasia had remarkably few complications compared with the transsexual group. The most common complications were defects in the skin grafts and vaginal stenosis. The transsexuals therefore had an extended recovery period including several admissions and visits to the outpatient clinic. The difference in genotype does not explain the high complication rate in the transsexual group as eight in the vaginal agenesis or aplasia group had Morris syndrome (testicular feminisation (XY)). However, the phenotype may be of importance in vaginal construction as the male (transsexual) pelvis is narrow and the levator muscles are stronger than those in the female pelvis.

  7. Streptococcal toxic shock syndrome secondary to group A Streptococcus vaginitis.

    Science.gov (United States)

    Hikone, Mayu; Kobayashi, Ken-Ichiro; Washino, Takuya; Ota, Masayuki; Sakamoto, Naoya; Iwabuchi, Sentaro; Ohnishi, Kenji

    2015-12-01

    Streptococcal toxic shock syndrome (TSS) is a systemic illness usually caused in the setting of infection by group A Streptococcus (GAS). The primary infections are often invasive infections of the respiratory tract or necrotizing infections of the skin and soft tissue, but some infections occur without relevant focus. GAS vaginitis is a rare condition among adult women and is accordingly thought to be uncommon as a cause of streptococcal TSS. Here we report the cases of two postmenopausal women with streptococcal TSS secondary to GAS vaginitis, one aged 55 and one aged 60. Both came to our emergency department with complaints or symptoms of abdominal pain, fever, hypotension, and multi-organ failure. In both cases, the relevant factor associated with streptococcal infection was a recent episode of GAS vaginitis. Both underwent fluid management and 14 days of antibiotic treatment and fully recovered without complications. Vaginitis was likely to be the primary infectious trigger of TSS in these two cases. Intrauterine device insertion, endometrial biopsy, and post-partum state have all been previously reported in TSS patients, and the female genital tract has been described as a portal of entry. GAS vaginitis warrants appropriate treatment as it may progress to severe systemic infection as described. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Potential Use of Antimicrobial Peptides as Vaginal Spermicides/Microbicides

    Directory of Open Access Journals (Sweden)

    Nongnuj Tanphaichitr

    2016-03-01

    Full Text Available The concurrent increases in global population and sexually transmitted infection (STI demand a search for agents with dual spermicidal and microbicidal properties for topical vaginal application. Previous attempts to develop the surfactant spermicide, nonoxynol-9 (N-9, into a vaginal microbicide were unsuccessful largely due to its inefficiency to kill microbes. Furthermore, N-9 causes damage to the vaginal epithelium, thus accelerating microbes to enter the women’s body. For this reason, antimicrobial peptides (AMPs, naturally secreted by all forms of life as part of innate immunity, deserve evaluation for their potential spermicidal effects. To date, twelve spermicidal AMPs have been described including LL-37, magainin 2 and nisin A. Human cathelicidin LL-37 is the most promising spermicidal AMP to be further developed for vaginal use for the following reasons. First, it is a human AMP naturally produced in the vagina after intercourse. Second, LL-37 exerts microbicidal effects to numerous microbes including those that cause STI. Third, its cytotoxicity is selective to sperm and not to the female reproductive tract. Furthermore, the spermicidal effects of LL-37 have been demonstrated in vivo in mice. Therefore, the availability of LL-37 as a vaginal spermicide/microbicide will empower women for self-protection against unwanted pregnancies and STI.

  9. Use of locally delivered dequalinium chloride in the treatment of vaginal infections: a review.

    Science.gov (United States)

    Mendling, Werner; Weissenbacher, Ernst Rainer; Gerber, Stefan; Prasauskas, Valdas; Grob, Philipp

    2016-03-01

    Vaginal infections are responsible for a large proportion of gynaecological outpatient visits. Those are bacterial vaginosis (BV), vulvovaginal candidosis (VVC), aerobic vaginitis (AV) associated with aerobic bacteria, and mixed infections. Usual treatments show similar acceptable short-term efficacy, but frequent recurrences and increasing microbial resistance are unsolved issues. Furthermore, vaginal infections are associated with a variety of serious adverse outcomes in pregnancy and generally have a major impact on quality of life. Identifying the correct therapy can be challenging for the clinician, particularly in mixed infections. Dequalinium chloride (DQC) is an anti-microbial antiseptic agent with a broad bactericidal and fungicidal activity. Systemic absorption after vaginal application of DQC is very low and systemic effects negligible. Vaginal DQC (Fluomizin vaginal tablets) has been shown to have equal clinical efficacy as clindamycin in the treatment of BV. Its broad antimicrobial activity makes it appropriate for the treatment of mixed vaginal infections and in case of uncertain diagnosis. Moreover, resistance of pathogens is unlikely due to its multiple mode of action, and vaginal DQC provides also a reduced risk for post-treatment vaginal infections. Vaginal DQC (10 mg) as 6-day therapy offers a safe and effective option for empiric therapy of different vaginal infections in daily practice. This review summarizes the available and relevant pharmacological and clinical data for the therapy of vaginal infections with vaginal DQC and provides the rationale for its use in daily gynaecologic practice.

  10. Local Expression of Vaginal Th1 and Th2 Cytokines in Murine Vaginal Candidiasis under Different Immunity Conditions

    Institute of Scientific and Technical Information of China (English)

    Shanjuan CHEN; Shaohua LI; Yan WU; Zhixiang LIU; Jiawen LI

    2008-01-01

    To investigate the expression of vaginal Th1 and Th2 cytokines in rats with experimental vaginal candidiasis under different immune conditions, ICR murine vaginal candidiasis model was established and immno-suppressed murine models of vaginal cadidiasis were established in estrogen-treated mice. Non-estrogen-treated mice were used as controls. The mRNA level of Th1(IL-2)/Th2 (IL-4, IL-10, TGF-β1) cytokines in murine vaginal tissues was determined by RT-PCR.The cykotine in local tissues was increased to different extent under normal immune condition. IL-2mRNA was increased during early stage of infection, while IL-10 was increased transiently during late stage of infection. TGF-β1 production was found to be increased persistently. At same time, the expression of IL-2 mRNA was suppressed in immno-suppressed group, and the level of IL-4, IL-10,and TGF-β1 were higher than the normal immunity group to different degree during infection. The high level of IL-2 mRNA during early stage of infection was associated with clearance of mucosal Candidia albicans (C. albicans), and its expression suppressed leading to decreased clearance of mucosal C. albican in immuno-suppression. The over-expression of IL-4 and IL-10 could significantly enhance the susceptibility to C. albicans infection in mice.

  11. Large vesico-vaginal fistula caused by a foreign body.

    Science.gov (United States)

    Massinde, An; Kihunrwa, A

    2013-07-01

    Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

  12. Oral microflora in infants delivered vaginally and by caesarean section.

    Science.gov (United States)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron; Blomqvist, Susanne; Dahlén, Gunnar; Twetman, Svante

    2011-11-01

    BACKGROUND.  Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. AIM.  To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. DESIGN.  This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County Hospital in Halmstad, Sweden. Medically compromised and premature children (oral health need to be further investigated.

  13. Aetiology and management of non-specific vaginitis.

    Science.gov (United States)

    Dattani, I M; Gerken, A; Evans, B A

    1982-01-01

    In a study of 100 women with non-specific vaginitis, characterised by a vaginal discharge which was malodorous and pruritic in most cases and caused dyspareunia and dysuria in some, Gardnerella vaginalis was isolated in 46% of patients. When present, G vaginalis was significantly associated with Mycoplasma hominis and Bacteroides species. Isolation of G vaginalis was unrelated to the presenting symptoms. Treatment with povidone-iodine pessaries for two weeks produced no pronounced benefit, either clinically or microbiologically, compared with a placebo. Nevertheless, 68% of all patients followed reported improvement four weeks after the start of treatment. The findings suggest that G vaginalis is one cause of non-specific vaginitis, which is more likely to be seen in women using oral contraceptives and is usually cured spontaneously. PMID:7034858

  14. The Human Vaginal Bacterial Biota and Bacterial Vaginosis

    Directory of Open Access Journals (Sweden)

    Sujatha Srinivasan

    2008-01-01

    Full Text Available The bacterial biota of the human vagina can have a profound impact on the health of women and their neonates. Changes in the vaginal microbiota have been associated with several adverse health outcomes including premature birth, pelvic inflammatory disease, and acquisition of HIV infection. Cultivation-independent molecular methods have provided new insights regarding bacterial diversity in this important niche, particularly in women with the common condition bacterial vaginosis (BV. PCR methods have shown that women with BV have complex communities of vaginal bacteria that include many fastidious species, particularly from the phyla Bacteroidetes and Actinobacteria. Healthy women are mostly colonized with lactobacilli such as Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus iners, though a variety of other bacteria may be present. The microbiology of BV is heterogeneous. The presence of Gardnerella vaginalis and Atopobium vaginae coating the vaginal epithelium in some subjects with BV suggests that biofilms may contribute to this condition.

  15. Acrometastasis to hand in vaginal carcinoma: A rare entity

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2012-01-01

    Full Text Available Although metastases to bones from solid tumors are very common, involvement of small bones of the hands is extremely rare. We report the first case of acrometastasis in vaginal carcinoma. We present a 65-year-old multiparous woman with FIGO Stage II vaginal carcinoma. The patient received treatment with external beam radiotherapy followed by brachytherapy. She had complete response to above treatment. Eleven months later, she presented with swelling on dorsum of hand. Investigations revealed metastasis to 4th metacarpal bone with lung metastasis. Hence, we present a patient with metastasis of carcinoma vagina to the 4 th metacarpal to draw the attention for the potential of such lesions to be developed in this region. It should be remembered that bone metastasis at unusual sites might be seen in vaginal carcinoma. We present this case because of its rarity and for documentation and discussion.

  16. Prevalência de diagnóstico médico auto-relatado de miomas uterinos em população brasileira: Padrões demográficos e socioeconômicos no Estudo Pró-Saúde *

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    Karine de Lima Sírio Boclin

    2013-06-01

    Full Text Available Introdução: Os miomas uterinos (MU são considerados os tumores mais comuns do sistema reprodutor feminino; no entanto, existem poucos estudos epidemiológicos sobre essa condição no Brasil. Objetivo: Estimar as prevalências de história auto-relatada de MU segundo características demográficas, socioeconômicas e de acesso a serviços de saúde. Métodos: Foram analisados dados de 1.733 trabalhadoras de universidade no Rio de Janeiro, participantes da linha de base do Estudo Pró-Saúde (1999-2001, em relação a três desfechos: (1 diagnóstico médico de MU, (2 MU com sintomas prévios ao diagnóstico e (3 casos que realizaram histerectomia pelo tumor. As prevalências e seus intervalos de 95% de confiança (IC 95% foram estimadas em relação a estratos de variáveis demográficas (idade, cor/raça, socioeconômicas (escolaridade, renda e marcadoras de acesso a serviços de saúde (teste Papanicolaou , exame de mama, plano de saúde. Resultados: A prevalência de diagnóstico médico de MU foi de 23,3% (IC 95% - 21,3; 25,2; a de MU com sintomas prévios ao diagnóstico, de 13,3% (IC 95% - 11,7; 15,0 e a de histerectomia pelo tumor, de 8,4% (IC 95% - 7,5; 10,3. Entre participantes abaixo de 45 anos de idade, foram observadas prevalências mais elevadas nos estratos de piores condições socioeconômicas e de cor/raça preta. Entre aquelas com 45 anos ou mais, foram encontradas maiores prevalências entre mulheres com melhor acesso a serviços de saúde. Conclusão: Entre as mulheres brasileiras investigadas, os MU constituem problema relevante de saúde, com prevalências e gradientes sociodemográficos similares aos observados em populações de outros países.

  17. Free glycogen in vaginal fluids is associated with Lactobacillus colonization and low vaginal pH.

    Directory of Open Access Journals (Sweden)

    Paria Mirmonsef

    Full Text Available Lactobacillus dominates the lower genital tract microbiota of many women, producing a low vaginal pH, and is important for healthy pregnancy outcomes and protection against several sexually transmitted pathogens. Yet, factors that promote Lactobacillus remain poorly understood. We hypothesized that the amount of free glycogen in the lumen of the lower genital tract is an important determinant of Lactobacillus colonization and a low vaginal pH.Free glycogen in lavage samples was quantified. Pyrosequencing of the 16S rRNA gene was used to identify microbiota from 21 African American women collected over 8-11 years.Free glycogen levels varied greatly between women and even in the same woman. Samples with the highest free glycogen had a corresponding median genital pH that was significantly lower (pH 4.4 than those with low glycogen (pH 5.8; p<0.001. The fraction of the microbiota consisting of Lactobacillus was highest in samples with high glycogen versus those with low glycogen (median = 0.97 vs. 0.05, p<0.001. In multivariable analysis, having 1 vs. 0 male sexual partner in the past 6 months was negatively associated, while BMI ≥30 was positively associated with glycogen. High concentrations of glycogen corresponded to higher levels of L. crispatus and L. jensenii, but not L. iners.These findings show that free glycogen in genital fluid is associated with a genital microbiota dominated by Lactobacillus, suggesting glycogen is important for maintaining genital health. Treatments aimed at increasing genital free glycogen might impact Lactobacillus colonization.

  18. Total laparoscopic hysterectomy : retrospective analysis of 262 cases

    OpenAIRE

    Silva, Cristina Nogueira; Ribeiro, Samuel Santos; Barata, Sónia; Alho, Conceição; Osório, Filipa; Jorge, Carlos Calhaz

    2014-01-01

    Introdução: A histerectomia é a cirurgia ginecológica major mais frequentemente realizada nos países desenvolvidos, considerando- -se três principais vias de abordagem: vaginal, abdominal e laparoscópica. Apesar de múltiplas vantagens, a histerectomia totalmente laparoscópica tem-se associado a controvérsia relativamente à taxa de complicações. Objectivos: Análise da nossa casuística de histerectomia totalmente laparoscópica e avaliação da taxa de complicações. Material e Métodos:...

  19. Descubriendo las prácticas de cuidado de adolescentes gestantes con infección vaginal Discovering care practices of pregnant adolescents with vaginal infection Descobrindo as práticas de cuidado de adolescentes gestantes com infecção vaginal

    Directory of Open Access Journals (Sweden)

    MUÑOZ DE RODRÍGUEZ LUCY

    2009-12-01

    ethnographic design, based on ethno-nursing of Leininger’s trans-cultural theory. Interviews and Spradley’s ethnographic analysis were used and an average of three interviews was applied to each one of the 7 participants, until saturation of information was achieved. The sample’s representativeness was based on the quality of the information offered. From the in depth analysis, three domains and taxonomies were built: 1. Knowledge of vaginal infection, 2. Protecting actions, 3. Counseling received. The study revealed that pregnant adolescents had knowledge of vaginal infections, they knew its causes and consequences and they established protective measures aimed at combating the infection and at avoiding re-infection, with treatments based more on informal counseling rather than on a formal one. For pregnant adolescents, treating the vaginal infection meant putting into practice the advice received from the informal and formal sources in combating vaginal infection until it disappear and in avoiding re-infection as well as complications for themselves and for the baby to be born. The different ways they had of knowing and of establishing care practices during the vaginal infection were evident and the absence of formal counseling from professional nurses was highlighted.O estudo visa descobrir o significado de cuidado a partir de práticas e crenças culturais das adolescentes gestantes com diagnóstico de infecção vaginal que se apresentaram no posto de controle pré-natal da ESE Hospital San Rafael de Girardot durante o primeiro trimestre de 2007. Desenho qualitativo, de tipo etnográfico, baseado na etnoenfermagem da teoria transcultural de Leininger. A técnica de pesquisa esteve baseada no uso do questionário e analise etnográfica de Spradley, com uma média de três entrevistas a cada uma das sete participantes, até que houve suficiente informação. A amostra esteve caracterizada pela qualidade da informação fornecida. A partir da análise em

  20. Inhibition of HIV and HSV infection by vaginal lactobacilli in vitro and in vivo

    National Research Council Canada - National Science Library

    Zabihollahi, Rezvan; Motevaseli, Elahe; Sadat, Seyed Mehdi; Azizi-Saraji, Ali Reza; Asaadi-Dalaie, Sogol; Modarressi, Mohammad Hossein

    2012-01-01

    ...) is the portal of entry for sexually transmitted pathogens. The in vitro anti-viral effect of vaginal and non-vaginal lactobacillus was evaluated using single cycle HIV-1 replication and HSV-2 plaque reduction assays...

  1. Women Report Vaginal Ring for Preventing HIV had Little Effect on Sexual Intercourse

    Science.gov (United States)

    ... News Releases News Release Tuesday, October 18, 2016 Women report vaginal ring for preventing HIV had little ... social harm were associated with low adherence. Most women who used an experimental vaginal ring for HIV ...

  2. Treatment of vaginal infections: effectiveness of the association of metronidazole and clotrimazole

    Directory of Open Access Journals (Sweden)

    Simone Ferrero

    2010-03-01

    Full Text Available The normal vagina of women of reproductive age is colonised by lactobacilli that produce lactic acid, hydrogen peroxide and bacteriocins; these substances contribute to lowering the vaginal pH. A low vaginal pH creates an environment hostile to the growth of other microrganisms. When the number of lactobacilli is decreased, the resulting increase in the pH may favour vaginal infections. The three most common vaginal infections are bacterial vaginosis, trichomoniasis, and vaginal candidosis. There are multiple clinical and laboratory tests for diagnosing vaginal infections; the most commonly used methods for diagnosing bacterial vaginosis are the Amsel’s criteria and the Nugent’s Gram stain scale. Infections caused by Candida and Trichomonas vaginalis can be diagnosed by microscopic examination of vaginal secretions. Clotrimazole and metronidazole, especially when administered topically, are highly effective in treating vaginal infections.

  3. Effects of feminine hygiene products on the vaginal mucosal biome

    Directory of Open Access Journals (Sweden)

    Raina N. Fichorova

    2013-02-01

    Full Text Available Background: Over-the-counter (OTC feminine hygiene products come with little warning about possible side effects. This study evaluates in-vitro their effects on Lactobacillus crispatus, which is dominant in the normal vaginal microbiota and helps maintain a healthy mucosal barrier essential for normal reproductive function and prevention of sexually transmitted infections and gynecologic cancer. Methods: A feminine moisturizer (Vagisil, personal lubricant, and douche were purchased OTC. A topical spermicide (nonoxynol-9 known to alter the vaginal immune barrier was used as a control. L. crispatus was incubated with each product for 2 and 24h and then seeded on agar for colony forming units (CFU. Human vaginal epithelial cells were exposed to products in the presence or absence of L. crispatus for 24h, followed by epithelium-associated CFU enumeration. Interleukin-8 was immunoassayed and ANOVA was used for statistical evaluation. Results: Nonoxynol-9 and Vagisil suppressed Lactobacillus growth at 2h and killed all bacteria at 24h. The lubricant decreased bacterial growth insignificantly at 2h but killed all at 24h. The douche did not have a significant effect. At full strength, all products suppressed epithelial viability and all, except the douche, suppressed epithelial-associated CFU. When applied at non-toxic dose in the absence of bacteria, the douche and moisturizer induced an increase of IL-8, suggesting a potential to initiate inflammatory reaction. In the presence of L. crispatus, the proinflammatory effects of the douche and moisturizer were countered, and IL-8 production was inhibited in the presence of the other products. Conclusion: Some OTC vaginal products may be harmful to L. crispatus and alter the vaginal immune environment. Illustrated through these results, L. crispatus is essential in the preservation of the function of vaginal epithelial cells in the presence of some feminine hygiene products. More research should be invested

  4. Vaginal delivery simulation in the Obstetrics and Gynaecology clerkship.

    Science.gov (United States)

    Nitsche, Joshua; Morris, Dana; Shumard, Kristina; Akoma, Ugochi

    2016-10-01

    Although simulation is now used in other areas of obstetrics and gynaecology, its utility in the training of an uncomplicated vaginal delivery is surprisingly under-explored. Here we describe our experience integrating simulation into the third-year Obstetrics and Gynaecology (OB/GYN) clerkship. In 2013/14, at the start of each 4-week OB/GYN clerkship, each third-year student participated in a 90-minute vaginal delivery simulation session using the Noelle(®) simulator. Upon completion of the clerkship, they were surveyed using a five-point Likert scale questionnaire (1, inferior; 5, superior) to assess self-perceived training adequacy, clinical preparedness and number of deliveries performed during the clerkship. Students who completed the clerkship in 2012/13, before the introduction of the simulation, were also surveyed to serve as a comparison group. Survey scores and number of deliveries performed were compared between the two cohorts of students. The 2013/14 cohort (n = 98) who received simulation training gave their training in vaginal deliveries an average rating of 4.1, versus 2.7 for the 2012/13 cohort that did not receive the simulation (n = 80; p < 0.001). Self-perceived preparedness to perform a vaginal delivery was 4.0 in the 2013/14 cohort, versus 3.0 in the 2012/13 cohort (p < 0.001). There was no difference in the number of deliveries performed between the cohorts. Students that received simulation rated their training adequacy and readiness to perform a vaginal delivery higher than students that did not receive training. Simulation did not increase participation in real-life deliveries. The utility of simulation in the training of an uncomplicated vaginal delivery is under-explored. © 2015 John Wiley & Sons Ltd.

  5. Mifepristone-induced abortion and vaginal bleeding in subsequent pregnancy.

    Science.gov (United States)

    Liang, Hong; Gao, Er-sheng; Chen, Ai-min; Luo, Lin; Cheng, Yi-min; Yuan, Wei

    2011-12-01

    The aim of this study is to explore the effect of first-trimester mifepristone-induced abortion on vaginal bleeding in subsequent pregnancy. This observational cohort study was conducted during 1998-2001 at antenatal clinics in Beijing, Chengdu, and Shanghai, China. The study enrolled 4,931 women with one previous mifepristone-induced abortion, 4,925 women with no history of induced abortion, and 4,800 women with one previous surgical abortion and followed them through pregnancy and childbirth. The rates of vaginal bleeding in pregnant women with a history of medical abortion, no abortion, and surgical abortion were 16.5%, 13.9%, and 17.3%, respectively. The women with medical abortion had a higher risk (adjusted relative risk (aRR)=1.17, 95% confidence interval (CI): 1.07, 1.29) of vaginal bleeding compared with those with no abortion but similar risk to prior surgical abortion. When the correlation between medical abortion and vaginal bleeding was examined by period, increased risk was observed only in the early period (abortion and no abortion showed that the observed risks increased particularly in those with abortion at gestational age ≤ 7 weeks (aRR=1.33, 95% CI: 1.18, 1.49), those followed by a postabortion curettage (aRR=1.58, 95% CI: 1.37, 1.84) or complications (aRR=1.99, 95% CI: 1.67, 2.37). There was no difference between women with medical abortion and women with surgical abortion in the occurrence of vaginal bleeding for either period. One previous mifepristone-induced abortion increased the risk of vaginal bleeding in early gestation period of subsequent pregnancy compared with no abortion, especially if abortion occurred before 7 weeks of gestation and was followed by a curettage or complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Streptococcus salivarius K12 Limits Group B Streptococcus Vaginal Colonization.

    Science.gov (United States)

    Patras, Kathryn A; Wescombe, Philip A; Rösler, Berenice; Hale, John D; Tagg, John R; Doran, Kelly S

    2015-09-01

    Streptococcus agalactiae (group B streptococcus [GBS]) colonizes the rectovaginal tract in 20% to 30% of women and during pregnancy can be transmitted to the newborn, causing severe invasive disease. Current routine screening and antibiotic prophylaxis have fallen short of complete prevention of GBS transmission, and GBS remains a leading cause of neonatal infection. We have investigated the ability of Streptococcus salivarius, a predominant member of the native human oral microbiota, to control GBS colonization. Comparison of the antibacterial activities of multiple S. salivarius strains by use of a deferred-antagonism test showed that S. salivarius strain K12 exhibited the broadest spectrum of activity against GBS. K12 effectively inhibited all GBS strains tested, including disease-implicated isolates from newborns and colonizing isolates from the vaginal tract of pregnant women. Inhibition was dependent on the presence of megaplasmid pSsal-K12, which encodes the bacteriocins salivaricin A and salivaricin B; however, in coculture experiments, GBS growth was impeded by K12 independently of the megaplasmid. We also demonstrated that K12 adheres to and invades human vaginal epithelial cells at levels comparable to GBS. Inhibitory activity of K12 was examined in vivo using a mouse model of GBS vaginal colonization. Mice colonized with GBS were treated vaginally with K12. K12 administration significantly reduced GBS vaginal colonization in comparison to nontreated controls, and this effect was partially dependent on the K12 megaplasmid. Our results suggest that K12 may have potential as a preventative therapy to control GBS vaginal colonization and thereby prevent its transmission to the neonate during pregnancy.

  7. A PREVALÊNCIA DE INCONTINÊNCIA URINÁRIA EM MULHERES NA PÓS-MENOPAUSA

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    Juliana de Oliveira Souza

    2015-08-01

    Full Text Available Este trabalho teve como objetivo verificar a prevalência de incontinência urinária em mulheres no período pós-menopausa e traçar o perfil epidemiológico dessa população. Foram entrevistadas quarenta mulheres com idade entre 50 e 82 anos, com um período mínimo de um ano de amenorreia. A coleta de dados foi realizada utilizando um questionário elaborado pelos próprios autores, que buscavam informações referentes a fatores de risco para a incontinência urinária e suas características clínicas. Dentre as mulheres entrevistadas, 20 apresentavam incontinência urinária, sendo que 70% das mulheres incontinentes eram caucasianas e 80% apresentavam alterações no Índice de Massa Corporal e não faziam uso de Terapia de Reposição Hormonal. Quanto ao histórico gineco-obstétrico, a maioria vivenciou 5 ou mais partos normais e foi submetida à histerectomia. Muitas mulheres entrevistadas relataram perda de urina em mais de uma situação da vida diária. Quando questionadas sobre o tratamento, 80% delas referiram nunca ter procurado ajuda médica e nenhuma delas fazia tratamento para a doença. Sendo assim, na assistência à saúde da mulher, mostra-se necessária a identificação do problema e de seus fatores de risco, assim como estratégias de intervenções para prevenção, diagnóstico e tratamento relacionados à perda urinária feminina.

  8. Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora

    Directory of Open Access Journals (Sweden)

    Cristina Vallone

    2012-01-01

    Full Text Available A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

  9. Effect of sow parity on vaginal electrical impedance.

    Science.gov (United States)

    Rezác, P; Kukla, R; Pöschl, M

    2002-08-15

    The influence of sow parity on the changes of vaginal impedance after weaning was examined. Sows were monitored twice a day for oestrus via exposure to a sexually mature boar. The criterion for confirmation of ovulation was an increase in plasma progesterone levels above 12.5 nmol l(-1) 8 and 12 days after oestrus onset. The impedance measurements were carried out by a four-terminal method. In sows of all parities, the vaginal impedance decreased gradually after weaning (P four-terminal method.

  10. Uterine Arteriovenous Malformation with Sudden Heavy Vaginal Hemmorhage

    Directory of Open Access Journals (Sweden)

    Marianne Haughey

    2013-09-01

    Full Text Available Dysfunctional uterine bleeding (DUB is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility. [West J Emerg Med. 2013;14(5:411-414.

  11. Complications of vaginal hysterectomy - (Analysis of 1105 cases

    Directory of Open Access Journals (Sweden)

    Bhattacharya Menna

    1978-01-01

    Full Text Available Eleven hundred and five cases of vaginal hysterectomy are analysed and their complications discussed. More than 90% of the patients were between the ages of 31 to 60 years. The common indications for hysterectomy were prolapse (51% and dysfunctional uterine bleeding (34.9%. In four cases abdominal approach was necessary to complete the operation. The overall incidence of major complications was 4% and the corrected mortality rate was 0.18%. The complications of vaginal hysterec-tomy by other authors are discussed.

  12. Radiotherapy - an effective treatment for vaginal verrucous carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Reinecke, L. (Witwatersand Univ. and Garden City Clinic, Johannesburg (South Africa)); Thornley, A.L. (Witwatersrand Univ., Johannesburg (South Africa). Dept. of Zoology)

    1993-04-01

    Vaginal carcinoma makes up 1%-2% of all gynaecological tumours. Verrucous carcinoma of the vagina is even more rare -only 16 cases are reported in the scientific literature. A case of a complete regression after 60 Gy fractionated radiotherapy by a tumour 12 cm[sup 3] in size is reported. Most authors are of the opinion that radiotherapy causes anaplastic transformation of verrucous carcinoma. The minority view, that anaplastic transformation does not occur, is correct and is supported by our clinical and radiological data. The conflicting literature on vaginal verrucous carcinoma (VVC) is reviewed with reference to verrucous carcinoma at other sites. (Author).

  13. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    Science.gov (United States)

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  14. [Primary amenorrhea by transverse vaginal septum: a case report and review of the literature].

    Science.gov (United States)

    González-Zárate, Alba Citlalli; Velásquez-Mamani, Jaime

    2014-09-01

    The transverse vaginal septum is one of the rarest anomalies of the reproductive tract classified depending on location. It is manifested by primary amenorrhea, cyclic pain and progressive mass growth at abdominopelvic level, ultrasound and magnetic resonance imaging provides the diagnosis, location and thickness of a transverse vaginal septum, treatment is surgical. We present a case of a teenage patient with primary amenorrhea due to lower transverse vaginal septum with surgical resection and satisfactory follow-up with successful vaginal patency.

  15. Analysis of Lactobacillus Products for Phages and Bacteriocins That Inhibit Vaginal Lactobacilli

    Directory of Open Access Journals (Sweden)

    Lin Tao

    1997-01-01

    Full Text Available Objective: Bacterial vaginosis is associated with an unexplained loss of vaginal lactobacilli. Previously, we have identified certain vaginal lactobacilli-released phages that can inhibit in vitro other vaginal lactobacilli. However, there is no apparent route for phages to be transmitted among women. The purpose of this study was to identify whether certain Lactobacillus products commonly used by women release phages or bacteriocins that can inhibit vaginal lactobacilli.

  16. Development of an in vitro alternative assay method for vaginal irritation

    OpenAIRE

    Ayehunie, Seyoum; Cannon, Chris; LaRosa, Karen; Pudney, Jeffrey; Anderson, Deborah J.; Klausner, Mitchell

    2010-01-01

    The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus-2. Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed u...

  17. The vaginal microbiome, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth.

    Science.gov (United States)

    Witkin, S S

    2015-01-01

    Ascending bacterial infection is implicated in about 40-50% of preterm births. The human vaginal microbiota in most women is dominated by lactobacilli. In women whose vaginal microbiota is not lactobacilli-dominated anti-bacterial defence mechanisms are reduced. The enhanced proliferation of pathogenic bacteria plus degradation of the cervical barrier increase bacterial passage into the endometrium and amniotic cavity and trigger preterm myometrial contractions. Evaluation of protocols to detect the absence of lactobaciili dominance in pregnant women by self-measuring vaginal pH, coupled with measures to promote growth of lactobacilli are novel prevention strategies that may reduce the occurrence of preterm birth in low-resource areas. © 2014 Royal College of Obstetricians and Gynaecologists.

  18. High Dose Vaginal Misoprostol Versus Concentrated Oxytocin + Low Dose Vaginal Misoprostol for Mid-Trimester Labor Induction: A Randomized Trial

    Science.gov (United States)

    Nuthalapaty, Francis S.; Ramsey, Patrick S.; Biggio, Joseph R.; Owen, John

    2013-01-01

    Objective To compare the efficacy and side effects of a high-dose vaginal misoprostol regimen to concentrated intravenous oxytocin plus low-dose vaginal misoprostol for mid-trimester labor induction. Study Design Women at 14-24 weeks, with obstetric or fetal indications for delivery and no prior cesarean, were randomly assigned to receive either vaginal misoprostol 600 μg ×1, then 400 μg q 4 hr × 5 (Group 1) or escalating-dose concentrated oxytocin infusions (277-1667 mU/min) plus vaginal misoprostol 400 μg × 1, then 200 μg q 6 hr × 2, then 100 μg × 1 (Group 2). Analysis was by intent to treat. Primary outcomes were live birth rate and induction-to-delivery interval. Results The intended sample size was 70 women per group; however, the trial was terminated at the initial interim analysis due to a highly significant difference in one of the primary study outcomes. Twenty women were assigned to Group 1 and 18 were assigned to the Group 2. Median induction-to-delivery interval was significantly shorter in Group 1 (12 hr, range 4 - 44 hr) versus Group 2 (18 hr, range 7 - 36 hr; p=0.01). Induction success rate at 12 hours was significantly higher in the Group 1 (60%), compared to Group 2 (22%, p=.02). No significant difference was noted in the live birth rate between Group 1 and 2 (13%, 0%, p = 0.16). The incidence of retained placenta requiring curettage, chorioamnionitis, intrapartum fever, nausea, emesis, and diarrhea were similar between both groups. Conclusion Compared to concentrated oxytocin plus low-dose vaginal misoprostol, high-dose vaginal misoprostol significantly shortens mid-trimester labor inductions. PMID:16157113

  19. Changes in tissue composition of the vaginal wall of premenopausal women with prolapse

    NARCIS (Netherlands)

    Kerkhof, M.H.; Ruiz-Zapata, A.M.; Bril, H.; Bleeker, M.C.G.; Belien, J.A.M.; Stoop, R.; Helder, M.N.

    2014-01-01

    Objective The objective of this study was to compare histological and biochemical features of the (normal) precervical anterior vaginal wall and the prolapsed anterior vaginal wall of women with pelvic organ prolapse (POP). These data were compared to tissue of the precervical anterior vaginal wall

  20. 76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation

    Science.gov (United States)

    2011-03-29

    ... COMMISSION In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation AGENCY: U.S... certain vaginal ring birth control devices by reason of infringement of claim 1 of U.S. Patent No. 6,086... importation, or the sale within the United States after importation of certain vaginal ring birth control...

  1. Qualitative accounts of patients' determinants of vaginal dilator use after pelvic radiotherapy

    NARCIS (Netherlands)

    R.M. Bakker (Rinske M.); W. Vermeer (Willemijn); C.L. Creutzberg (Carien); J.W.M. Mens (Jan); R.A. Nout; M.M. ter Kuile (Moniek)

    2015-01-01

    textabstractIntroduction: Treatment with pelvic external beam radiotherapy with brachytherapy (EBRT/BT) for gynecological cancers may cause sexual dysfunction because of vaginal shortening and tightening. Regular vaginal dilator use is thought to reduce vaginal shortening and/or tightening, but comp

  2. Lipid peroxidation and antioxidant status in vagina microenvironment of patients with several common vaginitis.

    Science.gov (United States)

    Guo, H Y; Hu, X M; Han, D D; Wang, Z P; Meng, L

    2013-01-01

    Oxidative stress has been suggested to play an important role in many diseases, including vaginitis. To evaluate oxidative biomarkers in the secretion of cervix samples of vaginitis, this study will illustrate the status of lipid peroxidation and antioxidant status in vaginal microenvironment. A total of 257 patients with vaginitis, including candida vaginitis, bacterial vaginosis, and trichomonas vaginitis were involved in this study. Cervico-vaginal fluid was collected from these patients before and after treatment, and the malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), hydrogen peroxide (H2O2), and vitamin C levels were measured by enzyme-linked immunosorbent assay (ELISA). The results revealed that the MDA and H2O2 levels were increased in the vaginitis patients, while there was no significant difference in MDA level among different kinds of vaginitis before treatment. The CAT and vitamin C levels in vaginitis were decreased before treatment. Moreover, the data also showed that the MDA and H2O2 levels were decreased, while the CAT, SOD, and vitamin C levels were increased after received treatment, respectively, and there was no significant difference between controls and vaginitis. This study indicated that oxidative stress played an important role in vaginitis.

  3. Qualitative accounts of patients' determinants of vaginal dilator use after pelvic radiotherapy

    NARCIS (Netherlands)

    R.M. Bakker (Rinske M.); W. Vermeer (Willemijn); C.L. Creutzberg (Carien); J.W.M. Mens (Jan); R.A. Nout; M.M. ter Kuile (Moniek)

    2015-01-01

    textabstractIntroduction: Treatment with pelvic external beam radiotherapy with brachytherapy (EBRT/BT) for gynecological cancers may cause sexual dysfunction because of vaginal shortening and tightening. Regular vaginal dilator use is thought to reduce vaginal shortening and/or tightening, but

  4. 21 CFR 529.1003 - Flurogestone acetate-impregnated vaginal sponge.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Flurogestone acetate-impregnated vaginal sponge... § 529.1003 Flurogestone acetate-impregnated vaginal sponge. (a) Specifications. Each vaginal sponge... ewes during their normal breeding season. (2) Limitations. Using applicator provided, insert...

  5. Comparison of the moisturization efficacy of two vaginal moisturizers: Pectin versus polycarbophil technologies.

    Science.gov (United States)

    Caswell, Michael; Kane, Michael

    2002-01-01

    This study was designed to compare the vaginal deposition and moisturization of two vaginal moisturizers, Summer's Eve (SE), based on pectin, and Replens (Rp), based on polycarbophil, in a double-blind crossover study design. Fifty-one female patients were each randomly assigned to one of two treatment groups. After a one-week washout period, the products were used for two weeks. After another one-week washout period, product assignments were switched. Colposcopy examinations were performed at the beginning and at the end of each product use. Of the forty-seven patients completing the study, 41 (87%) were found to have no vaginal residue after SE vaginal moisturizer, while only 25 (53%) were found to have no vaginal residue after using Rp vaginal moisturizer. No difference in relief of vaginal dryness or in product acceptance was found between the two products. This study shows that the use of SE vaginal moisturizer, based on pectin, resulted in significantly less vaginal residue compared to Rp vaginal moisturizer, based on polycarbophil, and in comparable relief of vaginal dryness. These results strongly suggest that bioadhesion is not important in vaginal moisturizers.

  6. Presença de Candida nas mucosas vaginal e bucal e sua relação com IgA salivar Relationship between Candida in vaginal and oral mucosae and salivary IgA

    Directory of Open Access Journals (Sweden)

    Célia Regina Gonçalves e Silva

    2008-06-01

    Full Text Available OBJETIVO: correlacionar a presença de leveduras do gênero Candida na cavidade bucal e vaginal de mulheres com e sem candidíase vulvovaginal (CVV com os níveis de IgA secretora (IgAs presentes na saliva. MÉTODOS: cinqüenta e uma mulheres foram incluídas; 13 apresentaram CVV e 38 formaram o Grupo Controle. De cada paciente, foram coletados 2,0 mL de saliva sem estimulação e secreção vaginal com o auxílio de swab, que foi imerso a seguir em 2,0 mL de solução fisiológica. As amostras foram semeadas em ágar Sabouraud dextrose com cloranfenicol para isolamento e contagem de colônias, e os isolados foram identificadas fenotipicamente. Na saliva de ambos os grupos foi quantificada IgA pela técnica ELISA. RESULTADOS: nas 13 pacientes com diagnóstico clínico e micológico de CVV, a média de unidades formadoras de colônias de Candida por mililitro de secreção vaginal (ufc/mL foi de 52.723 e 23,8% dos pacientes apresentaram colonização na mucosa bucal com menor quantidade de ufc/mL (6.030. Os níveis de IgAs na saliva foram mais baixos no grupo com CVV (média de densidade: 0,3 quando comparados aos níveis de IgA do Grupo Controle (média de DO: 0,6. Onze pacientes (37% do Grupo Controle apresentaram colonização por Candida na cavidade bucal, com média de ufc/mL mais baixa quando comparada ao grupo com CVV. O Grupo Controle também apresentou menor quantidade de ufc/mL (1.973 na cavidade vaginal quando comparado com o Grupo CVV (52.942. CONCLUSÕES: os resultados demonstraram que os pacientes com diagnóstico clínico de candidíase vulvovaginal apresentaram maior quantidade de Candida, tanto na cavidade vaginal quanto na bucal, e apresentaram menores níveis de IgA anti-Candida na saliva.PURPOSE: to correlate the presence of yeast from the Candida genus in the oral and vaginal cavity of women with and without vulvovaginal candidiasis (VVC, with secretor IgA levels (IgAs present in the saliva. METHODS: among the 51 women

  7. Establishing and sustaining a healthy vaginal environment: analysis of data from a randomized trial of periodic presumptive treatment for vaginal infections.

    Science.gov (United States)

    Balkus, Jennifer E; Richardson, Barbra A; Mandaliya, Kishorchandra; Kiarie, James; Jaoko, Walter; Ndinya-Achola, Jeckoniah O; Marrazzo, Jeanne; Farquhar, Carey; McClelland, R Scott

    2011-07-15

    Data from a randomized trial of oral periodic presumptive treatment (PPT) to reduce vaginal infections were analyzed to assess the effect of the intervention on a healthy vaginal environment (normal flora confirmed by Gram stain with no candidiasis or trichomoniasis). The incidence of a healthy vaginal environment was 608 cases per 100 person-years in the intervention arm and 454 cases per 100 person-years in the placebo arm (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.17-1.58). Sustained vaginal health (healthy vaginal environment for ≥3 consecutive visits) was also more frequent in the intervention arm (HR, 1.69; 95% CI, 1.23-2.33). PPT is effective at establishing and sustaining a healthy vaginal environment.

  8. Vaginal Symptoms after Reconstructive Surgery for Prolapsed Pelvic Organ

    Directory of Open Access Journals (Sweden)

    Tahereh Eftekhar

    2010-09-01

    Full Text Available Objective: Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse.Materials and methods: In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ–VS questionnaire pre– and post operation 3 months later.Results: Mean age was 44.86 (31–74 years and %72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order (8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05.Conclusion: Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction.

  9. Characteristics of women with continued use of vaginal pessaries.

    Science.gov (United States)

    Lewthwaite, Barbara J; Staley, Doug; Girouard, Lise; Maslow, Ken

    2013-01-01

    Vaginal pessaries have been shown to be a safe, effective treatment for pelvic organ prolapse, and in some cases, female urinary incontinence. There are limited data that predict long-term pessary use; therefore, the aim of this retrospective, exploratory study was to describe selected characteristics of women using a pessary for 12 months or longer in a nurse-run clinic.

  10. Vaginal hygiene and douching: perspectives of Hispanic men.

    Science.gov (United States)

    McKee, Diane; Baquero, Maria; Anderson, Matthew; Karasz, Alison

    2009-02-01

    Vaginal douching is widely practised by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction and sexuality. Little previous research has addressed the beliefs and practices of Latina women and none has included the perspective of men, though limited data suggests that women may douche to please male partners. The present study seeks to identify the socially and culturally shaped beliefs and attitudes that influence douching practices from the perspective of Latino men. We conducted in-depth qualitative interviews in English or Spanish with adult Latino men seeking primary care at a community health centre in New York City. Results indicate that these Latino men (mostly of Caribbean descent) are emphatic about the role of cleanliness in vaginal health, reporting that it substantially influences their choice of partner. Most are very supportive of douching, which they consider a necessary hygiene activity. Vaginal health is perceived as a state that must be attained and maintained through proactive hygiene measures that remove seminal residue, menstrual blood, sweat and bacteria that contaminate the vagina. The implications of these findings for interventions with Latina women are discussed.

  11. Optimized Benzalkonium Chloride Gel: A Potential Vaginal Microbicides

    Institute of Scientific and Technical Information of China (English)

    Xun-cheng DING; Wei-hua LI; Jie-fei LI; Qiang-yi WANG

    2007-01-01

    Objective To develop an optimized BZK gel with good pharmaceutical effect and less toxicity to vaginal mucosa.Methods Four methods as below were used to research the spermicidal activity of BZK gel: 1)in vitro spermicidal test; 2) in vivo spermicidal test in rabbits; 3) anti-fertility test in rabbits; 4)contraceptive test in rabbits. Mucosal irritation test was used in rats to evaluate the safety of optimized BZK gel. Microbiological assessments were used to research anti-STI pathogens (including treponema pallidum, neisseria gonorrhoeae, trichomona vaginalis, candida albicans,ureaplama urealyticum, herpes simplex virus type-2, chlamydiae trachomatis) effect of optimized BZK gel.Results In vitro spermicidal test, EC50 of BZK gel was 0.029 mg/ml, a little higher than that of N-9 (0.019 mg/ml). The MIC of BZK gel was 0.25 mg/ml, similar to that of N-9 (0.20 mg/ml).The vaginal mucosal irritation test in rats showed that 0.429% BZK gel showed only minimal vaginal irritation, and did not damage the vaginal epithelium or cause local inflammation in rats. Microbiological assessments showed that optimized BZK gel could inhibit or inactivate common STI pathogens even after 3-fold or 5-fold dilution.Conclusion Optimized BZK gel was an effective microbicides.

  12. Antibiotic use during pregnancy alters the commensal vaginal microbiota

    DEFF Research Database (Denmark)

    Stokholm, J.; Schjørring, S.; Eskildsen, Carl Emil Aae

    2014-01-01

    Antibiotics may induce alterations in the commensal microbiota of the birth canal in pregnant women. Therefore, we studied the effect of antibiotic administration during pregnancy on commensal vaginal bacterial colonization at gestational week 36. Six hundred and sixty-eight pregnant women from...

  13. Adaptive plasticity of vaginal innervation in term pregnant rats.

    Science.gov (United States)

    Liao, Zhaohui; Smith, Peter G

    2011-12-01

    Changes in reproductive status place varied functional demands on the vagina. These include receptivity to male intromission and sperm transport in estrus, barrier functions during early pregnancy, and providing a conduit for fetal passage at parturition. Peripheral innervation regulates vaginal function, which in turn may be influenced by circulating reproductive hormones. We assessed vaginal innervation in diestrus and estrus (before and after the estrous cycle surge in estrogen), and in the early (low estrogen) and late (high estrogen) stages in pregnancy. In vaginal sections from cycling rats, axons immunoreactive for the pan-neuronal marker protein gene product 9.5 (PGP 9.5) showed a small reduction at estrus relative to diestrus, but this difference did not persist after correcting for changes in target size. No changes were detected in axons immunoreactive for tyrosine hydroxylase (sympathetic), vesicular acetylcholine transporter (parasympathetic), or calcitonin gene-related peptide and transient receptor potential vanilloid type 1 (TRPV-1; sensory nociceptors). In rats at 10 days of pregnancy, innervation was similar to that observed in cycling rats. However, at 21 days of pregnancy, axons immunoreactive for PGP 9.5 and each of the subpopulation-selective markers were significantly reduced both when expressed as percentage of sectional area or after correcting for changes in target size. Because peripheral nerves regulate vaginal smooth muscle tone, blood flow, and pain sensitivity, reductions in innervation may represent important adaptive mechanisms facilitating parturition.

  14. Granulomatous Vaginal Ulceration due to Metastatic Cutaneous Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1995-01-01

    Full Text Available A 28-year-old woman with a prior history of Crohn's disease was evaluated for painful vaginal ulceration in 1984. Subsequent studies revealed isolated involvement of the vagina with a granulomatous inflammatory process characteristic of metastatic cutaneous Crohn's disease. Conservative symptomatic treatment was associated with resolution and no subsequent recurrence of genital tract disease.

  15. STUDY ON A NEW LEVONORGESTREL VAGINAL CONTRACEPTIVE RING

    Institute of Scientific and Technical Information of China (English)

    ZHANGHai-Wei; ZHENGHuai-Mei

    1989-01-01

    A new contraceptive vaginal ring was jointly produced by the Shanghai Medical University and the Shanghai Rubber Products Research Institute. It has an outer silicone elastomer shell and a tilling of 35 mg levonorgestrel gel in inner core. Amount of LNG release is

  16. Vaginal Practices of HIV-Negative Zimbabwean Women

    Directory of Open Access Journals (Sweden)

    Abigail Norris Turner

    2010-01-01

    Full Text Available Background. Vaginal practices (VPs may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n=2,185 participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84% reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR: 1.17, 95% CI: 1.04–1.32. Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86. Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored.

  17. Vaginal Practices of HIV-Negative Zimbabwean Women

    Science.gov (United States)

    Turner, Abigail Norris; Morrison, Charles S.; Munjoma, Marshall W.; Moyo, Precious; Chipato, Tsungai; van de Wijgert, Janneke H.

    2010-01-01

    Background. Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84%) reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR): 1.17, 95% CI: 1.04–1.32). Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86). Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored. PMID:20871844

  18. The Effect of Prolapse Surgery on Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; van der Vaart, C. Huub; Laan, Ellen; Roovers, Jan-Paul W. R.

    2011-01-01

    Introduction. Prolapse surgery has been shown to have major impact on sexual function. Since prolapse surgery not only influences psychological factors but might also influence physiological conditions such as vaginal innervation, there is a need for objective outcome measurements to better understa

  19. TROMBOSIS DE LA VENA OVARICA DERECHA POSTPARTO VAGINAL

    OpenAIRE

    Donoso S.,Enrique; Poblete L,José; Vargas L.,Mauricio

    2002-01-01

    Se presenta un caso clínico de trombosis de la vena ovárica derecha postparto vaginal. Se analizan los métodos de diagnóstico por imágenes, el diagnóstico diferencial, el tratamiento y la tromboprofilaxis en una futura gestación

  20. Vaginal birth after two or more previous cesarean sections.

    Science.gov (United States)

    Farmakides, G; Duvivier, R; Schulman, H; Schneider, E; Biordi, J

    1987-03-01

    The recommendation from the American College of Obstetricians and Gynecologists is to allow vaginal delivery after one cesarean section. This report is an update of our experience of 57 women with two or more cesarean sections who were allowed to labor.

  1. New techniques to characterise the vaginal microbiome in pregnancy

    Directory of Open Access Journals (Sweden)

    Nadeem O. Kaakoush

    2016-03-01

    Full Text Available Understanding of the vaginal microbiome in health and disease is essential to screen, detect and manage complications in pregnancy. One of the major complications of pregnancy is preterm birth, which is the leading world-wide cause of death and disability in children under five years of age. The aetiology of preterm birth is multifactorial, but a causal link has been established with infection. Despite the importance of understanding the vaginal microbiome in pregnancy in order to evaluate strategies to prevent and manage PTB, currently used culture based techniques provide limited information as not all pathogens are able to be cultured.The implementation of culture-independent high-throughput techniques and bioinformatics tools are advancing our understanding of the vaginal microbiome. New methods employing 16S rRNA and metagenomics analyses make possible a more comprehensive description of the bacteria of the human microbiome. Several studies on the vaginal microbiota of pregnant women have identified a large number of taxa. Studies also suggest reduced diversity of the microbiota in pregnancy compared to non-pregnant women, with a relative enrichment of the overall abundance of Lactobacillus species, and significant differences in the diversity of Lactobacillus spp. A number of advantages and disadvantages of these techniques are discussed briefly. The potential clinical importance of the new techniques is illustrated through recent reports where traditional culture-based techniques failed to identify pathogens in high risk complicated pregnancies whose presence subsequently was established using culture-independent, high-throughput analyses.

  2. Deep sequencing of the vaginal microbiota of women with HIV

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); A.D. Fernandes (Andrew); J.M. Macklaim (Jean); R.J. Dickson (Russell); J. Changalucha (John); G.B. Gloor (Gregory); G.K. Reid (Gregor)

    2010-01-01

    textabstractBackground:Women living with HIV and co-infected with bacterial vaginosis (BV) are at higher risk for transmitting HIV to a partner or newborn. It is poorly understood which bacterial communities constitute BV or the normal vaginal microbiota among this population and how the microbiota

  3. Living with vesico-vaginal fistula: experiences of women awaiting ...

    African Journals Online (AJOL)

    3Department of Social Work, University of Nigeria, Nsukka, Nigeria ... Worldwide two million women are living with vesico-vaginal fistula (VVF) with an annual incidence of 50,000 to 100,000 new ..... disability characteristics and well-being.

  4. Genome Sequences of Nine Gram-Negative Vaginal Bacterial Isolates

    Science.gov (United States)

    Deitzler, Grace E.; Ruiz, Maria J.; Lu, Wendy; Weimer, Cory; Park, SoEun; Robinson, Lloyd S.; Hallsworth-Pepin, Kymberlie; Wollam, Aye; Mitreva, Makedonka

    2016-01-01

    The vagina is home to a wide variety of bacteria that have great potential to impact human health. Here, we announce reference strains (now available through BEI Resources) and draft genome sequences for 9 Gram-negative vaginal isolates from the taxa Citrobacter, Klebsiella, Fusobacterium, Proteus, and Prevotella. PMID:27688330

  5. The Effect of Prolapse Surgery on Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; van der Vaart, C. Huub; Laan, Ellen; Roovers, Jan-Paul W. R.

    Introduction. Prolapse surgery has been shown to have major impact on sexual function. Since prolapse surgery not only influences psychological factors but might also influence physiological conditions such as vaginal innervation, there is a need for objective outcome measurements to better

  6. Benefits of Laser Therapy in Postmenopausal Vaginal Atrophy

    Science.gov (United States)

    Brînzan, Daniela; Pǎiuşan, Lucian; Daşcǎu, Voicu; Furǎu, Gheorghe

    2011-08-01

    Maybe the worst aspect of menopause is the decline of the quality of the sexual life. The aim of the study is to demonstrate the beneficial effects of laser therapy in comparison with topical application of estrogen preparations, for the treatment of vaginal atrophy and sexual dysfunctions induced by menopause. A total of 50 menopausal patients were examined during a one year period. The methods used for objectifying vaginal atrophy and sexual dysfunctions were history taking, local clinical exam and PAP smear. From this group, 40 patients had vaginal atrophy with sexual dysfunctions. They have been treated differently, being included in four groups: patients treated with local estrogens, patients treated with intravaginal laser therapy, patients treated with both laser therapy and estrogens, patients treated with estrogens and placebo laser therapy. Therapeutic benefit, improvement of vaginal atrophy and quality of sexual life, were objectified by anamnesis (questionnaire), local and general clinical examination and PAP smear. The best results have been obtained, by far, in the 3rd group, followed by the women treated only with laser. In conclusion, we can say that laser therapy is the best way for solving the sexual inconveniences of menopause.

  7. Superoxide Radical Formation in Isolated PMN from Experimental Vaginal Trichomoniasis

    Directory of Open Access Journals (Sweden)

    Z Valadkhani

    2006-06-01

    Full Text Available Trichomoniasis, the most widespread sexually transmitted disease is caused by Trichomonas vaginalis. This parasite is site specific for the genitourinary tract and recruitment of macrophages as well as polymorphonuclear nutrophils (PMN to the site of infection is the first line of defense as a component of non-specific resistance and immunity. In this study, BALB/c mice were infected with 10 isolates from symptomatic and 10 from asymptomatic patients. Then PMN from vaginal washes, vaginal tissue and blood of infected mice was isolated and the rate of superoxide formation by intact stimulated PMN was measured. Results showed that, mice infected with symptomatic isolates indicated significant increase in polymorphs with increase in days of infection as compared with mice infected with asymptomatic isolate and control (uninfected animals. Vaginal tissue cells generated maximal amount of superoxide in symptomatic isolates infected animals (5.17 ± 0.36 as compared to asymptomatic isolates (4.54 ± 0.43, which brings out the maximal abnormality in PMN in this localized area. The amount of superoxide radicals generated by cells of vaginal washes and blood of symptomatic isolate infected mice 4.29 ± 0.25 and 2.16 ± 0.35 was less than the asymptomatic isolate (4.94 ± 0.49 and 3.18 ± 0.26, respectively. This study indicates that super oxide radical generation may play role in establishing the infection.

  8. Effects of vaginal lactobacilli in Chlamydia trachomatis infection.

    Science.gov (United States)

    Mastromarino, Paola; Di Pietro, Marisa; Schiavoni, Giovanna; Nardis, Chiara; Gentile, Massimo; Sessa, Rosa

    2014-07-01

    Increasing evidence indicates that abnormal vaginal flora lacking lactobacilli facilitates the acquisition of several sexually transmitted diseases including Chlamydia trachomatis. C. trachomatis, the most common bacterial agent of genital infections worldwide, can progress from the lower to upper reproductive tract and induce severe sequelae. The ability of C. trachomatis to develop into a persistent form has been suggested as key pathogenetic mechanism underlying chronic infections and sequelae. The aim of our study was to investigate the C. trachomatis interaction with vaginal microbiota analyzing the effects of Lactobacillus strains (L. brevis and L. salivarius) on the different phases of C. trachomatis developmental cycle. In addition, the effect of lactobacilli on persistent chlamydial forms induced by HSV-2 coinfection has also been evaluated. Our results demonstrated significant inhibition of C. trachomatis multiplication by vaginal lactobacilli. L. brevis was significantly more effective than L. salivarius (plactobacilli to protect from infection is strain-dependent. Lactobacilli had an adverse effect on elementary chlamydial bodies (plactobacilli toward persistent C. trachomatis forms induced by HSV-2 coinfection. A significant increase in the production of C. trachomatis infectious progeny was observed in C. trachomatis/HSV-2 coinfection in the presence of L. brevis (p=0.01) despite a significant inhibition of C. trachomatis multiplication (p=0.028). Our data suggest that a healthy vaginal microbiota can reduce the risk of acquiring C. trachomatis infection and counteract the development of persistent chlamydial forms.

  9. Amnioinfusion among women attempting vaginal birth after cesarean delivery.

    Science.gov (United States)

    Strong, T H; Vega, J S; O'Shaughnessy, M J; Feldman, D B; Koemptgen, J G

    1992-05-01

    Eighteen of 901 women (2%) attempting vaginal birth after cesarean delivery (VBAC) received amnioinfusion. No untoward effects occurred in the subjects or their fetuses. We conclude that, though amnioinfusion in the setting of a VBAC attempt is needed only infrequently, it appears to be a reasonable intrapartum management option. The usual safeguards for a VBAC attempt should be followed.

  10. Laser therapy for the restoration of vaginal function.

    Science.gov (United States)

    Gambacciani, Marco; Palacios, Santiago

    2017-05-01

    Laser therapy has a therapeutic role in various medical conditions and most recently has gained interest as a non-hormonal treatment for genitourinary syndrome of menopause (GSM) and as a non-invasive option for stress urinary incontinence (SUI). Several therapies are available to alleviate GSM symptoms, including hormonal and non-hormonal products. Both microablative fractional CO2 laser and the non-ablative vaginal Er:YAG laser (VEL) induce morphological changes in the vaginal tissues, and data from non-randomized clinical trials suggest that laser therapy can alleviate vaginal dryness and dyspareunia. VEL has been reported to improve SUI as well as vaginal prolapse. Although large randomized trials have not been reported, the evidence suggests that VEL can be offered as a safe and efficacious alternative to hormone replacement therapy (HRT) for GSM, as well as a first-line treatment for mild to moderate SUI, before surgical procedures are resorted to. Randomized studies are needed to compare laser treatments with other therapies, as well as to assess the duration of the therapeutic effects and the safety of repeated applications. Research is presently evaluating both an automated robotic probe for VEL treatments and an intraurethral probe for the treatment of severe and type III SUI. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Posterior vaginal wall Gartner′s duct cyst

    Directory of Open Access Journals (Sweden)

    Ripan Bala

    2015-01-01

    Full Text Available Cyst of posterior vaginal wall is very rare. This case relates to a patient who presented with polypoidal mass protruding out from vagina which could have been easily mistaken as uterovaginal prolapse, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.

  12. How to Use Vaginal Tablets, Suppositories, and Creams

    Science.gov (United States)

    Using Vaginal Tablets, Suppositories, and CreamsIt is best to use these products just before your bedtime. Lying down will reduce leakage of the ... the applicator from the tube.For tablets or suppositories: Remove the medication from the wrapper and place ...

  13. Nanoparticle incorporation of melittin reduces sperm and vaginal epithelium cytotoxicity.

    Directory of Open Access Journals (Sweden)

    Andrew P Jallouk

    Full Text Available Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001. However, melittin nanoparticles were not cytotoxic to sperm (p = 0.42 or vaginal epithelium (p = 0.48 at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ≥20 µM (p<0.001 and were toxic to sperm at equivalent melittin concentrations ≥40 µM (p<0.001. Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy.

  14. Throwing the dice for the diagnosis of vaginal complaints?

    Directory of Open Access Journals (Sweden)

    Taras David

    2006-02-01

    Full Text Available Abstract Backround Vaginitis is among the most common conditions women are seeking medical care for. Although these infections can easily be treated, the relapse rate is high. This may be due to inadequate use of the diagnostic potential. Methods We evaluated the misjudgement rate of the aetiology of vaginal complaints. A total of 220 vaginal samples from women with a vaginal complaint were obtained and analysed for numbers of total lactobacilli, H2O2-producing lactobacilli, total aerobic cell counts and total anaerobic cell counts including bifidobacteria, Bacteroides spp., Prevotella spp. Additionally, the presence of Atopobium vaginae, Gardnerella vaginalis, Candida spp. and Trichomonas vaginalis was evaluated by DNA-hybridisation using the PCR and Affirm VPIII Microbial Identification Test, respectively. Results The participating physicians diagnosed Bacterial vaginosis (BV as origin of discomfort in 80 cases, candidiasis in 109 cases and mixed infections in 8 cases. However, a present BV, defined as lack of H2O2-lactobacilli, presence of marker organisms, such as G. vaginalis, Bacteroides spp. or Atopobium vaginae, and an elevated pH were identified in only 45 cases of the women examined. Candida spp. were detected in 46 cases. Interestingly, an elevated pH corresponded solely to the presence of Atopobium vaginae, which was detected in 11 cases. Conclusion Errors in the diagnosis of BV and candida vulvovaginitis (CV were high. Interestingly, the cases of misjudgement of CV (77% were more numerous than that of BV (61%. The use of Amsel criteria or microscopy did not reduce the number of misinterpretations. The study reveals that the misdiagnosis of vaginal complaints is rather high.

  15. [Diagnosis of vaginitis-vaginosis by hibridization with DNA strands].

    Science.gov (United States)

    García-Agudo, Lidia; Jesús de la Calle, Iría; Román Enry, Manuela; Aznar Marín, Pilar; Rodríguez-Iglesias, Manuel

    2013-04-01

    Vaginal infections lie among the most common causes women ask for medical advice. In order of frequency bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis are responsible for 90% of vaginitis/vaginosis. To evaluate a DNA hybridization test for simultaneous molecular detection of Gardnerella vaginalis, Candida species and Trichomonas vaginalis, as an alternative to conventional microbiological methods. Cohort, cross-sectional, and comparative study of 1,003 vaginal samples from symptomatic women from our health-care area. Two swabs were obtained from each woman, one for routine microbiological diagnosis of vaginal infection (wet mount, Gram stain, and mycological culture) and the other for the DNA hybridization test (Affirm VPIII, Becton Dickinson). This method detects clinically significant levels of G. vaginalis (2 x 10(5) CFU/ml), Candida spp. (1 x 10(4) cells) and T. vaginalis (5x103 trichomonads). Out of the 1,003 women studied, 30.6% tested positive for bacterial vaginosis, 23.3% for vulvovaginal candidiasis, and 0.5% for trichomoniasis. The Affirm VPIII method turned out positive in 27.5%, 27.4% and 0.5% of cases, respectively. No statistically significant differences were found between the molecular technique and conventional methods for microbiological diagnosis of vaginitis/ vaginosis (p < 0.05). The Affirm VPIII test correlated well with wet mount, Gram stain and mycological culture. Although its cost is relatively high, it is fast, reproducible, easy, and can be done in either clinical laboratories or Gynecology offices, which permits prescribing a specific early treatment.

  16. Comparison of storage conditions for human vaginal microbiome studies.

    Directory of Open Access Journals (Sweden)

    Guoyun Bai

    Full Text Available BACKGROUND: The effect of storage conditions on the microbiome and metabolite composition of human biological samples has not been thoroughly investigated as a potential source of bias. We evaluated the effect of two common storage conditions used in clinical trials on the bacterial and metabolite composition of the vaginal microbiota using pyrosequencing of barcoded 16S rRNA gene sequencing and (1H-NMR analyses. METHODOLOGY/PRINCIPAL FINDINGS: Eight women were enrolled and four mid-vaginal swabs were collected by a physician from each woman. The samples were either processed immediately, stored at -80°C for 4 weeks or at -20°C for 1 week followed by transfer to -80°C for another 4 weeks prior to analysis. Statistical methods, including Kolmogorovo-Smirnov and Wilcoxon tests, were performed to evaluate the differences in vaginal bacterial community composition and metabolites between samples stored under different conditions. The results showed that there were no significant differences between samples processed immediately after collection or stored for varying durations. (1H-NMR analysis of the small molecule metabolites in vaginal secretions indicated that high levels of lactic acid were associated with Lactobacillus-dominated communities. Relative abundance of lactic acid did not appear to correlate with relative abundance of individual Lactobacillus sp. in this limited sample, although lower levels of lactic acid were observed when L. gasseri was dominant, indicating differences in metabolic output of seemingly similar communities. CONCLUSIONS/SIGNIFICANCE: These findings benefit large-scale, field-based microbiome and metabolomic studies of the vaginal microbiota.

  17. Effect of Foeniculum vulgare (fennel) vaginal cream on vaginal atrophy in postmenopausal women: A double-blind randomized placebo-controlled trial.

    Science.gov (United States)

    Yaralizadeh, Masomeh; Abedi, Parvin; Najar, Shahnaz; Namjoyan, Foroogh; Saki, Amal

    2016-02-01

    Vaginal atrophy is one of the main concerns of postmenopausal women. The aim of the present study was to investigate the effect of fennel vaginal cream on vaginal atrophy in postmenopausal women in Ahvaz, Iran. This double-blind randomized controlled trial was conducted on 60 postmenopausal women (45-65 years of age) in Ahvaz, Iran. The study participants were randomly divided into one of two groups, receiving either a placebo (n=30) or fennel 5% vaginal cream (n=30) administered as one application per day (5g/day) for 8 weeks. The vaginal pH and maturation vaginal index (MVI) were measured at baseline and 8 weeks after the intervention, while the vaginal atrophy symptoms was measured at baseline and at 2, 4, and 8 weeks after the intervention. The data were analyzed using the independent t-test, chi-square test, paired sample t-test, and the generalized estimating equation. The number of superficial cells increased significantly in the fennel group after 8 weeks compared to the control group (76.1±15.3 vs. 11.8±8, peffective means to manage the symptoms of vaginal atrophy in postmenopausal women and is devoid of side effects. Larger studies are necessary to confirm the positive impact of fennel for vaginal conditions occurring among postmenopausal women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Histerectomía vaginal en pacientes sin prolapso uterino Vaginal hysterectomy in patients with uterus prolapse

    National Research Council Canada - National Science Library

    Miguel Emilio García Rodríguez; Ramón Ezequiel Romero Sánchez

    2011-01-01

    ... de la investigación fue determinar la eficacia y factibilidad de la histerectomía vaginal por la técnica de Heaney, practicada en pacientes sin prolapso uterino, incluso en presencia de los factores antes mencionados. MÉTODOS. Se realizó...

  19. Tratamento da vaginose bacteriana com gel vaginal de Aroeira (Schinus terebinthifolius Raddi: ensaio clínico randomizado Treatment of bacterial vaginosis with Schinus terebinthifolius Raddi vaginal gel: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2003-03-01

    Full Text Available OBJETIVOS: testar a eficácia e a tolerância do gel de aroeira (Schinus terebinthifolius Raddi para tratamento da vaginose bacteriana. MÉTODOS: quarenta e oito mulheres com vaginose bacteriana sintomática (de acordo com os critérios de Amsel foram incluídas em ensaio clínico randomizado, duplo-cego, controlado, comparando-se o uso do gel vaginal de aroeira (25 casos com placebo (23 casos. Os principais desfechos avaliados foram: taxa de cura, presença de lactobacilos na colpocitologia depois do tratamento e efeitos colaterais. Realizou-se análise estatística usando os testes chi2 e exato de Fisher, ao nível de significância de 5%. RESULTADOS: adotando-se os parâmetros clínicos de Amsel para vaginose bacteriana, a taxa de cura foi de 84% no grupo da aroeira e 47,8% no grupo placebo (p = 0,008. Observou-se freqüência significativamente maior de lactobacilos na colpocitologia entre as pacientes tratadas com aroeira (43,5% em relação ao placebo (4,3% (p = 0,002. Efeitos adversos relacionados ao tratamento não foram freqüentes em ambos os grupos. CONCLUSÕES: o presente estudo indica que o gel vaginal de aroeira é efetivo e seguro para o tratamento da vaginose bacteriana. Além disso, sugerem-se potenciais efeitos benéficos na flora vaginal.PURPOSE: to test the efficacy of and tolerance to Schinus terebinthifolius Raddi gel in the treatment of bacterial vaginosis. METHODS: forty-eight women with symptomatic bacterial vaginosis (according to Amsel's criteria were enrolled in a randomized, double-blind, controlled trial comparing Schinus terebinthifolius Raddi gel (25 cases with placebo (23 cases. The main outcome parameters were: rate of cure, presence of lactobacilli in Pap smear after treatment and side effects. Statistical analysis was performed using the chi2 and the Fisher exact test at 5% level of significance. RESULTS: using Amsel's clinical parameters of bacterial vaginosis, the cure rate was 84% in the Schinus group and

  20. Detection of GBV-C/HGV RNA in cervico-vaginal smears from healthy individuals

    Directory of Open Access Journals (Sweden)

    Maria Angelica Ehara Watanabe

    2008-10-01

    Full Text Available The purpose of the present study was to evaluate the sexual transmission of GBV-C/HGV, through RNA detection in cervicovaginal smears. Therefore the GBV-C/HGV RNA in cervicovaginal smears from apparently healthy women was investigated using routine proceedings for prophylactic screening to cervical cancer. GBV-C/HGV RNA was detected by reverse transcriptase and polymerase chain reaction (RT-PCR. Only one woman presented co-infection with human papilloma virus (HPV. The GBV-C/HGV RNA was detected in 13/73 (17.57% healthy women and it's prevalence in participating women between 28-43 years old was 53.85%. No association was found with GBV-C/HGV for the age of first sexual intercourse and number of pregnancies. In GBV-C/HGV RNA positive women, 69.23% were married. In conclusion, the present findings show that cervical and vaginal specimens could contain the GBV-C/HGV RNA.O objetivo do presente estudo foi avaliar a transmissão sexual de GBV-C/HBV, através da detecção do RNA viral em raspados cérvico-vaginais. Portanto, a presença do RNA GBV-C/HGV foi investigada em raspados cérvico-vaginais em mulheres aparentemente saudáveis que realizaram exames preventivos para câncer cervical. GBV-C/HGV RNA foi detectado por reação de transcriptase reversa e reação em cadeia da polimerase (RT-PCR. Apenas uma mulher apresentou a co-infecção com o papiloma vírus humano (HPV. O RNA GBV-C/HGV foi detectado em 13/73 (17,57% mulheres saudáveis e sua prevalência entre participantes da idade de 28-43 anos foi de 53,85%. Não foi observada relação entre a presença do RNA GBV-C/HGV com a idade de primeira relação sexual, nem com o número de gestações. Entre as mulheres que apresentavam o RNA viral, 69,23% eram casadas. O presente estudo demonstrou que secreções cérvico-vaginais podem conter o RNA viral GBV-C/HBV.

  1. Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia.

    Science.gov (United States)

    Senturk, Mehmet Baki; Cakmak, Yusuf; Atac, Halit; Budak, Mehmet Sukru

    2015-01-01

    Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients' requests influenced outcome. Trial of labor should take into consideration the patient's preference, together with the proper setting.

  2. Application of the low-level laser therapy for the treatment of vaginitis

    Science.gov (United States)

    Passeniouk, A. N.; Mikhailov, V. A.

    2000-06-01

    Vaginitis is the most common female infectious disease. Females suffering from this disorder are annually increasing in number. There are a lot of modalities of treatment of vaginitis, but because of drug allergy and microbe's stability to drug the treatment of vaginitis is difficult. Our study compares the efficacy of laser-therapy with drug therapy in the treatment of non-specific vaginitis and vaginal candidiasis. Thirty women reci4eed the LLLT by local action with antiseptic liquid daily during ten days, 20 women received metronidazole and fluconozole and vaginal application of metronidazole. The results suggest that local laser-therapy is able to remove sights of vaginitis more efficiently and faster than drug therapy. Repair of normal vaginal microflora, which is the best indicator of recovery, was significantly at a faster rate in laser-therapy group. There were no report of adverse reaction with vaginal laser- therapy, whereas there were women on drug therapy who reported side effects. In conclusion, vaginal aser-therapy with antiseptic liquid is a suitable, effective, safe and chip alternative to drug therapy in the treatment of vaginitis.

  3. Forensic interlaboratory evaluation of the ForFLUID kit for vaginal fluids identification.

    Science.gov (United States)

    Giampaoli, Saverio; Alessandrini, Federica; Berti, Andrea; Ripani, Luigi; Choi, Ajin; Crab, Roselien; De Vittori, Elisabetta; Egyed, Balazs; Haas, Cordula; Lee, Hwan Young; Korabecná, Marie; Noel, Fabrice; Podini, Daniele; Tagliabracci, Adriano; Valentini, Alessio; Romano Spica, Vincenzo

    2014-01-01

    Identification of vaginal fluids is an important step in the process of sexual assaults confirmation. Advances in both microbiology and molecular biology defined technical approaches allowing the discrimination of body fluids. These protocols are based on the identification of specific bacterial communities by microfloraDNA (mfDNA) amplification. A multiplex real time-PCR assay (ForFLUID kit) has been developed for identifying biological fluids and for discrimination among vaginal, oral and fecal samples. In order to test its efficacy and reliability of the assay in the identification of vaginal fluids, an interlaboratory evaluation has been performed on homogeneous vaginal swabs. All the involved laboratories were able to correctly recognize all the vaginal swabs, and no false positives were identified when the assay was applied on non-vaginal samples. The assay represents an useful molecular tool that can be easily adopted by forensic geneticists involved in vaginal fluid identification.

  4. Successful treatment of Depot Medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in Adolescents

    Directory of Open Access Journals (Sweden)

    Kristin M. Rager

    2006-01-01

    Full Text Available High discontinuation rates for depot medroxyprogesterone acetate (DMPA in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

  5. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer

    Science.gov (United States)

    Dominguez-Bello, Maria G.; De Jesus-Laboy, Kassandra M.; Shen, Nan; Cox, Laura M.; Amir, Amnon; Gonzalez, Antonio; Bokulich, Nicholas A.; Song, Se Jin; Hoashi, Marina; Rivera-Vina, Juana I.; Mendez, Keimari; Knight, Rob; Clemente, Jose C.

    2016-01-01

    Exposure of newborns to the maternal vaginal microbiota is interrupted with cesarean birthing. Babies delivered by Cesarean section (C-section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders. Here we conducted a pilot study in which infants delivered by C-section are exposed to maternal vaginal fluids at birth. Similar to vaginally delivered babies, the gut, oral, and skin microbiome of these newborns during the first 30 days of life was enriched in vaginal bacteria underrepresented in unexposed C-section infants, albeit similarity to vaginally-delivered infants was higher in oral and skin than in anal samples. Although the long-term health consequences of restoring the microbiota of C-section born infants remain unclear, our results demonstrate that vaginal microbes can be partially restored at birth in C-section delivered babies. PMID:26828196

  6. Complete vaginal outlet stenosis in a patient with Sheehan’s syndrome

    Science.gov (United States)

    Choo, Minji; Park, Hana

    2016-01-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety. PMID:27896263

  7. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid

    Science.gov (United States)

    Moncla, Bernard J.; Chappell, Catherine A.; Debo, Brian M.; Meyn, Leslie A.

    2016-01-01

    In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use) and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed. The activities of four of six glycosidases in the samples from women with bacterial vaginosis were significantly increased when compared to normal or intermediate women: sialidase, P = IUDs (P = 0.02). The number of sialic acid binding sites was lower in the postmenopausal group (P = 0.04), but the number of high mannose binding sites, measured with Griffithsin, was not significantly different among the 6 hormonal groups. The glycosidase levels in the cervical-vaginal mucus were rather low in the groups, with exception of α-glucosidase activity that was much lower in the postmenopausal group (Pmicroorganisms. These effects were so influential that it required us to remove subjects with BV for data interpretation of the impact of hormones. We also suggest that certain changes occurring in vaginal/cervical proteins are due to bacteria or their products. Therefore, the quantitation of vaginal mucins and lectin binding offers a new method to monitor bacteria-host interactions in the female reproductive tract. The data suggest that some of the changes in these components are the result of host processing, such as the increases in mucin content, while the microflora is responsible for the increases in glycosidases and the decreases in lectin binding. The methods should be considered a valid marker for insult to the female genital tract. PMID:27437931

  8. A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

    Directory of Open Access Journals (Sweden)

    Binti R. Bhatiyani

    2017-01-01

    Full Text Available Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed. Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6 were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs. Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol. Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

  9. Associations between vaginal pathogenic community and bacterial vaginosis in Chinese reproductive-age women.

    Science.gov (United States)

    Ling, Zongxin; Liu, Xia; Luo, Yueqiu; Wu, Xiaoxing; Yuan, Li; Tong, Xiaojuan; Li, Lanjuan; Xiang, Charlie

    2013-01-01

    Bacterial vaginosis (BV) is one of the most common urogenital infections among women of reproductive age that represents shifts in microbiota from Lactobacillus spp. to diverse anaerobes. The aim of our study was to evalute the diagnostic values of Gardnerella, Atopobium, Eggerthella, Megasphaera typeI, Leptotrichia/Sneathia and Prevotella, defined as a vaginal pathogenic community for BV and their associations with vaginal pH and Nugent scores. We investigated the vaginal pathogenic bacteria and Lactobacillus spp. with species-specific real-time quantitative PCR (qPCR) in 50 BV-positive and 50 BV-negative Chinese women of reproductive age. Relative to BV-negative subjects, a siginificant decline in Lactobacillus and an obvious increase in bacteria in the vaginal pathogenic community were observed in BV-postive subjects (P<0.05). With the exception of Megasphaera typeI, other vaginal pathogenic bacteria were highly predictable for BV with a better sensitivity and specificity. The vaginal pathogenic community was positively associated with vaginal pH and Nugent scores, while Lactobacillus spp., such as L. iners and L. crispatus was negatively associated with them (P<0.05). Our data implied that the prevalance of vaginal pathogenic bacteria as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Vaginal microbiota shifts, especially the overgrowth of the vaginal pathogenic community, showed well diagnostic values in predicting BV. Postive correlations between those vaginal pathogenic bacteria and vaginal pH, Nugent score indicated the vaginal pathogenic community rather than a single vaginal microorganism, was participated in the onset of BV directly.

  10. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    Science.gov (United States)

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

  11. In vitro/in vivo performance of different complexes of itraconazole used in the treatment of vaginal candidiasis

    Directory of Open Access Journals (Sweden)

    Mohammad Aamir Mirza

    2012-12-01

    Full Text Available A large majority of new chemical entities and many existing drug molecules exhibit poor aqueous solubility, which may limit their potential use in developing drug formulations, with optimum bioavailability. One of the approaches to improve the solubility of a poorly water soluble drug and eventually its bioavailability is complexation with agents like humic acid (HA, fulvic acid (FA, β-cyclodextrin (β-CD, 2-hydroxypropyl-β-cyclodextrin (HP-β-CD and caffeine (Caff. The current work emphasized at employing these agents to prepare different complexes and their in vitro/in vivo assessment. All the complexes evaluated for their complexation efficiency and authenticated by molecular modeling; conformational analysis, differential scanning calorimetry (DSC, X-ray diffraction (XRD, nuclear magnetic resonance (NMR and mass spectroscopy. Furthermore, the complexes were assessed in an in vivo, rat vaginal model for their efficacy in treatment of vaginal candidiasis. Amongst the five tested complexes, fulvic acid-itraconazole complex yielded better solubility as well as in vivo efficacy and therefore may further be explored for developing a commercial formulation for treating vaginal candidiasis.A maioria das novas entidades químicas e muitas moléculas de fármacos existentes apresenta fraca solubilidade em água, o que pode limitar seu uso potencial no desenvolvimento de formulações com biodisponibilidade ideal. Uma das abordagens para melhorar a solubilidade de um fármaco pouco solúvel em água e, eventualmente, a sua biodisponibilidade é a complexação com agentes como o ácido húmico (HA, ácido fúlvico (FA, β-ciclodextrina (β-CD, 2-hidroxipropil-β-ciclodextrina (HP-β-CD e cafeína (Caff. O presente trabalho baseia-se no uso desses agentes para preparar diferentes complexos e suas avaliações in vitro/in vivo. Todos os complexos foram avaliados quanto à eficiência de complexação por modelação molecular, análise conformacional

  12. Prevotella as a Hub for Vaginal Microbiota under the Influence of Host Genetics and Their Association with Obesity.

    Science.gov (United States)

    Si, Jiyeon; You, Hyun Ju; Yu, Junsun; Sung, Joohon; Ko, GwangPyo

    2017-01-11

    While the vaginal ecosystem is maintained through mutualistic relationships between the host and the vaginal bacteria, the effect of host genetics on the vaginal microbiota has not been well characterized. We examined the heritability of vaginal microbiota and its association with obesity in 542 Korean females, including 222 monozygotic and 56 dizygotic twins. The vaginal microbiota significantly varied depending on host menopausal status and bacterial vaginosis. Lactobacillus and Prevotella, whose relative abundances are strongly associated with bacterial vaginosis, were the most heritable bacteria among the beneficial and potentially pathogenic vaginal microbiota, respectively. Candidate gene analysis revealed an association between genetic variants of interleukin-5 and the abundance of Prevotella sp. Furthermore, host obesity significantly increased the diversity of the vaginal microbiota in association with Prevotella. Our results provide insight into the effect of host genetics on the vaginal microbiota and their association with both vaginal and non-vaginal health. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. MTN-001: randomized pharmacokinetic cross-over study comparing tenofovir vaginal gel and oral tablets in vaginal tissue and other compartments.

    Directory of Open Access Journals (Sweden)

    Craig W Hendrix

    Full Text Available BACKGROUND: Oral and vaginal preparations of tenofovir as pre-exposure prophylaxis (PrEP for human immunodeficiency virus (HIV infection have demonstrated variable efficacy in men and women prompting assessment of variation in drug concentration as an explanation. Knowledge of tenofovir concentration and its active form, tenofovir diphosphate, at the putative vaginal and rectal site of action and its relationship to concentrations at multiple other anatomic locations may provide key information for both interpreting PrEP study outcomes and planning future PrEP drug development. OBJECTIVE: MTN-001 was designed to directly compare oral to vaginal steady-state tenofovir pharmacokinetics in blood, vaginal tissue, and vaginal and rectal fluid in a paired cross-over design. METHODS AND FINDINGS: We enrolled 144 HIV-uninfected women at 4 US and 3 African clinical research sites in an open label, 3-period crossover study of three different daily tenofovir regimens, each for 6 weeks (oral 300 mg tenofovir disoproxil fumarate, vaginal 1% tenofovir gel [40 mg], or both. Serum concentrations after vaginal dosing were 56-fold lower than after oral dosing (p<0.001. Vaginal tissue tenofovir diphosphate was quantifiable in ≥90% of women with vaginal dosing and only 19% of women with oral dosing. Vaginal tissue tenofovir diphosphate was ≥130-fold higher with vaginal compared to oral dosing (p<0.001. Rectal fluid tenofovir concentrations in vaginal dosing periods were higher than concentrations measured in the oral only dosing period (p<0.03. CONCLUSIONS: Compared to oral dosing, vaginal dosing achieved much lower serum concentrations and much higher vaginal tissue concentrations. Even allowing for 100-fold concentration differences due to poor adherence or less frequent prescribed dosing, vaginal dosing of tenofovir should provide higher active site concentrations and theoretically greater PrEP efficacy than oral dosing; randomized topical dosing PrEP trials

  14. Identification and genotyping of bacteria from paired vaginal and rectal samples from pregnant women indicates similarity between vaginal and rectal microflora

    Directory of Open Access Journals (Sweden)

    Temmerman Marleen

    2009-10-01

    Full Text Available Abstract Background The vaginal microflora is important for maintaining vaginal health and preventing infections of the reproductive tract. The rectum has been suggested as the major source for the colonisation of the vaginal econiche. Methods To establish whether the rectum can serve as a possible bacterial reservoir for colonisation of the vaginal econiche, we cultured vaginal and rectal specimens from pregnant women at 35-37 weeks of gestation, identified the isolates to the species level with tRNA intergenic length polymorphism analysis (tDNA-PCR and genotyped the isolates for those subjects from which the same species was isolated simultaneously vaginally and rectally, by RAPD-analysis. One vaginal and one rectal swab were collected from a total of each of 132 pregnant women at 35-37 weeks of gestation. Swabs were cultured on Columbia CNA agar and MRS agar. For each subject 4 colonies were selected for each of both sites, i.e. 8 colonies in total. Results Among the 844 isolates that could be identified by tDNA-PCR, a total of 63 bacterial species were present, 9 (14% only vaginally, 26 (41% only rectally, and 28 (44% in both vagina and rectum. A total of 121 (91.6% of 132 vaginal samples and 51 (38.6% of 132 rectal samples were positive for lactobacilli. L. crispatus was the most frequently isolated Lactobacillus species from the vagina (40% of the subjects were positive, followed by L. jensenii (32%, L. gasseri (30% and L. iners (11%. L. gasseri was the most frequently isolated Lactobacillus species from the rectum (15%, followed by L. jensenii (12%, L. crispatus (11% and L. iners (2%. A total of 47 pregnant women carried the same species vaginally and rectally. This resulted in 50 vaginal/rectal pairs of the same species, for a total of eight different species. For 34 of the 50 species pairs (68%, isolates with the same genotype were present vaginally and rectally and a high level of genotypic diversity within species per subject was also

  15. Citologia vaginal a fresco na gravidez: correlação com a citologia corada pela técnica de Papanicolaou Fresh wet mount in pregnancy: correlation with Pap smears

    OpenAIRE

    Amadeu Ramos da Silva Filho

    2004-01-01

    OBJETIVO: analisar o conteúdo vaginal utilizando o exame citológico a fresco na primeira consulta pré-natal em mulheres com ou sem queixas genitais e correlacionar os resultados com os encontrados na citologia corada pela técnica de Papanicolaou. A microscopia direta durante a gravidez deve ser valorizada e reconhecida como método propedêutico capaz de diagnosticar, de forma imediata, 90% dos casos de vaginose bacteriana, candidose e tricomonose. MÉTODOS: estudo prospectivo em 216 gestantes, ...

  16. Assessing the thickness of the vaginal wall and vaginal mucosa in pre-menopausal versus post-menopausal women by transabdominal ultrasound: A feasibility study.

    Science.gov (United States)

    Balica, Adrian; Wald-Spielman, Daniella; Schertz, Katherine; Egan, Susan; Bachmann, Gloria

    2017-08-01

    As life expectancy increases, the number of women reporting adverse genito-urinary symptoms (genitourinary syndrome of menopause; GSM) from menopause, including vaginal dryness and sexual pain, also will increase. Current objective measurements of vaginal atrophy such as maturation index require vaginal swabs and are invasive; at present, no minimally invasive measurements exist. The purpose of this study was to assess whether total vaginal wall thickness (TVT) and total vaginal mucosa thickness (TMT) as measured by transabdominal ultrasound could qualify as additional objective markers of vaginal wall thinning which could be related to menopausal status. Women presenting for pelvic ultrasound had a transabdominal ultrasound scan performed to measure TVT and TMT at the level of the bladder trigone. In addition, a transvaginal endometrial lining thickness was measured. The ultrasound measurement data from 76 participants showed that there was a significant difference in the mean value for TVT and endometrial lining between pre- and post-menopausal women. The same difference in mean was not observed for TMT. TVT may be a reliable measure of vaginal thinning, which worsens with estrogen decline. These preliminary data also suggest that TMT does not have the same correlation as the TVT measurement. A larger sample is needed to further assess the usefulness and sensitivity of these measures and whether there is clinical and/or research usefulness in obtaining vaginal wall measurements by transabdominal ultrasound. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Rescreening for abnormal vaginal flora in pregnancy and re-treating with clindamycin vaginal cream significantly increases cure and improvement rates

    DEFF Research Database (Denmark)

    Lamont, R F; Taylor-Robinson, D; Bassett, P

    2012-01-01

    We investigated 199 pregnant women with bacterial vaginosis (BV) who received clindamycin vaginal cream (CVC) for three days and compared with 205 women treated with placebo. The vaginal flora was assessed at each visit. At the second visit, 71% in the CVC group were cured/improved, compared...

  18. Does vaginal reconstructive surgery with or without vaginal hysterectomy or trachelectomy improve sexual well being? A prospective follow-up study.

    NARCIS (Netherlands)

    Stoutjesdijk, J.; Vierhout, M.E.; Spruijt, J.; Massolt, E.T.

    2006-01-01

    OBJECTIVE: To compare sexual well being in women with pelvic organ prolapse before and after vaginal reconstructive surgery. METHODS: Sixty-seven women, mean age 61 (36-85) years, who underwent vaginal reconstructive surgery, were asked to complete detailed questionnaires before and after surgery. I

  19. Comparison of the effects of Mycocin vaginal cream and Metronidazole vaginal gel on treatment of bacterial vaginosis: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Maryam Asadi

    2016-08-01

    Full Text Available Metronidazole is recommended as the first-line treatment for Bacterial Vaginosis (BV. With respect to various side effects of metronidazole and increased antibiotic resistance, it seems necessary to find a medication with fewer side effects. The present study aimed to compare the effects of Mycocin vaginal cream (made of garlic and thyme and metronidazole vaginal gel on treatment of the patients with BV. This clinical trial which was conducted on 120 married women aged 18-44 years whose infection with BV was diagnosed through clinical Amsel criteria. The participants were randomly divided into two groups of 60 receiving Mycocin vaginal cream or metronidazole vaginal gel for seven days. Clinical Amsel criteria and the patients’ complaints were assessed again 7 days after completion of the treatment period. The results showed a decrease in the patients’ complaints and clinical Amsel criteria after the treatment with Mycocin vaginal cream and metronidazole vaginal gel. However, no significant difference was observed between the two groups regarding clinical improvement in Amsel criteria (P<0.05. Mixed Garlic and Thyme vaginal cream (Mycocin seems to be an appropriate alternative for metronidazole vaginal gel in treatment of BV.

  20. Subserosal hematoma of the sigmoid colon after vaginal delivery

    Science.gov (United States)

    Bacalbașa, N; Bohîlțea, RE; Dumitru, M; Turcan, N; Cîrstoiu, MM

    2017-01-01

    Postpartum hemorrhage is an obstetrical emergency that represents the leading cause of maternal mortality. Severe hemorrhagic complications that could appear postpartum are the abdomino-pelvic hematomas, which result from the rupture of the pelvic vessels. We reported a very rare case of puerperal retroperitoneal subserosal hematoma of sigmoid colon following vaginal delivery, which was successfully managed by conservative methods. As far as we know, there are only a few case reports of intramural hematoma of sigmoid colon in literature, having other etiologies than vaginal delivery trauma. The particularities of the case consisted in the association of hemangiomas and the low risk thrombophilia. Diagnosis was based on the clinical exam and the paraclinical founding. Laparotomy is generally considered the last choice, in life threatening cases with hemodynamic instability, compression signs, and presence of contrast leakage on noninvasive imaging methods, but avoiding colonic resection after dissection represented the true challenge of the case. PMID:28255383

  1. Speciation and susceptibility testing of Candida isolates from vaginal discharge

    Directory of Open Access Journals (Sweden)

    Swapna Muthusamy

    2016-09-01

    Full Text Available Candida is a normal commensal that takes the role of a pathogen under compromised conditions. Increased longevity of human life and immunocompromised conditions together paves the way for the increase in opportunistic infections like candidiasis. Vulvovaginal candidiasis (VVC is the second most common cause of vaginal discharge next to Chlamydia.1 VVC is the leading cause of abnormal vaginal discharge due to microbial causes. Untreated VVC is a possible risk factor for acquisition of HIV.2 Prevention of sexually transmitted infections (STIs including VVC can reduce the transmission of HIV since STIs and HIV have the common mode of transmission and one enhances the risk of infection with the other. Early diagnosis and treatment of candidiasis can reduce the pregnancy related morbidity

  2. Eggs containing larvae of Enterobius vermicularis in vaginal smear

    Directory of Open Access Journals (Sweden)

    Jyothi B Shetty

    2012-01-01

    Full Text Available Enterobius vermicularis also known commonly as pinworm is the most common intestinal parasite. It is a nematode that inhabits the human terminal ileum, colon and appendix. The fertilized female migrates to the perianal area where eggs are deposited but occasionally introduces itself into adjacent orifices, most commonly the female genitourinary tract. Thus the eggs can be seen in the vaginal smear as a result of contamination. We report a case wherein the patient presented with signs and symptoms of vulvovaginitis. In her vaginal smear there were eggs of Enterobius vermicularis which showed a coiled larva within it. In the background there were plenty of acute inflammatory cells. This patient responded favorably to antihelminthics. We report this case to highlight the morphology of the parasite and also to emphasize that such findings should not be neglected. Timely reporting and appropriate treatment of such cases will prevent further complications of this parasite including endometritis, salphingitis and peritonitis.

  3. Missed Iatrogenic Bladder Rupture Following Normal Vaginal Delivery.

    Science.gov (United States)

    Baheti, Vidyasagar H; Wagaskar, Vinayak G; Patwardhan, Sujata K

    2015-10-01

    Bladder rupture following caesarian section is well documented complications. Intraperitoneal bladder rupture following normal vaginal delivery is very rare. Hereby, we present a case report of intraperitoneal bladder rupture presented late following normal vaginal delivery. We report a case of spontaneous intraperitoneal urinary bladder rupture following uneventful outlet forceps delivery in a 22-year-old primi gravid woman with gestational diabetes mellitus and fetal macrosomia who presented with large urinary ascites, anuria and renal failure. Emergent exploratory laparotomy with repair of the intraperitoneal bladder rupture helped to prevent its potential complications. Postpartum patients who undergo episiotomy or perineal repair may land up in unnoticed urinary retention which may rarely terminate in spontaneous urinary bladder rupture. Awareness of its manifestations amongst emergency physician would help to initiate appropriate timely management.

  4. Posterior vaginal wall cyst of Mullerian origin: a case report

    Directory of Open Access Journals (Sweden)

    Sunita Samal

    2015-02-01

    Full Text Available Cystic lesions of vagina are relatively uncommon and an incidental finding during routine gynaecological examination. Mullerian cysts are congenital cysts of vagina, usually reported during childbearing age group. These cysts mostly arise at the level of cervix and extend anteriorly in relation to bladder, but very rarely they may also extend posteriorly. This is a rare case of posterior vaginal wall cyst of Mullerian origin. A 36-year-old multi para (P2L2 both SVD, presented with a mass descending through vagina since 2-3 months. Pelvic examination revealed a 5x5 cm cystic mass arising from the posterior vaginal wall. Complete excision of the cyst was done. The cyst was filled with chocolate coloured material and histopathology confirmed a Mullerian cyst. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 245-246

  5. Pregnant women’s preference for vaginal or caesarean childbirth

    Directory of Open Access Journals (Sweden)

    Lígia Ebner Melchiori

    2009-10-01

    Full Text Available The study investigated the preference for delivery in 40 pregnant women using a semi-structured interview. Most women (75% reported a preference for vaginal delivery, mainly because they believe it will result in a speedy recovery and be better for them and/or their babies. Of the women interviewed, 15% preferred a caesarean section because they considered it be less painful. These preferences, in general, were influenced by friends. Most women said they had fear of parturition due to: feelings of pain/suffering, concern of something happening to them or their babies and because the situation is unknown or assessed in a negative fashion. The presence of trusted people, like one’s husband, mother or doctor, could minimize this fear. These results reinforce the contributions of health professionals, such as psychologists, in answering the psychosocial needs of pregnant women in situations of delivery and birth.   Keywords: vaginal birth; caesarean section; pregnancy; health psychology.

  6. Vaginal myofibroblastoma with glands expressing mammary and prostatic antigens.

    Science.gov (United States)

    Wallenfels, I; Chlumská, A

    2012-01-01

    A case of unusual vaginal myofibroblastoma containing glands which expressed mammary and prostatic markers is described. The tumor occurred in 70-year-old woman in the proximal third of the vagina. It showed morphology and immunophenotype typical of so-called cervicovaginal myofibroblastoma. The peripheral zone of the lesion contained a few groups of glands suggesting vaginal adenosis or prostatic-type glands on initial examination. The glands showed a surprising simultaneous expression of mammary markers mammaglobin and GCDFP-15 and prostatic markers prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP). Immunostains for alpha-smooth muscle actin, p63 and CD10 highlighted the myoepithelial cell layer of the glands. The finding indicates that simultaneous use of both mammary and prostatic markers for examination of unusual glandular lesions in the vulvovaginal location can be helpful for an exact diagnosis, and can contribute to better understanding of prostatic and mammary differentiations in the female lower genital tract.

  7. Helping a 10-year-old Haitian girl with vaginitis.

    Science.gov (United States)

    Leveille-Tulce, Anne Marie B

    2014-06-01

    The purpose of this case study is to demonstrate how nurses who work with Haitian children and families can use NANDA-I (diagnosis), the Nursing Outcomes Classification, and the Nursing Interventions Classification to assist a 10-year-old child with symptoms of vaginitis. The case study derives from the author's experience and literature sources. This case study demonstrates a nurse's clinical decision making while providing care to a 10-year-old girl with symptoms of vaginitis. Increased knowledge and awareness about appropriate health behaviors can increase patients' power and enable them to freely act and adopt health behaviors to improve health outcomes. Placing patients at the center of the nursing process and partnering with patients to plan and develop interventions enable them to take actions and improve health outcomes. © 2013 NANDA International.

  8. Sugar expressions on the vaginal epithelium in pregnant mice.

    Science.gov (United States)

    Yasunaga, Youhei; Takeuchi, Takashi; Shimokawa, Tetsuya; Nabeta, Motowo; Matsuu, Aya; Asano, Atsushi; Ohta, Yasuhiko

    2012-06-01

    Sugar expressions were examined on the epithelium of both the middle portion of the vagina and the vaginal portion of the cervical canal (CC) in pregnant mice to understand the pathogenesis of bacterial infection in the female reproductive organ by using a panel of lectins. As a result, N-acetylglucosamine was positive before pregnant day (P) 7 but negative after P10 and at diestrus on both the vagina and the CC. In addition, some differences in sugar expressions were seen between them. These results suggest that sugar expressions on the mucosal surface would change not only site-specifically but also time-dependently, and these sugar differences indicate the possibility of the alteration of the settled bacterial species on the vaginal mucosa in pregnancy.

  9. Changes in vaginal microbiota following antimicrobial and probiotic therapy

    Directory of Open Access Journals (Sweden)

    Jean M. Macklaim

    2015-08-01

    Full Text Available Background: The composition of the vaginal microbiota is known to be important for health. When infections occur, antimicrobial therapy is often poorly efficacious. Objective and design: We used 16S rRNA gene sequencing to characterize changes in the bacterial microbiota following oral antimicrobial and probiotic interventions. Results: While the bacterial vaginal profiles of women with vulvovaginal candidiasis were dominated by lactobacilli as in healthy women, and unchanged by therapy, Gardnerella vaginalis, Prevotella, Atopobium, Sneathia, and Megasphaera dominated the vagina of women with bacterial vaginosis (BV, and treatment with tinidazole plus Lactobacillus reuteri RC-14+L. rhamnosus GR-1 resulted in an increased relative abundance of indigenous L. iners or L. crispatus. Conclusions: The ability to restore homeostasis provides a rationale for conjoint use of probiotics with antibiotic treatment of BV.

  10. Novel three-dimensional autologous tissue-engineered vaginal tissues using the self-assembly technique.

    Science.gov (United States)

    Orabi, Hazem; Saba, Ingrid; Rousseau, Alexandre; Bolduc, Stéphane

    2017-02-01

    Many diseases necessitate the substitution of vaginal tissues. Current replacement therapies are associated with many complications. In this study, we aimed to create bioengineered neovaginas with the self-assembly technique using autologous vaginal epithelial (VE) and vaginal stromal (VS) cells without the use of exogenous materials and to document the survival and incorporation of these grafts into the tissues of nude female mice. Epithelial and stromal cells were isolated from vaginal biopsies. Stromal cells were driven to form collagen sheets, 3 of which were superimposed to form vaginal stromas. VE cells were seeded on top of these stromas and allowed to mature in an air-liquid interface. The vaginal equivalents were implanted subcutaneously in female nude mice, which were sacrificed after 1 and 2 weeks after surgery. The in vitro and animal-retrieved equivalents were assessed using histologic, functional, and mechanical evaluations. Vaginal equivalents could be handled easily. VE cells formed a well-differentiated epithelial layer with a continuous basement membrane. The equivalent matrix was composed of collagen I and III and elastin. The epithelium, basement membrane, and stroma were comparable to those of native vaginal tissues. The implanted equivalents formed mature vaginal epithelium and matrix that were integrated into the mice tissues. Using the self-assembly technique, in vitro vaginal tissues were created with many functional and biological similarities to native vagina without any foreign material. They formed functional vaginal tissues after in vivo animal implantation. It is appropriate for vaginal substitution and disease modeling for infectious studies, vaginal applicants, and drug testing.

  11. [Vaginal microscopic evidence in women with symptoms of genital infection].

    Science.gov (United States)

    Cerbini, S; Greco, M; Lalli, P; Santucci, A; Pitzurra, M

    1985-01-01

    Vaginal living organisms have been defined as the most complete in human ecology. As many as 100 million colonies of microorganisms can live in a single ml of vaginal liquid. More common are the anaerobic types, particularly the lactobacillus and bacteroides. The low pH of the vagina, normally 4, is due to the high lactic acid content of the lactobacillus. Pathogenic bacteria is inhibited at 4.5 pH. Conversely, it proliferates at a high pH. The slightest alteration of this delicate equilibrium allows potentially pathogenic bacteria to grow to a concentration high enough to produce symptoms. Researchers have sought to identify new pathological microorganisms, due to the increase in reported cases of vaginal infection in recent years. New strains such as microplasmas and chlamydia are assuming greater importance. Evidence of the numerous vaginal microbes comes from anamnestic, symptomatological data and from simple laboratory tests conducted in gynecological clinics with microscopes and Gram coloration. 663 women were examined in 6 laboratories. The computerized data revealed that only 29, or 4.37%, showed no symptoms at all and had gone to the lab for a mere check up; 175, or 26.40%, complained of pain, burning and itching; 361, or 54.45%, revealed symptoms associated with leukorrhea; 98, or 14.78%, showed only leukorrhea. The epidemiological study shows the importance of candida albicans in the infectious pathology of the female genital organ. Trichomonas vaginalis and grambacteria infection have been detected particularly when an IUD is used. The negative result of numerous bacterioscopic exams has shown the necessity of more in-depth study of genital infections, using analytical cultural methodology.

  12. Vaginal tuberculosis in an elderly kidney transplant recipient

    Directory of Open Access Journals (Sweden)

    Nemati Eghlim

    2009-01-01

    Full Text Available Female genital tuberculosis (FGTB is extremely rare in post-menopausal women. A 59-year-old woman developed vaginal tuberculosis one year after receiving a kidney transplant from a living donor. Her complaints included abdominal pain, fever, and weight loss. Furthermore, her tu-berculin skin test was negative. She was successfully treated with quadruple anti-TB therapy for 6 months.

  13. Forgotten Vaginal Foreign Body Presenting as Cervical Dystocia.

    Science.gov (United States)

    Chawla, Sonia; Singla, Anshuja; Chandra, Charu; Falodia, Swati

    2016-02-01

    Generally encountered in paediatrics age group, vaginal foreign body is a rare presentation in gynaecological clinics. Inserted as a part of sexual abuse, gratification or psychiatric disorder, these foreign bodies can present with a varied symptomatology. We report a case of 22-year-old female, a victim of domestic violence, who had a foreign body inserted in the vagina which was forgotten. Later it was discovered when she presented at term with cervical dystocia.

  14. Perspectives on Promoting Hospital Primary Vaginal Birth: A Qualitative Study.

    Science.gov (United States)

    Kennedy, Holly P; Doig, Eleanor; Tillman, Stephanie; Strauss, Amanda; Williams, Beth; Pettker, Christian; Illuzzi, Jessica

    2016-12-01

    One in three women will deliver by cesarean, a procedure that can be life saving, but which also carries short- and long-term risks. There is growing interest in preventing primary cesarean deliveries, while optimizing the health of the mother and infant. The primary aim of this study was to use participatory action strategies and ethnographic interview data collected from diverse stakeholders in birth (caregivers, women, policymakers) about facilitators and barriers to the achievement of primary vaginal birth in first-time mothers in hospital settings. The secondary aim was to use the findings to identify strategies to promote primary vaginal birth and future areas of research. Individual and small group interviews were conducted with caregivers and policymakers (N = 79) and first-time mothers (N = 24) at a northeastern hospital. All interviews were audio-recorded, transcribed, and analyzed using Atlas.ti. Four broad themes were identified: 1) preparation for childbirth, 2) early labor management, 3) caregiver knowledge and practice style, and 4) birth environment (physical, cultural/emotional). The first two were closely linked from caregivers' perspectives. If the woman was not prepared for childbirth, it was perceived she would be more likely to present to the hospital in early labor. Once there, it was hard to prevent admission and interventions. A woman's knowledge and confidence were perceived as powerful mediators for vaginal birth. Caregivers and first-time mothers identified early labor management and childbirth preparation as important factors to promote primary vaginal birth in hospital settings. Both deserve further inquiry as potential strategies to decrease rising cesarean delivery rates. © 2016 Wiley Periodicals, Inc.

  15. Diabetes Insipidus after normal vaginal delivery: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2014-07-01

    Treatment was continuing, when the symptoms of central diabetes insipidus resolve and urinary concentrating ability was preferred. Maximum urinary osmolality over the next 11 hours was assessed, 730 mosm/kg was considered normal. Conclusion: Close attention to electrolyte and fluid balance is important in the postpartum period. The symptoms of transient vasopressin-resistant diabetes insipidus resolve in few days to a few weeks after vaginal delivery or when hepatic function returns to normal.

  16. Trichomonas vaginalis Infection in a Tertiary Care Vaginitis Center.

    Science.gov (United States)

    Keating, Maria A; Nyirjesy, Paul

    2015-09-01

    Trichomonas vaginalis infection (TVI) is one of the most common sexually transmitted diseases in the United States. We sought to determine the features of TVI in a referral-based vaginitis center, focusing on diagnosis and treatment of difficult cases. We conducted a retrospective review of all patients with TVI, based on International Classification of Diseases, Ninth Revision codes, seen at the Drexel Vaginitis Center between January 2008 and November 2013. Information collected on each subject included demographics, symptoms, examination findings, diagnostic tests, and treatment regimens. Of approximately 4000 new patient visits during our study period, 80 subjects were identified with TVI. Twenty subjects presented with known TVI, with most having clinically resistant infections. Diagnosis was confirmed by saline microscopy in 45%, OSOM rapid test in 40%, and clinical history in the remaining 15%. Treatment regimens varied: 20% received single 2-g dosing of either metronidazole or tinidazole, 50% received high-dose regimens, 20% received therapy with vaginal paromomycin, and 10% underwent desensitization for nitroimidazole allergy. Sixty subjects had newly diagnosed TVI, with 35% diagnosed by saline microscopy, 41.7% by OSOM rapid test, and 23.3% by APTIMA. Treatment regimens for these subjects included single 2-g dosing in 88.3%, high-dose regimen in 8.3%, and other formulations in the remaining 3.4%. In total, 80% of our subjects returned for follow-up; all of whom were cured. T. vaginalis infection is a rare condition in a tertiary care vaginitis center and often requires nonstandard treatments. Among those who returned for follow-up, the cure rate was 100%.

  17. Prediction of scar integrity and vaginal birth after caesarean delivery.

    OpenAIRE

    Valentin, Lil

    2013-01-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has bee...

  18. A CASE REPORT OF ADENOMYOSIS WITH UTERO - VAGINAL PROLAPSE

    Directory of Open Access Journals (Sweden)

    Amulya

    2015-06-01

    Full Text Available Adenomyosis is a benign condition defined as growth of the endometrial glands and stroma deep into the myometrium. It is difficult to diagnose. It usually does not cause significant uterine enlargement. Here we present a case of third degree utero - vaginal prolapse with grossly enlarged uterus (24 weeks, the clinical and MR findings of which was mimicking sarcoma. Final diagnosis was est ablished after hysterectomy based on histo - pathological features.

  19. Deep sequencing of the vaginal microbiota of women with HIV.

    Directory of Open Access Journals (Sweden)

    Ruben Hummelen

    Full Text Available BACKGROUND: Women living with HIV and co-infected with bacterial vaginosis (BV are at higher risk for transmitting HIV to a partner or newborn. It is poorly understood which bacterial communities constitute BV or the normal vaginal microbiota among this population and how the microbiota associated with BV responds to antibiotic treatment. METHODS AND FINDINGS: The vaginal microbiota of 132 HIV positive Tanzanian women, including 39 who received metronidazole treatment for BV, were profiled using Illumina to sequence the V6 region of the 16S rRNA gene. Of note, Gardnerella vaginalis and Lactobacillus iners were detected in each sample constituting core members of the vaginal microbiota. Eight major clusters were detected with relatively uniform microbiota compositions. Two clusters dominated by L. iners or L. crispatus were strongly associated with a normal microbiota. The L. crispatus dominated microbiota were associated with low pH, but when L. crispatus was not present, a large fraction of L. iners was required to predict a low pH. Four clusters were strongly associated with BV, and were dominated by Prevotella bivia, Lachnospiraceae, or a mixture of different species. Metronidazole treatment reduced the microbial diversity and perturbed the BV-associated microbiota, but rarely resulted in the establishment of a lactobacilli-dominated microbiota. CONCLUSIONS: Illumina based microbial profiling enabled high though-put analyses of microbial samples at a high phylogenetic resolution. The vaginal microbiota among women living with HIV in Sub-Saharan Africa constitutes several profiles associated with a normal microbiota or BV. Recurrence of BV frequently constitutes a different BV-associated profile than before antibiotic treatment.

  20. Demonstration of Microbial Subgroups among Normal Vaginal Microbiota Data

    OpenAIRE

    Lee, M.-L. T.

    2011-01-01

    In this study we identified subgroups of observations relating to the healthy vaginal microbiota. This microbiota resides in a dynamic environment that undergoes cyclic change during the menstrual cycle. Cluster analysis procedures were applied to divide a set of 226 normal microbiota observations into groups. Three subgroups containing 100, 65, and 61 observations were identified. Plots of principal components determined by canonical analysis were obtained to demonstrate graphically the clus...