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Sample records for intravaginal practices vaginal

  1. Effect of intravaginal practices on the vaginal and cervical mucosa of Zimbabwean women

    NARCIS (Netherlands)

    van de Wijgert, J. H.; Chirenje, Z. M.; Iliff, V.; Mbizvo, M. T.; Mason, P. R.; Gwanzura, L.; Shiboski, S.; Padian, N. S.

    2000-01-01

    OBJECTIVES: Lesions on the vaginal and cervical mucosa may facilitate transmission of HIV and other sexually transmitted diseases (STDs). We evaluated the relationship between intravaginal practices and the presence of colposcopic lesions in Zimbabwean women. METHODS: Users and nonusers of

  2. Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women

    NARCIS (Netherlands)

    van de Wijgert, J. H.; Mason, P. R.; Gwanzura, L.; Mbizvo, M. T.; Chirenje, Z. M.; Iliff, V.; Shiboski, S.; Padian, N. S.

    2000-01-01

    One hundred sixty-nine Zimbabwean women were studied to determine whether the use of intravaginal practices (cleaning with the fingers, wiping the vagina, and inserting traditional substances) are associated with disturbances of vaginal flora and acquisition of sexually transmitted diseases (STDs).

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

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    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.

  4. A New Wireless Biosensor for Intra-Vaginal Temperature Monitoring

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    Isabel de la Torre

    2010-11-01

    Full Text Available Wireless Body Sensors for medical purposes offer valuable contributions to improve patients’ healthcare, including diagnosis and/or therapeutics monitoring. Body temperature is a crucial parameter in healthcare diagnosis. In gynecology and obstetrics it is measured at the skin’s surface, which is very influenced by the environment. This paper proposes a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in a Wireless Sensor Network (WSN for remote data access and monitoring. We present the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used in different medical applications, including preterm labor prevention and fertility and ovulation period detection. The features of the constructed testbed were validated in laboratory tests verifying its accuracy and performance.

  5. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis.

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    Nicola Low

    2011-02-01

    Full Text Available Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition.We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I(2 values 0.0%-16.1%. Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18-1.83, insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00-1.71, and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01-1.53 remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04-1.47. Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, p<0.001 or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, p<0.001, respectively.This study provides evidence to suggest that some intravaginal practices increase

  6. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis.

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    Low, Nicola; Chersich, Matthew F; Schmidlin, Kurt; Egger, Matthias; Francis, Suzanna C; van de Wijgert, Janneke H H M; Hayes, Richard J; Baeten, Jared M; Brown, Joelle; Delany-Moretlwe, Sinead; Kaul, Rupert; McGrath, Nuala; Morrison, Charles; Myer, Landon; Temmerman, Marleen; van der Straten, Ariane; Watson-Jones, Deborah; Zwahlen, Marcel; Hilber, Adriane Martin

    2011-02-15

    Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition. We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I(2) values 0.0%-16.1%). Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18-1.83), insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00-1.71), and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01-1.53) remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04-1.47). Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, pflora, and HIV acquisition has not yet been demonstrated. More consistency in the definition and measurement of specific intravaginal practices is warranted so that the effects of specific intravaginal

  7. Estradiol-induced vaginal mucus inhibits antigen penetration and CD8(+) T cell priming in response to intravaginal immunization.

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    Seavey, Matthew M; Mosmann, Tim R

    2009-04-14

    Although vaginal immunization has been explored as a strategy to induce mucosal immunity in the female reproductive tract, this site displays unique immunological features that probably evolved to inhibit anti-paternal T cell responses after insemination to allow successful pregnancy. We previously demonstrated that estradiol, which induces an estrus-like state, prevented CD8(+) T cell priming during intravaginal immunization of mice. We now show that estradiol prevented antigen loading of vaginal antigen presenting cells (APCs) after intravaginal immunization. Histological examination confirmed that estradiol prevented penetration of peptide antigen into the vaginal wall. Removal of the estradiol-induced mucus barrier by mucinase partially restored antigen loading of vaginal APC and CD8(+) T cell proliferation in vivo. The estradiol-induced mucus barrier may thus prevent exposure to antigens delivered intravaginally, supplementing additional estradiol-dependent mechanism(s) that inhibit CD8(+) T cell priming after insemination or vaginal vaccination.

  8. Estradiol-induced vaginal mucus inhibits antigen penetration and CD8+ T cell priming in response to intravaginal immunization

    Science.gov (United States)

    Seavey, Matthew M.; Mosmann, Tim R.

    2010-01-01

    Although vaginal immunization has been explored as a strategy to induce mucosal immunity in the female reproductive tract, this site displays unique immunological features that probably evolved to inhibit anti-paternal T cell responses after insemination to allow successful pregnancy. We previously demonstrated that estradiol, which induces an estrus-like state, prevented CD8+ T cell priming during intravaginal immunization of mice. We now show that estradiol prevented antigen loading of vaginal antigen presenting cells (APC) after intravaginal immunization. Histological examination confirmed that estradiol prevented penetration of peptide antigen into the vaginal wall. Removal of the estradiol-induced mucus barrier by mucinase partially restored antigen loading of vaginal APC and CD8+ T cell proliferation in vivo. The estradiol-induced mucus barrier may thus prevent exposure to antigens delivered intravaginally, supplementing additional estradiol-dependent mechanism(s) that inhibit CD8+ T cell priming after insemination or vaginal vaccination. PMID:19428849

  9. Safe and sustained vaginal delivery of pyrimidinedione HIV-1 inhibitors from polyurethane intravaginal rings.

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    Johnson, Todd J; Srinivasan, Priya; Albright, Theodore H; Watson-Buckheit, Karen; Rabe, Lorna; Martin, Amy; Pau, Chou-Pong; Hendry, R Michael; Otten, Ron; McNicholl, Janet; Buckheit, Robert; Smith, James; Kiser, Patrick F

    2012-03-01

    The potent antiretroviral pyrimidinediones IQP-0528 (PYD1) and IQP-0532 (PYD2) were formulated in polyurethane intravaginal rings (IVRs) as prophylactic drug delivery systems to prevent the sexual transmission of HIV-1. To aid in the selection of a pyrimidinedione candidate and the optimal loading of the drug in the IVR delivery system, four pyrimidinedione IVR formulations (PYD1 at 0.5 wt% [PYD1(0.5 wt%)], PYD1(1 wt%), PYD2(4 wt%), and PYD2(14 wt%)) were evaluated in pigtail macaques over 28 days for safety and pyrimidinedione vaginal biodistribution. Kinetic analysis of vaginal proinflammatory cytokines, native microflora, and drug levels suggested that all formulations were safe, but only the high-loaded PYD2(14 wt%) IVR demonstrated consistently high pyrimidinedione vaginal fluid and tissue levels over the 28-day study. This formulation delivered drug in excess of 10 μg/ml to vaginal fluid and 1 μg/g to vaginal tissue, a level over 1,000 times the in vitro 50% effective concentration. The in vitro release of PYD1 and PYD2 under nonsink conditions correlated well with in vivo release, both in amount and in kinetic profile, and therefore may serve as a more biologically relevant means of evaluating release in vitro than typically employed sink conditions. Lastly, the pyrimidinediones in the IVR formulation were chemically stable after 90 days of storage at elevated temperature, and the potent nanomolar-level antiviral activity of both molecules was retained after in vitro release. Altogether, these results point to the successful IVR formulation and vaginal biodistribution of the pyrimidinediones and demonstrate the usefulness of the pigtail macaque model in evaluating and screening antiretroviral IVR formulations prior to preclinical and clinical evaluation.

  10. Induction of labour: a comparison between controlled-release dinoprostone vaginal pessary (Cervidil) and dinoprostone intravaginal gel (Prostin E2).

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    Kho, Ee Min; Sadler, Lynn; McCowan, Lesley

    2008-10-01

    There are various prostaglandin preparations available for inducing labour. Controlled-release dinoprostone vaginal pessary is used in a number of centres in Australia and New Zealand. To compare the efficacy and safety of controlled-release dinoprostone vaginal pessary (Cervidil) with dinoprostone intravaginal gel (Prostin E2) for induction of labour. Retrospective cohort study of 969 women who were induced using either 10-mg controlled-released dinoprostone vaginal pessary (n=507) or intravaginal dinoprostone gel (n=462) at National Women's Health, Auckland City Hospital. Study outcomes included induction to delivery interval, mode of delivery, rate of oxytocin augmentation and incidence of uterine hyperstimulation. Induction to vaginal birth interval was longer among nullipara receiving the pessary compared to those receiving intravaginal gel (21.5 vs 17.8 h, P=0.004). There was no difference in rates of oxytocin augmentation or in mode of birth between pessary and gel groups. There was a trend to more uterine hyperstimulation among women induced with the pessary compared with those induced with intravaginal gel (22 (4.5%) vs 11 (2.4%) relative risk (RR) 1.9 (0.9-3.9)). Hyperstimulation associated with an abnormal fetal heart pattern (14 (2.9%) vs 2 (0.4%), RR 6.5 (1.5-28.9)) or treated with tocolytics (9 (1.8%) vs 1 (0.2%), RR 8.4 (1.1-66)) was more common in women who received the pessary. Use of dinoprostone vaginal pessaries did not shorten time to delivery or improve any other birth outcome measured compared to dinoprostone intravaginal gel. Clinically significant hyperstimulation appeared more common following use of the pessary. Large randomised controlled trials are needed to confirm or refute these findings.

  11. Intra-vaginal Zinc Oxide Tetrapod Nanoparticles as Novel Immunoprotective Agents against Genital Herpes

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    Antoine, Thessicar E.; Hadigal, Satvik R.; Yakoub, Abraam; Mishra, Yogendra K.; Bhattacharya, Palash; Haddad, Christine; Valyi-Nagy, Tibor; Adelung, Rainer; Prabhakar, Bellur S.; Shukla, Deepak

    2016-01-01

    Virtually all efforts to generate an effective protection against the life-long, recurrent genital infections caused by Herpes simplex virus-2 (HSV-2) have failed. Apart from sexual transmission, the virus can also be transmitted from mothers to neonates, and is a key facilitator of HIV co-acquisition. Here, we uncover a nanoimmunotherapy using specially designed Zinc Oxide Tetrapod Nanoparticles (ZOTEN) with engineered oxygen vacancies. We demonstrate that ZOTEN, when used intravaginally as a microbicide, is an effective suppressor of HSV-2 genital infection in female BALB/c mice. The strong HSV-2 trapping ability of ZOTEN significantly reduced the clinical signs of vaginal infection and effectively decreased animal mortality. In parallel, ZOTEN promoted the presentation of bound HSV-2 virions to mucosal antigen presenting cells, enhancing T cell- mediated and antibody-mediated responses to the infection, and thereby, suppressing a re-infection. We also found that ZOTEN exhibits strong adjuvant-like properties, which is highly comparable to alum, a commonly used adjuvant. Overall, our study provides very first evidence for the protective efficacy of an intravaginal microbicide/vaccine or microbivac platform against primary and secondary female genital herpes infections. PMID:27183601

  12. Intravaginal insertion in KwaZulu Natal: sexual practices and preferences in the context of microbicide gel use

    NARCIS (Netherlands)

    Gafos, M.; Mzimela, M.; Sukazi, S.; Pool, R.; Montgomery, C.; Elford, J.

    2010-01-01

    Intravaginal insertion is often associated with the concept of ‘dry’ sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal

  13. Immune response of heifers to vaginal submucosal or subcutaneous vaccination and intravaginal challenge with Ureaplasma diversum.

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    Mulira, G L; Saunders, J R

    1994-04-01

    Twenty beef heifers were randomly assigned to five equal groups and vaccinated: Group 1--in vaginal submucosa (VM) with Ureaplasma diversum ultrasonicated whole cells (WC) in complete Freund's adjuvant (CFA); Group 2--in VM with U. diversum cell membranes (CM) in CFA; Group 3--subcutaneously (SC) with CM in CFA; Group 4--in VM with CM alone; and Group 5--in VM with phosphate buffered saline (PBS) in CFA. A second vaccination with the same antigens in incomplete Freund's adjuvant was given after four weeks, and three weeks later, all heifers were challenged intravaginally with 3.6 x 10(7) colony-forming units (CFU) of U. diversum strain 2312. Immunoglobulins that reacted with U. diversum were measured in serum and cervicovaginal mucus (CVM) by an enzyme-linked-immunosorbent assay. In groups 1 and 2, vaccination by the VM route with WC or CM antigens, stimulated high levels of U. diversum-reactive IgG1 and IgG2 antibodies in serum as well as CVM, but a low IgA response only in CVM. In group 4, VM vaccination with CM (no adjuvant) elicited a minimal IgG1 and IgG2 response in serum and CVM. In group 3, SC vaccination with CM antigen stimulated high IgG1 and IgG2 reactivity in both serum and CVM, but no IgA reactivity. Very little IgM reactivity was detected in the four vaccinated groups. Intravaginal challenge resulted in characteristic granular vulvitis in all vaccinated and control heifers, with all animals remaining culture-positive for the 35 day observation period. The infection stimulated a marked increase in the specific IgA response in CVM of the three groups vaccinated with either, adjuvanted antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Qualitative and quantitative analysis of bacteria from vaginitis associated with intravaginal implants in ewes following estrus synchronization

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    Carlos Otávio de Paula Vasconcelos

    2016-04-01

    Full Text Available ABSTRACT: This study evaluated the presence of vaginitis and the bacterial load associated with different intravaginal implants in ewes. Twenty-four Dorper and crossbred ewes were allocated into three groups and received intravaginal implant containing 0.3g progesterone (CIDR(r, 60mg MAP or sponges without progesterone (CONTROL for six days. Then, CIDR and MAP treated-ewes received 12.5mg dinoprost and 300IU eCG. Vaginal mucus samples were collected at four times: before device insertion, at the day of its removal, 24 and 48 hours after. The samples were cultured and the colonies were counted (CFU/mL and identified. The results obtained from the counting of CFU mL-1 were submitted to Kruskal-Wallis H test, with P0.05 in comparison with MAP and CIDR-treated ewes. During the occurrence of vaginitis, the predominant isolates belonged to the coliform group, mainly Escherichia coli (72.7%. Such infection was not determined by the members of the vaginal microbiota that were present before implant insertion and normal microbiota was restored between 24 to 48 hours after insert removal.

  15. Rectal and bladder dose reduction with the addition of intravaginal balloons to vaginal packing in intracavitary brachytherapy for cervical cancer.

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    Eng, T Y; Patel, A J; Ha, C S

    2016-01-01

    The use of intravaginal Foley balloons in addition to conventional packing during high-dose-rate (HDR) tandem and ovoids intracavitary brachytherapy (ICBT) is a means to improve displacement of organs at risk, thus reducing dose-dependent complications. The goal of this project was to determine the reduction in dose achieved to the bladder and rectum with intravaginal Foley balloons with CT-based planning and to share our packing technique. One hundred and six HDR-ICBT procedures performed for 38 patients were analyzed for this report. An uninflated Foley balloon was inserted into the vagina above and below the tandem flange separately and secured in place with vaginal packing. CT images were then obtained with both inflated and deflated Foley balloons. Plan optimization occurred and dose volume histogram data were generated for the bladder and rectum. Maximum dose to 0.1, 1.0, and 2.0 cm(3) volumes for the rectum and bladder were analyzed and compared between inflated and deflated balloons using parametric statistical analysis. Inflation of intravaginal balloons allowed significant reduction of dose to the bladder and rectum. Amount of reduction was dependent on the anatomy of the patient and the placement of the balloons. Displacement of the organs at risk by the balloons allowed an average of 7.2% reduction in dose to the bladder (D0.1 cm(3)) and 9.3% to the rectum (D0.1 cm(3)) with a maximum reduction of 41% and 43%, respectively. For patients undergoing HDR-ICBT, a significant dose reduction to the bladder and rectum could be achieved with further displacement of these structures using intravaginal Foley balloons in addition to conventional vaginal packing. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Improvement of abnormal vaginal flora in Ugandan women by self-testing and short use of intravaginal antimicrobials.

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    Donders, G; Bellen, G; Donders, F; Pinget, J; Vandevelde, I; Michiels, T; Byamughisa, J

    2017-04-01

    The vaginal composition of African women is more often lactobacillus-deficient compared to that of women from other areas around the world. Lactobacillus-deficient microflora is a known risk factor for serious health problems, such as preterm birth, cervix cancer, and entrapment of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The aim of this study was to assess the effect of local vaginal antibiotic or antiseptic treatment on abnormal vaginal flora (AVF), aerobic vaginitis (AV), and bacterial vaginosis (BV) among women in rural, semi-urban, and urban areas in Uganda, as compared to placebo. In a double-blind, placebo-controlled, randomized trial, 300 women presenting for outpatient routine, follow-up, or medical care at Mulago Hospital in Kampala, Uganda, were enrolled to receive 6 days of treatment with vaginal rifaximin (RFX), dequalinium chloride (DQC), or placebo if they had an increased vaginal pH of >4.5 as determined by self-testing. At initial visit and at control visit after 4 weeks, a smear was taken for blinded wet mount microscopy to determine AVF, BV, AV, and Candida severity scores. As compared to placebo, both RFX or DQC treatments dramatically diminished BV prevalence and severity from the initial to follow-up visit: the BV score declined from 2.5 to 1.6 (p improvements in the AV score were seen in both treatment regimens: moderate and severe AV declined from AV scores of 6.3 to 3.6 (p = 0.003) and from 6.6 to 4.1 (p improvements when compared with placebo. Women with normal flora and Candida at the initial visit showed less Candida after 4 weeks in the group treated with DQC (p = 0.014). Even after a short duration of intravaginal treatment with local non-absorbable antiseptics or antibiotics produced significant, lasting improvements in the vaginal microbiome composition of women with disturbed vaginal microflora. As African women have high prevalences of BV, AV, and AVF, this approach could

  17. Examining targets for HIV prevention: intravaginal practices in Urban Lusaka, Zambia.

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    Alcaide, Maria L; Chisembele, Maureen; Mumbi, Miriam; Malupande, Emeria; Jones, Deborah

    2014-03-01

    Intravaginal practices (IVP) are the introduction of products inside the vagina for hygienic, health, or sexuality reasons. The influence of men and Alengizis, traditional marriage counselors for girls, in promoting IVP has not been explored. We conducted gender-concordant focus groups and key informant interviews with Alengizis. The responses were conducted grouped into three themes: (1) cultural norms, (2) types and reasons for IVP, and (3) health consequences. We found that IVP were used by all participants in our sample and were taught from generation to generation by friends, relatives, or Alengizis. The reasons for women to engage in IVP were hygienic, though men expect women to engage in IVP to enhance sexual pleasure. Approximately 40% of women are aware that IVP can facilitate genital infections, but felt they would not feel clean discontinuing IVP. All men were unaware of the vaginal damage caused by IVP, and were concerned about the loss of sexual pleasure if women discontinued IVP. Despite the health risks of IVP, IVP continue to be widespread in Zambia and an integral component of hygiene and sexuality. The frequency of IVP mandates exploration into methods to decrease or ameliorate their use as an essential component of HIV prevention.

  18. Intravaginal boric acid: is it an alternative therapeutic option for vaginal trichomoniasis?

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    Thorley, Nicola; Ross, Jonathan

    2017-12-09

    Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common curable sexually transmitted infection worldwide. Current guidance in the UK is to treat TV with a nitroimidazole antibiotic. The high prevalence of TV, high rate of antibiotic resistance and limited tolerability to nitroimidazoles suggest that alternative treatment regimens are needed. Intravaginal boric acid (BA) has been used safely for the treatment of candida vulvovaginitis and bacterial vaginosis, and in vitro studies suggest BA is active against TV. We review the evidence for the efficacy of BA in patients with TV. MEDLINE, EMBASE, CINAHL, AMED, HMIC and BNI and Grey literature databases, The Cochrane Library, Trial Registers, conference abstracts and proceedings were searched. Inclusion criteria were women aged 16 years or over with microbiological confirmation of TV infection and using BA as treatment. There were no restrictions on language, publication date or study design. The in vitro evidence for BA activity against TV was also reviewed. No randomised controlled trials or case series were found. Four case reports demonstrated TV clearance with BA using a variety of dose regimens (dose 600 mg alternate nights to 600 mg two times per day; duration 1-5 months). In vitro studies suggest that BA has activity against TV which is independent of its effect on pH. Further evaluation of BA for the treatment of uncomplicated TV is required, but it may be useful when therapeutic options are limited. If shown to be safe and effective, intravaginal BA might provide a well-tolerated alternative anti-infective treatment which reduces community exposure to systemic antibiotics. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Intravaginal administration of lactic acid bacteria modulated the incidence of purulent vaginal discharges, plasma haptoglobin concentrations, and milk production in dairy cows.

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    Ametaj, B N; Iqbal, S; Selami, F; Odhiambo, J F; Wang, Y; Gänzle, M G; Dunn, S M; Zebeli, Q

    2014-04-01

    This investigation studied the effects of intravaginal administration of a mixture of lactic acid bacteria (LAB) on the incidence of purulent vaginal discharges (PVD), plasma haptoglobin concentrations, and milk production in dairy cows. A total of 82 pregnant primiparous and multiparous Holstein dairy cows were used in this study. Half of the cows received intravaginally 1mL of LAB at 10(10)-10(12)cfu/mL and the other half 1mL of reconstituted skim milk (i.e., carrier) (controls). Administration of LAB was conducted once per wk during 2 and 1wk before the expected day of calving and at 1, 2, 3, and 4wk postpartum. Data demonstrated that intravaginal administration of LAB decreased the occurrence of PVD at 3wk postpartum (Pmilk than their control counterparts (Pmilk yield (P>0.05). Overall, this is the first study demonstrating that intravaginal LAB administration lowers the incidence of PVD and enhances milk production in dairy cows. Further research is warranted to evaluate the effects of LAB on reproductive performance in a larger cohort of cows. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Static and dynamic MRI of a urinary control intra-vaginal device

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    Maubon, A.J. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Department of Radiology, CHU Dupuytren, Limoges (France); Boncoeur-Martel, M.P. [Department of Radiology, CHU Dupuytren, Limoges (France); Juhan, V.; Rouanet, J.P. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Courtieu, C.R. [Department of Gynecology, C. M. C. Beausoleil, Montpellier (France); Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France); Thurmond, A.S. [Women' s Imaging, Meridian Park Hospital, Portland, OR (United States); Aubas, P. [Department of Medical Information, Hopital Arnaud de Villeneuve, F-34295 Montpellier (France); Mares, P. [Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France)

    2000-06-01

    The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 {+-} 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 {+-} 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 {+-} 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 {+-} 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

  1. Static and dynamic MRI of a urinary control intra-vaginal device

    International Nuclear Information System (INIS)

    Maubon, A.J.; Boncoeur-Martel, M.P.; Juhan, V.; Rouanet, J.P.; Courtieu, C.R.; Thurmond, A.S.; Aubas, P.; Mares, P.

    2000-01-01

    The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 ± 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 ± 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 ± 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 ± 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

  2. Meaning-making matters in product design: users' sensory perceptions and experience evaluations of long-acting vaginal gels and intravaginal rings.

    Science.gov (United States)

    Rosen, Rochelle K; van den Berg, Jacob J; Vargas, Sara E; Senocak, Natali; Shaw, Julia G; Buckheit, Robert W; Smith, Kelley Alison; Guthrie, Kate Morrow

    2015-12-01

    Users' sensory perceptions and experiences of intravaginal products can inform acceptability and adherence. Focusing on the meanings women derive from formulation/device characteristics facilitates developers' design iterations toward optimizing user experience. We investigated how users of long-acting gels and intravaginal rings (IVRs) impute meaning to characteristics that may affect future product use. Focus groups were conducted with contraceptive IVR and vaginal lubricant users. Current perceptibility science and historical theory on the cultural acceptability of fertility regulating methods informed the analysis. A total of 21 IVR users and 29 lubricant users attended focus groups in which they manipulated products in their hands and discussed reactions to product characteristics. Participants used prior product experiences and sensory perceptions of prototype manipulations to inform meanings about product properties and performance for pregnancy, disease prevention, comfort, and perceived efficacy. The meanings derived from product characteristics depended on why the product would be used; a characteristic deemed problematic in one risk context may be considered preferable in another. Intravaginal product users create narratives that ascribe influence or causality to product characteristics. These meanings, whether correct or incorrect biologically, will shape vaginal product acceptability, use, and effectiveness. Long-acting and sustained-release drug delivery systems will be part of the multipurpose prevention continuum. Developers must consider how sensory experiences and culturally salient assumptions shape the meanings users make of product design characteristics. Those meanings will ultimately impact use and effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause.

    Science.gov (United States)

    Labrie, Fernand; Archer, David F; Koltun, William; Vachon, Andrée; Young, Douglas; Frenette, Louise; Portman, David; Montesino, Marlene; Côté, Isabelle; Parent, Julie; Lavoie, Lyne; Beauregard, Adam; Martel, Céline; Vaillancourt, Mario; Balser, John; Moyneur, Érick

    2016-03-01

    The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause (GSM). In a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial, the effect of daily intravaginal 0.50% DHEA (6.5 mg) (Prasterone, EndoCeutics) was examined on four coprimary objectives, namely percentage of parabasal cells, percentage or superficial cells, vaginal pH, and moderate to severe pain at sexual activity (dyspareunia) identified by the women as their most bothersome vulvovaginal atrophy symptom. The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups, respectively. After daily intravaginal administration of 0.50% DHEA for 12 weeks, when compared to baseline by the analysis of covariance test, the percentage of parabasal cells decreased by 27.7% over placebo (P < 0.0001), whereas the percentage of superficial cells increased by 8.44% over placebo (P < 0.0001), vaginal pH decreased by 0.66 pH unit over placebo (P < 0.0001), and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo (P = 0.0002). On the other hand, moderate to severe vaginal dryness present in 84.0% of women improved at 12 weeks by 1.44 severity score unit compared to baseline, or 0.27 unit over placebo (P = 0.004). At gynecological evaluation, vaginal secretions, epithelial integrity, epithelial surface thickness, and color all improved by 86% to 121% over the placebo effect (P < 0.0001 for all comparisons with placebo). Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology. The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at

  4. Determination of Prognostic Factors for Vaginal Mucosal Toxicity Associated With Intravaginal High-Dose Rate Brachytherapy in Patients With Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bahng, Agnes Y.; Dagan, Avner [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Bruner, Deborah W. [University of Pennsylvania School of Nursing, Philadelphia, PA (United States); Lin, Lilie L., E-mail: lin@xrt.upenn.edu [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    2012-02-01

    Purpose: The objective of this study was to determine the patient- and treatment-related prognostic factors associated with vaginal toxicity in patients who received intravaginal high dose rate (HDR) brachytherapy alone as adjuvant treatment for endometrial cancer. Secondary goals of this study included a quantitative assessment of optimal dilator use frequency and a crude assessment of clinical predictors for compliant dilator use. Methods and Materials: We retrospectively reviewed the charts of 100 patients with histologically confirmed endometrial cancer who underwent total hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection and adjuvant intravaginal brachytherapy between 1995 and 2009 at the Hospital of University of Pennsylvania. The most common treatment regimen used was 21 Gy in three fractions (71 patients). Symptoms of vaginal mucosal toxicity were taken from the history and physical exams noted in the patients' charts and were graded according to the Common Toxicity Criteria for Adverse Events v. 4.02. Results: The incidence of Grade 1 or asymptomatic vaginal toxicity was 33% and Grade 2-3 or symptomatic vaginal toxicity was 14%. Multivariate analysis of age, active length, and dilator use two to three times a week revealed odds ratios of 0.93 (p = 0.013), 3.96 (p = 0.008), and 0.17 (p = 0.032) respectively. Conclusion: Increasing age, vaginal dilator use of at least two to three times a week, and shorter active length were found to be significantly associated with a decreased risk of vaginal stenosis. Future prospective studies are necessary to validate our findings.

  5. Relationship between non-genital tender point tenderness and intra-vaginal muscle pain intensity: Ratings in women with provoked vestibulodynia and implications for treatment

    Science.gov (United States)

    PHILLIPS, Nancy; BROWN, Candace; BACHMANN, Gloria; WAN, Jim; WOOD, Ronald; ULRICH, Dagny; BACHOUR, Candi; FOSTER, David

    2016-01-01

    Background Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder; both of unknown etiology. Association of these conditions is well documented. Intra-vaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps to define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these two conditions. Objective 1) correlate pain intensity during the non-genital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, 2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. Study Design Ninety-two subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (Numerical rating scale> 1) in at least 11 sites of the 18-point non-genital tender point tenderness exam. Vaginal pain sensitivity was measured using an intra-vaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm2 forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of non-genital and those of iliococcygeus regions and the posterior vaginal wall. Independent t-tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance

  6. Rationale and Safety Assessment of a Novel Intravaginal Drug-Delivery System with Sustained DL-Lactic Acid Release, Intended for Long-Term Protection of the Vaginal Microbiome.

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    Hans Verstraelen

    Full Text Available Bacterial vaginosis is a prevalent state of dysbiosis of the vaginal microbiota with wide-ranging impact on human reproductive health. Based on recent insights in community ecology of the vaginal microbiome, we hypothesize that sustained vaginal DL-lactic acid enrichment will enhance the recruitment of lactobacilli, while counteracting bacterial vaginosis-associated bacteria. We therefore aimed to develop an intravaginal device that would be easy to insert and remove, while providing sustained DL-lactic acid release into the vaginal lumen. The final prototype selected is a vaginal ring matrix system consisting of a mixture of ethylene vinyl acetate and methacrylic acid-methyl methacrylate copolymer loaded with 150 mg DL-lactic acid with an L/D-lactic acid ratio of 1:1. Preclinical safety assessment was performed by use of the Slug Mucosal Irritation test, a non-vertebrate assay to evaluate vaginal mucosal irritation, which revealed no irritation. Clinical safety was evaluated in a phase I trial with six healthy nulliparous premenopausal volunteering women, with the investigational drug left in place for 7 days. Colposcopic monitoring according to the WHO/CONRAD guidelines for the evaluation of vaginal products, revealed no visible cervicovaginal mucosal changes. No adverse events related to the investigational product occurred. Total release from the intravaginal ring over 7 days was estimated through high performance liquid chromatography at 37.1 (standard deviation 0.9 mg DL-lactic acid. Semisolid lactic acid formulations have been studied to a limited extent in the past and typically consist of a large volume of excipients and very high doses of lactic acid, which is of major concern to mucosal safety. We have documented the feasability of enriching the vaginal environment with pure DL-lactic acid with a prototype intravaginal ring. Though the efficacy of this platform remains to be established possibly requiring further development, this

  7. Anatomical and functional outcomes of posterior intravaginal slingplasty for the treatment of vaginal vault or uterine prolapse: a prospective, multicenter study.

    Science.gov (United States)

    Lee, Young-Suk; Han, Deok Hyun; Lee, Ji Youl; Kim, Joon Chul; Choo, Myung-Soo; Lee, Kyu-Sung

    2010-03-01

    We aimed to evaluate the anatomical and functional outcomes of posterior intravaginal slingplasty (P-IVS) for the treatment of a vaginal vault or uterine prolapse (VP/UP). This was a 12-month prospective, multicenter, observational study. Women aged over 30 years who presented with stage II or greater VP/UP underwent P-IVS by four urologists at four university hospitals. Preoperatively, pelvic examination by use of the Pelvic Organ Prolapse Quantification (POP-Q) system, the Pelvic Floor Distress Inventory (PFDI) questionnaire, the 3-day frequency volume chart, and uroflowmetry were completed. At the 12-month follow-up, changes in the POP-Q, PFDI, frequency volume chart, and uroflowmetry parameters were assessed. Cure was defined as VP/UP stage 0 and improvement as stage I. The cure and improvement rates among the 32 women were 65.6% and 34.4%, respectively. All subscale scores of the Urinary Distress Inventory, the general subscale score of the Pelvic Organ Prolapse Distress Inventory, and the rectal prolapse subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. There were no significant changes in the frequency volume chart or uroflowmetry parameters. There was one case of surgery-related transfusion. Trans-vaginal repair by P-IVS is an effective and safe procedure for restoring the anatomical defect and improving the associated pelvic floor symptoms in women with VP/UP.

  8. Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Damast, Shari, E-mail: shari.damast@yale.edu [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Alektiar, Kaled M. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goldfarb, Shari [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Eaton, Anne; Patil, Sujata [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mosenkis, Jeffrey [Department of Comparative Human Development, University of Chicago, Chicago, Illinois (United States); Bennett, Antonia [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Atkinson, Thomas [Department of Psychiatry, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Jewell, Elizabeth; Leitao, Mario; Barakat, Richard; Carter, Jeanne [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Basch, Ethan [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2012-10-01

    Purpose: We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy. Methods and Materials: A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from <6 months to >5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, based on the published validation study. Results: SD was reported by 81% of respondents. The mean ({+-} standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 ({+-}2.0); orgasm, 2.5 ({+-}2.4); desire, 2.4 ({+-}1.3); arousal, 2.2 ({+-}2.0); dryness, 2.1 ({+-}2.1); and pain, 1.9 ({+-}2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, -7.1 points; 95% CI, -11.2 to -3.1; P<.001), lack of vaginal lubricant use (effect size, -4.4 points; 95% CI, -8.7 to -0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, -4.6 points; 95% CI, -9.3-0.2; P=.059). Conclusions: The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use.

  9. Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy

    International Nuclear Information System (INIS)

    Damast, Shari; Alektiar, Kaled M.; Goldfarb, Shari; Eaton, Anne; Patil, Sujata; Mosenkis, Jeffrey; Bennett, Antonia; Atkinson, Thomas; Jewell, Elizabeth; Leitao, Mario; Barakat, Richard; Carter, Jeanne; Basch, Ethan

    2012-01-01

    Purpose: We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy. Methods and Materials: A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from 5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, based on the published validation study. Results: SD was reported by 81% of respondents. The mean (± standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 (±2.0); orgasm, 2.5 (±2.4); desire, 2.4 (±1.3); arousal, 2.2 (±2.0); dryness, 2.1 (±2.1); and pain, 1.9 (±2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, −7.1 points; 95% CI, −11.2 to −3.1; P<.001), lack of vaginal lubricant use (effect size, −4.4 points; 95% CI, −8.7 to −0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, −4.6 points; 95% CI, −9.3-0.2; P=.059). Conclusions: The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use.

  10. Vaginal practices among women at high risk of HIV infection in Uganda and Tanzania: recorded behaviour from a daily pictorial diary.

    Directory of Open Access Journals (Sweden)

    Suzanna C Francis

    Full Text Available BACKGROUND: Intravaginal practices (IVP are highly prevalent in sub-Saharan African and have been implicated as risk factors for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred women were recruited from a HIV prevention intervention feasibility study in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal cleansing during the six week study period. The most common types of cleansing were with water only or water and soap. In both countries, intravaginal insertion (e.g. with herbs was less common than cleansing, but insertion was practiced by more participants in Uganda (46% than in Tanzania (10%. In Uganda, participants also reported more frequent sex, and more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse after sex if they reported no condom use. CONCLUSIONS: While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant

  11. Vaginal practices of HIV-negative Zimbabwean women

    NARCIS (Netherlands)

    Turner, Abigail Norris; Morrison, Charles S.; Munjoma, Marshall W.; Moyo, Precious; Chipato, Tsungai; van de Wijgert, Janneke H.

    2010-01-01

    Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary

  12. Comparison of intracervical and intravaginal misoprostol for cervical ripening and labour induction in patients with an unfavourable cervix.

    Science.gov (United States)

    Srisomboon, J; Piyamongkol, W; Aiewsakul, P

    1997-03-01

    To compare the efficacy of intracervical versus intravaginal misoprostol for cervical ripening and labour induction at term in patients with an unfavourable cervix. A total of 100 pregnant women with indications for induction of labour and unfavourable cervix (Bishop score intracervically (50 cases) or intravaginally (50 cases). No significant differences were noted between intracervical and intravaginal misoprostol in terms of Bishop score change, (score 7.2 vs score 7.5), interval from gel insertion to vaginal delivery (17.0 hours vs 16.4 hours), meperidine as analgesic requirement (80% vs 76%), route of delivery and perinatal outcome. Uterine tachysystole occurred in 24 per cent and 32 per cent in the intracervical and intravaginal groups respectively which did not significantly differ, however, all could be rapidly resolved by terbutaline injection. No evidence of fetal distress was noted in these events. Spillage of gel out of the cervix was observed in 70 per cent of patients receiving intracervical misoprostol. Fever was observed in one patient of each group. No other serious side effects were found in both groups. One patient in the intravaginal group had postpartum hemorrhage due to delayed placental separation and uterine atony. The two routes of misoprostol gel application appear to be safe and equally effective in ripening cervix and inducing labour, however, the intravaginal application is more convenient to administer practically compared with the intracervical.

  13. Cervical ripening: a randomized comparison between intravaginal misoprostol and an intracervical balloon catheter combined with intravaginal dinoprostone.

    Science.gov (United States)

    Perry, K G; Larmon, J E; May, W L; Robinette, L G; Martin, R W

    1998-06-01

    Our purpose was to compare the efficacy of intravaginal misoprostol and intracervical Foley catheter/intravaginal dinoprostone for cervical ripening. Patients admitted for induction of labor were randomized to receive intravaginal misoprostol 25 microg every 4 hours or intracervical Foley catheter/intravaginal dinoprostone 4 mg every 4 hours. Patients not entering active labor and having ruptured membranes or arrest of dilatation received intravenous oxytocin. Sixty-five patients received Foley catheter/dinoprostone gel and 62 patients received misoprostol. The mean time until cervical ripening was less in the catheter/gel group (7.5 +/- 3.4 vs 12.0 +/- 5.9 hours, p Intracervical Foley catheter/intravaginal dinoprostone was associated with more rapid cervical ripening, shorter induction to vaginal delivery interval, and greater number of vaginal deliveries within 24 hours.

  14. Vaginitis

    Science.gov (United States)

    ... The vulva may be red and swollen. The vaginal discharge usually is white, lumpy, and has no odor. ... trichomoniasis may include a yellow-gray or green vaginal discharge. The discharge may have a fishy odor. There ...

  15. Sulfonate-modified phenylboronic acid-rich nanoparticles as a novel mucoadhesive drug delivery system for vaginal administration of protein therapeutics: improved stability, mucin-dependent release and effective intravaginal placement

    Directory of Open Access Journals (Sweden)

    Li CY

    2016-11-01

    IFN demonstrated that PBNP-S could stay in the vagina and maintain intravaginal IFN level for much longer time than IFN solution (24 hours vs several hours without obvious histological irritation to vaginal mucosa after vaginal administration to mice. In summary, good stability, easy loading and controllable release of protein therapeutics, in vitro and in vivo mucoadhesive properties and local safety of PBNP-S suggested it as a promising nanoscale mucoadhesive drug delivery system for vaginal administration of protein therapeutics. Keywords: mucoadhesion, phenylboronic acid, stability, controlled-release, protein therapeutics, nanoparticles

  16. Effects of vaginal douching education on Turkish women's vaginal douching practice.

    Science.gov (United States)

    Mete, Samiye; Yenal, Kerziban; Tokat, Merlinda Aluş; Serçekuş, Pinar

    2012-01-01

    Vaginal douching (VD) is a very common practice in Turkish culture. This practice is affected by individual and cultural characteristics. The aim of the research was to determine how the education based on Pender's health promotion model (HPM) affects women's decision to quit vaginal douche and the factors that cause women to continue VD practices. The HPM guided the 2-hr education process. The sample has 58 women. As a result, the model education-based HPM helped 69% of women to quit VD practice. It was also determined that education affected women who performed VD to feel clean and to comply with the religion but was less effective in women who had lower education or performed VD to comply with the husband's demand. Finally, the study showed that the education based on HPM affected the women to change their attitude toward VD and quit it.

  17. Polymeric gels for intravaginal drug delivery.

    Science.gov (United States)

    Cook, Michael T; Brown, Marc B

    2018-01-28

    Intravaginal drug delivery can elicit a local effect, or deliver drugs systemically without hepatic first pass metabolism. There are a number of emerging areas in intravaginal drug delivery, but the vagina is a challenging route of administration, due to the clearance mechanisms present which result in poor retention of dosage forms, and the potential for irritation and other adverse reactions. Gel formulations are desirable due to the ease of application, spreading and that they cause little to no discomfort to the patient. However, these dosage forms, in particular, are poorly retained and traditional gels typically have little control over drug release rates. This has led to a large number of studies on improving the retention of vaginal gels and modulating the controlled release of drugs from the gel matrix. This review outlines the anatomy and physiology of the vagina, focussing on areas relevant to drug delivery. Medical applications of vaginally administered medicines is then discussed, followed by an overview of polymeric gels in intravaginal drug delivery. The sensorial properties of intravaginal gels, and how these relate to user compliance are also summarised. Finally, some important barriers to marketing approval are described. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Vaginal Practices of HIV-Negative Zimbabwean Women

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    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.

  19. Mathematical model of microbicidal flow dynamics and optimization of rheological properties for intra-vaginal drug delivery: Role of tissue mechanics and fluid rheology.

    Science.gov (United States)

    Anwar, Md Rajib; Camarda, Kyle V; Kieweg, Sarah L

    2015-06-25

    Topically applied microbicide gels can provide a self-administered and effective strategy to prevent sexually transmitted infections (STIs). We have investigated the interplay between vaginal tissue elasticity and the yield-stress of non-Newtonian fluids during microbicide deployment. We have developed a mathematical model of tissue deformation driven spreading of microbicidal gels based on thin film lubrication approximation and demonstrated the effect of tissue elasticity and fluid yield-stress on the spreading dynamics. Our results show that both elasticity of tissue and yield-stress rheology of gel are strong determinants of the coating behavior. An optimization framework has been demonstrated which leverages the flow dynamics of yield-stress fluid during deployment to maximize retention while reaching target coating length for a given tissue elasticity. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Demba, Edward; Morison, Linda; van der Loeff, Maarten Schim; Awasana, Akum A; Gooding, Euphemia; Bailey, Robin; Mayaud, Philippe; West, Beryl

    2005-03-09

    among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting). In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.

  1. [Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding'].

    Science.gov (United States)

    de Vries, Corlien J H; Meijer, Loes J; Janssen, C A H Ineke; Burgers, Jako S; Opstelten, Wim

    2015-01-01

    The revised Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding' provides recommendations for abnormal bleeding in women in the reproduction phase of life and for post-menopausal bleeding. This guideline is closely attuned to the guideline on 'Heavy menstrual bleeding' of the Dutch Society of Obstetrics and Gynaecology. Transvaginal sonography is not reliable for excluding endometrial carcinoma in women with abnormal vaginal bleeding treated with tamoxifen. The choice of medical treatment is determined in consultation with the patient. The following factors are assessed: severity and bother, long-term need for contraception, preference for cycle control, desire to have a child, pain during menstruation, comorbidity and use of medication. Treatment options are nonhormonal (NSAIDs, or tranexamic acid) or hormonal (a levonorgestrel-releasing intrauterine system, or combined oral contraceptive). In women of reproductive age, referral is indicated if medical treatment is not effective. Other indications are intracavitary abnormalities diagnosed by transvaginal sonography, tamoxifen use, persistent contact bleeding, and suspicion of coagulation disorders. Indications for referral for post-menopausal bleeding include: sonographic endometrial thickness > 4 mm, abnormal cervical cytology, tamoxifen use, irregular bleeding during use of hormone therapy for vasomotor symptoms and persistent or recurrent bleeding, regardless of endometrial thickness.

  2. Posterior intravaginal slingplasty with preservation of the uterus: a modified surgical technique in a young myelomeningocele patient

    NARCIS (Netherlands)

    Verguts, Jasper; Roovers, Jan-Paul; de Ridder, Dirk; Coremans, Georges; Deprest, Jan

    2007-01-01

    We report a case of uterine prolapse in a young woman, treated by posterior intravaginal slingplasty with preservation of the uterus as a feasible and safe surgical procedure. Posterior intravaginal slingplasty is commonly used to correct vaginal vault prolapse, but may be a valuable alternative to

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

    Directory of Open Access Journals (Sweden)

    Bailey Robin

    2005-03-01

    .8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting. Conclusion In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.

  4. Anterior intravaginal slingplasty tunneller device for stress incontinence and posterior intravaginal slingplasty for apical vault prolapse: a 2-year prospective multicenter study.

    Science.gov (United States)

    Vardy, Michael D; Brodman, Michael; Olivera, Cedric K; Zhou, Huan-Sue; Flisser, Adam J; Bercik, Richard S

    2007-07-01

    The purpose of this study was to report the outcome for (1) anterior intravaginal slingplasty in the treatment of urodynamic stress incontinence and (2) posterior intravaginal slingplasty for apical prolapse (> or = stage II). This was a 2-year prospective multicenter study: patients, 430; anterior intravaginal slingplasty, 144; posterior intravaginal slingplasty, 164; both procedures, 122 (552 tapes total). At 6 and 12 months, the results of the Pelvic Floor Impact Questionnaire, cough stress test, and Pelvic Organ Prolapse Quantitation were assessed. Statistical analyses used paired t-tests. Of the women in the study, 95% (42 women) had a negative cough stress test result through 12 months (n = 44 women), and 96% (127 women) had a negative cough stress test result at 6 months (n = 132). At 6 months, apical support was optimal in 95.3% (143/150 women) and was satisfactory in 2.7% (4/150 women) and at 12 months, 98.1% (52/53 women), 1.9% (1/53 women). Seventeen of 430 patients (4.0%) had vaginal mesh extrusion. Pelvic Floor Impact Questionnaire scores significantly improved (P < .0001). Anterior intravaginal slingplasty and posterior intravaginal slingplasty are safe and effective when performed with other procedures. For anterior intravaginal slingplasty, the rates of perforation and retention are low, but early extrusions are seen. Patients showed improvements in the Pelvic Floor Impact Questionnaire, regardless of extrusion.

  5. [Summary of the practice guideline 'Vaginal discharge' (first revision) from the Dutch College of General Practitioners].

    Science.gov (United States)

    Boukes, F S; Boeke, A J P; Dekker, J H; Wiersma, T; Goudswaard, A N

    2007-06-16

    The 1996 practice guideline of the Dutch College of General Practitioners (NHG) on vaginal discharge has been updated. Most women who visit their doctor with complaints about vaginal discharge do not have an increased risk of a sexually-transmitted disease. Investigations into vaginal discharge comprise history taking, physical examination and microscopic analysis in the laboratory of the general practitioner. Additional investigation into Chlamydia, gonorrhoea and Trichomonas infection is only necessary if the patient history reveals an increased risk of a sexually-transmitted disease. A Candida infection or bacterial vaginosis should only be treated if the patient experiences bothersome complaints. Treatment of a Candida infection consists of a vaginally applied imidazole compound. Bacterial vaginosis can be treated with oral administration of metronidazole. Patients with vaginal fluor can be examined and, if necessary, treated by their general practitioner. Referral to a gynaecologist is rarely necessary.

  6. Induction of labor in prolonged pregnancy with unfavorable cervix: comparison of sequential intracervical Foley catheter-intravaginal misoprostol and intravaginal misoprostol alone.

    Science.gov (United States)

    Ande, A Babatunde; Ezeanochie, C Michael; Olagbuji, N Biodun

    2012-04-01

    To compare the outcome of induced labor at term using sequential intracervical Foley catheter with intravaginal misoprostol versus intravaginal misoprostol alone. A prospective matched case control study among parturient with prolonged pregnancy and unfavorable cervix at a tertiary hospital in Nigeria. The study population was 100 with a mean age of 29.46 ± 3.88 years. Parturient with prior cervical priming using intracervical Foley catheter had significantly lower oxytocin augmentation of uterine contractions in labor (44 vs. 64%, P = 0.045), shorter mean insertion to active phase labor duration (233 ± 98 vs. 354 ± 154 min, P = 0.0001), shorter insertion to delivery interval (514 ± 175 vs. 627 ± 268, P = 0.014), more vaginal delivery intracervical Foley catheter and intravaginal misoprostol for cervical ripening and induction of labor appears to be a safe and more effective method compared to intravaginal misoprostol in parturient at term with unfavorable cervices.

  7. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  8. Vaginitis: Diagnosis and Treatment.

    Science.gov (United States)

    Paladine, Heather L; Desai, Urmi A

    2018-03-01

    Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Bacterial vaginosis is implicated in 40% to 50% of cases when a cause is identified, with vulvovaginal candidiasis accounting for 20% to 25% and trichomoniasis for 15% to 20% of cases. Noninfectious causes, including atrophic, irritant, allergic, and inflammatory vaginitis, are less common and account for 5% to 10% of vaginitis cases. Diagnosis is made using a combination of symptoms, physical examination findings, and office-based or laboratory testing. Bacterial vaginosis is traditionally diagnosed with Amsel criteria, although Gram stain is the diagnostic standard. Newer laboratory tests that detect Gardnerella vaginalis DNA or vaginal fluid sialidase activity have similar sensitivity and specificity to Gram stain. Bacterial vaginosis is treated with oral metronidazole, intravaginal metronidazole, or intravaginal clindamycin. The diagnosis of vulvovaginal candidiasis is made using a combination of clinical signs and symptoms with potassium hydroxide microscopy; DNA probe testing is also available. Culture can be helpful for the diagnosis of complicated vulvovaginal candidiasis by identifying nonalbicans strains of Candida. Treatment of vulvovaginal candidiasis involves oral fluconazole or topical azoles, although only topical azoles are recommended during pregnancy. The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for the diagnosis of trichomoniasis in symptomatic or high-risk women. Trichomoniasis is treated with oral metronidazole or tinidazole, and patients' sex partners should be treated as well. Treatment of noninfectious vaginitis should be directed at the underlying cause. Atrophic vaginitis is treated with hormonal and nonhormonal therapies. Inflammatory vaginitis may improve with

  9. Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

    Science.gov (United States)

    Kim, Jun-Mo; Park, Yoo Jin

    2017-12-01

    Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter , Escherichia coli , Candida , and Gardnerella ). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

  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 treatment. Of this group, 10 patients who had triggers for their 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. Paediatric vaginal discharge | Makwela | South African Family Practice

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 49, No 7 (2007) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  12. Second Trimester Medical Termination of Pregnancy with Combined Intracervical and Intravaginal Misoprostol: Comparative Analysis with Intravaginal Misoprostol-A Pilot Study.

    Science.gov (United States)

    Desai, Gaurav Shyam; Chandavarkar, Abhishek; Gopal, Sriram; Sawant, Ganpat; Desai, Shyam V

    2016-10-01

    Intravaginal placement of misoprostol has been used extensively to terminate second trimester pregnancies. Intracervical misoprostol is an alternative method of termination of pregnancy for women in this period of gestation. To assess the efficacy and safety of combined intracervical and intravaginal misoprostol in the management of mid-trimester medical termination of pregnancy and to compare it with intravaginal misoprostol. In this IRB approved prospective study, twenty-two women (mean age 25.4 ± 3.2 years, range 23-32 years; mean BMI 22.3 ± 3.4 kg/m(2); mean parity 2.1 ± 1.4, average gestational age 17.9 ± 2.4 weeks) underwent second trimester termination of pregnancy at our institution. Patient cohort was randomized into two treatment protocols depending on the drug used and route of administration. Induction-abortion interval, need for surgical evacuation, completeness of abortion and side effects if any were documented. Mean induction-abortion interval for intravaginal group and combination group was comparable (t = 7.9 ± 1.8 and 6.5 ± 3.5 h, respectively). Three patients required surgical evacuation for incomplete abortion (n = 2 after vaginal misoprostol and one after intracervical-intravaginal misoprostol). Number of patients aborting within 6 h was more in the intracervical-intravaginal group (36.3 %). Patients with intracervical misoprostol complained of abdominal pain more often than those in other groups. Excessive bleeding and uterine rupture was not seen in any patient. Intracervical misoprostol is an effective method of medical treatment of second trimester pregnancy failure. Its short induction to abortion interval and acceptable safety profile makes induction via the cervical route acceptable for second trimester abortion.

  13. Foreign Body in Vagina: An Uncommon Cause of Vaginitis in Children

    African Journals Online (AJOL)

    Vaginal discharge in children may result from a variety of causes. A long.standing intra.vaginal foreign body can pose both diagnostic and therapeutic challenges in children. Treatment failure may occur because of alteration of the normal vaginal flora. A 6.year.old girl, who lived with her parents, presented with a ...

  14. Dynamic clinical measurements of voluntary vaginal contractions and autonomic vaginal reflexes.

    Science.gov (United States)

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

    2014-12-01

    The 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 and might be involved in the pathophysiology of genito-pelvic pain/penetration disorder. The aim of this study was to detect the presence of a canalicular vaginal "sphincter mechanism" by measuring intravaginal pressure at different levels of the vaginal canal during voluntary pelvic floor contractions and during induced reflexive contractions. Sixteen nulliparous women, without sexual dysfunction and pelvic floor trauma, were included in the study. High-resolution solid-state circumferential catheters were used to measure intravaginal pressures and vaginal contractions at different levels in the vaginal canal. Voluntary intravaginal pressure measurements were performed in the left lateral recumbent position only, while reflexive intravaginal pressure measurements during slow inflation of a vaginal balloon were performed in the left lateral recumbent position and in the sitting position. Intravaginal pressures and vaginal contractions were the main outcome measures. In addition, a general demographic and medical history questionnaire was administered to gain insight into the characteristics of the study population. Fifteen out of the sixteen women had deep and superficial vaginal high-pressure zones. In one woman, no superficial high-pressure zone was found. The basal and maximum pressures, as well as the duration of the autonomic reflexive contractions significantly exceeded the pressures and the duration of the voluntary contractions. There were no significant differences between the reflexive measurements obtained in the left lateral recumbent and the sitting position. The two high-pressure zones found in this study, as a result of voluntary contractions and, even more pronounced

  15. Vaginal Atrophy

    Science.gov (United States)

    ... urinary signs and symptoms: Vaginal dryness Vaginal burning Vaginal discharge Genital itching Burning with urination Urgency with urination ... others). Also make an appointment if you have vaginal symptoms, such as unusual ... burning or soreness. Causes Genitourinary syndrome of menopause ( ...

  16. Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis.

    Directory of Open Access Journals (Sweden)

    Noelle Noyes

    Full Text Available The vaginal microbiome plays an influential role in several disease states in reproductive age women, including bacterial vaginosis (BV. While demographic characteristics are associated with differences in vaginal microbiome community structure, little is known about the influence of sexual and hygiene habits. Furthermore, associations between the vaginal microbiome and risk symptoms of bacterial vaginosis have not been fully elucidated. Using Bayesian network (BN analysis of 16S rRNA gene sequence results, demographic and extensive questionnaire data, we describe both novel and previously documented associations between habits of women and their vaginal microbiome. The BN analysis approach shows promise in uncovering complex associations between disparate data types. Our findings based on this approach support published associations between specific microbiome members (e.g., Eggerthella, Gardnerella, Dialister, Sneathia and Ruminococcaceae, the Nugent score (a BV diagnostic and vaginal pH (a risk symptom of BV. Additionally, we found that several microbiome members were directly connected to other risk symptoms of BV (such as vaginal discharge, odor, itch, irritation, and yeast infection including L. jensenii, Corynebacteria, and Proteobacteria. No direct connections were found between the Nugent Score and risk symptoms of BV other than pH, indicating that the Nugent Score may not be the most useful criteria for assessment of clinical BV. We also found that demographics (i.e., age, ethnicity, previous pregnancy were associated with the presence/absence of specific vaginal microbes. The resulting BN revealed several as-yet undocumented associations between birth control usage, menstrual hygiene practices and specific microbiome members. Many of these complex relationships were not identified using common analytical methods, i.e., ordination and PERMANOVA. While these associations require confirmatory follow-up study, our findings strongly

  17. Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis.

    Science.gov (United States)

    Noyes, Noelle; Cho, Kyu-Chul; Ravel, Jacques; Forney, Larry J; Abdo, Zaid

    2018-01-01

    The vaginal microbiome plays an influential role in several disease states in reproductive age women, including bacterial vaginosis (BV). While demographic characteristics are associated with differences in vaginal microbiome community structure, little is known about the influence of sexual and hygiene habits. Furthermore, associations between the vaginal microbiome and risk symptoms of bacterial vaginosis have not been fully elucidated. Using Bayesian network (BN) analysis of 16S rRNA gene sequence results, demographic and extensive questionnaire data, we describe both novel and previously documented associations between habits of women and their vaginal microbiome. The BN analysis approach shows promise in uncovering complex associations between disparate data types. Our findings based on this approach support published associations between specific microbiome members (e.g., Eggerthella, Gardnerella, Dialister, Sneathia and Ruminococcaceae), the Nugent score (a BV diagnostic) and vaginal pH (a risk symptom of BV). Additionally, we found that several microbiome members were directly connected to other risk symptoms of BV (such as vaginal discharge, odor, itch, irritation, and yeast infection) including L. jensenii, Corynebacteria, and Proteobacteria. No direct connections were found between the Nugent Score and risk symptoms of BV other than pH, indicating that the Nugent Score may not be the most useful criteria for assessment of clinical BV. We also found that demographics (i.e., age, ethnicity, previous pregnancy) were associated with the presence/absence of specific vaginal microbes. The resulting BN revealed several as-yet undocumented associations between birth control usage, menstrual hygiene practices and specific microbiome members. Many of these complex relationships were not identified using common analytical methods, i.e., ordination and PERMANOVA. While these associations require confirmatory follow-up study, our findings strongly suggest that future

  18. Vaginal symptoms of unknown etiology - a study in dutch general-practice

    NARCIS (Netherlands)

    Dekker, Janny H.; Boeke, A. Joan P.; Janssens, J; van Eijk, J.Th.M.

    Vaginal symptoms are frequently presented by women to general practitioners. In many cases, the aetiology of these symptoms remains unknown. This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors

  19. Sustained delivery of commensal bacteria from pod-intravaginal rings.

    Science.gov (United States)

    Gunawardana, Manjula; Mullen, Madeline; Yoo, Jennifer; Webster, Paul; Moss, John A; Baum, Marc M

    2014-01-01

    Topical administration of live commensal bacteria to the vaginal tract holds significant potential as a cost-effective strategy for the treatment of sexually transmitted infections and the delivery of mucosal vaccines. Probiotic-releasing intravaginal rings (IVRs) embody significant theoretical advantages over traditional daily-dosage forms, such as sustained and controlled delivery leading to improved adherence to therapy compared to that of frequent dosing. The conventional IVR designs, however, are not amenable to the delivery of live bacteria. We have developed a novel pod-IVR technology where polymer-coated tablets ("pods") of Lactobacillus gasseri strain ATCC 33323, a commensal microorganism of human origin, are embedded in silicone IVRs. The release rate of bacterial cells is controlled by the diameter of a delivery channel that exposes a portion of the pod to external fluids. In vitro studies demonstrated that the prototype devices released between 1.1×10(7) and 14×10(7) cells per day for up to 21 days in a controlled sustained fashion with stable burst-free release kinetics. The daily release rates were correlated with the cross-sectional area of the delivery channel. Bacteria in the IVR pods remained viable throughout the in vitro studies and formed biofilms on the surfaces of the devices. This proof-of-principle study represents the first demonstration of a prolonged, sustained release of bacteria from an intravaginal device and warrants further investigation of this device as a nonchemotherapeutic agent for the restoration and maintenance of normal urogenital flora.

  20. An evaluation of prostaglandin E2 vaginal gel use in practice.

    Science.gov (United States)

    Taylor, S J; Peat, J K; Armour, C L

    1999-08-01

    The purpose of this study was to investigate the effectiveness of prostaglandin E2 vaginal gel as used in practice, rather than its efficacy as assessed in randomised, controlled, clinical trials. This product is used to ripen the cervix prior to induction of labour, sometimes making unnecessary the use of the standard treatment for induction, artificial rupture of the membranes (ARM) plus oxytocin. In this study, effectiveness of the gel was assessed in terms of changes in mode of delivery, and in particular the risk of Caesarean section. An historical control was used and the risk of Caesarean section for women induced in the 1990/91 (before the introduction of the gel) was compared with that for women induced in 1992/93 (after the introduction of the gel). Maternal characteristics which may have been different in the two groups and factors which might influence the risk of Caesarean section were controlled for statistically using logistic regression, thus reducing any bias towards one group. After adjusting for the factors which had a significant effect on the process of labour from induction to birth, it was found that the risk of Caesarean section was not significantly lower in the 1992/93-time period, when the gel was in regular use, from that in the 2 years prior to its introduction (Odds ratio 1.09, CI95% 0.88, 1.36). Following the introduction of PGE2 gel, no difference in effectiveness, as measured in terms of mode of delivery, was detected in this study of practice, which included patients with more complex obstetric problems.

  1. Vaginal Infections

    Science.gov (United States)

    ... around your vagina , or a problem with your vaginal discharge (fluid). If you've had sexual contact with ... discharge Types of vaginal infections Ways to avoid vaginal infections Abnormal discharge top You may wonder if the fluid, or ...

  2. Vaginal dryness

    Science.gov (United States)

    ... Light bleeding after intercourse Painful sexual intercourse Slight vaginal discharge Vaginal soreness, itching or burning ... the vagina are thin, pale or red. Your vaginal discharge may be tested to rule out other causes ...

  3. Low dose intravaginal misoprostol versus intracervical balloon ...

    African Journals Online (AJOL)

    Background:The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. Objective:To compare the safety and efficacy of a low dose intravaginal misoprostol and intracervical Foley's catheter for cervical ripening. Design:A ...

  4. Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women.

    Science.gov (United States)

    Dessole, Salvatore; Rubattu, Giovanni; Ambrosini, Guido; Gallo, Omar; Capobianco, Giampiero; Cherchi, Pier Luigi; Marci, Roberto; Cosmi, Erich

    2004-01-01

    To assess the efficacy and safety of intravaginal estriol administration on urinary incontinence, urogenital atrophy, and recurrent urinary tract infections in postmenopausal women. Eighty-eight postmenopausal women with urogenital aging symptoms were enrolled in this prospective, randomized, placebo-controlled study. Participants were randomly divided into two groups, with each group consisting of 44 women. Women in the treatment group received intravaginal estriol ovules: 1 ovule (1 mg) once daily for 2 weeks and then 2 ovules once weekly for a total of 6 months as maintenance therapy. Women in the control group received inert placebo vaginal suppositories in a similar regimen. We evaluated urogenital symptomatology, urine cultures, colposcopic findings, urethral cytologic findings, urethral pressure profiles, and urethrocystometry before as well as after 6 months of treatment. After therapy, the symptoms and signs of urogenital atrophy significantly improved in the treatment group in comparison with the control group. Thirty (68%) of the treated participants, and only seven (16%) of the control participants registered a subjective improvement of their incontinence. In the treated participants, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure, in mean urethral closure pressure as well as in the abdominal pressure transmission ratio to the proximal urethra. Urethrocystometry showed positive but not statistically significant modifications. Our results show that intravaginal administration of estriol may represent a satisfactory therapeutic choice for those postmenopausal women with urogenital tract disturbances who have contraindications or refuse to undergo standard hormone therapy.

  5. Vaginal Laxity, Sexual Distress, and Sexual Dysfunction: A Cross-Sectional Study in a Plastic Surgery Practice.

    Science.gov (United States)

    Qureshi, Ali A; Sharma, Ketan; Thornton, Melissa; Myckatyn, Terence M; Tenenbaum, Marissa M

    2018-01-23

    Sexual health issues can be characterized by vaginal laxity (VL), sexual distress, and sexual dysfunction. The epidemiology of these issues in plastic surgery patients, and especially breast cancer survivors, remains poorly understood. To prospectively assess sexual health issues in a plastic surgery patient population with and without breast cancer. A prospective cohort study was created in our practice from June to August 2017 with administration of a survey including the vaginal laxity questionnaire (VLQ), female sexual distress scale-revised (FSDS-R), and female sexual function index (FSFI). Multivariate logistic regression identified the controlled effect of patient variables on development of sexual health issues. Of 291 patients solicited, 239 completed the survey (37.7% breast cancer survivors vs 62.3% without). Prevalence of VL was nearly 1 in 6 women. Of these, 46.0% met criteria for sexual distress (FSDS-R ≥ 11.0) and 64.8% had sexual dysfunction (FSFI ≤ 26.5). Breast cancer survivors exhibited significantly greater overall sexual dysfunction (P < 0.001) and greater dysfunction within all FSFI domains of desire, arousal, lubrication, orgasm, satisfaction, and pain (all P < 0.02). On multivariate regression, number of vaginal deliveries predicted development of VL (OR 1.87, P < 0.001), presence of VL predicted sexual distress (OR 3.01, P = 0.007), while history of breast cancer predicted sexual dysfunction (OR 1.87, P < 0.05). Sexual health issues are prevalent amongst plastic surgery patients. Aesthetic practices can improve patients' quality of life by focusing on these areas. Potential therapeutic options to address sexual health issues should consider addressing vaginal laxity. © 2018 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  6. How useful are high vaginal swabs in general practice? Results of a multicentre study.

    Science.gov (United States)

    Jungmann, E; Johnson, A M; Ridgway, G; Durrant, K; Robinson, A J

    2004-04-01

    Vulvovaginal symptoms are a common reason for consultation with a general practitioner (GP). High vaginal swabs (HVS) are used to investigate symptoms, but their usefulness is poorly evaluated and microbiological tests performed vary between laboratories. In this multicentre study of 797 women with genital symptoms attending GPs, diagnostic yield of HVS was poor except for Candida spp. (22%). There is an urgent need to establish the most cost-effective approach for the management of these women.

  7. [Diagnosis of vaginal discharge].

    Science.gov (United States)

    Böcher, Sidsel; Helmig, Rikke Bek; Arpi, Magnus; Bjerrum, Lars

    2018-01-15

    Changes in vaginal discharge are often caused by imbalance in the vaginal microflora, and laboratory testing is usually of little use, as most microbes detected are commensals. In-office diagnosis in general practice using wet mount microscopy and Amsel criteria is helpful and often sufficient to ensure correct diagnosis and treatment. Laboratory testing of vaginal discharge should only be performed, if sexually transmitted disease is suspected, if there is treatment failure or inconclusive wet mount prior to gynaecological surgery, and in pregnant women with recurrent miscarriage or preterm birth.

  8. Novel intravaginal nanomedicine for the targeted delivery of saquinavir to CD4+ immune cells

    Directory of Open Access Journals (Sweden)

    Yang S

    2013-08-01

    Full Text Available Sidi Yang,1,2 Yufei Chen,1,2 Kaien Gu,1,2 Alicia Dash,1,2 Casey L Sayre,1 Neal M Davies,1 Emmanuel A Ho1,2 1Faculty of Pharmacy, 2Laboratory for Drug Delivery and Biomaterials, University of Manitoba, Winnipeg, MB, Canada Abstract: The goal of this study was to develop and characterize an intravaginal nanomedicine for the active targeted delivery of saquinavir (SQV to CD4+ immune cells as a potential strategy to prevent or reduce HIV infection. The nanomedicine was formulated into a vaginal gel to provide ease in self-administration and to enhance retention within the vaginal tract. SQV-encapsulated nanoparticles (SQV-NPs were prepared from poly(lactic-co-glycolic acid(PLGA and conjugated to antihuman anti-CD4 antibody. Antibody-conjugated SQV-NPs (Ab-SQV-NPs had an encapsulation efficiency (EE% of 74.4% ± 3.7% and an antibody conjugation efficiency (ACE% of 80.95% ± 1.10%. Over 50% of total loaded SQV was released from NPs over 3 days. NPs were rapidly taken up by Sup-T1 cells, with more than a twofold increase in the intracellular levels of SQV when delivered by Ab-SQV-NPs in comparison to controls 1 hour post-treatment. No cytotoxicity was observed when vaginal epithelial cells were treated for 24 hours with drug-free Ab-NPs (1,000 µg/mL, 1% HEC placebo gel (200 mg/mL, or 1% HEC gel loaded with drug-free Ab-NPs (5 mg NPs/g gel, 200 mg/mL of gel mixture. Overall, we described an intravaginal nanomedicine that is nontoxic and can specifically deliver SQV into CD4+ immune cells. This platform may demonstrate potential utility in its application as postexposure prophylaxis for the treatment or reduction of HIV infection, but further studies are required. Keywords: nanoparticles, saquinavir, antibody conjugation, intravaginal gel, HIV/AIDS, microbicide

  9. In vitro validation of vaginal sampling in rape victims: the problem of Locard's principle.

    Science.gov (United States)

    Loeve, Arjo J; Bilo, Rob A C; Emirdag, Eda; Sharify, Maryam; Jansen, Frank Willem; Dankelman, Jenny

    2013-06-01

    Intra-vaginal traces can serve as supporting physical evidence of vaginal penetration in sex-crime cases. Vaginal trace sampling guidelines prescribe using a speculum and swabs or swabs only. The use of Locard's exchange theory requires samples of trace materials to always be contamination-free and of accurately known origin. If traces from the outer genital area are accidentally introduced into the vagina during sampling, these traces may be recorded as originating in a location where they were not present at the time of evidence collection. The goal of this study was to assess the risks of false positive findings in vitro of traces found inside the vagina due to trace dislocation caused by current vaginal trace sampling methods (swab-only or with speculum), and for a new method that uses a sleeve accessory to prevent trace dislocation. Starch solution was applied to the labia of three clean female genitalia mock-ups with vaginas of various diameters and structures. The speculum, swab-only, and sleeve methods were each used 30 times on each mock-up, giving a total of 90 repetitions of each method. Iodine was used to determine whether any starch traces had been introduced vaginally. The speculum and swab-only methods gave 100 and 63-87 % false positive results respectively due to trace dislocation. The sleeve method reduced this to 2 % (0 % after correction). The results suggest that there is a need to conduct clinical in vivo studies to determine whether these results translate into everyday practice and to ensure reliable trace sampling in sex-crime cases.

  10. Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis

    OpenAIRE

    Noyes, Noelle; Cho, Kyu-Chul; Ravel, Jacques; Forney, Larry J.; Abdo, Zaid

    2018-01-01

    The vaginal microbiome plays an influential role in several disease states in reproductive age women, including bacterial vaginosis (BV). While demographic characteristics are associated with differences in vaginal microbiome community structure, little is known about the influence of sexual and hygiene habits. Furthermore, associations between the vaginal microbiome and risk symptoms of bacterial vaginosis have not been fully elucidated. Using Bayesian network (BN) analysis of 16S rRNA gene ...

  11. Estrogen Vaginal

    Science.gov (United States)

    ... in women who are experiencing or have experienced menopause (change of life; the end of monthly menstrual periods). Femring® brand estradiol vaginal ring is also used to treat hot flushes ... are experiencing menopause. Premarin® brand vaginal cream is also used to ...

  12. 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 ...

  13. 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

  14. Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome due to microperforation and pyocolpos in obstructed vaginal canal.

    Science.gov (United States)

    Wozniakowska, Ewa; Torres, Anna; Milart, Pawel; Wozniak, Slawomir; Czuczwar, Piotr; Szkodziak, Piotr; Paszkowski, Tomasz

    2014-08-01

    To present a rare anomaly consisting of uterus didelphys, longitudinal vaginal septum, obstructed hemivagina with pyocolpos, fistula to the open vaginal canal, and ipsilateral renal agenesis, referred as Herlyn-Werner-Wunderlich syndrome (HWWS). A 14-year-old girl with recurring purulent vaginal discharge lasting for a few months. Preoperative examination revealed one vaginal canal with one cervical opening on the right side. There was a fistula leading from the obstructed vaginal canal to the left vagina. Intravaginal ultrasound examination demonstrated a longitudinal vaginal septum and a closed pyocolpos on the right side. The longitudinal vaginal septum was excised by way of electrocauterization under direct vision. HWWS should be considered in the differential diagnosis in patients with uterus didelphys and unusual symptoms such as pyocolpos and vaginal discharge. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. Terconazole Vaginal Cream, Vaginal Suppositories

    Science.gov (United States)

    Terconazole comes as a cream and suppository to insert into the vagina. It is usually used daily at bedtime for either 3 or 7 days. ... prescribed by your doctor.To use the vaginal cream or vaginal suppositories, read the instructions provided with ...

  16. Short communication: Drug residues in goat milk after prophylactic use of antibiotics in intravaginal sponges for estrus synchronization.

    Science.gov (United States)

    Romero, T; Balado, J; Althaus, R L; Beltrán, M C; Molina, M P

    2016-01-01

    The aim of this study was to determine whether the prophylactic use of antibiotics in intravaginal sponges used for estrus synchronization in goats may result in the presence of inhibitors in milk and, therefore, of positive results by microbial screening tests. Ninety-eight Murciano-Granadina goats were used, divided into 7 groups of 14 animals. Intravaginal sponges were placed in 6 groups using 2 concentrations of 3 different antibiotics: doxycycline, oxytetracycline, and sulfathiazole-framycetin. The sponges of the control group were placed without antibiotics. Milk samples were collected daily until 7 d posttreatment and analyzed using 3 microbial tests. Positive samples were retested by specific receptor-binding assays to confirm the positive results. Vaginal status was evaluated by visual assessment of the external aspect of the sponges after removal. The microbial test response was not affected by either day posttreatment or dose of antibiotic used, except for oxytetracycline at the higher concentration. Moreover, no positive results were obtained using receptor-binding assays, suggesting that residues, if present in milk, did not exceed the regulatory (safety) levels established for these drugs. The occurrence of soiled sponges was higher in the control group. With respect to the dose of antibiotics used, no significant differences were found for the lower dose administered. However, a significant increase in the percentage of clean sponges was observed for the higher dose of doxycycline. We conclude that the prophylactic use of low doses of doxycycline, oxytetracycline, or sulfathiazole in intravaginal sponges used for synchronization of estrus helps to reduce clinical vaginitis in dairy goats and does not seem to be the cause of positive results in microbial inhibitor tests used to detect antibiotics in goat milk. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  17. High Levels of Inflammatory Cytokines in the Reproductive Tract of Women with BV and Engaging in Intravaginal Douching: A Cross-Sectional Study of Participants in the Women Interagency HIV Study.

    Science.gov (United States)

    Alcaide, Maria L; Rodriguez, Violeta J; Brown, Megan R; Pallikkuth, Suresh; Arheart, Kristopher; Martinez, Octavio; Roach, Margaret; Fichorova, Raina N; Jones, Deborah L; Pahwa, Savita; Fischl, Margaret A

    2017-04-01

    High levels of inflammatory cytokines in the genital tract suggest mucosal vulnerability and increased risk of HIV and sexually transmitted infection (STI) acquisition. Intravaginal douching is associated with bacterial vaginosis (BV) in women in the United States, and both douching and BV are linked to HIV and STI acquisition. This study evaluates inflammatory cytokines in the genital tract to increase understanding of the effects of both BV and intravaginal douching to the vaginal mucosa. A cross-sectional study of participants in the Miami WIHS investigated 72 reproductive age women (45 HIV + and 27 high-risk HIV - ) who completed intravaginal douching questionnaires and underwent collection of vaginal swabs and cervicovaginal lavages (CVLs). BV was assessed using the Nugent score. Inflammatory cytokines in the CVLs (interleukin [IL]-6, IL-8, IL-1α, IL-1β, soluble intracellular adhesion molecule-1 [sICAM-1], interferon [IFN]α2, chemokine C ligand 5 (CCL5), vascular endothelial growth factor (VEGF), monocyte chemotactic protein-1 (MCP1), tumor necrosis factor alpha (TNFα), and secretory leukocyte protease inhibitor [SLPI]) were measured. Fourteen (19%) women reported intravaginal douching; 24 (33%) had BV. BV, intravaginal douching, and HIV were associated with higher levels of inflammatory cytokines. After controlling for demographic and risk factors and HIV status, women who had BV and douched had higher levels of inflammatory cytokines than those without BV and who did not douche, or who only had BV or only douched. These findings suggest that BV and douching are associated with greater mucosal inflammation and may facilitate HIV acquisition and transmission. Although longitudinal studies are needed to determine temporal associations and causality, interventions to decrease rates of intravaginal douching and BV could significantly decrease women's risks of acquiring STIs and HIV and limit the spread of HIV.

  18. The effect of treatment regimens for vaginitis and cervicitis on vaginal colonization by lactobacilli.

    Science.gov (United States)

    Agnew, K J; Hillier, S L

    1995-01-01

    The goal of this study was to determine the effect of various treatment regimens on vaginal colonization by H2O2-positive and H2O2-negative lactobacilli. The subset of women enrolled in a large longitudinal cohort study who had Chlamydia trachomatis (n = 13), bacterial vaginosis (n = 105), yeast vaginitis (n = 15), or mucopurulent cervicitis (n = 47) were compared with 93 women without genital infection from the same population. The effect of various treatment regimens on lactobacilli was evaluated. Use of doxycycline, azithromycin, clotrimazole, and fluconazole had little effect on vaginal colonization by Lactobacillus. Use of oral or vaginal metronidazole led to an increase in Lactobacillus, which persisted 1 month after therapy. Intravaginal clindamycin use caused a decrease 1 week post-therapy, but at 1 month, levels of lactobacilli were similar to those in the metronidazole treatment group. Women treated with oral ampicillin had a modest increase in Lactobacillus levels. Use of antimicrobial agents for treating vaginitis and cervicitis do not cause a decrease in vaginal colonization by Lactobacillus, which is detectable 1 week to 1 month after treatment.

  19. Acceptability of a non-woven device for vaginal drug delivery of microbicides or other active agents.

    Science.gov (United States)

    Joanis, Carol L; Hart, Catherine W

    2010-06-01

    Vaginal microbicides could reduce incidence of HIV. However, the current method of delivering gel formulations (standard applicator) can result in acceptability concerns/issues. This study evaluated the concept of using a non-woven textile material (modified tampon) for vaginal drug delivery. The study was nested within a Phase I randomized safety trial of lime juice concentrations used intra-vaginally. Of 47 women completing the safety trial, 16 were interviewed about their experiences. Overall, women found the concept of non-woven materials for vaginal drug delivery acceptable for use in delivering yeast medications (13 of 16) and STI/HIV preventives (10 of 16).

  20. 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 ...

  1. 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.

  2. Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women

    NARCIS (Netherlands)

    van de Wijgert, Janneke H. H. M.; Morrison, Charles S.; Cornelisse, Peter G. A.; Munjoma, Marshall; Moncada, Jeanne; Awio, Peter; Wang, Jing; van der Pol, Barbara; Chipato, Tsungai; Salata, Robert A.; Padian, Nancy S.

    2008-01-01

    OBJECTIVE: To evaluate interrelationships between bacterial vaginosis (BV), vaginal yeast, vaginal practices (cleansing and drying/tightening), mucosal inflammation, and HIV acquisition. METHODS: A multicenter, prospective, observational cohort study was conducted, enrolling 4531 HIV-negative women

  3. Foley Catheter versus Vaginal Misoprostol for Labour Induction

    Directory of Open Access Journals (Sweden)

    Nasreen Noor

    2015-01-01

    Full Text Available Objectives. To compare the efficacy and safety of intravaginal misoprostol with transcervical Foley catheter for labour induction. Material and Methods. One hundred and four women with term gestation, with Bishop score < 4, and with various indications for labour induction were randomly divided into two groups. In Group I, 25 μg of misoprostol tablet was placed intravaginally, 4 hourly up to maximum 6 doses. In Group II, Foley catheter 16F was placed through the internal os of the cervix under aseptic condition and then inflated with 50 cc of sterile saline. Statistical analysis was done using SPSS software. Results. The induction to delivery interval was 14.03 ± 7.61 hours versus 18.40 ± 8.02 hours (p<0.01. The rate of vaginal delivery was 76.7% versus 56.8% in misoprostol and transcervical Foley catheter group, respectively. Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups. Conclusion. Intravaginal misoprostol is associated with a shorter induction to delivery interval as compared to Foley’s catheter and it increases the rate of vaginal delivery in cases of unripe cervix at term. Transcervical Foley catheter is associated with a lower incidence of uterine hyperstimulation during labour.

  4. Vaginal contraception--an update.

    Science.gov (United States)

    Edelman, D A; Thompson, S

    1982-04-01

    A number of new and innovative methods of vaginal contraceptive have been developed in recent years and are currently being evaluated. Some of these methods are described briefly and the available data on their safety and efficacy are presented. 3 types of contraceptive sponges have been developed--collagen sponge, intravaginal insert, and Secure sponge--and are now being evaluated. The collagen sponge, a cylindrical-shaped disk, exerts its contraceptive effect by acting as a physical barrier to the sperm and through its ability to absorb semen much in excess of its own weight. Preliminary data confirm the effectiveness of the sponge obtained from post-coital tests. The intravaginal insert (IVI) is made of a polyester material incorporating the spermicide nonoxynol-9. In a small clinical evaluation of the IVI, 49 women were followed up for 1 month. No pregnancies or unexpected adverse reactions were reported. The Secure sponge is made of polyurethane and incorporates 1 g of the spermicide nonoxynol-9. Its primary mode of action in preventing pregnancy is through the release of nonoxynol-9. In a multiclinic phase 2 evaluation of the Secure, which included 382 women, the 6-month gross life-table pregnancy rate was 3.8 +or- 1.3/100 women; the 6-month gross discontinuation rate for all reasons was 26.2 +or- 3.4/100 women. Sufficient data from the comparative trials of the Secure and Neo Sampoon foaming suppository studies conducted in Yugoslavia, Taiwan, and Bangladesh have been reported to the International Fertility Research Program (IFRP). The 12-month life-table rates for reasons leading to discontinuation of the contraceptive methods were not significantly different except for the category of "other personal reasons." The advantages Secure provides over other vaginal contraceptives are identified. Foaming vaginal suppositories similar to Neo Sampoon but containing 100 mg nonoxynol-9 are being developed and evaluated in the U.S. Clinical data on these products are

  5. Studies of Immune Responses in Candida vaginitis

    Science.gov (United States)

    De Bernardis, Flavia; Arancia, Silvia; Sandini, Silvia; Graziani, Sofia; Norelli, Sandro

    2015-01-01

    The widespread occurrence of vaginal candidiasis and the development of resistance against anti-fungal agents has stimulated interest in understanding the pathogenesis of this disease. The aim of our work was to characterize, in an animal model of vaginal candidiasis, the mechanisms that play a role in the induction of mucosal immunity against C. albicans and the interaction between innate and adaptive immunity. Our studies evidenced the elicitation of cell-mediated immunity (CMIs) and antibody (Abs)-mediated immunity with a Th1 protective immunity. An immune response of this magnitude in the vagina was very encouraging to identify the proper targets for new strategies for vaccination or immunotherapy of vaginal candidiasis. Overall, our data provide clear evidence that it is possible to prevent C. albicans vaginal infection by active intravaginal immunization with aspartyl proteinase expressed as recombinant protein. This opens the way to a modality for anti-Candida protection at the mucosa. The recombinant protein Sap2 was assembled with virosomes, and a vaccine PEVION7 (PEV7) was obtained. The results have given evidence that the vaccine, constituted of virosomes and Secretory aspartyl proteinase 2 (Sap2) (PEV7), has an encouraging therapeutic potential for the treatment of recurrent vulvovaginal candidiasis. PMID:26473934

  6. [The practice guideline 'Vaginal discharge' (first revision) from the Dutch College of General Practitioners; a response from the perspective of gynaecology].

    Science.gov (United States)

    Hogewoning, C J A; Ottervanger, H P; Adriaanse, A H; Trum, J W

    2007-06-16

    The Dutch College of General Practitioners (NHG) revised their practice guideline on vaginal discharge. From a gynaecological point of view, relocation of cervix problems from this guideline to the NHG guideline 'The STD consultation' is not practical. Moreover, the role of simple, but effective diagnosis with a microscope in the primary-care setting cannot be overemphasized. The reluctance to oral treatment is rather inopportune, because once-only ingestion has the advantage of promoting compliance. As physical examination is not always necessary in a recurrent Candida infection, treatment performed by the patient with imidazole compounds is a possibility that does not always result in abuse or increased resistance.

  7. 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.

  8. Size-fitting of Intravaginal Rings for Macaques and in vitro Release Kinetics of Zinc Finger Inhibitors

    OpenAIRE

    Malcolm, Karl; Smith, James M.; Appella, Ettore; Schito, Marco; Hayashi, Ryo; Lanier, Nattawan; Otten, Ronald; Butera, Sal; McConville, Christopher; Woolfson, David

    2008-01-01

    Background: Small molecule inhibitors of the zinc finger domain (ZFI) in the nucleocapsid protein (NCp7) of HIV-1 are potent inhibitors of HIV and SIVreplication and may have utility as topical products to prevent infection. Furthermore, intravaginal rings (IVRs) were developed as coitally-independent,sustained release devices which could be used for administration of HIV microbicides. The aims of these studies were to demonstrate that IVRs sized formacaques are practical and compatible with ...

  9. Antiretroviral pre-exposure prophylaxis prevents vaginal transmission of HIV-1 in humanized BLT mice.

    Directory of Open Access Journals (Sweden)

    Paul W Denton

    2008-01-01

    Full Text Available Worldwide, vaginal transmission now accounts for more than half of newly acquired HIV-1 infections. Despite the urgency to develop and implement novel approaches capable of preventing HIV transmission, this process has been hindered by the lack of adequate small animal models for preclinical efficacy and safety testing. Given the importance of this route of transmission, we investigated the susceptibility of humanized mice to intravaginal HIV-1 infection.We show that the female reproductive tract of humanized bone marrow-liver-thymus (BLT mice is reconstituted with human CD4+ T and other relevant human cells, rendering these humanized mice susceptible to intravaginal infection by HIV-1. Effects of HIV-1 infection include CD4+ T cell depletion in gut-associated lymphoid tissue (GALT that closely mimics what is observed in HIV-1-infected humans. We also show that pre-exposure prophylaxis with antiretroviral drugs is a highly effective method for preventing vaginal HIV-1 transmission. Whereas 88% (7/8 of BLT mice inoculated vaginally with HIV-1 became infected, none of the animals (0/5 given pre-exposure prophylaxis of emtricitabine (FTC/tenofovir disoproxil fumarate (TDF showed evidence of infection (Chi square = 7.5, df = 1, p = 0.006.The fact that humanized BLT mice are susceptible to intravaginal infection makes this system an excellent candidate for preclinical evaluation of both microbicides and pre-exposure prophylactic regimens. The utility of humanized mice to study intravaginal HIV-1 transmission is particularly highlighted by the demonstration that pre-exposure prophylaxis can prevent intravaginal HIV-1 transmission in the BLT mouse model.

  10. Intravaginal Misoprostol for Cervical Ripening and Labor Induction in Nulliparous Women: A Double-blinded, Prospective Randomized Controlled Study

    Science.gov (United States)

    Zhang, Yu; Zhu, Hao-Ping; Fan, Jian-Xia; Yu, Hong; Sun, Li-Zhou; Chen, Lian; Chang, Qing; Zhao, Nai-Qing; Di, Wen

    2015-01-01

    Background: In China, no multicenter double-blinded prospective randomized controlled study on labor induction has been conducted till now. This study is to evaluate the efficacy and safety of intravaginal accurate 25-μg misoprostol tablets for cervical ripening and labor induction in term pregnancy in nulliparous women. Methods: This was a double-blinded, prospective randomized controlled study including nulliparous women from 6 university hospitals across China. Subjects were randomized into misoprostol or placebo group with the sample size ratio set to 7:2. Intravaginal 25-μg misoprostol or placebo was applied at an interval of 4 h (repeated up to 3 times) for labor induction. Primary outcome measures were the incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h. Safety assessments included the incidences of maternal morbidity and adverse fetal/neonatal outcomes. Results: A total of 173 women for misoprostol group and 49 women for placebo were analyzed. The incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h was higher in the misoprostol group than in the placebo (64.2% vs. 22.5%, relative risk [RR]: 2.9, 95% confidence interval [CI]: 1.4–6.0). The incidence of onset of labor within 24 h was significantly higher in the misoprostol group than in the placebo group (48.0% vs. 18.4%, RR: 2.6, 95% CI: 1.2–5.7); and the induction-onset of labor interval was significantly shorter in the misoprostol group (P = 0.0003). However, there were no significant differences in the median process time of vaginal labor (6.4 vs. 6.8 h; P = 0.695), incidence (39.3% vs. 49.0%, RR: 0.8, 95% CI: 0.4–1.5) and indications (P = 0.683) of cesarean section deliveries, and frequencies of maternal, fetal/neonatal adverse events between the groups. Conclusion: Intravaginal misoprostol 25 μg every 4 h is efficacious and safe in labor induction and cervical ripening. PMID:26481739

  11. Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice

    NARCIS (Netherlands)

    de Vries, Corlien J. H.; Wieringa-de Waard, Margreet; Bindels, Patrick J. E.; Ankum, Willem M.

    2011-01-01

    Diagnostic ultrasonography is used by GPs in approximately 10% of patients of reproductive age with abnormal vaginal bleeding. Transvaginal sonography is recommended as a first-line diagnostic instrument for assessing uterine pathology. To assess if findings resulting from open-access sonography

  12. Abnormal vaginal bleeding in women of reproductive age: a descriptive study of initial management in general practice

    NARCIS (Netherlands)

    de Vries, Corlien J. H.; Wieringa-de Waard, Margreet; Vervoort, Cléo-Lotte A. G.; Ankum, Willem M.; Bindels, Patrick J. E.

    2008-01-01

    BACKGROUND: Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care.

  13. Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy.

    Science.gov (United States)

    Rezk, Mohamed Abd-Allah; Sanad, Zakaria; Dawood, Ragab; Emarh, Mohamed; Masood, Alaa

    2015-01-01

    To examine the effectiveness, safety and acceptability of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. This clinical study was conducted on 90 pregnant patients intended for termination of pregnancy between 13 and 24 gestational weeks for any indication. Enrolled women are equally allocated into three groups: • Group I (Misoprostol group): a standard regimen of moistened misoprostol (400 μg) 4 hourly inserted vaginally. • Group II (Catheter group): intracervical Foley catheter inserted, inflated and placed on traction. • Group III (Combined group): intracervical Foley catheter inserted with a standard regimen of moistened misoprostol (400 μg) 4 hourly intravaginally was used. Procedure efficacy (defined as complete abortion performed on site), safety and acceptability were assessed. The induction to abortion interval was 7.5±1.25 h in the combined group, compared to 11.76±1.63 h in the misoprostol group and 19.76±1.52 h in the catheter group (p valueintracervical Foley catheter and misoprostol for termination of second trimester pregnancy.

  14. VBAC Scoring: Successful vaginal delivery in previous one caesarean section in induced labour

    International Nuclear Information System (INIS)

    Raja, J.F.; Bangash, K.T.; Mahmud, G.

    2013-01-01

    Objective: To develop a scoring system for the prediction of successful vaginal birth after caesarean section, following induction of labour with intra-vaginal E2 gel (Glandin). Methods: The cross-sectional study was conducted from January 2010 to August 2011, at the Pakistan Institute of Medical Sciences in Islamabad. Trial of labour in previous one caesarean section, undergoing induction with intra-vaginal E2 gel, was attempted in 100 women. They were scored according to six variables; maternal age; gestation; indications of previous caesarean; history of vaginal birth either before or after the previous caesarean; Bishop score and body mass index. Multivariate and univariate logistic regression analysis was used to develop the scoring system. Results: Of the total, 67 (67%) women delivered vaginally, while 33 (33%) ended in repeat caesarean delivery. Among the subjects, 55 (55%) women had no history of vaginal delivery either before or after previous caesarean section; 15 (15%) had history of vaginal births both before and after the previous caesarean; while 30 (30%) had vaginal delivery only after the previous caesarean section. Rates of successful vaginal birth after caesarean increased from 38% in women having a score of 0-3 to 58% in patients scoring 4-6. Among those having a score of 7-9 and 10-12, the success rates were 71% and 86% respectively. Conclusion: Increasing scores correlated with the increasing probability of vaginal birth after caesarean undergoing induction of labour. The admission VBAC scoring system is useful in counselling women with previous caesarean for the option of induction of labour or repeat caesarean delivery. (author)

  15. Cervico-vaginal foetal fibronectin: A predictor of cervical response at ...

    African Journals Online (AJOL)

    Méthodologie: Vingt patients (20) soignées dans une institution de la santé tertière du sud ouest du Nigeria entre mars et mai 2003 étaient randomisés pour la maturation cervicale à travers soit Misoprostol intravaginal soit Foley Catheter transcervical. Sécrétions cervico-vaginal ont été évaluées pour la présence de FNF ...

  16. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  17. Acute mesenteric venous thrombosis with a vaginal contraceptive ring.

    Science.gov (United States)

    Eilbert, Wesley; Hecht, Benjamin; Zuiderveld, Loren

    2014-07-01

    Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring.

  18. Unexpected Inflammatory Effects of Intravaginal Gels (Universal Placebo Gel and Nonoxynol-9 on the Upper Female Reproductive Tract: A Randomized Crossover Study.

    Directory of Open Access Journals (Sweden)

    Karen Smith-McCune

    Full Text Available Intravaginal anti-HIV microbicides could provide women with a self-controlled means for HIV prevention, but results from clinical trials have been largely disappointing. We postulated that unrecognized effects of intravaginal gels on the upper female reproductive tract might contribute to the lower-than-expected efficacy of HIV microbicides. Our objective was to study the effects of intravaginal gels on the immune microenvironment of the cervix and uterus. In this randomized crossover study, 27 healthy female volunteers used a nightly application of intravaginal nonoxynol-9 (N9 gel as a "failed" microbicide or the universal placebo gel (UPG as a "safe" gel (intervention cycles, or nothing (control cycle from the end of menses to the mid-luteal phase. At a specific time-point following ovulation, all participants underwent sample collection for measurements of T-cell phenotypes, gene expression, and cytokine/chemokine protein concentrations from 3 anatomic sites above the vagina: the cervical transformation zone, the endocervix and the endometrium. We used hierarchical statistical models to estimate mean (95% CI intervention effects, for N9 and UPG relative to control. Exposure to N9 gel and UPG generated a common "harm signal" that included transcriptional up-regulation of inflammatory genes chemokine (C-C motif ligand 20 (macrophage inflammatory factor-3alpha and interleukin 8 in the cervix, decreased protein concentrations of secretory leukocyte protease inhibitor, and transcriptional up-regulation of inflammatory mediators glycodelin-A and osteopontin in the endometrium. These results need to be replicated with a larger sample, but underscore the need to consider the effects of microbicide agents and gel excipients on the upper female reproductive tract in studies of vaginal microbicides.

  19. Analytical Method Validation of High-Performance Liquid Chromatography and Stability-Indicating Study of Medroxyprogesterone Acetate Intravaginal Sponges

    Directory of Open Access Journals (Sweden)

    Nidal Batrawi

    2017-02-01

    Full Text Available Medroxyprogesterone acetate is widely used in veterinary medicine as intravaginal dosage for the synchronization of breeding cycle in ewes and goats. The main goal of this study was to develop reverse-phase high-performance liquid chromatography method for the quantification of medroxyprogesterone acetate in veterinary vaginal sponges. A single high-performance liquid chromatography/UV isocratic run was used for the analytical assay of the active ingredient medroxyprogesterone. The chromatographic system consisted of a reverse-phase C18 column as the stationary phase and a mixture of 60% acetonitrile and 40% potassium dihydrogen phosphate buffer as the mobile phase; the pH was adjusted to 5.6. The method was validated according to the International Council for Harmonisation (ICH guidelines. Forced degradation studies were also performed to evaluate the stability-indicating properties and specificity of the method. Medroxyprogesterone was eluted at 5.9 minutes. The linearity of the method was confirmed in the range of 0.0576 to 0.1134 mg/mL ( R 2 > 0.999. The limit of quantification was shown to be 3.9 µg/mL. Precision and accuracy ranges were found to be %RSD <0.2 and 98% to 102%, respectively. Medroxyprogesterone capacity factor value of 2.1, tailing factor value of 1.03, and resolution value of 3.9 were obtained in accordance with ICH guidelines. Based on the obtained results, a rapid, precise, accurate, sensitive, and cost-effective analysis procedure was proposed for quantitative determination of medroxyprogesterone in vaginal sponges. This analytical method is the only available method to analyse medroxyprogesterone in veterinary intravaginal dosage form.

  20. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal Delivery ... Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is assisted ...

  1. [Intravaginal culture and embryo transfer. A new method for the fertilization of human oocytes].

    Science.gov (United States)

    Ranoux, C; Dubuisson, J B; Foulot, H; Aubriot, F X

    1987-12-01

    This technique was developed at the University Clinic of Port-Royal. It corresponds to the intravaginal culture of embryos and their transfer into the uterus. After ovocyte stimulation, most often by Clomid HMG, the follicles are aspirated under laparoscopic or sonographic control 34 to 36 hours after HCG. After being collected, the ovocytes are placed, whatever their stage of maturity, in one or several 3 ml tubes completely filled with culture medium (B2 of pure Menezo). Up to 4 ovocytes per tube are thus fertilized with 10 to 20,000 mobile spermatozoids/ml, prepared in the usual dilution, centrifugation and migration. Then the tube(s) are placed in the posterior vaginal cul-de-sac, kept in place with a diaphragm where they will remain during the 44 to 48 hours of culture time. Following that time, the contents of the tube are examined in order to evaluate the occurrence and the stage of embryonic division. A first series of 100 aspirations has enabled to obtain 15 pregnancies, still evolving, including two births of healthy children. A randomized series is currently in progress to determine a possible difference in the rates of pregnancy between CIVETE and the classic technique. Beside its new psychological contribution, this technique has demonstrated that it was possible to culture human embryos in the absence of CO2; its extreme simplicity should lead to a broader expansion of this technique.

  2. Segmented polyurethane intravaginal rings for the sustained combined delivery of antiretroviral agents dapivirine and tenofovir.

    Science.gov (United States)

    Johnson, Todd J; Gupta, Kavita M; Fabian, Judit; Albright, Theodore H; Kiser, Patrick F

    2010-02-19

    Dual segment polyurethane intravaginal rings (IVRs) were fabricated to enable sustained release of antiretroviral agents dapivirine and tenofovir to prevent the male to female sexual transmission of the human immunodeficiency virus. Due to the contrasting hydrophilicity of the two drugs, dapivirine and tenofovir were separately formulated into polymers with matching hydrophilicity via solvent casting and hot melt extrusion. The resultant drug loaded rods were then joined together to form dual segment IVRs. Compression testing of the IVRs revealed that they are mechanically comparable to the widely accepted NuvaRing IVR. Physical characterization of the individual IVR segments using wide angle X-ray scattering and differential scanning calorimetry determined that dapivirine and tenofovir are amorphous and crystalline within their polymeric segments, respectively. In vitro release of tenofovir from the dual segment IVR was sustained over 30 days while dapivirine exhibited linear release over the time period. A 90 day accelerated stability study confirmed that dapivirine and tenofovir are stable in the IVR formulation. Altogether, these results suggest that multisegment polyurethane IVRs are an attractive formulation for the sustained vaginal delivery of drugs with contrasting hydrophilicity such as dapivirine and tenofovir. 2009 Elsevier B.V. All rights reserved.

  3. A randomized clinical trial to compare the efficacy of different doses of intravaginal misoprostol with intracervical dinoprostone for cervical ripening and labor induction.

    Science.gov (United States)

    Saxena, P; Puri, M; Bajaj, M; Mishra, A; Trivedi, S S

    2011-07-01

    To compare the efficacy of 25 vs. 50 microg of intravaginal misoprostol vs. intracervical dinoprostone for cervical ripening and labor induction. 210 women with Bishop's score intracervical dinoprostone to maximum of 3 doses and outcome parameters were compared. Induction to vaginal delivery interval was significantly lower (p < 0.05) for 50 microg (13.8 +/- 6.62 hours) as compared to 25 microg misoprostol (16.4 +/- 7.34 hours) or dinoprostone group (16.3 +/- 7.49 hours). Maximum improvement (p < 0.05) in Bishop's score and minimum oxytocin requirement (p < 0.05) was seen with misoprostol 50 microg. No significant difference was observed for women delivering vaginally within 24 hours (93.8 vs. 89.7 vs. 85.4%), patients delivering after one dose (24.3 vs. 21.4 vs. 20%), cesarean deliveries, fetal outcome, complications like hyperstimulation and fetal heart abnormalities for the 50 vs. 25 microg misoprostol vs. dinoprostone group. Intravaginal misoprostol 50 microg administered 6 hourly appears to be most effective as it has least induction to delivery time, has maximum improvement in Bishop's score, least oxytocin requirement without any increase in complication rate.

  4. MRI of vaginal conditions

    International Nuclear Information System (INIS)

    Lopez, C.; Balogun, M.; Ganesan, R.; Olliff, J.F.

    2005-01-01

    Magnetic resonance imaging (MRI) has become an important part of the assessment of suspected vaginal pathology. This pictorial review demonstrates the MRI features and some of the histopathological findings of a variety of vaginal conditions. These may be congenital (total vaginal agenesis, partial vaginal agenesis, longitudinal vaginal septum, transverse vaginal septum), benign (Bartholin's cyst, diffuse vaginal inflammation, invasive endometriosis, ureterovaginal fistula, post-surgical appearances with the formation of a neovagina and adhesions) or malignant, usually due to extension or recurrence from another pelvic malignancy. In this paper, examples of the above are described and illustrated together with examples of the much rarer primary vaginal malignancies

  5. MRI of vaginal conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, C. [Department of Radiology, Birmingham Women' s Hospital, Birmingham (United Kingdom)]. E-mail: carolina.lopez@bwhct.nhs.uk; Balogun, M. [Department of Radiology, Birmingham Women' s Hospital, Birmingham (United Kingdom); Ganesan, R. [Department of Histopathology, Birmingham Women' s Hospital, Birmingham (United Kingdom); Olliff, J.F. [University Hospital Birmingham, Birmingham (United Kingdom)

    2005-06-01

    Magnetic resonance imaging (MRI) has become an important part of the assessment of suspected vaginal pathology. This pictorial review demonstrates the MRI features and some of the histopathological findings of a variety of vaginal conditions. These may be congenital (total vaginal agenesis, partial vaginal agenesis, longitudinal vaginal septum, transverse vaginal septum), benign (Bartholin's cyst, diffuse vaginal inflammation, invasive endometriosis, ureterovaginal fistula, post-surgical appearances with the formation of a neovagina and adhesions) or malignant, usually due to extension or recurrence from another pelvic malignancy. In this paper, examples of the above are described and illustrated together with examples of the much rarer primary vaginal malignancies.

  6. A Novel Microbicide/Contraceptive Intravaginal Ring Protects Macaque Genital Mucosa against SHIV-RT Infection Ex Vivo.

    Science.gov (United States)

    Villegas, Guillermo; Calenda, Giulia; Ugaonkar, Shweta; Zhang, Shimin; Kizima, Larisa; Mizenina, Olga; Gettie, Agegnehu; Blanchard, James; Cooney, Michael L; Robbiani, Melissa; Fernández-Romero, José A; Zydowsky, Thomas M; Teleshova, Natalia

    2016-01-01

    Women need multipurpose prevention products (MPTs) that protect against sexually transmitted infections (STIs) and provide contraception. The Population Council has developed a prototype intravaginal ring (IVR) releasing the non-nucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 (M), zinc acetate (ZA), carrageenan (CG) and levonorgestrel (LNG) (MZCL IVR) to protect against HIV, HSV-2, HPV and unintended pregnancy. Our objective was to evaluate the anti-SHIV-RT activity of MZCL IVR in genital mucosa. First, macaque vaginal tissues were challenged with SHIV-RT in the presence of (i) MIV-150 ± LNG or (ii) vaginal fluids (VF); available from studies completed earlier) collected at various time points post insertion of MZCL and MZC IVRs. Then, (iii) MZCL IVRs (vs. LNG IVRs) were inserted in non-Depo Provera-treated macaques for 24h and VF, genital biopsies, and blood were collected and tissues were challenged with SHIV-RT. Infection was monitored with one step SIV gag qRT-PCR or p27 ELISA. MIV-150 (LCMS/MS, RIA), LNG (RIA) and CG (ELISA) were measured in different compartments. Log-normal generalized mixed linear models were used for analysis. LNG did not affect the anti-SHIV-RT activity of MIV-150 in vitro. MIV-150 in VF from MZC/MZCL IVR-treated macaques inhibited SHIV-RT in vaginal mucosa in a dose-dependent manner (pex vivo infection relative to baseline (96%; ppost LNG IVR group (90%, p<0.001). No MIV-150 dose-dependent protection was observed, likely because of high MIV-150 concentrations in all vaginal tissue samples. In cervical tissue, MIV-150 inhibited infection vs. baseline (99%; p<0.05). No cervical tissue was available for MIV-150 measurement. Exposure to LNG IVR did not change tissue infection level. These observations support further development of MZCL IVR as a multipurpose prevention technology to improve women's sexual and reproductive health.

  7. Intra-vaginal temperature is not related to the time of ovulation in sows.

    NARCIS (Netherlands)

    Soede, N.M.; Hazeleger, W.; Broos, J.; Kemp, B.

    1997-01-01

    The effects of intravenous (iv) administration of the opioid antagonists naloxone and naltrexone on the restraint-induced suppression of the pro-estrous LH surge were studied in cyclic female rats. To minimize stress during repeated blood sampling, the rats were provided with a jugular vein cannula.

  8. Recurrent vaginal discharge in children.

    Science.gov (United States)

    McGreal, Sharon; Wood, Paul

    2013-08-01

    Childhood vaginal discharge remains a frequent reason for referral from primary to secondary care. The Pediatric and Adolescent Gynecology (PAG) service at Kettering General Hospital was established in 1993 and provides a specialized service that meets the needs of children with gynaecological conditions. To investigate recurrent vaginal discharge noting symptomatology, defining pathogens, common and rarer causes, exploring management regimes, and any changes in practice over time. Retrospective review spanning 15 years identifying prepubertal children attending the outpatient PAG clinic with recurrent vaginal discharge. We reviewed the medical notes individually. 110 patients were identified; 85% were referred from primary care. The age distribution was bimodal at four and eight years. Thirty-five percent of our patients were discharged after the initial consultation. The commonest cause of discharge was vulvovaginitis (82%). Other important causes included suspected sexual abuse (5%), foreign body (3%), labial adhesions (3%), vaginal agenesis (2%). 35% of patients were admitted for vaginoscopy. Vaginal discharge is the most common gynecological symptom in prepubertal girls and can cause repeated clinical episodes. Vulvovaginitis is the most common cause and often responds to simple hygiene measures. Awareness of the less common causes of vaginal discharge is essential. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  9. 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

  10. Topical Delivery of Tenofovir Disoproxil Fumarate and Emtricitabine from Pod-Intravaginal Rings Protects Macaques from Multiple SHIV Exposures.

    Directory of Open Access Journals (Sweden)

    Priya Srinivasan

    Full Text Available Topical preexposure prophylaxis (PrEP against HIV has been marginally successful in recent clinical trials with low adherence rates being a primary factor for failure. Controlled, sustained release of antiretroviral (ARV drugs may help overcome these low adherence rates if the product is protective for extended periods of time. The oral combination of tenofovir disoproxil fumarate (TDF and emtricitabine (FTC is currently the only FDA-approved ARV drug for HIV PrEP. A novel pod-intravaginal ring (IVR delivering TDF and FTC at independently controlled rates was evaluated for efficacy at preventing SHIV162p3 infection in a rigorous, repeat low-dose vaginal exposure model using normally cycling female pigtailed macaques. Six macaques received pod-IVRs containing TDF (65 mg and FTC (68 mg every two weeks, and weekly vaginal exposures to 50 TCID50 of SHIV162p3 began one week after the first pod-IVR insertion. All pod-IVR-treated macaques were fully protected throughout the study (P = 0.0002, Log-rank test, whereas all control animals became infected with a median of 4 exposures to infection. The topical, sustained release of TDF and FTC from the pod-IVR maintained protective drug levels in macaques over four months of virus exposures. This novel and versatile delivery system has the capacity to deliver and maintain protective levels of multiple drugs and the protection observed here warrants clinical evaluation of this pod-IVR design.

  11. Local and Systemic Functional Responses of Mouse Macrophages to Intravaginal Infection with Type 2 Herpes Simplex Virus and Vaccination.

    Science.gov (United States)

    Zaitseva, L G; Bekhalo, V A; Kireeva, I V; Shaposhnikova, G M; Nagurskaya, E V; Barinskii, I F; Nesterenko, V G

    2017-05-01

    Activity of cathepsin D and phagocytosis of macrophages from vaginal lavage fluid, peritoneal exudation, and spleen were studied in mice of sensitive (DBA/2) and resistant (BALB/c) lines after intravaginal infection with type 2 herpes simplex virus and vaccination. Activity of cathepsin D and intensity of phagocytosis (irrespective of the macrophage source) and their ratio in BALB/c mice in early terms after infection were close to the control levels taken as a unit. In DBA/2 mice, these parameters and their balance were shifted and changes in cathepsin D activity depended on the time after challenge. Activities of cellular and extracellular cathepsin D increased sharply on day 1 postinfection under conditions of local virus interaction with the vaginal mucosa and activation of the pathological process. Later, after generalization of the infection, activity of cathepsin D decreased, while phagocytosis increased in all the studied macrophage populations. Vaccination corrected the cathepsin D/phagocytosis imbalance and created conditions for rapid elimination of the virus.

  12. Qualitative and quantitative intravaginal targeting: key to anti-HIV-1 microbicide delivery from test tube to in vivo success.

    Science.gov (United States)

    Pillay, Viness; Mashingaidze, Felix; Choonara, Yahya E; Du Toit, Lisa C; Buchmann, Eckhart; Maharaj, Vinesh; Ndesendo, Valence M K; Kumar, Pradeep

    2012-06-01

    The past decade has seen several effective anti-HIV-1 agent discoveries, yet microbicides continue to disappoint clinically. Our review expounds the view that unsatisfactory microbicide failures may be a result of inefficient delivery systems employed. We hereby propose a thorough scientific qualitative and quantitative investigation of important aspects involved in HIV-1 transmission as a prerequisite for microbicide delivery. Intravaginal targeting of HIV-1 increases the chances of microbicide success, wherein vaginal microenvironmental factors including pH should be maintained at HIV-1 prohibitive acidic levels simultaneously to ward off other sexually transmitted diseases, which compromise vaginal epithelial barrier properties. Furthermore, choice of receptors to target both on HIV-1 and on target cells is vital in deterring transmission. Appropriate modeling of virus-target cell interactions as well as targeting early stages of the HIV-1 infection accompanied by computation and delivery of appropriate microbicide quantities could revolutionize microbicide research, ultimately delivering a female-controlled HIV-1 prevention modality appropriately. Copyright © 2012 Wiley Periodicals, Inc.

  13. Vaginal microbial communities from synchronized heifers and cows with reproductive disorders.

    Science.gov (United States)

    Gonzalez Moreno, C; Fontana, C; Cocconcelli, P S; Callegari, M L; Otero, M C

    2016-11-01

    To evaluate changes in the resident microbial population in the cranial vaginal mucosa induced by a progesterone-releasing intravaginal device (PRID) compared to the vaginal microbiota of cows with reproductive disorders. Vaginal discharge was evaluated by clinical examination and a Vaginitis Diagnosis Score was performed by exfoliative cytology. All samples classified as positive and some classified as negative by clinical evaluation were later diagnosed as positive for vaginitis by cytological analysis. Bacterial diversity profiles were performed by PCR-DGGE and clustered according to the reproductive health status of the specimens, revealing a correspondence between the structures of the communities in the vagina and the clinical profile. Representative bands from each group were sequenced and identified as Ruminococcus sp., Dialister sp., Escherichia sp./Shigella sp., Virgibacillus sp., Campylobacter sp., Helcoccoccus sp., Staphylococcus sp., Bacillus sp., Actinopolymorpha sp., Exiguobacterium sp., Haemophilus sp./Histophilus sp., Aeribacillus sp., Porphyromonas sp., Lactobacillus sp. and Clostridium sp. Our results contribute to the knowledge of the vaginal microbiome in synchronized heifers showing positive or negative clinical vaginitis. This study contributes to the understanding of a dynamic vaginal colonization by bacterial consortiums during the synchronization with a widely used PRID protocol. Also, the results reveal the presence of well-known metritis-related pathogens as well as emerging uterine opportunistic pathogens. The provided information will allow to carry out further studies to elucidate functional roles of these native micro-organisms in the bovine reproductive tract. © 2016 The Society for Applied Microbiology.

  14. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

    Directory of Open Access Journals (Sweden)

    Justin T Clark

    Full Text Available The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  15. Engineering a Segmented Dual-Reservoir Polyurethane Intravaginal Ring for Simultaneous Prevention of HIV Transmission and Unwanted Pregnancy

    Science.gov (United States)

    Clark, Justin T.; Clark, Meredith R.; Shelke, Namdev B.; Johnson, Todd J.; Smith, Eric M.; Andreasen, Andrew K.; Nebeker, Joel S.; Fabian, Judit; Friend, David R.; Kiser, Patrick F.

    2014-01-01

    The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems. PMID:24599325

  16. 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

  17. Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment.

    Science.gov (United States)

    Phillips, Nancy; Brown, Candace; Bachmann, Gloria; Wan, Jim; Wood, Ronald; Ulrich, Dagny; Bachour, Candi; Foster, David

    2016-12-01

    Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder, both of unknown etiology. Association of these conditions is well documented. Intravaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these 2 conditions. We sought to: (1) correlate pain intensity during the nongenital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, and (2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. In all, 92 subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (numeric rating scale >1) in at least 11 sites of the 18-point nongenital tender point tenderness exam. Vaginal pain sensitivity was measured using an intravaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm 2 forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of nongenital and those of iliococcygeus regions and the posterior vaginal wall. Independent t tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance level was at P pain

  18. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level: a retrospective cohort study

    NARCIS (Netherlands)

    Vankan, E.; Schoorel, E.N.; Kuijk, S.M. van; Mol, B.J.; Nijhuis, J.G.; Aardenburg, R.; Alink, M.; Boer, K. de; Delemarre, F.M.; Dirksen, C.D.; Dooren, I.M. van; Franssen, M.T.; Kaplan, M.; Kleiverda, G.; Kuppens, S.M.; Kwee, A.; Langenveld, J.; Lim, F.T.; Melman, S.; Sikkema, M.J.; Smits, L.J; Visser, H.; Woiski, M.D.; Scheepers, H.C.; Hermens, R.P.M.G.

    2017-01-01

    INTRODUCTION: Large practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. MATERIAL AND METHODS:

  19. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level : A retrospective cohort study

    NARCIS (Netherlands)

    Vankan, Emy; Schoorel, Ellen N. C.; van Kuijk, Sander M. J.; Mol, Ben-Willem J.; Nijhuis, Jan G.; Aardenburg, Robert; Alink, Marleen; de Boer, Karin; Delemarre, Friso M. C.; Dirksen, Carmen D.; Van Dooren, Ivo M. A.; Franssen, Maureen T. M.; Kaplan, Mesrure; Kleiverda, Gunilla; Kuppens, Simone M. I.; Kwee, Anneke; Langenveld, Josje; Lim, Frans T. H.; Melman, Sonja; Sikkema, Marko J.; Smits, Luc J.; Visser, Harry; Woiski, Mallory; Scheepers, Hubertina C.; Hermens, Rosella P. M. G.

    IntroductionLarge practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. Material and methodsThis

  20. Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women.

    Science.gov (United States)

    Labrie, Fernand; Archer, David; Bouchard, Céline; Fortier, Michel; Cusan, Leonello; Gomez, José-Luis; Girard, Ginette; Baron, Mira; Ayotte, Normand; Moreau, Michèle; Dubé, Robert; Côté, Isabelle; Labrie, Claude; Lavoie, Lyne; Berger, Louise; Gilbert, Lucy; Martel, Céline; Balser, John

    2009-01-01

    The objective of this study was to provide evidence that the transformation of DHEA into both androgens and/or estrogens locally in cells of the three layers of the vagina (epithelium, lamina propria, and muscularis) would have effects of greater impact, including effects on sexual function, than only effects on superficial epithelial cells as achieved with estrogens. This prospective, randomized, double-blind, and placebo-controlled phase III clinical trial has evaluated the effect of daily local intravaginal application of Prasterone (dehydroepiandrosterone; DHEA) for 12 weeks on the domains of sexual dysfunction, namely, desire/interest, arousal, orgasm, and pain at sexual activity, in 216 postmenopausal women with moderate to severe symptoms of vaginal atrophy. A time- and dose-dependent improvement of the four domains of sexual function was observed. At the 12-week time interval, the 1.0% DHEA dose led, compared with placebo, to 49% (P = 0.0061) and 23% (P = 0.0257) improvements of the desire domains in the Menopause Specific Quality of Life and Abbreviated Sex Function questionnaires, respectively. Compared with placebo, the Abbreviated Sex Function arousal/sensation domain was improved by 68% (P = 0.006), the arousal/lubrication domain by 39% (P = 0.0014), orgasm by 75% (P = 0.047), and dryness during intercourse by 57% (P = 0.0001). By a local action in the vagina, DHEA applied daily at doses at which serum steroids remain well within normal postmenopausal values exerts relatively potent beneficial effects on all four aspects of sexual dysfunction. Such data indicate that combined androgenic/estrogenic stimulation in the three layers of the vagina exerts important beneficial effects on sexual function in women without systemic action on the brain and other extravaginal tissues.

  1. Vaginal yeast infection

    Science.gov (United States)

    ... are available as creams, ointments, vaginal tablets or suppositories and oral tablets. Most can be bought without ... Medicine for up to 14 days Clotrimazole vaginal suppository or fluconazole pill every week to prevent new ...

  2. Hysterectomy - vaginal - discharge

    Science.gov (United States)

    Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you are unable to urinate. You have a discharge from your vagina that has a bad odor. You have bleeding ...

  3. 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 ...

  4. [Severe vaginal discharge following rectal surgery].

    Science.gov (United States)

    Burg, L C; Bremers, A J A; Heesakkers, J P F A; Kluivers, K B

    2018-01-01

    Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on identifying fistula formation. If no fistula is found, in most cases no other cause for severe vaginal discharge can be demonstrated. In our practice, we saw three patients (49-, 54- and 74-years-old, respectively) with similar severe vaginal discharge after rectal surgery and in whom no explanation for the vaginal discharge could be found. For this reason we conducted a literature search into this condition. Anatomical changes appear to be responsible for heavy vaginal discharge following rectal surgery. Changes in pelvic floor muscles and compression of the distal part of the vagina may lead to pooling of fluid in the proximal part of the vagina, resulting in severe discharge. Symptomatic treatment may reduce the symptoms.

  5. Vaginal Bleeding

    Science.gov (United States)

    ... Gynecology. ACOG Practice Bulletin No. 128. Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstetrics and Gynecology. 2012;120:197. Kaunitz AM. Approach to abnormal uterine bleeding in nonpregnant reproductive-age women. http://www.uptodate. ...

  6. Contraceptive efficacy and safety studies of a novel microemulsion-based lipophilic vaginal spermicide.

    Science.gov (United States)

    D'Cruz, O J; Yiv, S H; Waurzyniak, B; Uckun, F M

    2001-01-01

    To investigate the in vivo contraceptive potency and safety of a novel microemulsion-based lipophilic vaginal spermicide. In vitro and in vivo spermicidal activity and safety of a submicron-particle-size, lipophilic gel-microemulsion (GM-4). Center for Advanced Preclinical Sciences at the Parker Hughes Institute. Nine male volunteer sperm donors. Motile human sperm in semen and medium were exposed to eight GM-4 components or GM-4 formulation. Forty-eight ovulated NZW rabbits in subgroups of 16 with or without intravaginal administration of GM-4 or nonoxynol-9 gel (N-9; Gynol II) were artificially inseminated and allowed to complete pregnancy. Eleven rabbits were exposed to daily intravaginal application of GM-4 with and without N-9 for 10 consecutive days. Ten of 20 B(6)C(3)F(1) mice were given repetitive intravaginal application of GM-4 for 5 days/week over 13 consecutive weeks. The motility of human sperm treated with GM-4 components and GM-4. Term pregnancy in rabbits and histopathological grading of rabbit vaginal tissue for irritation. Evaluation of mice for survival, growth, hematologic parameters, blood-chemistry profiles, absolute and relative organ weights, and histopathology. The individual components of GM-4 lacked spermicidal activity in human semen, whereas the GM-4 formulation containing all the eight pharmacological excipients exhibited potent spermicidal activity with rapid kinetics. GM-4 showed remarkable contraceptive activity in the rigorous rabbit model. None of the 16 (0%) rabbits given GM-4 intravaginally before artificial insemination became pregnant. By contrast, 15 of 16 (93.7%) control rabbits and 5 of 16 (31.2%) Gynol II-treated rabbits became pregnant and delivered newborns. Thus, GM-4 was a significantly more effective contraceptive than a commercially available N-9 gel [100% vs. 68.7% protection; Pspermicidal GM-4 formulation is safe and significantly more effective than N-9 in preventing conception.

  7. Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study.

    Science.gov (United States)

    Tempera, G; Bonfiglio, G; Cammarata, E; Corsello, S; Cianci, A

    2004-07-01

    The term 'aerobic vaginitis' defines a 'new' vaginal pathology that is neither classifiable as specific vaginitis nor as bacterial vaginosis. We studied a sample of 30 women with a clinical and microbiological diagnosis of aerobic vaginitis and compared the efficacy and tolerability of kanamycin and meclocycline, two products commercially available in Italy in the form of vaginal pessaries. In chronological order of enrollment, the patients were alternately treated with kanamycin or meclocycline; the dose of administration in both groups was of one pessary per day for 6 days. The evaluation of the therapeutic efficacy was carried out both at the first check-up (7th-8th day) and at a second check-up (13th-16th day). At the first follow-up carried out immediately at the end of therapy, the percentage of normalisation of clinical signs and symptoms was increased independently of the type of treatment in the case of moderate grade aerobic vaginitis, while kanamycin was produced a better effect in the group with severe aerobic vaginitis. Furthermore, at the second follow-up, a direct correlation with recovery of vaginal homeostasis was demonstrated by the normalisation of the vaginal pH and by the presence of lactobacilli, only in kanamycin treated group. In conclusion, our results showed the validity of the treatment with kanamycin intravaginally in this recently recognised disease.

  8. Luteal Phase Support in assisted reproductive technology treatment: focus on Endometrin(R) (progesterone) vaginal insert.

    Science.gov (United States)

    Check, Jerome H

    2009-08-01

    Supplementation of progesterone in the luteal phase and continuance of progesterone therapy during the first trimester has been found in several studies to have benefits in promoting fertility, preventing miscarriages and even preventing pre-term labor. Though it can be administered orally, intramuscularly or even sublingually, a very effective route with fewer side effects can be achieved by an intravaginal route. The first vaginal preparations were not made commercially but were compounded by pharmacies. This had the disadvantage of lack of control by the Food and Drug Administration (FDA) ensuring efficacy of the preparations. Furthermore there was a lack of precise dosing leading to batch to batch variation. The first commercially approved vaginal progesterone preparation in the United States was a vaginal gel which has proven very effective. The main side effect was accumulation of a buildup of the vaginal gel sometimes leading to irritation. Natural micronized progesterone for vaginal administration with the brand name of Utrogestan A((R)) had been approved even before the gel in certain European countries. Endometrin((R)) vaginal tablets are the newest natural progesterone approved by the FDA. Comparisons to the vaginal gel and to intramuscular progesterone have shown similar efficacy especially in studies following controlled ovarian hyperstimulation and oocyte egg retrieval and embryo transfer. Larger studies are needed to compare side effects.

  9. Foreign body in vagina: an uncommon cause of vaginitis in children.

    Science.gov (United States)

    Chinawa, Jm; Obu, Ha; Uwaezuoke, Sn

    2013-01-01

    Vaginal discharge in children may result from a variety of causes. A long-standing intra-vaginal foreign body can pose both diagnostic and therapeutic challenges in children. Treatment failure may occur because of alteration of the normal vaginal flora. A 6-year-old girl, who lived with her parents, presented with a foul-smelling, blood-stained vaginal discharge as well as dysuria for 2 years. There was no history of sexual abuse. Initial evaluation that excluded gynecologic examination revealed lower abdominal tenderness. Vaginal swab and urine cultures yielded Staphylococcus aureus sensitive to ceftriaxone only. She was commenced on this antibiotic for 2 weeks, but the discharge persisted, necessitating referral to the gynecologist. Examination under anesthesia by the gynecologist revealed shreds of toilet tissue paper extracted from the vagina and slight excoriations on the wall of the vagina. Vaginal foreign body can present with diverse symptoms. It should be considered in any young female patient presenting with recurrent or persistent vaginal discharge.

  10. A Novel Microbicide/Contraceptive Intravaginal Ring Protects Macaque Genital Mucosa against SHIV-RT Infection Ex Vivo.

    Directory of Open Access Journals (Sweden)

    Guillermo Villegas

    Full Text Available Women need multipurpose prevention products (MPTs that protect against sexually transmitted infections (STIs and provide contraception. The Population Council has developed a prototype intravaginal ring (IVR releasing the non-nucleoside reverse transcriptase inhibitor (NNRTI MIV-150 (M, zinc acetate (ZA, carrageenan (CG and levonorgestrel (LNG (MZCL IVR to protect against HIV, HSV-2, HPV and unintended pregnancy. Our objective was to evaluate the anti-SHIV-RT activity of MZCL IVR in genital mucosa. First, macaque vaginal tissues were challenged with SHIV-RT in the presence of (i MIV-150 ± LNG or (ii vaginal fluids (VF; available from studies completed earlier collected at various time points post insertion of MZCL and MZC IVRs. Then, (iii MZCL IVRs (vs. LNG IVRs were inserted in non-Depo Provera-treated macaques for 24h and VF, genital biopsies, and blood were collected and tissues were challenged with SHIV-RT. Infection was monitored with one step SIV gag qRT-PCR or p27 ELISA. MIV-150 (LCMS/MS, RIA, LNG (RIA and CG (ELISA were measured in different compartments. Log-normal generalized mixed linear models were used for analysis. LNG did not affect the anti-SHIV-RT activity of MIV-150 in vitro. MIV-150 in VF from MZC/MZCL IVR-treated macaques inhibited SHIV-RT in vaginal mucosa in a dose-dependent manner (p<0.05. MIV-150 in vaginal tissue from MZCL IVR-treated animals inhibited ex vivo infection relative to baseline (96%; p<0.0001 and post LNG IVR group (90%, p<0.001. No MIV-150 dose-dependent protection was observed, likely because of high MIV-150 concentrations in all vaginal tissue samples. In cervical tissue, MIV-150 inhibited infection vs. baseline (99%; p<0.05. No cervical tissue was available for MIV-150 measurement. Exposure to LNG IVR did not change tissue infection level. These observations support further development of MZCL IVR as a multipurpose prevention technology to improve women's sexual and reproductive health.

  11. 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.

  12. Efficacy and safety of intravaginal misoprostol versus intracervical dinoprostone for labor induction at term: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Aihai; Lv, Jieqiang; Hu, Yue; Lang, Junzhe; Ma, Luhang; Chen, Wenbing

    2014-04-01

    Recent studies suggest that misoprostol may be more effective than dinoprostone in pregnant women with unfavorable cervix. The objective here is to investigate and compare the efficacy and safety of intravaginal misoprostol and intracervical dinoprostone for labor induction, including incidence of cesarean section, vaginal delivery rate within 24 h, uterine hyperstimulation, tachysystole, oxytocin augmentation, neonatal intensive care unit (NICU) admissions, and Apgar score of less than 7 at 1 and 5 min. Databases searched were MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials, up to July 2013. Randomized controlled trials comparing intravaginal misoprostol with intracervical dinoprostone in women with singleton pregnancy, intact membranes and unfavorable cervix (Bishop's intracervical dinoprostone; however, dinoprostone has been demonstrated to be safer because of the lower incidence of uterine hyperstimulation and tachysystole. Further high-quality studies assessing the possible effectiveness of misoprostol and dinoprostone in selected groups of patients are warranted. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  13. TABIQUE VAGINAL TRANSVERSO Y ATRESIA VAGINAL

    OpenAIRE

    Bustos,Paola; Smirnow,Marcia

    2003-01-01

    El tabique vaginal transverso, la atresia vaginal parcial y la atresia vaginal total, son una gama de alteraciones congénitas, en las que se ve afectada la continuidad de la vagina. En conjunto, son malformaciones poco frecuentes del aparato genital. A continuación exponemos la experiencia de nuestro servicio respecto a esta patología, durante 13 años(1989 a 2002), presentando 4 casos clínicos y un análisis del tema basado en la literatura

  14. EFFECT OF FLUOROGESTONE ACETATE ON THE VAGINAL MICROBIOTA FROM EWES PELIBUEY IN THE PAPALOAPAN REGION

    Directory of Open Access Journals (Sweden)

    Nohemí Gabriela Cortés-López

    2013-09-01

    Full Text Available Ewes are polyoestrous seasonal animals, however in order to increase their fertility, progesterone derivatives are used by means of impregnated sponges with 20 mg of fluorogestone acetate (FGA. Nevertheless, the use of sponges with FGA generates vaginitis, erythema and interferes with fertility. This paper studies the effect of FGA and sponge over the microbiota vaginal in ewes anestrous. To obtain experimental samples, fifteen ewes anestrous were used. Five ewes were used as control group. Ten ewes anestrous were used and data were collected before, withdrawal and 56 h after withdrawal of sponges with and without FGA, in order to quantify, identify and evaluate changes in the vaginal bacterial microbiota. In the normal microbiota were found Escherichia and Klebsiella strains; however, after removal of the devices, were found enteropathogenic coliform bacterias and some opportunistic as Shigella, Enterobacter, Citrobacter, E. coli, Pseudomonas and Acinetobacter. Also found that the device without FGA, induces a change in the vaginal microbiota, thus, causes vaginitis. In vitro sensitivity tests were performed on the strains identified using twelve different antibiotics; the results showed a higher sensibility to enoxacin, then to the trimethoprim-sulfamethoxazole, ceftriaxone, chloramphenicol and ampicillin. Antibiotics use is necessary to prevent the vaginitis in ewes with dispositive. In conclusion, the intravaginal sponges promote of the vagina inflammation and produce coliform bacteria in vagina.

  15. Absence of Effect of Intravaginal Miconazole, Clindamycin, Nonoxynol‐9, and Tampons on the Pharmacokinetics of an Anastrozole/Levonorgestrel Intravaginal Ring

    OpenAIRE

    Nave, Rüdiger; Klein, Stefan; Müller, André; Chang, Xinying; Höchel, Joachim

    2017-01-01

    Abstract A study was performed to investigate the effect of an intravaginally administered antimycotic, an antibiotic, and a spermicide plus the co‐usage of tampons on the pharmacokinetics (PK) of levonorgestrel (LNG) and anastrozole (ATZ) administered as an intravaginal ring (IVR) releasing 1050 μg ATZ per day and 40 μg LNG per day. In this parallel‐group, randomized, open‐label study, healthy premenopausal women received an IVR as the main treatment. Comedications were administered on 3 con...

  16. PROSPECTIVE STUDY COMPARING EFFECTIVENESS OF SINGLE AND MULTIPLE DOSE 25 MICROGRAMS INTRAVAGINAL MISOPROSTOL FOR INDUCTION OF LABOUR AT TERM

    Directory of Open Access Journals (Sweden)

    Arati Achamma

    2016-06-01

    Full Text Available OBJECTIVES/PURPOSE To compare two dosing regimens of the same 25 mcg misoprostol with respect to Induction delivery interval, successful vaginal delivery and its associated maternal and neonatal outcomes. METHODS Prospective study was conducted among 300 low risk pregnant patients at 40 weeks’ gestation, attending labour room in the Dept. of OBG, Amala Institute of Medical sciences, comparing, A-single dose 25 mcg misoprostol in 24 hours Vs. B-multiple dose 25 mcg misoprostol (4 hourly up to 3 doses intravaginally for its effectiveness. RESULTS Statistically significant difference was obtained in the number of deliveries within 24 hours in group A and B (36.6% Vs. 63.4% with p value 0.002. The induction delivery interval between primigravidae and multigravidae were statistically significant (12.5 =/-3.9 Vs 11.08=/-4.3 with p value 0.035 but not significant between groups A and B. There was no statistical difference in other maternal and neonatal outcomes. Incidence of MSL and foetal distress were higher in primigravidae after single dose itself. Serious adverse outcomes like MAS, NND, APGAR<7 at one minute and uterine rupture were not encountered in this study. CONCLUSION Around 65% of women delivered with a single dose of misoprostol in 24 hours. Most multigravidae delivered vaginally with a single dose in 24 hours. It appears that in multigravidae a single dose induction is adequate; however, in primigravidae multiple doses of 25 mcg misoprostol is best to achieve delivery within 24 hours.

  17. Combination Pod-Intravaginal Ring Delivers Antiretroviral Agents for HIV Prophylaxis: Pharmacokinetic Evaluation in an Ovine Model

    Science.gov (United States)

    Moss, John A.; Butkyavichene, Irina; Churchman, Scott A.; Gunawardana, Manjula; Fanter, Rob; Miller, Christine S.; Yang, Flora; Easley, Jeremiah T.; Marzinke, Mark A.; Hendrix, Craig W.; Smith, Thomas J.

    2016-01-01

    Preexposure prophylaxis (PrEP) against HIV using oral regimens based on the nucleoside reverse transcriptase inhibitor tenofovir disoproxil fumarate (TDF) has been effective to various degrees in multiple clinical trials, and the CCR5 receptor antagonist maraviroc (MVC) holds potential for complementary efficacy. The effectiveness of HIV PrEP is highly dependent on adherence. Incorporation of the TDF-MVC combination into intravaginal rings (IVRs) for sustained mucosal delivery could increase product adherence and efficacy compared with oral and vaginal gel formulations. A novel pod-IVR technology capable of delivering multiple drugs is described. The pharmacokinetics and preliminary local safety characteristics of a novel pod-IVR delivering a combination of TDF and MVC were evaluated in the ovine model. The device exhibited sustained release at controlled rates over the 28-day study and maintained steady-state drug levels in cervicovaginal fluids (CVFs). Dilution of CVFs during lavage sample collection was measured by ion chromatography using an inert tracer, allowing corrected drug concentrations to be measured for the first time. Median, steady-state drug levels in vaginal tissue homogenate were as follows: for tenofovir (TFV; in vivo hydrolysis product of TDF), 7.3 × 102 ng g−1 (interquartile range [IQR], 3.0 × 102, 4.0 × 103); for TFV diphosphate (TFV-DP; active metabolite of TFV), 1.8 × 104 fmol g−1 (IQR, 1.5 × 104, 4.8 × 104); and for MVC, 8.2 × 102 ng g−1 (IQR, 4.7 × 102, 2.0 × 103). No adverse events were observed. These findings, together with previous pod-IVR studies, have allowed several lead candidates to advance into clinical evaluation. PMID:27067321

  18. Distribution of a spermicide containing Nonoxynol-9 in the vaginal canal and the upper female reproductive tract.

    Science.gov (United States)

    Barnhart, K T; Stolpen, A; Pretorius, E S; Malamud, D

    2001-06-01

    Topical, intravaginal microbicides and spermicides are greatly needed to prevent transmission of sexually transmitted diseases and/or unwanted pregnancies. The development of such compounds is a high research priority. The presumed method of action of existing, or novel, microbicides/spermicides is to provide a chemical barrier to the vaginal epithelium preventing exposure to micro-organisms. Other intravaginal products are used to treat vaginal bacteria of fungal infections. Little is known, however, about the actual or optimal initial distribution and subsequent spread of medications placed in the vagina. We describe a sensitive new technique to quantify the spread of a gel placed in the vagina using magnetic resonance imaging (MRI). Five millilitres of an over-the-counter spermicide containing Nonoxynol-9 was mixed with Gadolinium. MRI was used to quantify spread of the mixture 10 min after insertion with a standard applicator. We demonstrated contiguous spread of gel throughout the vagina. The coverage of material was thicker in the upper vagina than in the lower vagina. We also demonstrated, for the first time, that spermicidal compounds may migrate from the vaginal canal into the endocervix within 10 min of insertion. This finding suggests that topical microbicides/spermicides may act both in the vaginal canal and in the upper female genital tract.

  19. Vaginal microbiota in menopause

    OpenAIRE

    Martinus Tarina; Wresti Indriatmi; Larisa Paramitha; Evita Halim Effendi; Shannaz Nadia Yusharyahya; Hanny Nilasari

    2016-01-01

    The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the...

  20. Decision-making in operative vaginal delivery: when to intervene, where to deliver and which instrument to use? Qualitative analysis of expert clinical practice.

    Science.gov (United States)

    Bahl, Rachna; Murphy, Deirdre J; Strachan, Bryony

    2013-10-01

    To identify the decision-making process involved in determining when to intervene, where to deliver and the optimal choice of instrument for operative vaginal deliveries in the second stage of labour. A qualitative study using interviews and video recordings took place at two university teaching hospitals (St. Michael's Hospital Bristol and Ninewells Hospital, Dundee). Ten obstetricians and eight midwives were identified as experts in conducting or supporting operative vaginal deliveries. Semi-structured interviews were carried out using routine clinical scenarios. The experts were also video recorded conducting low cavity vacuum and mid-cavity rotational forceps deliveries in a simulation setting. The interviews and video recordings were transcribed verbatim and analysed using thematic coding. The anonymised data were independently coded by three researchers and then compared for consistency of interpretation. The experts reviewed the coded interview and video data for respondent validation and clarification. The themes that emerged following the final coding were used to identify the decision-making process when planning and conducting an operative vaginal delivery. Key decision points were reported in selecting when and where to conduct an operative vaginal delivery and which instrument to use. The final decision-making list highlights the various decision points to consider when performing an operative vaginal delivery. We identified clinical factors that experts take into consideration when selecting where the delivery should take place and the preferred choice of instrument. This detailed illustration of the decision-making process could aid trainees' understanding of the approach to safe operative vaginal delivery, aiming to minimise morbidity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Toll-Like Receptors and Cytokines as Surrogate Biomarkers for Evaluating Vaginal Immune Response following Microbicide Administration

    Directory of Open Access Journals (Sweden)

    Sadhana M. Gupta

    2008-01-01

    Full Text Available Topical microbicides are intended for frequent use by women in reproductive age. Hence, it is essential to evaluate their impact on mucosal immune function in the vagina. In the present study, we evaluated nisin, a naturally occurring antimicrobial peptide (AMP, for its efficacy as an intravaginal microbicide. Its effect on the vaginal immune function was determined by localizing Toll-like receptors (TLRs-3, 9 and cytokines (IL-4, 6 , 10 and TNF-α in the rabbit cervicovaginal epithelium following intravaginal administration of high dose of nisin gel for 14 consecutive days. The results revealed no alteration in the expression of TLRs and cytokines at both protein and mRNA levels. However, in SDS gel-treated group, the levels were significantly upregulated with the induction of NF-κB signalling cascade. Thus, TLRs and cytokines appear as sensitive indicators for screening immunotoxic potential of candidate microbicides.

  2. Paediatric vaginal discharge

    African Journals Online (AJOL)

    Vaginal discharge in the prepubertal patient is a common symptom, and can be a source of distress for the caregiver and con- cern for the healthcare worker. Several factors predispose these patients to the development of recurrent vaginal discharge. Unless noticed by the caregiver, this problem can persist for long periods ...

  3. Estimation of the optimal brachytherapy utilisation rate in the treatment of vaginal cancer and comparison with patterns of care

    International Nuclear Information System (INIS)

    Thompson, Stephen R.; Delaney, Geoff P.; Gabriel, Gabriel S.; Barton, Michael B.; Jacob, Susannah

    2012-01-01

    Having previously modelled the optimal proportion of uterine cervix and corpus cancers that should be treated with brachytherapy (BT), we aimed to complete the assessment of the role of BT for gynaecological cancers by estimating the optimal proportion of vaginal cancer cases that should be treated with BT, the optimal BT utilisation (BTU) rate for vaginal cancer. We compared this with actual vaginal BTU and assessed quality of BT for vaginal cancer by a Patterns-of-Care Study (POCS). Evidence-based guidelines were used to construct an optimal BTU decision tree for vaginal cancer. Searches of the epidemiological literature to ascertain the proportion of patients who fulfilled the criteria for BT were conducted. The robustness of the model was tested by sensitivity analyses and by peer review. A retrospective POCS of BT in New South Wales (NSW) for 2003 was conducted, and actual BTU for vaginal cancer was determined. Differences between optimal and actual BTU were assessed. Quality of BT for vaginal cancer was compared with published benchmarks. The optimal vaginal cancer BTU rate was estimated to be 85% (range 81–87%). In NSW in 2003, actual vaginal cancer BTU was only 42% (95% confidence interval 22–62%). In NSW, only nine patients were treated, all with intra-vaginal cylinders, and two of four to lower than recommended doses. BT for vaginal cancers is under utilised in NSW compared with the proposed optimal models of care. BT quality may have been suboptimal and this may relate to the rarity of this disease.

  4. Intravaginal rings as delivery systems for microbicides and multipurpose prevention technologies

    Directory of Open Access Journals (Sweden)

    Thurman AR

    2013-10-01

    Full Text Available Andrea Ries Thurman, Meredith R Clark, Jennifer Hurlburt, Gustavo F Doncel CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA Abstract: There is a renewed interest in delivering pharmaceutical products via intravaginal rings (IVRs. IVRs are flexible torus-shaped drug delivery systems that can be easily inserted and removed by the woman and that provide both sustained and controlled drug release, lasting for several weeks to several months. In terms of women's health care products, it has been established that IVRs effectively deliver contraceptive steroids and steroids for the treatment of postmenopausal vaginal atrophy. A novel application for IVRs is the delivery of antiretroviral drugs for the prevention of human immunodeficiency virus (HIV genital infection. Microbicides are antiviral drugs delivered topically for HIV prevention. Recent reviews of microbicide IVRs have focused on technologies in development and optimizing ring design. IVRs have several advantages, including the ability to deliver sustained drug doses for long periods of time while bypassing first pass metabolism in the gut. IVRs are discreet, woman-controlled, and do not require a trained provider for placement or fitting. Previous data support that women and their male sexual partners find IVRs highly acceptable. Multipurpose prevention technology (MPT products provide protection against unintended/mistimed pregnancy and reproductive tract infections, including HIV. Several MPT IVRs are currently in development. Early clinical testing of new microbicide and MPT IVRs will require a focus on safety, pharmacokinetics and pharmacodynamics. Specifically, IVRs will have to deliver tissue concentrations of drugs that are pharmacodynamically active, do not cause mucosal alterations or inflammation, and do not change the resident microbiota. The emergence of resistance to antiretrovirals will need to be investigated. IVRs should not

  5. 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.

  6. Prospective randomised controlled trial to compare safety and efficacy of intravaginal Misoprostol with intracervical Cerviprime for induction of labour with unfavourable cervix.

    Science.gov (United States)

    Krithika, K S; Aggarwal, N; Suri, V

    2008-04-01

    A randomised prospective trial was carried out to compare the efficacy and safety of intravaginal Misoprostol with intracervical dinoprostone gel for induction of labour in cases of unfavourable cervix. One hundred women with an unfavourable cervix requiring induction of labour were randomised to receive either 25 microm vaginal Misoprostol 4-hourly or 0.5 mg of intracervical dinoprostone 12 hourly. The outcome measured was change in Bishop's score, percentage of women going into labour, induction to delivery interval, need for oxytocin, mode of delivery and complications. The parity, mean period of gestation and Bishop's score were similar in both the groups. The improvement in Bishop's score at 12 h was significantly better in the Misoprostol group. Induction to delivery interval was shorter in the Misoprostol group, 16.59 +/- 5.13 h vs 27.77 +/- 12.71 h. The rate of complications was comparable. Vaginal Misoprostol 25 microg 4-hourly is safe and effective for induction of labour with shorter induction to delivery interval.

  7. Abnormal vaginal discharge: what does and does not work in treating underlying causes.

    Science.gov (United States)

    French, Linda; Horton, Jennifer; Matousek, Michelle

    2004-11-01

    Antifungal medications for intravaginal use have been available in the United States for more than a decade. Women may be inclined to self-diagnose yeast infections with any vaginal discharge or other vulvovaginal symptoms that they deem abnormal. As we saw in the first part of this article, "Abnormal vaginal discharge: Using office diagnostic testing more effectively" (J Fam Pract 2004; 53[10]:805-814), abnormal discharge is more likely to be bacterial vaginosis or no pathogen at all. Potential delay in diagnosis and treatment of a sexually transmitted disease is also a concern. Increasing resistance of Candida sp. to imidazoles is associated with indiscriminate use of over-the-counter products.

  8. Definition and classification of abnormal vaginal flora.

    Science.gov (United States)

    Donders, Gilbert G G

    2007-06-01

    Studying the vaginal microflora is not only fascinating, with many discoveries to be made, it is also a very practical way to help women get rid of bothersome and sometimes dangerous infections. Gram-stained vaginal preparations, Pap smears, specific cultures, and nucleic acid detection techniques can be used to diagnose the constituents of the vaginal flora, but in trained hands office-based microscopy of a fresh vaginal smear, preferably using a x400 magnification phase-contrast microscope, allows almost every diagnosis and combination of diagnoses imaginable. In this chapter I will address the pros and cons of the tools that are in use to study vaginal flora, and discuss the different types of bacterial flora and the difficulties encountered in reaching the correct diagnosis of pathological conditions. The 'intermediate flora' is addressed separately, and a new entity--'aerobic vaginitis'--is discussed. Future research should focus on the interaction between infecting microorganisms and host defence mechanisms, as both together generate the pathogenicity of these conditions.

  9. Safety Study of an Antimicrobial Peptide Lactocin 160, Produced by the Vaginal Lactobacillus rhamnosus

    Directory of Open Access Journals (Sweden)

    Sara E. Dover

    2007-01-01

    Full Text Available Objective. To evaluate the safety of the antimicrobial peptide, lactocin 160. Methods. Lactocin 160, a product of vaginal probiotic Lactobacillus rhamnosus 160 was evaluated for toxicity and irritation. An in vitro human organotypic vaginal-ectocervical tissue model (EpiVaginal was employed for the safety testing by determining the exposure time to reduce tissue viability to 50% (ET-50. Hemolytic activity of lactocin160 was tested using 8% of human erythrocyte suspension. Susceptibility of lactobacilli to lactocin160 was also studied. Rabbit vaginal irritation (RVI model was used for an in vivo safety evaluation. Results. The ET-50 value was 17.5 hours for lactocin 160 (4.9 hours for nonoxynol 9, N9. Hemolytic activity of lactocin 160 was 8.2% (N9 caused total hemolysis. Lactobacilli resisted to high concentrations of peptide preparation. The RVI model revealed slight vaginal irritation. An average irritation index grade was evaluated as “none.” Conclusions. Lactocin 160 showed minimal irritation and has a good potential for intravaginal application.

  10. Postoperative vaginal radiation in endometrial cancer using a remote afterloading technique

    International Nuclear Information System (INIS)

    Mandell, L.; Nori, D.; Anderson, L.; Hilaris, B.

    1985-01-01

    Carcinoma of the endometrium is the most common malignancy of the female genital tract. In early stage endometrial cancer, surgery remains the primary mode of treatment while radiation therapy plays an adjuvant role. Prophylactic vaginal radiation has been shown to reduce significantly the incidence of vaginal recurrences. Between the years 1969-1976, 330 patients with FIGO Stages I and II endometrial cancer were treated according to a standard departmental policy in which 40 Gy of external radiation was given to high risk Stage I and II patients in combination with surgery and intravaginal radiation. With this regimen, the mucosal surface received a total equivalent dose of 40 Gy. These treatments were given on an outpatient basis without the need for any sedation or analgesics. The minimum follow-up was 5 years, with a median follow-up of 8.5 years. The overall pelvic and/or vaginal recurrence rate was 2.7%. The incidence of vaginal complications was 3.7%. The advantages of a remote after loading technique in delivering vaginal vault radiation in endometrial cancer are discussed

  11. Myomectomy by vaginal route

    Directory of Open Access Journals (Sweden)

    Milovanović Zagorka

    2004-01-01

    Full Text Available In recent years, the development of new surgical techniques in uterus myoma treatment have reduced operative trauma significantly. Our objective was to present operative technique-vaginal myomectomy, making a prospective clinical study where we have evaluated the operative and postoperative period after intentive diagnosis. The result of our study shows the feasibility of myomectomy by entering the peritoneum through the posterior vaginal fornix, using traditional and cheap surgical instruments and thus avoiding the trauma of laparatomy, minimal operative blood loss, reduced operating time and postoperative recovery. In our opinion, vaginal myomectomy could be useful for the treatment of selected cases with fundal or posterior wall uterine myomas.

  12. Evaluation of vaginal pessary use by South African gynaecologists ...

    African Journals Online (AJOL)

    Introduction. The use of vaginal pessaries for conservative management of pelvic organ prolapse (POP) is well established. However, there are limited data on current clinical practice among gynaecologists, and the aim of this survey was therefore to evaluate vaginal pessary use among South African gynaecologists.

  13. Vaginal bleeding between periods

    Science.gov (United States)

    ... varicose veins) IUD use (may cause occasional spotting) Ectopic pregnancy Miscarriage Other pregnancy complications Vaginal dryness due to ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for ...

  14. Can Vaginitis Be Prevented?

    Science.gov (United States)

    ... examples of safe sex. 1 Centers for Disease Control and Prevention. (2010). Self-study STD module—vaginitis . ... Halvorson New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...

  15. Vaginal and Vulvar Cancer

    Science.gov (United States)

    ... find more information about vaginal, vulvar, and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  16. 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 ... repair; Urinary incontinence - vaginal wall repair Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  17. Vaginal Diseases - Multiple Languages

    Science.gov (United States)

    ... 简体中文) Expand Section Colposcopy - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Vaginal Infection - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual ...

  18. Vaginal delivery - discharge

    Science.gov (United States)

    Pregnancy - discharge after vaginal delivery ... return in: 4 to 9 weeks after your delivery if you're not breastfeeding 3 to 12 ... can start sexual activity around 6 weeks after delivery, if the discharge or lochia has stopped. Women ...

  19. Deeply infiltrating endometriosis: Evaluation of retro-cervical space on MRI after vaginal opacification

    International Nuclear Information System (INIS)

    Fiaschetti, Valeria; Crusco, Sonia; Meschini, Alessandro; Cama, Valentina; Di Vito, Livio; Marziali, Massimiliano; Piccione, Emilio; Calabria, Ferdinando; Simonetti, Giovanni

    2012-01-01

    Objectives: To prospectively investigate diagnostic value and tolerability of MRI after intra-vaginal gel opacification for diagnosis and preoperative assessment of deeply infiltrating endometriosis. Methods: Sixty-three women with clinical suspicion of deeply infiltrating endometriosis were previously examined with trans-vaginal ultrasonography and then with MRI pre and post administration of vaginal gel. We evaluated the tolerability of this procedure with a scoring scale from 0 to 3. We also assessed with a score from 1 to 4 the visibility of four regions: Douglas-pouch, utero-sacral-ligaments, posterior-vaginal-fornix and recto-vaginal-septum. All patients underwent laparoscopic surgery after MRI. Results: Five patients considered procedure intolerable. Visibility of utero-sacral-ligaments and posterior-vaginal-fornix showed to be increased with gel (p < 0.001). In 57 out of 80 patients the MRI has allowed us to diagnose deeply infiltrating endometriosis. Overall, the percentages of MRI-sensitivity, specificity, positive predictive value and negative predictive value were respectively 67.8%, 95.3%, 89.4 and 83.5% without gel, and 90.8%, 94.6%, 90.8% and 94.6% with gel; trans-vaginal ultrasonography sensitivity, specificity, positive predictive value and negative predictive value were 57.5%, 96.6%, 90.9% and 79.5%. In evaluation of utero-sacral-ligaments trans-vaginal ultrasonography, MRI without gel and with gel sensitivity was respectively 61.9%, 47.6% and 81%; for recto-vaginal-septum these values were 12.5%, 68.7% and 93.7%; for pouch of Douglas 82%, 87% and 97.4%; finally for posterior-vaginal-fornix 27.3%, 36.4% and 81.8%. Conclusions: MRI with gel opacification of vagina should be recommended for suspicion of deep infiltrating endometriosis, in particular for the added value in evaluation of recto-vaginal septum, utero-sacral ligaments and posterior vaginal fornix.

  20. Deeply infiltrating endometriosis: Evaluation of retro-cervical space on MRI after vaginal opacification

    Energy Technology Data Exchange (ETDEWEB)

    Fiaschetti, Valeria; Crusco, Sonia [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione Policlinico ' Tor Vergata' , Viale Oxford 81, Rome (Italy); Meschini, Alessandro, E-mail: a.mesko@libero.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione Policlinico ' Tor Vergata' , Viale Oxford 81, Rome (Italy); Cama, Valentina; Di Vito, Livio [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione Policlinico ' Tor Vergata' , Viale Oxford 81, Rome (Italy); Marziali, Massimiliano; Piccione, Emilio [Department of Gynecology and Obstetrics, Fondazione Policlinico ' Tor Vergata' , Viale Oxford 81, Rome (Italy); Calabria, Ferdinando [Department of Nuclear Medicine and Diagnostic Imaging, IRCCS Neuromed, Pozzilli (Italy); Simonetti, Giovanni [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione Policlinico ' Tor Vergata' , Viale Oxford 81, Rome (Italy)

    2012-11-15

    Objectives: To prospectively investigate diagnostic value and tolerability of MRI after intra-vaginal gel opacification for diagnosis and preoperative assessment of deeply infiltrating endometriosis. Methods: Sixty-three women with clinical suspicion of deeply infiltrating endometriosis were previously examined with trans-vaginal ultrasonography and then with MRI pre and post administration of vaginal gel. We evaluated the tolerability of this procedure with a scoring scale from 0 to 3. We also assessed with a score from 1 to 4 the visibility of four regions: Douglas-pouch, utero-sacral-ligaments, posterior-vaginal-fornix and recto-vaginal-septum. All patients underwent laparoscopic surgery after MRI. Results: Five patients considered procedure intolerable. Visibility of utero-sacral-ligaments and posterior-vaginal-fornix showed to be increased with gel (p < 0.001). In 57 out of 80 patients the MRI has allowed us to diagnose deeply infiltrating endometriosis. Overall, the percentages of MRI-sensitivity, specificity, positive predictive value and negative predictive value were respectively 67.8%, 95.3%, 89.4 and 83.5% without gel, and 90.8%, 94.6%, 90.8% and 94.6% with gel; trans-vaginal ultrasonography sensitivity, specificity, positive predictive value and negative predictive value were 57.5%, 96.6%, 90.9% and 79.5%. In evaluation of utero-sacral-ligaments trans-vaginal ultrasonography, MRI without gel and with gel sensitivity was respectively 61.9%, 47.6% and 81%; for recto-vaginal-septum these values were 12.5%, 68.7% and 93.7%; for pouch of Douglas 82%, 87% and 97.4%; finally for posterior-vaginal-fornix 27.3%, 36.4% and 81.8%. Conclusions: MRI with gel opacification of vagina should be recommended for suspicion of deep infiltrating endometriosis, in particular for the added value in evaluation of recto-vaginal septum, utero-sacral ligaments and posterior vaginal fornix.

  1. Pharmacokinetics of adriamycin vaginal suppository on uterine cervical cancer

    International Nuclear Information System (INIS)

    Noda, Tsuneo; Kiyozuka, Yasuhiko; Katakami, Yoshiaki

    1986-01-01

    Vaginal suppositories of Adriamycin (ADM, 5 mg), for reducing the capacity for repair from sublethal damage of X-ray-irradiated cells, were prepared using Wipepsol S-55 as the vehicle, and were intravaginally administered to patients with advanced uterine cervical cancer, and their pharmacokinetics and clinical effects were studied. The ADM concentration in the uterine cervical cancer tissues indicated high levels (17 to 566 μg/g), and migration into the cardinal ligament and regional lymph nodes was noted. However, little ADM was detected in serum (0 to 0.14 μg/g), probably because of its molecular weight and excellent tissue absorbance, and no side effects, such as cardiotoxicity and myelosuppression due to consecutive administration were detected. Histologically, the effect obtained when administered alone was limited, administration in combination with radiotherapy being more effective. Accordingly, radiotherapy of advanced uterine cervical cancer with concomitant administration of ADM vaginal suppositories seems to bring about a more powerful antitumoral effect with fewer systemic side effects. (author)

  2. Assessment of vaginal atrophy: a review

    NARCIS (Netherlands)

    Weber, M. A.; Limpens, J.; Roovers, J. P. W. R.

    2015-01-01

    The aim of this study is to provide an evidence-based definition of vaginal atrophy (VA) and present an overview of subjective and objective measurements of VA applicable in clinical practice and research. A systematic literature search was performed in MEDLINE and EMBASE to identify studies

  3. [HPV contamination of endocavity vaginal ultrasound probes].

    Science.gov (United States)

    Heard, I; Favre, M

    2015-02-01

    While the use of endovaginal ultrasound probes is increasing, the risk of contamination of women with endocavity vaginal probes was not assessed. In particular, the clinical significance of detection of human papillomavirus (HPV) infection, the most common sexually transmitted viral infection, on endovaginal ultrasound probes is uncertain. The recommendations of good practice for decontamination of these probes developed by the High Council for Public Health and the Academy of Medicine have not been evaluated. The objective of this article was to review recent publications concluding to the detection of HPV and human cellular DNA after gynecological examination and disinfection of vaginal ultrasound probes. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Time-dose relationships of PMSG and map-intravaginal sponges ...

    African Journals Online (AJOL)

    Different dosage levels of pregnant mare serum gonadotrophin (PMSG) were applied in conjunction with medroxyprogesterone acetate impregnated intravaginal sponges at different times in relation to sponge removal the object of the study was to find the most economical dose level and the correct time of application ...

  5. Vaginal microbiota in menopause

    Directory of Open Access Journals (Sweden)

    Martinus Tarina

    2016-12-01

    Full Text Available The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp, and Streptococcus sp. The normal vaginal microbiota’s imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H2O2-producing Lactobacillus. They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp.

  6. Prostaglandin E2 Labour Induction with Intravaginal (Minprostin versus Intracervical (Prepidil Administration at Term: Randomized Study of Maternal and Neonatal Outcome and Patient’s Perception Using the Osgood Semantic Differential Scales

    Directory of Open Access Journals (Sweden)

    Joscha Reinhard

    2014-01-01

    Full Text Available Aim. To compare the efficacy, safety, and patient’s perception of two prostaglandin E2 application methods for induction of labour. Method. Above 36th weeks of gestation, all women, who were admitted to hospital for induction of labour, were prospectively randomised to intravaginal 1 mg or intracervical 0.5 mg irrespective of cervical Bishop score. The main outcome variables were induction-to-delivery interval, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, rate of vaginal delivery, and patient’s perception using semantic differential questionnaire. Results. Thirty-nine patients were enrolled in this study. There was no statistical significant difference between the two groups in regard to perceptions of induction. The median induction delivery time using intravaginal versus intracervical administration was 29.9 versus 12.8 hours, respectively (P=0.04. No statistically difference between the groups was detected in regard to parity, gestation age, cervical Bishop score, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, and mode of birth. Summary. Irrespective of the cervical Bishop Score, intracervical gel had a shorter induction delivery time without impingement on the women’s perception of induction.

  7. Prostaglandin E2 labour induction with intravaginal (Minprostin) versus intracervical (Prepidil) administration at term: randomized study of maternal and neonatal outcome and patient's perception using the osgood semantic differential scales.

    Science.gov (United States)

    Reinhard, Joscha; Rösler, Roberta; Yuan, Juping; Schiermeier, Sven; Herrmann, Eva; Eichbaum, Michael H; Louwen, Frank

    2014-01-01

    To compare the efficacy, safety, and patient's perception of two prostaglandin E2 application methods for induction of labour. Above 36th weeks of gestation, all women, who were admitted to hospital for induction of labour, were prospectively randomised to intravaginal 1 mg or intracervical 0.5 mg irrespective of cervical Bishop score. The main outcome variables were induction-to-delivery interval, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, rate of vaginal delivery, and patient's perception using semantic differential questionnaire. Thirty-nine patients were enrolled in this study. There was no statistical significant difference between the two groups in regard to perceptions of induction. The median induction delivery time using intravaginal versus intracervical administration was 29.9 versus 12.8 hours, respectively (P = 0.04). No statistically difference between the groups was detected in regard to parity, gestation age, cervical Bishop score, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, and mode of birth. Irrespective of the cervical Bishop Score, intracervical gel had a shorter induction delivery time without impingement on the women's perception of induction.

  8. 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...... 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....

  9. Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

    International Nuclear Information System (INIS)

    Friedman, Lois C.; Abdallah, Rita; Schluchter, Mark; Panneerselvam, Ashok; Kunos, Charles A.

    2011-01-01

    Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.

  10. Vaginal itching and discharge - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003159.htm Vaginal itching and discharge - child To use the sharing features on this ... problem in girls before the age of puberty. Vaginal discharge may also be present. The color, smell, and ...

  11. Vaginitis: Beyond the Basics.

    Science.gov (United States)

    Mills, Benjie Brown

    2017-06-01

    Vaginal complaints are one of the most common reasons women seek the advice of a health care provider. Uncomplicated infections such as vulvovaginal candidiasis, bacterial vaginosis, or trichomoniasis are easy to diagnose and treat. However, about 8% of patients will have a more complicated course with failure to respond to treatment or rapid recurrence of symptoms. Understanding the need for a methodical, diagnostic approach to help these women with recurrent or refractory cases of vaginal symptoms will aid the clinician achieve successful patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. Short communication: Evaluation of vaginal discharge following treatment with a progesterone insert.

    Science.gov (United States)

    Fischer-Tenhagen, C; von Krueger, X; Heuwieser, W

    2012-08-01

    Yellowish discharge after application of intravaginal progesterone releasing inserts is frequently observed in cows. The objective of this study was to compare the bacteriological contamination of the vagina and uterus before and after a treatment with a progesterone insert in heifers. Forty-two Holstein heifers received a progesterone releasing insert [Eazi-Breed controlled internal drug release (CIDR) insert; Pfizer Animal Health, Berlin, Germany] for 7d. The protruding tail had been removed from half of the inserts (no tail group: n=21; tail group: n=21). Nine heifers from the tail group lost the insert within the 7-d treatment interval and were excluded. Heifers identified in estrus were artificially inseminated on d 9 or 10. Vaginal discharge was scored on a 4-point scale [vaginal discharge score (VDS) 0 to 3] and vaginal swabs were taken for bacteriological examination on d 0 and 7 and the day of artificial insemination (AI). Furthermore, cytological and bacteriological samples were obtained from the uterus on d 7 and the day of AI. On d 0, coliforms and Streptococcus spp. were found in vaginal swabs of 21 heifers (64%). On d 7, all heifers showed purulent vaginal discharge (VDS 2 to 3). The VDS was higher in the tail group compared with the no tail group. Arcanobacterium pyogenes, coliforms, and Streptococcus spp. were isolated from the vaginal swabs in 32 of 33 (96%) heifers on d 7. On the day of AI, VDS had improved to 0 or 1 in 96% of the heifers. However, A. pyogenes, coliforms, and Streptococcus spp. were still isolated in 17 of 33 (53%) heifers from the vagina and in 32 of 33 (96%) heifers from the endometrium. Endometrial cytology revealed polymorphonuclear neutrophils (PMN) in 11 heifers (6 to 32% PMN). Five samples exceeded the threshold of 5% PMN, and 2 samples exceeded the 10% PMN threshold, indicative of subclinical endometritis. In conclusion, pyogenic bacteria were found in the vagina and uterus on d 7 and the day of AI after intravaginal

  14. Development of amino acid substituted gemini surfactant-based mucoadhesive gene delivery systems for potential use as noninvasive vaginal genetic vaccination.

    Science.gov (United States)

    Singh, Jagbir; Michel, Deborah; Getson, Heather M; Chitanda, Jackson M; Verrall, Ronald E; Badea, Ildiko

    2015-02-01

    Recently, we synthesized amino acid- and peptide-substituted gemini surfactants, 'biolipids' that exhibited high transfection efficiency in vitro. In this study, we developed these plasmid DNA and gemini surfactant lipid particles for noninvasive administration in vaginal cavity. Novel formulations of these gene delivery systems were prepared with poloxamer 407 to induce in situ gelling of the formulation and diethylene glycol monoethyl ether to improve their penetration across mucosal tissue. Poloxamer at 16% w/v concentration in diethylene glycol monoethyl ether aqueous solution produced dispersions that gelled near body temperature and had a high yield value, preventing leakage of the formulation from the vaginal cavity. Intravaginal administration in rabbits showed that the glycyl-lysine-substituted gemini surfactant led to a higher gene expression compared with the parent unsubstituted gemini surfactant. This provides a proof-of-concept that amino acid substituted gemini surfactants can be used as noninvasive mucosal (vaginal) gene delivery systems to treat diseases associated with mucosal epithelia.

  15. 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.

  16. To Pack or Not to Pack? A Randomized Trial of Vaginal Packing After Vaginal Reconstructive Surgery.

    Science.gov (United States)

    Westermann, Lauren B; Crisp, Catrina C; Oakley, Susan H; Mazloomdoost, Donna; Kleeman, Steven D; Benbouajili, Janine M; Ghodsi, Vivian; Pauls, Rachel N

    2016-01-01

    Placement of vaginal packing after pelvic reconstructive surgery is common; however, little evidence exists to support the practice. Furthermore, patients have reported discomfort from the packs. We describe pain and satisfaction in women treated with and without vaginal packing. This institutional review board-approved randomized-controlled trial enrolled patients undergoing vaginal hysterectomy with prolapse repairs. The primary outcome was visual analog scales (VASs) for pain on postoperative day 1. Allocation to "packing" ("P") or "no-packing" ("NP") arms occurred intraoperatively at the end of surgery. Visual analog scales regarding pain and satisfaction were completed early on postoperative day 1 before packing removal. Visual analog scale scores for pain, satisfaction, and bother attributable to packing were recorded before discharge. All packing and perineal pads were weighed to calculate a "postoperative vaginal blood loss." Perioperative data were collected from the hospital record. Our sample size estimation required 74 subjects. Ninety-three women were enrolled. After exclusions, 77 were randomized (P, 37; NP, 40). No differences were found in surgical information, hemoglobin levels, or narcotic use between groups. However, "postoperative vaginal blood loss" was greater in packed subjects (P discharge (P, 35.0 vs NP, 40.0; P = 0.43] were not significantly different between treatment arms. Likewise, VAS scores for satisfaction before removal of packing (P, 81.0 vs NP, 90.0; P = 0.08] and before discharge (P, 90.0 vs NP, 90.5; P = 0.60] were not significantly different. Packed patients noted lower nursing verbal pain scores (P = 0.04) and used less ketorolac (P = 0.01). Bother from packing was low overall. Although there was no difference based on VAS, women receiving vaginal packing had lower nursing documented pain and used less ketorolac than packed women. Vaginal packing may provide benefit and can remain part of the surgical practice.

  17. MANAGEMENT OF VAGINAL DISCHARGE

    African Journals Online (AJOL)

    Enrique

    , an oral antifungal should be used weekly, e.g. 100 mg flucona- zole.7. The discharge of candidiasis is curd- like and adherent due to direct hyphal invasion of epithelial tissues resulting in erythema of the vaginal epithelium. Clinical diagnosis ...

  18. 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.

  19. 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

  20. [Prevalence of 7 microorganisms in abnormal vaginal secretions (vaginitis)].

    Science.gov (United States)

    Roupas, A; Wyss, R; Anner, R

    1985-10-19

    Seven microorganisms (N. gonorrhoeae, C. albicans, T. vaginalis, G. vaginalis, M. hominis, U. urealyticum and Streptococcus of group B) have been assayed in genital samplings of 164 asymptomatic women (control group) and of 374 women suffering from abnormal vaginal secretions (vaginitis group). All these bacteria except group B Streptococci were isolated in the vaginitis group more frequently than in the control group (p less than 0.01). The proportion of negative cultures for all tested bacteria was 39% in the control group and 6.4% in the vaginitis group (p less than 0.01). This shows an association of these bacteria with 70% of the patients of the vaginitis group and with only 26% of the women of the control group (p less than 0.01). It is to be noted that the pH values are higher in the group of women with vaginitis than in the control group (p less than 0.01). Comparison of the microbial flora during "specific" an "non-specific" vaginitis indicates that G. vaginalis is isolated more frequently in patients with non-specific vaginitis than among those with specific vaginitis (p less than 0.01). Likewise, M. hominis is isolated more frequently in groups of women with either non-specific vaginitis or T. vaginalis vaginitis, than in groups of patients with a C. albicans vaginitis (p less than 0,01). The results of this study indicate that there is a causal relationship between vaginitis and the presence of T. vaginalis. C. albicans, G. vaginalis, M. hominis or N. gonorrhoeae, either as a single or a mixed infection, and that there is a relationship between increased pH values and abnormal vaginal secretions.

  1. Preparation and Evaluation of Intravaginal Ring Containing Drospirenone

    Directory of Open Access Journals (Sweden)

    Ying Zhang

    2013-01-01

    Full Text Available In the present study, we investigated the feasibility of the vaginal administration of drospirenone silicone IVR. The in vitro release characteristics of matrix-type and reservoir-type IVR were compared under sink conditions in 21 days. At the same time, API excipients compatibility and preformulation study was performed by HPLC, IR, and DSC methods. Biocompatibility of reservoir system was evaluated by tolerability on tissue level in rats. It was found that, under strong light exposure, high temperature, and high humidity conditions, drospirenone and excipients had no significant interactions. The daily release of reservoir-type IVR was about 0.5 mg/d sustaining 21 days, which significantly decreased the burst effect compared with the matrix system. When drospirenone was modified by the PVPk30 in the reservoir system formulation, the daily release rate increased to 1.0 mg/d sustaining 21 days. The cumulative release of reservoir-type IVR was fitted to zero release equation. In addition, biocompatibility of drospirenone IVR system in this dosage is safe. It is feasibility feasibile to further developed for safe, convenient, and effective contraceptive drug delivery with reduced dosing interval.

  2. 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. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Tracking the luminal exposure and lymphatic drainage pathways of intravaginal and intrarectal inocula used in nonhuman primate models of HIV transmission.

    Science.gov (United States)

    Smedley, Jeremy; Turkbey, Baris; Bernardo, Marcelino L; Del Prete, Gregory Q; Estes, Jacob D; Griffiths, Gary L; Kobayashi, Hisataka; Choyke, Peter L; Lifson, Jeffrey D; Keele, Brandon F

    2014-01-01

    Over 80% of sexual HIV-1 transmissions originate from a single viral variant, but the underlying basis for this transmission bottleneck remains to be elucidated. Nonhuman primate models of mucosal virus transmission allow opportunities to gain insight into the basis of this mucosal bottleneck. We used simulated inocula consisting of either non-infectious vital dye or contrast dye with non-invasive magnetic resonance imaging (MRI) to visualize mucosal exposure and passive lymphatic drainage patterns following vaginal and rectal exposures in Indian origin rhesus macaques. Results revealed a limited overall distance of dye coverage from the anal verge following 1 ml (n = 8) intrarectally administered, which greatly increased with a 3 ml (n = 8) volume. Intravaginal dye exposure using 2 ml revealed complete coverage of the mucosa of the vagina and ectocervix, however dye was not detectable in the endocervix, uterus, fallopian tubes or ovaries in nuliparous sexually mature rhesus macaques (n = 9). In addition, following submucosal and intranodal injections of vital dye or MRI contrast dye in the rectum (n = 9), or distal and proximal vagina (n = 4), the lymphatic drainage pathways were identified as first the internal then common iliac chain followed by para-aortic lymph nodes. Drainage from the distal descending colon (n = 8) was via the para-colonic lymph nodes followed by the inferior mesenteric and para-aortic lymph nodes. Analysis after vaginal challenge with infectious SIVmac239 followed by euthanasia at day 3 revealed a pattern of viral dissemination consistent with the imaging results. These results provide insights into potential patterns of viral dissemination that can help guide efforts to better elucidate the earliest events of virus transmission and potential intervention strategies.

  4. Tracking the luminal exposure and lymphatic drainage pathways of intravaginal and intrarectal inocula used in nonhuman primate models of HIV transmission.

    Directory of Open Access Journals (Sweden)

    Jeremy Smedley

    Full Text Available Over 80% of sexual HIV-1 transmissions originate from a single viral variant, but the underlying basis for this transmission bottleneck remains to be elucidated. Nonhuman primate models of mucosal virus transmission allow opportunities to gain insight into the basis of this mucosal bottleneck. We used simulated inocula consisting of either non-infectious vital dye or contrast dye with non-invasive magnetic resonance imaging (MRI to visualize mucosal exposure and passive lymphatic drainage patterns following vaginal and rectal exposures in Indian origin rhesus macaques. Results revealed a limited overall distance of dye coverage from the anal verge following 1 ml (n = 8 intrarectally administered, which greatly increased with a 3 ml (n = 8 volume. Intravaginal dye exposure using 2 ml revealed complete coverage of the mucosa of the vagina and ectocervix, however dye was not detectable in the endocervix, uterus, fallopian tubes or ovaries in nuliparous sexually mature rhesus macaques (n = 9. In addition, following submucosal and intranodal injections of vital dye or MRI contrast dye in the rectum (n = 9, or distal and proximal vagina (n = 4, the lymphatic drainage pathways were identified as first the internal then common iliac chain followed by para-aortic lymph nodes. Drainage from the distal descending colon (n = 8 was via the para-colonic lymph nodes followed by the inferior mesenteric and para-aortic lymph nodes. Analysis after vaginal challenge with infectious SIVmac239 followed by euthanasia at day 3 revealed a pattern of viral dissemination consistent with the imaging results. These results provide insights into potential patterns of viral dissemination that can help guide efforts to better elucidate the earliest events of virus transmission and potential intervention strategies.

  5. Analysis of intravaginal misoprostol 0.2 mg versus intracervical dinoprostone 0.5 mg doses for labor induction at term pregnancies.

    Science.gov (United States)

    Górnisiewicz, Teresa; Jaworowski, Andrzej; Zembala-Szczerba, Małgorzata; Babczyk, Dorota; Huras, Hubert

    2017-01-01

    Labor-induction methods are used in about 23% of labors. Most commonly, pharmacological methods are used to pre-induct the labor with dinoprostone - a PGE2 analog, and misoprostol - a PGE1 analog. The aim of this study was to evaluate two pharmacological methods of labor induction with the use of prostaglandins applied via an intravagi-nal insert containing misoprostol at a dose of 0.2 mg and intracervical gel containing dinoprostone at a dose of 0.5 mg. This retrospective study was conducted on a group of 50 adult patients qualified for the pre-induction of labor. Following data were recorded: the time from the drug administration to the beginning of regular contractile function, the time from administration to amniotic fluid rupture, the time from medicament administration to the vaginal labor or caesarean section, the duration of I, II and III stages of labor, the delivery method and in the event of caesarean section - the indications for surgery. In comparison to dinoprostone, the misoprostol application was found to shorten the time from drug administration to amniotic fluid rupture by 14.1 hours, the time to the beginning of the first stage of labor by 11.7 hours and from the drug administration to the delivery by 17.3 hours (p-value intracervical gel with dinoprostone at a dose of 0.5mg. Thorough analysis of these methods requires further studies.

  6. High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus.

    Science.gov (United States)

    Haddow, Andrew D; Nalca, Aysegul; Rossi, Franco D; Miller, Lynn J; Wiley, Michael R; Perez-Sautu, Unai; Washington, Samuel C; Norris, Sarah L; Wollen-Roberts, Suzanne E; Shamblin, Joshua D; Kimmel, Adrienne E; Bloomfield, Holly A; Valdez, Stephanie M; Sprague, Thomas R; Principe, Lucia M; Bellanca, Stephanie A; Cinkovich, Stephanie S; Lugo-Roman, Luis; Cazares, Lisa H; Pratt, William D; Palacios, Gustavo F; Bavari, Sina; Pitt, M Louise; Nasar, Farooq

    2017-08-01

    Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present.

  7. High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus

    Science.gov (United States)

    Nalca, Aysegul; Rossi, Franco D.; Miller, Lynn J.; Wiley, Michael R.; Perez-Sautu, Unai; Washington, Samuel C.; Norris, Sarah L.; Wollen-Roberts, Suzanne E.; Shamblin, Joshua D.; Kimmel, Adrienne E.; Bloomfield, Holly A.; Valdez, Stephanie M.; Sprague, Thomas R.; Principe, Lucia M.; Bellanca, Stephanie A.; Cinkovich, Stephanie S.; Lugo-Roman, Luis; Cazares, Lisa H.; Pratt, William D.; Palacios, Gustavo F.; Bavari, Sina; Pitt, M. Louise; Nasar, Farooq

    2017-01-01

    Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present. PMID:28548637

  8. Pudendal nerve latency time in normal women via intravaginal stimulation

    Directory of Open Access Journals (Sweden)

    Geraldo A. Cavalcanti

    2006-12-01

    Full Text Available INTRODUCTION & OBJECTIVES: Studies of motor conduction for the efferent functional assessment of the pudendal nerve in women with pelvic dysfunctions have been conducted through researching distal motor latency times. The transrectal approach has been the classic approach for this electrophysiological examination. The objective of the present study is to verify the viability of the transvaginal approach in performing the exam, to establish normal values for this method and to analyze the influence of age, stature and parity in the latency value of normal women. MATERIALS AND METHODS: A total of 23 volunteers without genitourinary pathologies participated in this study. In each, pudendal motor latency was investigated through the transvaginal approach, which was chosen due to patient’s higher tolerance levels. RESULTS: The motor response represented by registering the M-wave was obtained in all volunteers on the right side (100% and in 13 volunteers on the left side (56.5%. The mean motor latency obtained in the right and left was respectively: 1.99 ± 0.41 and 1.92 ± 0.48 milliseconds (ms. There was no difference between the sides (p = 0.66. Latency did not correlate with age, stature or obstetric history. The results obtained in the present study were in agreement with those found by other researchers using the transrectal approach. CONCLUSION: The vaginal approach represents an alternative for pudendal nerve distal motor latency time, with similar results to those achieved through the transrectal approach. Normative values obtained herein might serve as a comparative basis for subsequent physiopathological studies.

  9. 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.

  10. Vaginal rugae: measurement and significance.

    Science.gov (United States)

    Whiteside, J L; Barber, M D; Paraiso, M F; Walters, M D

    2005-03-01

    To devise a validated measure of vaginal rugae and assess the relationships between vaginal rugae and important clinical parameters. Two techniques of assessing vaginal rugae were developed and their inter-/intra-observer variability assessed. Examination variability was assessed using intraclass correlation and by way of an analysis of the absolute difference between the two rugal quantitations. After validating the assessment technique, the rugal quantitations of 88 women were compared to clinical parameters such as age, estrogen status, stage of prolapse, parity, history of anterior vaginal wall surgery, and body mass index. Linear regression analysis was used to assess the relationships between vaginal rugae score and these clinical parameters. The mean age and body mass index of the subjects were 56 years (standard deviation (SD) +/- 13.8 years) and 30.4 kg/m2 (SD +/- 7.5 kg/m2), respectively. The median parity was 2 (range 0-11). A history of anterior vaginal wall surgery was present in 29% of subjects and 46% were estrogen-deficient. Scores for the two techniques to quantitate vaginal rugae were normally distributed. Both techniques demonstrated satisfactory interexaminer reliability. Increasing age and deficient estrogen status were found to be independent predictors of less vaginal rugae. Vaginal rugae can be reliably quantitated. Loss of vaginal rugae is associated with estrogen deficiency and advancing age.

  11. Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis

    Directory of Open Access Journals (Sweden)

    Evelyn Kaambo

    2018-03-01

    Full Text Available A healthy vaginal microbiota is considered to be significant for maintaining vaginal health and preventing infections. However, certain vaginal bacterial commensal species serve an important first line of defense of the body. Any disruption of this microbial barrier might result in a number of urogenital conditions including aerobic vaginitis (AV and bacterial vaginosis (BV. The health of the vagina is closely associated with inhabitant microbiota. Furthermore, these microbes maintain a low vaginal pH, prevent the acquisition of pathogens, stimulate or moderate the local innate immune system, and further protect against complications during pregnancies. Therefore, this review will focus on vaginal microbial “health” in the lower reproductive tract of women and on the physiological characteristics that determine the well-being of reproductive health. In addition, we explore the distinct versus shared characteristics of BV and AV, which are commonly associated with increased risk for preterm delivery.

  12. Intravaginal hormonal contraception for women of reproductive age with excessive body mass

    Directory of Open Access Journals (Sweden)

    I. B. Gridina

    2015-12-01

    Full Text Available There are a number of disadvantages inherent in all oral hormonal contraceptives: need for daily administration, fluctuations of hormone levels throughout the day, metabolism in the gastrointestinal tract, the effect of the first passage through the liver. All this became a prerequisite to the creation of prolonged oral hormonal methods of contraception, which would be devoid of these shortcomings. One of such method of hormonal contraception is intravaginal hormonal system. The aim was to determine the safety and efficacy of its use in women of reproductive age with overweight. 43 women were included. State of lipid metabolism, changes of the hemostatic system, blood pressure and weight fluctuations in the past 6 months of using intravaginal hormonal contraceptive system were studied. Results. It is established that hormonal intravaginal contraceptive ring gives minimal metabolic effects. Conclusion. This suggests that this ring can be used successfully in patients with excessive body mass, because there is no effect of the ring on hemostasis, lipid metabolism and body weight.

  13. Low dose intravaginal misoprostol versus intracervical baloon catheter for pre-induction cervical ripening.

    Science.gov (United States)

    Tabowei, T O; Oboro, V O

    2003-02-01

    The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. To compare the safety and efficacy of a low dose intravaginal misoprostol and intracervical Foley's catheter for cervical ripening. A prospective randomized controlled trial. Zonal General Hospital, Kwale, Nigeria from June 1, 1998 to May 30, 2001. Candidates for pre-induction cervical ripening were randomized to receive either 250 mcg of intravaginal misoprostol every four hours (n = 60) or intracervical Foley's catheter (n = 61). Failure to achieve cervical ripening within 24 hours, need for augmentation, maternal and foetal complications. Failure to achieve cervical ripening within two hours was reduced with misoprostol (Relative Risk [RR] 0.63, 95% Confidence Interval [CI] 0.43 - 0.92). Need for oxytocin augmentation was less in the misoprostol group (RR 0.76, 95% CI 0.64 to 0.91). No significant differences existed in rates for uterine hyperstimulation, Caesarean section, maternal and neonatal morbidity. Intravaginal misoprostol in a low dose was compared to intracervical balloon catheter for pre-induction ripening of the cervix.

  14. Preparation and in vitro/in vivo evaluation of gestodene (GEST) intravaginal ring.

    Science.gov (United States)

    Li, Chunxiao; Ning, Meiying; Yao, Xiaodong; Wang, Yankun; Liu, Ying

    2016-09-01

    Preparation and in vitro/in vivo evaluation of gestodene (GEST) intravaginal ring (IVR) formulations which can release a constant dose of GEST during 3 weeks were investigated. In present study a reservoir gestodene intravaginal ring, including a gestodene silicone elastomer core and the non-active silicone layer, was reported, which was manufactured by reaction injection moulding at 80°C for 20 min. The raw materials compatibility experiments showed that the silicone elastomer core carrier wouldn't interact with drugs. In vitro release samples were determined by HPLC and the experiment was performed under sink conditions. The equation of cumulative release verse time was Y=64.76χ+5.44 (r=0.9998), performing zero-order release at about the target dose of 60 µg/day over 21 days. Drug release increased with temperature elevating from 45 to 55°C, which could be attributed to optimizing the prescription. In addition, the pharmacokinetic and safety studies of gestodene intravaginal ring were evaluated in female New Zealand White rabbits. The GEST in plasma was analyzed by LC-MS/MS and the results proved that the correlation between in vitro and in vivo was relatively well.

  15. Humoral and secretory antibodies to Ureaplasma diversum in heifers following subcutaneous vaccination and vaginal infection.

    Science.gov (United States)

    Mulira, G L; Saunders, J R

    1994-04-01

    We measured antibody levels in serum and cervicovaginal mucus (CVM) of four heifers vaccinated with two inoculations of killed Ureaplasma diversum strain 2312 in incomplete Freund's adjuvant (IFA) two weeks apart, and six heifers given a placebo. Two weeks later, the vaccinates and four placebo heifers, were challenged by intravaginal inoculation with 6.4 x 10(8) colony-forming units of the homologous U. diversum strain. The remaining two placebo heifers served as unvaccinated, unchallenged controls. Antibody levels in serum and CVM of all heifers were determined by an enzyme-linked immunosorbent assay (ELISA). Vaccination stimulated specific IgG1 and IgG2 responses in serum and CVM but only a slight IgM and no IgA response. In both vaccinate and placebo heifers, subsequent intravaginal challenge resulted in a granular vulvitis (GV) with a predominant IgA response in the CVM. The GV gradually subsided during the 35 day observation period but ureaplasmas were consistently demonstrated by culture. We concluded that subcutaneous vaccination stimulated a specific, albeit nonprotective, IgG response in serum and CVM. In contrast, vaginal infection primarily induced a mucosal IgA response.

  16. What is normal vaginal flora?

    OpenAIRE

    Priestley, C J; Jones, B M; Dhar, J; Goodwin, L

    1997-01-01

    OBJECTIVE: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. DESIGN: A longitudinal surveillance of the vaginal flora over an eight week period. SUBJECTS: 26 female health care workers in local genitourinary medicine clinics. METHODS: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gr...

  17. Vaginitis in the adolescent patient.

    Science.gov (United States)

    Nyirjesy, P

    1999-08-01

    For any clinician involved in the health care of women, vaginitis remains an unavoidable problem. Vaginitis accounts for an estimated 10 million office visits each year, and it remains the most common reason for patient visits to obstetrician-gynecologists. Despite extensive self-diagnosis and self-treatment for vaginal symptoms in all age groups, important questions persist about the accuracy of such an approach. This article addresses these questions and approaches.

  18. Effect of Vaginal Hygiene Module to Attitudes and Behavior of Pathological Vaginal Discharge Prevention Among Female Adolescents in Slemanregency, Yogyakarta, Indonesia.

    Science.gov (United States)

    Sumarah, Sumarah; Widyasih, Hesty

    2017-06-01

    Objective: To determine the effect of vaginal hygiene module to attitudes and behavior of pathological vaginal discharge prevention in adolescent girls in Sleman Regency, Yogyakarta, Indonesia. Materials and methods: This present study is a quasi experiment with pretest and post-test control group design. A total of 80 female students was selected randomly from two secondary schools at the study site and then distributed equally to control and experimental group. Only participants in the experimental group were given self-learning vaginal hygiene module to maintain vaginal cleanliness. A questionnaire was used as an instrument to measure the attitudes and behavior of vaginal discharge prevention. Paired and independent sample t-tests with significance level (p value) at 0.05 and Confidence Interval (CI) of 95%were employed to compare the mean difference. Results: There is a significant difference in the students' attitude and practice of pathological vaginal discharge prevention between intervention and control group. The students who have been exposed to vaginal hygiene module for six months showed better attitudes and practice in pathological vaginal discharge prevention compared to their counterpart in control group who do not receive any module. Conclusion: The present study implied that vaginal hygiene module can be provided widely for female adolescents at their early puberty. District health officers may work closely with schools' health promoter to reach the students and create a supportive environment for reproductive health discussion and forum in order to achieve better adolescents' reproductive health status.

  19. Vaginal Discharge: What's Normal, What's Not

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Vaginal Discharge: What's Normal, What's Not KidsHealth / For Teens / Vaginal Discharge: What's Normal, What's Not Print Normal vaginal discharge ...

  20. 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 < 0.0001) (43% improvement). In 10 women, there was a trend of improving of vaginal 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.

  1. [Vaginal fibromas (author's transl)].

    Science.gov (United States)

    Marinetti, C; Comiti, J

    1980-05-01

    The author describes the characteristics of vaginal fibromas, as observed in one personal case and after a rview of the published literature. These tumors, which affect women during the period of genital activity, are not of frequent occurrence, and the principal signs are dyspareunia and metrorrhagia. The histological appearance of the tumours is very similar to that of uterine fibromas, but their pathogenicity appears to be different, and they progress in a similar manner to that of benign tumors. Because of the existence of a cleavage line they can be easily enucleated, the main therapeutic problem being the choice of the surgical approach to be employed.

  2. Red herring vaginal discharge.

    Science.gov (United States)

    Lee, Jun Hee; Pringle, Kirsty; Rajimwale, Ashok

    2013-09-18

    Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics.

  3. Weight gain, body image and sexual function in young patients treated with contraceptive vaginal ring. A prospective pilot study.

    Science.gov (United States)

    Morotti, Elena; Casadio, Paolo; Guasina, Francesca; Battaglia, Bruno; Mattioli, Mara; Battaglia, Cesare

    2017-08-01

    Oral contraceptives could induce mood changes. As far as our knowledge, there are no studies in literature that have examined the role of vaginal contraception in self-perceived body image. To evaluate the effects of intravaginal contraception on weight gain and perceived body image in relation with the Beck's Depression Inventory questionnaire (BDI) and the McCoy Female Sexuality Questionnaire (MFSQ). Twenty-one adult (18-35 years old) eumenorrheic (menstrual cycle of 25-35 days), lean (body mass index - BMI - of 19-25 kg/m 2 ) women who were referred for hormonal contraception were administered the Stunkard Figure Rating Scale (FRS), BDI and MFSQ. Subjects were studied in basal condition and after 6 months of therapy with vaginal contraception (NuvaRing®; Organon-Schering-Plough Italia, Milan, Italy). BMI, FRS, MFSQ and BDI. After 6 months of therapy with NuvaRing®, both body weight (60.0 ± 8.3; p = 0.050) and BMI (22.1 ± 3.1; p = 0.028) slightly, but statistically, increased. FRS and BDI showed no differences after the vaginal contraception. Hormonal contraception was associated with a significant decrease in the two-factor Italian MFSQ score. Vaginal ring seems a good alternative to other hormonal contraceptive not significantly altering the female sexuality and not influencing the FRS and BDI.

  4. A PROSPECTIVE RANDOMEZED CONTROLLED TRIAL OF TWO REGIMENS OF VAGINAL MISOPROSTOL IN SECOND TRIMESTER TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    L. Eslamian

    2007-09-01

    Full Text Available The search continues for a safe effective and cheap method for mid-trimester termination of pregnancy. Misoprostol is a strong contender in this respect. The dose schedule is still not fixed. The objective of this study was to compare the efficacy and adverse effects of two dose regimens of vaginal misoprostol for second trimester termination. Prospective randomized double blind controlled trial was undertaken in 162 women at 14-24 weeks gestation in a teaching hospital. Subjects were randomized to receive either regime A: 400 µg of intra vaginal misoprostol every 6h, or regime B: 200 µg of intravaginal misoprostol every 6h. The main outcome measure was the success rate at 24h, total dose required, induction-abortion interval and adverse effects. Data was analyzed by student's t-test, Mann-whitney U-test, the chi-squared test or Fisher's exact test. There was a significant difference in the success rate at 24 and 48hr (regime A: 74% and 97.5%; regime B: 61.7% and 88.9% P=0.016 & 0.029 respectively and in the mean induction abortion interval (14 Vs 20h, P=0.01 Mean Misoprostol requirement was significantly higher for regime A (731 µg ± 362 µg vs. 531µg ± 357µgm, P=0.001. Use of 400 µg vaginal misoprostol is superior to 200 µg vaginal misoprostol for second trimester abortion.

  5. No. 148-Guidelines for Operative Vaginal Birth.

    Science.gov (United States)

    Cargill, Yvonne M; MacKinnon, Catherine Jane

    2018-02-01

    To provide guidelines for operative vaginal birth in the management of the second stage of labour. Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth. Reduced fetal and maternal morbidity and mortality. MEDLINE and Cochrane databases were searched using the key words ''vacuum" and "birth" as well as "forceps" and "birth" for literature published in English from january 1970 to June 2004. The level of evidence and quality of rec-ommendations made are described using the Evaluation of Evidence from the Canadian Task Force on the Periodic Health Examination. VALIDATION: The Clinical Practice Obstetrics Committee and Executive and Council of the Society of Obstetricians and Gynaecologists of Canada approved these guidelines. Copyright © 2018. Published by Elsevier Inc.

  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. Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women.

    Science.gov (United States)

    Capobianco, Giampiero; Donolo, Ermes; Borghero, Gianna; Dessole, Francesco; Cherchi, Pier Luigi; Dessole, Salvatore

    2012-02-01

    To assess the effects of the combination of pelvic floor rehabilitation and intravaginal estriol administration on stress urinary incontinence (SUI), urogenital atrophy and recurrent urinary tract infections in postmenopausal women. Two-hundred-six postmenopausal women with urogenital aging symptoms were enrolled in this prospective randomized controlled study. Patients were randomly divided into two groups and each group consisted of 103 women. Subjects in the treatment group received intravaginal estriol ovules, such as 1 ovule (1 mg) once daily for 2 weeks and then 2 ovules once weekly for a total of 6 months as maintenance therapy plus pelvic floor rehabilitation. Subjects in the control group received only intravaginal estriol in a similar regimen. We evaluated urogenital symptomatology, urine cultures, colposcopic findings, urethral cytologic findings, urethral pressure profiles and urethrocystometry before, as well as after 6 months of treatment. After therapy, the symptoms and signs of urogenital atrophy significantly improved in both groups. 61/83 (73.49%) of the treated patients, and only 10/103 (9.71%) of the control patients referred a subjective improvement of their incontinence. In the patients treated by combination therapy with estriol plus pelvic floor rehabilitation, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure (MUP), in mean urethral closure pressure (MUCP), as well as in the abdominal pressure transmission ratio to the proximal urethra (PTR). Our results showed that combination therapy with estriol plus pelvic floor rehabilitation was effective and should be considered as a first-line treatment for symptoms of urogenital aging in postmenopausal women.

  8. [Preparation and release mechanism of gestodene reservoir-type intravaginal rings].

    Science.gov (United States)

    Li, Chun-Xiao; Wang, Yan-Kun; Ning, Mei-Ying

    2014-03-01

    This study taking gestodene (GEST) as a model, investigated the factors affecting reservoir-type intravaginal ring (IVR)'s drug release. This paper reported a gestodene intravaginal ring of reservoir design, comprising a gestodene silicone elastomer core encased in a non-medicated silicone sheath, separately manufactured by reaction injection moulding at 80 degrees C and heating vulcanization at 130 degrees C is reported. The test investigated the factors affecting drug release through a single variable method, taking the drug release rates of 21 days as standards. When changing the thickness of the controlling sheath outside, the ratio of the first day of drug release and mean daily release (MDR), named the relatively burst effect, is closing to 1 with the thickness of controlling sheath increasing, while the 1.25 mm sheath corresponding to 1.04 controlled the burst release effectively; a positive correlation (r = 0.992 2) existed between the average drug release (Q/t) and drug loading (A) within a certain range. The C6-165 controlling sheath with high solubility of GEST is easier to achieve controlled release of the drug; GEST crystalline power is more effective to implement controlled release of drugs among difficent states of the drug. A 1/4 fractional segment core gives a relatively burst effect of 1.76, while the 1/1 and 1/2 are 1.93 and 1.87 separately, at the same drug loading, concluding that use of a fractional segment core would allow development of a suitable GEST reservoir IVR. In summary, GEST reservoir-type IVR could be adjusted by the thickness of controlling sheath, the loading of drug, the material properties of controlling sheath, the dispersion state of drug, the additive composition and structure of intravaginal ring, to control the drug release behavior and achieve the desired drug release rate.

  9. Multiparous Ewe as a Model for Teaching Vaginal Hysterectomy Techniques.

    Science.gov (United States)

    Kerbage, Yohan; Cosson, Michel; Hubert, Thomas; Giraudet, Géraldine

    2017-12-01

    Despite being linked to improving patient outcomes and limiting costs, the use of vaginal hysterectomy is on the wane. Although a combination of reasons might explain this trend, one cause is a lack of practical training. An appropriate teaching model must therefore be devised. Currently, only low-fidelity simulators exist. Ewes provide an appropriate model for pelvic anatomy and are well-suited for testing vaginal mesh properties. This article sets out a vaginal hysterectomy procedure for use as an education and training model. A multiparous ewe was the model. Surgery was performed under general anesthesia. The ewe was in a lithotomy position resembling that assumed by women on the operating table. Two vaginal hysterectomies were performed on two ewes, following every step precisely as if the model were human. Each surgical step of vaginal hysterectomy performed on the ewe and on a woman were compared side by side. We identified that all surgical steps were particularly similar. The main limitations of this model are costs ($500/procedure), logistic problems (housing large animals), and public opposition to animal training models. The ewe appears to be an appropriate model for teaching and training of vaginal hysterectomy.

  10. 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.

  11. Female urinary incontinence and intravaginal electrical stimulation: an observational prospective study.

    Science.gov (United States)

    Chêne, Gautier; Mansoor, Aslam; Jacquetin, Bernard; Mellier, Georges; Douvier, Serge; Sergent, Fabrice; Aubard, Yves; Seffert, Pierre

    2013-09-01

    To assess the efficacy of intravaginal electrical stimulation in the management of female urinary incontinence. 359 Women with urinary incontinence (207 with stress incontinence [group A], 33 with urge incontinence [group B] and 119 with mixed urinary incontinence [group C]) were included in this multicenter prospective observational study. Patients were managed by home intravaginal electrical stimulation of the pelvic floor for 20-30 min per day, 5 days a week, for a period of 10 weeks. Identical clinical assessments were performed before and after pelvic floor rehabilitation, comprising a voiding diary and validated symptom and quality of life scores. Objective assessment demonstrated an overall cure rate of 63.5% (228/359): 65.7% (136/207) for group A, 57.6% (19/33) for group B, and 61.3% (73/119) for group C. The overall significant improvement rate was 15.6% (56/359): 14.6% (30/207) for group A, 24.2% (8/33) for group B and 15.1% (18/119) for group C. All domains of quality of life were significantly improved after pelvic floor muscle training (pstimulation intensities. No significant difference was observed between the various types of electrodes used (pstimulators probably make this treatment modality one of the first-line treatments for female stress urinary incontinence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Intravaginal testicular torsion in newborns. To fix or not to fix the contralateral testis?

    Directory of Open Access Journals (Sweden)

    G. Bordin

    2013-10-01

    Full Text Available Scrotal swelling suggesting testicular torsion is a rare urological emergency which requires a clinical urgent evaluation and most of the times must be managed surgically. In newborns it can occur in the postnatal period, usually within the twenty-eighth day of life, or more frequently in utero, during the descent of the testis into the scrotum. Usually its poor fixedness allows the testis an abnormal mobility inside the scrotum, configuring the framework of extravaginal torsion. On the contrary during the perinatal period a twist that takes place inside the tunica vaginalis, known as intravaginal torsion, is extremely uncommon and only few cases are well documented in the literature. Authors present a rare case of intravaginal testicular torsion occurred in perinatal period. In this situation only the early surgical exploration of the scrotum may allow the rescue of the gonad, although in rare cases. Timing of surgical treatment and need for contralateral testicular fixation remain controversial. However since the anatomical defect of the tunica vaginalis can be bilateral the surgical fixation even of the contralateral testis is important, now or later, in order to prevent any future torsion of this gonad. The authors also present a brief review of recent literature on the subject.

  13. Intravaginal immunization of mice with recombinant Salmonella enterica serovar Typhimurium expressing human papillomavirus type 16 antigens as a potential route of vaccination against cervical cancer.

    Science.gov (United States)

    Echchannaoui, Hakim; Bianchi, Matteo; Baud, David; Bobst, Martine; Stehle, Jean-Christophe; Nardelli-Haefliger, Denise

    2008-05-01

    Cervical cancer, the second leading cause of cancer deaths in women, is the consequence of high-risk human papillomavirus (HPV) infections. Toward the development of therapeutic vaccines that can induce both innate and adaptive mucosal immune responses, we analyzed intravaginal (ivag) vaccine delivery of live attenuated Salmonella enterica serovar Typhimurium expressing HPV16L1 as a model antigen. Innate immune responses were examined in cervicovaginal tissues by determining gene expression patterns by microarray analysis using nylon membranes imprinted with cDNA fragments coding for inflammation-associated genes. At 24 h, a wide range of genes, including those for chemokines and Th1- and Th2-type cytokine and chemokine receptors were up-regulated in mice ivag immunized with Salmonella compared to control mice. However, the majority of transcripts returned to their steady-state levels 1 week after immunization, suggesting a transient inflammatory response. Indeed, cervicovaginal histology of immunized mice showed a massive, but transient, infiltration of macrophages and neutrophils, while T cells were still increased after 7 days. Ivag immunization also induced humoral and antitumor immune responses, i.e., serum and vaginal anti-HPV16VLP antibody titers similar to those induced by oral immunization, and significant protection in tumor protection experiments using HPV16-expressing C3 tumor cells. These results show that ivag immunization with live attenuated Salmonella expressing HPV16 antigens modulates the local mucosal gene expression pattern into a transient proinflammatory profile, elicits strong systemic and mucosal immunity against HPV16, and confers protection against HPV16 tumor cells subcutaneously implanted in mice. Examination of the efficacy with which ivag HPV16E7E6 Salmonella induces regression of tumors located in cervicovaginal tissue is warranted.

  14. Influence of intracervical and intravaginal seminal plasma on the endometrium in assisted reproduction: a double-blind, placebo-controlled, randomized study.

    Science.gov (United States)

    Mayer, R B; Ebner, T; Yaman, C; Hartl, J; Sir, A; Krain, V; Oppelt, P; Shebl, O

    2015-02-01

    To investigate the effect of intracervical and intravaginal application of seminal plasma on the endometrium, as assessed by endometrial/subendometrial vascularization and endometrial volume between the day of oocyte retrieval and the day of embryo transfer in an in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle. This was a double-blind, placebo-controlled, randomized study including patients undergoing a first or second IVF/ICSI cycle. Homologous seminal plasma or placebo (sodium chloride) was injected into the cervix and posterior vaginal fornix just after follicle aspiration. Three-dimensional power Doppler examination was performed 30 min before oocyte retrieval and 30 min before embryo transfer. Main outcome measures were changes in vascularization flow index (VFI), flow index (FI) and vascularization index (VI) of the endometrium/subendometrium using VOCAL™ (Virtual Organ Computer-aided AnaLysis) and endometrial volume. One hundred patients agreed to participate in the study. Twenty-three patients were excluded, mainly as a result of canceled embryo transfer. Data were analyzed from 40 patients receiving seminal plasma and 37 receiving placebo. No significant differences between the two groups were seen in VFI, FI or VI of the endometrium or subendometrium or in endometrial volume on the day of oocyte pick-up and on the day of embryo transfer. Neither endometrial/subendometrial vascularization parameters nor endometrial volume seem to be affected by the application of seminal plasma in patients undergoing their first or second IVF/ICSI cycle. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  15. Urinary incontinence - vaginal sling procedures

    Science.gov (United States)

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... vaginal sling; Transobturator sling; Midurethral sling Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  16. 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.

  17. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    ... Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding ... of regular ovulation (anovulation). Doctors call the problem abnormal uterine bleeding (AUB) . AUB is more common in teenagers and ...

  18. Desquamative Inflammatory Vaginitis: The Unknown

    OpenAIRE

    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. It is an entity little known by clinicians, leading to a delay in diagnosis and the consequent alteration of the patients’ quality of life. The aim in this manuscript is to analyze DIV through the review of a case and the scientific literature. Case presentation: We report the case ...

  19. Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

    Science.gov (United States)

    Smith, James M; Moss, John A; Srinivasan, Priya; Butkyavichene, Irina; Gunawardana, Manjula; Fanter, Rob; Miller, Christine S; Sanchez, Debbie; Yang, Flora; Ellis, Shanon; Zhang, Jining; Marzinke, Mark A; Hendrix, Craig W; Kapoor, Amita; Baum, Marc M

    2017-01-01

    Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs) delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs) can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2) to prevent HIV, acyclovir (ACV) to prevent HSV, and etonogestrel (ENG) in combination with ethinyl estradiol (EE), FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6) over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1) for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing) 0.63; and ENG (low releasing) 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1) may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high-risk populations.

  20. Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

    Directory of Open Access Journals (Sweden)

    James M Smith

    Full Text Available Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2 to prevent HIV, acyclovir (ACV to prevent HSV, and etonogestrel (ENG in combination with ethinyl estradiol (EE, FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6 over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1 for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing 0.63; and ENG (low releasing 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1 may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high

  1. Innovative Approach for Interstitial Cystitis: Vaginal Pessaries Loaded Diazepam—A Preliminary Study

    Directory of Open Access Journals (Sweden)

    P. Capra

    2013-01-01

    Full Text Available Bladder pain is a characteristic disorder of interstitial cystitis. Diazepam is well known for its antispasmodic activity in the treatment of muscular hypertonus. The aim of this work was to develop and characterize vaginal pessaries as an intravaginal delivery system of diazepam for the treatment of interstitial cystitis. In particular, the performance of two types of formulations, with and without beta-glucan, was compared. In particular, the preparation of pessaries, according to the modified Pharmacopeia protocol, the setup of the analytical method to determine diazepam, pH evaluation, dissolution profile, and photostability assay were reported. Results showed that the modified protocol permitted obtaining optimal vaginal pessaries, without air bubbles, with good consistency and handling and with good pH profiles. In order to determine the diazepam amount, calibration curves with good correlation coefficients were obtained, by the spectrophotometric method, using placebo pessaries as matrix with the addition of diazepam standard solution. This method was demonstrated sensible and accurate to determine the amount of drug in batches. Dissolution profiles showed a complete diazepam release just after 15 minutes, even if beta-glucan pessaries released drug more gradually. Finally, a possible drug photodegradation after exacerbated UV-visible exposition was evaluated.

  2. Efficacy and safety of six hourly vaginal misoprostol versus intracervical dinoprostone: a randomized controlled trial.

    Science.gov (United States)

    Denguezli, Walid; Trimech, Adnene; Haddad, Anis; Hajjaji, Awatef; Saidani, Zahra; Faleh, Raja; Sakouhi, Mohamed

    2007-08-01

    To compare the efficacy and safety of intravaginal misoprostol versus dinoprostone cervical gel for cervical ripening and labour induction. We carried out an experimental clinical trial in which we enrolled 130 cervical consecutive patients with cervical ripening, randomly assigned to one of the following two treatment groups: (1) intravaginal misoprostol and (2) intracervical dinoprostone gel. A total of 50 microm of misoprostol was placed in the posterior vaginal fornix every 6 h for a maximum period of 24 h and 0.5 mg of dinoprostone was administrated in the uterine cervix every 6 h, for a maximum period of 24 h. The primary outcome measure was the number (rate) of women who went to vaginally deliver within 24 h of the protocol initiation. Among 130 patients evaluated, 65 were allocated to the misoprostol group and 65 to the dinoprostone group. The proportion of vaginal delivery within 24 h was significantly higher in the misoprostol group (75%) than in the dinoprostone group (53.8%) (RR = 1.40, 95% CI [1.07-1.45], P = 0.02). There was no significant difference between the mean time interval of delivery in the misoprostol group and the dinoprostone group (14.9 vs.15.8 h) (P = 0.51). The Bishop score was significantly higher in the misoprostol group, 6 h after the onset of the study (1.38; relative risk, 95% CI [1.02-1.85], P = 0.03). The Caesarean delivery rate for fetal distress was higher in the dinoprostone group (21 vs. 10.8%, P = 0.15). The tachysystole (Misoprostol 6.1% vs. dinoprostone 4.6%, relative risk 1.15, 95% CI [0.6-2.24]) and hyperstimulation syndrome rates (Misoprostol 7.6% vs. dinoprostone 4.6%, relative risk 1.26, 95% CI [0.72-2.24]) were slightly increased in the misoprostol group than in the dinoprostone group without reaching the level of statistical signification. Misoprostol as used in this protocol is more effective than cervical dinoprostone gel application in the cervical ripening and labour induction. There is a tendency for an

  3. [Operative vaginal deliveries training].

    Science.gov (United States)

    Dupuis, O

    2008-12-01

    The appropriate use of forceps, vacuums or spatulas facilitates the rapid delivery of foetuses faced with life-threatening situations. It also makes possible the relief of certain cases of prolonged second-stage labor. In France, operative vaginal delivery (OVD) accounts for approximately 10% of all births. OVD training aims to optimize maternal, as well as neonatal safety. It should enable trainees to indicate or contraindicate an OVD safely, as well as to choose the appropriate instrument, use it correctly, and master quality control principles. Traditional OVD training is confronted with both spatial and time-related limitations. Spatial constraints involve both the teacher and trainee who only have limited visual access to the pelvic canal, and the head of the foetus; the time constraint occurs whenever the OVD occurs in an emergency setting. These limitations have been further aggravated by new constraints: decreasing time dedicated to training (European safety rules prohibit work the day after night duty), increasing litigation, and constraints imposed by society. Training by means of simulation removes such limitations making it possible to both avoid exposing pregnant women to the hazards of traditional training, and adapt the training to the skills of each trainee. OVD training should include forceps, vacuums and the use of spatulas. The OVD skills of obstetricians should be audited regularly on both a personal and a confidential level. Such audits could be based on a method using a simulator. Prospective studies comparing traditional and simulation-based training should be encouraged.

  4. Diagnosis of vaginal discharge by wet mount microscopy: a simple and underrated method.

    Science.gov (United States)

    Mylonas, Ioannis; Bergauer, Florian

    2011-06-01

    Vaginal discharge is highly variable in quality and quantity among different individuals, and even in the same individual during different periods of life. Vaginal discharge is most commonly caused by infection with sexually transmitted organisms or increased colonization by different facultative pathogenic microorganisms (i.e., Gardnerella vaginalis). Noninfectious causes of vaginal discharge are quite rare (10% noninfectious as compared to 90% infectious causes). Most common in women with a vaginal infection is bacterial vaginosis (40%-50% of cases), followed by vulvovaginal candidosis (20%-25%), and then trichomoniasis (15%-20%). If infection is suspected as the primary cause, a sample of the vaginal discharge should be taken and examined microscopically. When evaluating vaginal secretions by phase-contrast wet mount microscopy, knowledge of what is normal versus abnormal is very important. Knowledge of the sensitivity and specificity of wet mount microscopy in different clinical settings is also important. Obstetricians & Gynecologists, Family Physicians After completing this CME activity, physicians should be better able to evaluate lifetime changes in vaginal secretions, characterize the physiological and pathological appearance of vaginal discharge, assess the clinical practicality and usefulness of wet mount microscopy and use wet mount microscopy to diagnose bacterial vaginosis and other common vaginal infections.

  5. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis.

    Science.gov (United States)

    Donders, Gilbert G G; Vereecken, Annie; Bosmans, Eugene; Dekeersmaecker, Alfons; Salembier, Geert; Spitz, Bernard

    2002-01-01

    To define an entity of abnormal vaginal flora: aerobic vaginitis. Observational study. University Hospital Gasthuisberg, Leuven, Belgium. 631 women attending for routine prenatal care or attending vaginitis clinic. Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured. Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-beta and leukaemia inhibitory factor in the vaginal fluid. Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

  6. Cervical ripening and induction of labor by prostaglandin E2: a comparison between intracervical gel and vaginal pessary.

    Science.gov (United States)

    D'Aniello, G; Bocchi, C; Florio, P; Ignacchiti, E; Guidoni, C G; Centini, G; Cito, G; Picciolini, E; Severi, F M; Petraglia, F

    2003-09-01

    To compare the effectiveness and safety of two formulations of prostaglandin (PG) E2 (gel and pessary) for induction of labor. Primary outcomes were cervical ripening, initiation/duration of labor, and type of delivery. A total of 115 women with singleton gestations were consecutively enrolled and assigned to receive intracervical PGE2 (dinoprostone 0.5 mg) by gel (n = 66) or PGE2 (dinoprostone 10 mg) by intravaginal pessary (n = 49). Independently from parity, the vaginal pessary induced successful cervical ripening with a slightly higher but not statistically significant occurrence of vaginal delivery with respect to gel induction. The mean time interval from induction to vaginal delivery did not differ between groups, despite being shorter for the pessary group in inducation-delivery intervals > 12 h. No significant differences were found between the groups with respect to patients who required a second course of PGE2 (9% vs. 2%), as well as oxytocin (11% vs. 13%) induction. No significant difference was found in the incidence of uterine hyperstimulation and other adverse reactions in nulliparas, or in fetal and neonatal outcome. Independently from parity, both PGE2 administration routes appeared to be effective in achieving cervical ripening, initiation of labor and optimal type of delivery, and showed the same incidence of side-effects.

  7. Effects of Processing and Storage on Pediococcus pentosaceus SB83 in Vaginal Formulations: Lyophilized Powder and Tablets

    Science.gov (United States)

    Borges, Sandra; Costa, Paulo; Silva, Joana; Teixeira, Paula

    2013-01-01

    Vaginal probiotics have an important role in preventing the colonization of the vagina by pathogens. This study aimed to investigate different formulations with Pediococcus pentosaceus SB83 (lyophilized powder and tablets with and without retarding polymer) in order to verify its stability and antilisterial activity after manufacture and during storage. The bacteriocinogenic activity of P. pentosaceus SB83 against Listeria monocytogenes was evaluated in simulated vaginal fluid. Suspension of Pediococcus pentosaceus SB83 reduced the pathogen only after 2 h and the lyophilized bacteria after 24 h of contact, and, in the tablets, P. pentosaceus SB83 lost the antimicrobial activity. The pH of simulated vaginal fluid decreased for all the tested conditions. As lyophilized powder demonstrated better results concerning antimicrobial activity, this formulation was selected to evaluate the antilisterial activity during the 12 months of storage. During storage at room temperature, lyophilized bacteria totally inhibited the pathogen only until one month of storage. At 4°C, P. pentosaceus SB83 showed antimicrobial activity during all the time of storage investigated. Therefore, the better formulation of P. pentosaceus SB83 is the lyophilized powder stored at 4°C, which may be administered intravaginally as a washing solution. PMID:23844367

  8. Qualitative Analysis of Sexually Experienced Adolescent Females: Attitudes about Vaginal Health

    Science.gov (United States)

    Francis, Jenny K R; Fraiz, Lauren Dapena; Catallozzi, Marina; Rosenthal, Susan L

    2016-01-01

    Structured Abstract Study Objective To explore adolescent’s perceptions of vaginal health, practices, and vaginally-placed products. Design Semi-structured interviews were audio-recorded and transcribed until achieving theoretical saturation. Setting Adolescent medicine clinics in NYC. Participants Adolescent females (n = 22) who were sexually experienced, predominately Hispanic (73%) with a mean age of 17.7 years (range 15–20 years). Interventions None Main Outcome Measures Interviews assessed perspectives on vaginal health, specific vaginal hygiene practices and attitudes about vaginally-placed products (contraceptive rings, intrauterine devices (IUDs), and proposed multi-purpose technologies (MPTs) administered as ring or gel). The interviews were transcribed and coded for relevant themes. Results Overlapping themes included young women’s view of their vagina as a space that needed to be healthy for sexual partners and future fertility. The vagina could not be presumed to be healthy and conversations about vaginal health were limited to only include specific individuals. All reported a variety of practices to maintain their vaginal health, including showering 1 to 5 times a day and using soaps specifically for the vagina. Attitudes about vaginally-placed products revealed concerns about the sensory experience of having a product in the vagina, safety concerns and interest in the product’s objective (prevention of pregnancy or infection). Conclusions Adolescents have very specific views and practices about their vaginas. Clinicians should initiate conversations about vaginal health and hygiene with adolescents and focus on the normalcy of the vagina. Development of vaginally-placed products should focus on the sensory experience, safety and purpose of the product. PMID:27133374

  9. Vaginal hysterectomy in a Nigerian tertiary health facility.

    Science.gov (United States)

    Obiechina, N J A; Ugboaja, J O; Onyegbule, O A; Eleje, G U

    2010-01-01

    Despite evidence that vaginal hysterectomy offers advantages in regard to operative time, complication rates and return to normal activities, gynaecologists remain reluctant to change their practice patterns because of concerns about safety and feasibility of the vaginal approach. We reviewed cases of vaginal hysterectomies done in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria over a ten year period. This is a retrospective analysis of cases of vaginal hysterectomy that were done in the hospital between 1st January 1998 and 31st December 2007. Data was analyzed with Epi info version 3.3.2. Outcome measures include duration of hospital stay, indication for the surgery, postoperative morbidity and mortality and the need for blood transfusion. Hysterectomy accounted for 224 of 1,370 gynaecological surgeries (16.4%). Vaginal hysterectomy was responsible for 47 (21.0%) of these 224 cases and accounted for 3.7% of all gynaecological surgeries. Majority of the patients were in the 7th decade of life with a mean age of 65.2 +/- 6.8. Most (87.5%) patients were retired farmers and grandmultiparous with a mean parity 6.5 +/- 2.4). Utero-vaginal prolapse was the only indication for the surgery. The only postoperative complication accounted was febrile morbidity which was reported in 5 (10.6%) of the patients had febrile morbidity. There were no cases of conversion to abdominal procedure. All the surgeries were done by the consultants. Vaginal hysterectomy was safe and associated with minimal morbidity to the patient. The only indication was uterovaginal prolapse and all the procedures were done by the consultants. There is need to transfer the skill to the Residents.

  10. Evaluación de la toxicidad vaginal de Croton lechleri en conejas

    Directory of Open Access Journals (Sweden)

    Salomón Ayala

    2010-04-01

    Full Text Available Objetivo: Evaluar la toxicidad vaginal de una preparación en gel de Croton lechleri en conejas. Diseño: Estudio experimental. Institución: Centro de Investigación de Bioquímica y Nutrición Alberto Guzmán Barrón, Instituto de Investigaciones Clínicas, Instituto de Patología de la Facultad de Medicina, y Facultad de Farmacia, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Resina de Croton lechleri y conejos hembras, blancos, Nueva Zelanda. Métodos: Los animales fueron distribuidos en tres grupos (n=5: I. Control, vehículo; II, C. lechleri 1%; y III, C. lechleri 5%; los conejos recibieron estas muestras en un volumen de 1 mL por vía intravaginal, una vez/día, durante 10 días consecutivos. Se observó el estado clínico general, así como la apariencia física de la vagina y el perineo por signos de flujo, eritema y edema. Al final del experimento se realizó la exéresis quirúrgica de la vagina de cada coneja y se evaluó macroscópicamente, buscando signos de irritación, sangrado o daño de la mucosa. Luego, se fijó en formol tamponado al 10% y posteriormente se tomó tres muestras representativas de las regiones cérvico-vaginal, media-vaginal, y urovaginal, para el estudio histopatológico. Principales medidas de resultados: Irritación vaginal. Resultados: El examen macroscópico de la vagina en el grupo control mostró aspecto congestivo leve en forma difusa, en todos los casos, y de aspecto similar en las muestras del grupo Croton lechleri al 1%. En la formulación al 5%, en dos casos se observó congestión petequial parcial leve. El estudio histopatológico reveló un puntaje promedio de irritación vaginal de 3,4 a 6 y 3,6 a 8 para las preparaciones al 1% y 5%, respectivamente. Conclusión: En nuestras condiciones experimentales, las preparaciones de gel de C. lechleri evaluadas fueron no irritantes para la mucosa vaginal y resultaron aceptables.

  11. A study of the potential of the pig as a model for the vaginal irritancy of benzalkonium chloride in comparison to the nonirritant microbicide PHI-443 and the spermicide vanadocene dithiocarbamate.

    Science.gov (United States)

    D'Cruz, Osmond J; Erbeck, Douglas; Uckun, Fatih M

    2005-01-01

    A porcine model was established to test the mucosal toxicity potential of a thiophene thiourea (PHI-443)-based anti-HIV microbicide and a vanadocene-based spermicide, vanadocene dithiocarbamate (VDDTC) in comparison to benzalkonium chloride (BZK). Nine domestic pigs (Duroc) in nonestrus stage received a single intravaginal application of 2% BZK, 2% PHI-443, or 0.1% VDDTC-containing gel. At various times after gel application, cell differentials and levels of inflammatory cytokines (IL-1beta, IL-4, IL-6, IL-8, IL-10, IL-18, IFN-gamma, and TNF-alpha) in cervicovaginal lavage (CVL) fluid were monitored by flow cytometry and ELISA, respectively. Eight pigs were exposed intravaginally to a gel with and without BZK or VDDTC for 4 consecutive days and vaginal tissues were scored histologically for inflammation using a new scoring system. Only CVL fluid from pigs exposed to BZK showed a significant increase of IL-1beta, IL-8, and also IL-18 production when compared to the controls, PHI-443 or VDDTC-treated groups. Maximum levels of BZK-induced IL-1beta (100-fold), IL-8 (2,500-fold), IL-18 (80-fold), and IFN-gamma (10-fold) were found at 24 hours. In the in vivo porcine vaginal irritation model, increased levels of vaginal IL-1beta, IL-8, and IL-18 were associated with histological changes consistent with vaginal inflammation. These results demonstrate that key cervicovaginal inflammatory cytokines are useful in vivo biomarkers for predicting the mucosal toxicity potential of vaginal products in the physiologically relevant and sensitive porcine model.

  12. Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual Participant Data Meta-analysis

    NARCIS (Netherlands)

    Low, N.; Chersich, M.F.; Schmidlin, K.; Egger, M.; Francis, S.C.; van de Wijgert, J.H.H.M.; Hayes, R.J.; Baeten, J.M.; Brown, J.; Delany-Moretlwe, S.; Kaul, R.; McGrath, N.; Morrison, C.; Myer, L.; Temmerman, M.; van Straten, A.; Watson-Jones, D.; Zwahlen, M.; Hilber, A.M.

    2011-01-01

    Background: Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate

  13. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis

    NARCIS (Netherlands)

    Low, Nicola; Chersich, Matthew F.; Schmidlin, Kurt; Egger, Matthias; Francis, Suzanna C.; van de Wijgert, Janneke H. H. M.; Hayes, Richard J.; Baeten, Jared M.; Brown, Joelle; Delany-Moretlwe, Sinead; Kaul, Rupert; McGrath, Nuala; Morrison, Charles; Myer, Landon; Temmerman, Marleen; van der Straten, Ariane; Watson-Jones, Deborah; Zwahlen, Marcel; Hilber, Adriane Martin

    2011-01-01

    Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the

  14. Changes in the prostacyctin sensitivity of thrombocytes after intravaginal radium irradiation of patients with corpus carcinoma

    International Nuclear Information System (INIS)

    Schneider, A.

    1987-01-01

    The goal of this work was to investigate, to what extent the platelet sensitivity in comparison to prostacyclin (PGI 2 ) should be seen as a responsible factor in the increase of the thrombosis rate. For this blood was examined from 22 patients with corpus carcinoma who had received an intravaginal Radium implant with a radiation dose of 960 mgeh to over 24 h. These patients were compared to a control group of 21 clinically healthy women. Even before the radiation therapy there was an increased aggregation rate of the thrombocytes in the carcinoma patients as well as a reduced sensitivity to PGI 2 . Under irradiation there was an even greater decrease in the sensitivity of the thrombocytes to PGI 2 . The aggregation speed increase statistically significantly and the number of thrombocytes decreased during the Radium irradiation. After the giving of heparin the sensitivity of the thrombocytes to PGI 2 sank strongly. (orig./MG) [de

  15. Intravaginal probiotics modulated metabolic status and improved milk production and composition of transition dairy cows.

    Science.gov (United States)

    Deng, Q; Odhiambo, J F; Farooq, U; Lam, T; Dunn, S M; Ametaj, B N

    2016-02-01

    The objective of this investigation was to evaluate whether intravaginal infusion of probiotics (a lactic acid bacteria cocktail) around parturition would influence metabolic status and increase milk production of transition dairy cows. One hundred pregnant Holstein dairy cows were assigned to 1 of the 3 experimental groups receiving intravaginal infusion of probiotics or carrier (i.e., sterile skim milk) once a week at wk -2, -1, and +1 relative to calving as follows: 2 consecutive probiotics before parturition and 1 carrier dose after parturition (TRT1), 3 consecutive probiotics doses around parturition (TRT2), and 3 consecutive carrier doses around parturition (CTR). The probiotics were a lyophilized culture mixture composed of FUA3089 and FUA3138 and FUA3140 with a cell count of 10 to 10 cfu/dose. Blood was sampled from wk -2 to +3 and milk was sampled on the third day in milk (DIM) and from wk +1 to +5 on a weekly basis. Feed intake and milk production was monitored until wk +8. Results showed that the TRT2 group (366.12 ± 49.77 μmol/L) had a lower ( = 0.01) concentration of NEFA in the serum than the CTR group (550.85 ± 47.16 μmol/L). The concentrations of IgG in the milk were 32.71 ± 3.00 mg/mL in the TRT1 group, 17.47 ± 4.54 mg/mL in the TRT2 group, and 6.73 ± 3.43 mg/mL in the CTR group at 3 DIM ( dairy cows.

  16. Formulation, stability study, and pre-clinical evaluation of a vaginal cream containing curcumin in a rat model of vulvovaginal candidiasis.

    Science.gov (United States)

    de Souza Fernandes, Lígia; Amorim, Yuri Martins; Silva, Elton Libério da; Silva, Samuel Calixto; Santos, Alécia Junia Aparecida; Peixoto, Franciele Natália; Pires, Luara Moniele Neves; Sakamoto, Raquel Yumi; Pinto, Flávia do Carmo Horta; Scarpa, Maria Virgínia Costa; Gonzaga de Freitas Araújo, Marcelo

    2018-03-08

    Owing to the growing resistance among isolates of Candida species to usual antifungal agents and the well-known therapeutic potential of curcumin, the purpose of this study was to develop and validate a vaginal formulation containing this substance and to evaluating its effectiveness in the treatment of experimental vulvovaginal candidiasis METHODS: Curcumin was incorporated in a vaginal cream in three concentrations (0.01, 0.1 and 1.0%). The different concentrations of the cream and its controls were intravaginally administered in an immunosuppressed rat model to evaluate the efficacy in the treatment of experimental vulvovaginal candidiasis. Samples of the cream were also subjected to centrifugation and physical stability tests and an analytical method for quantification of curcumin was validated based on HPLC RESULTS: The formulation was stable and the HPLC method could be considered suitable for the quantitative determination of curcumin in the cream. After six days of pre-clinical study, the number of infected animals was 1/6 in all groups treated with curcumin vaginal cream and the fungal burden showed a progressive reduction. Reduction of the inflammatory infiltrate was observed in the group treated with 1.0% cream CONCLUSION: Vaginal cream containing curcumin could be considered a promising effective antifungal medicine in the treatment of vulvovaginal candidiasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. 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...

  18. Temporal variability of human vaginal bacteria and relationship with bacterial vaginosis.

    Directory of Open Access Journals (Sweden)

    Sujatha Srinivasan

    Full Text Available Little is known about short-term bacterial fluctuations in the human vagina. This study used PCR to assess the variability in concentrations of key vaginal bacteria in healthy women and the immediate response to antibiotic treatment in women with bacterial vaginosis (BV.Twenty-two women assessed for BV using Amsel's criteria were evaluated daily for 7 or 14 days, then at 2, 3 and 4 weeks, using a panel of 11 bacterium-specific quantitative PCR assays. Participants with BV were treated with 5 days of intravaginal metronidazole. Participants without BV had vaginal biotas dominated by lactobacilli, whose levels fluctuated with menses. With onset of menstruation, quantities of Lactobacillus jensenii and Lactobacillus crispatus decreased and were found to be inversely related to Gardnerella vaginalis concentrations (p<0.001. Women with BV had a variety of fastidious bacteria whose concentrations dropped below detection thresholds 1-5 days after starting metronidazole. Recurrent BV was characterized by initial profound decreases of BV-associated bacteria after treatment followed by subsequent increases at relapse.The microbiota of the human vagina can be highly dynamic. Healthy women are colonized with Lactobacillus species, but levels can change dramatically over a month. Marked increases in G. vaginalis were observed during menses. Participants with BV have diverse communities of fastidious bacteria that are depleted by vaginal metronidazole therapy. Women with recurrent BV initially respond to antibiotic treatment with steep declines in bacterial concentrations, but these bacteria later reemerge, suggesting that antibiotic resistance in these bacteria is not an important factor mediating BV recurrence.

  19. What is normal vaginal flora?

    Science.gov (United States)

    Priestley, C J; Jones, B M; Dhar, J; Goodwin, L

    1997-02-01

    To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. A longitudinal surveillance of the vaginal flora over an eight week period. 26 female health care workers in local genitourinary medicine clinics. The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum. Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors. Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.

  20. Vaginitis: MedlinePlus Health Topic

    Science.gov (United States)

    ... of this page: https://medlineplus.gov/vaginitis.html Vaginitis On this page Basics Summary Start Here Symptoms Diagnosis and Tests Prevention and Risk Factors Treatments and Therapies Learn More Specifics See, Play and ...

  1. What is vaginal birth after cesarean (VBAC)?

    Science.gov (United States)

    ... Pinterest Email Print What is vaginal birth after cesarean (VBAC)? VBAC refers to vaginal delivery of a baby after a previous pregnancy was delivered by cesarean delivery. In the past, pregnant women who had ...

  2. Uterus Dysplasia Associated with Cervico-Vaginal Agenesis

    Directory of Open Access Journals (Sweden)

    Ali Mahdavi

    2017-10-01

    Full Text Available Müllerian ducts can form upper parts of normal female reproductive system and any failure in ductal fusion may result in to müllerian duct anomalies (MDA. We present a case of MDA and a uterus dysplasia with no evidence of cervical or upper vaginal tissue. This case showes the role of magnetic resonace imaging (MRI on MDA diagnosis and urges the need for a unified reliable and practical classification more compatible with clinical practice.

  3. Vaginal foreign body: Successful management with vaginoscopy

    OpenAIRE

    Yıldız, Şükrü; Ekin, Murat; Cengiz, Hüseyin; Dağdeviren, Hediye; Kaya, Cihan

    2013-01-01

    The etiology of chronic vaginal discharge in children varies and can be seen as infection, sexual abuse, congenital malformations, vulvar skin disease, vaginal neoplasms and a foreign body. A vaginal foreign body is not a common problem in childhood but it should always be considered when a little girl consults a physician with a chronic vaginal discharge problem. We present the diagnosis and treatment management via vaginoscopy applied to a 6 year old girl who complained of a foul smelling v...

  4. Efecto de un dispositivo intravaginal con progesterona sobre la actividad ovárica en yeguas cíclicas Effect of an intravaginal device containing progesterone on the ovarian activity in cyclic mares

    OpenAIRE

    C.P Bianchi; R Guerrero; I Videla Dorna; M.V Cavilla; M.A Aba

    2011-01-01

    Se evaluó el efecto de un dispositivo intravaginal conteniendo progesterona más una inyección de prostaglandina F2α (PGF2α) al retiro del dispositivo y la aplicación de Gonadotrofina Coriónica humana (hCG) al día 5 post retiro sobre la actividad ovárica en yeguas cíclicas. Adicionalmente, se evaluaron los porcentajes de preñez. Los animales se dividieron en: grupo T: animales tratados a partir del día 0 con dispositivo intravaginal conteniendo 1,38 g de progesterona durante 8 días m...

  5. 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

  6. A new method to measure vaginal sensibility

    NARCIS (Netherlands)

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

    2010-01-01

    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. To develop a new method to measure vaginal sensibility. We developed a technique to measure the

  7. Characterisation of the vaginal microflora of human ...

    African Journals Online (AJOL)

    Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. The current study set out to identify and compare culture isolates of vaginal microflora of human immunodeficiency virus (HIV) positive (HIV+) and HIV negative (HIV-) women at different phases during menstrual cycle ...

  8. Characterisation of the vaginal microflora of human ...

    African Journals Online (AJOL)

    Teresa kiama

    2014-02-26

    Feb 26, 2014 ... Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. The current study set out to identify and compare culture isolates of vaginal microflora of human immunodeficiency virus (HIV) positive (HIV+) and HIV negative (HIV-) women at different phases during.

  9. MRI in distal vaginal atresia

    International Nuclear Information System (INIS)

    Hugosson, C.; Jorulf, H.; Bakri, Y.

    1991-01-01

    Magnetric resonance imaging in two young females with abdominal pain revealed vaginal atresia with massive hematocolpos but a normal cervix and uterine body. Information obtained with MRI was superior to ultrasound and CT and is suggested as the examination of choice prior to surgical correction. (orig.)

  10. Asymptomatic Vaginal Disease In Pregnancy

    African Journals Online (AJOL)

    1974-04-17

    Apr 17, 1974 ... Clinical features, such as pruritus and the appearance of a discharge, were ... fashion. The clinical findings were not made known to the microbiologist or to the cytologist. The media used for culture were: blood agar (for identi- fication and isolation .... comparing the appearance of the vaginal secretion with.

  11. 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.

  12. Pregnancy and conception rate after two intravaginal inseminations with dog semen frozen either with 5% glycerol or 5% ethylene glycol.

    Science.gov (United States)

    Rota, Ada; Milani, C; Romagnoli, S; Zucchini, P; Mollo, A

    2010-03-01

    The primary goal of this study was to compare the effects of 5% ethylene glycol (EG) and 5% glycerol (G) on fertility of frozen-thawed dog semen following intravaginal insemination. The sperm-rich fraction of the ejaculate of three male dogs was collected, pooled and divided into two aliquots, and then frozen with a Tris-glucose-egg yolk-citric acid extender containing either 5% G or 5% EG. A total of 10 bitches were inseminated twice, five with G-frozen-thawed semen and five with EG-frozen-thawed semen; intravaginal inseminations were performed the 4th and the 5th day after the estimated LH peak; four straws, thawed in a 37 degrees C water bath for 1 min and diluted in a Tris buffer, were used for insemination (200 x 10(6) spermatozoa); the insemination dose was introduced in the cranial vagina of the bitch using a sterile plastic catheter. Ovariohysterectomy was performed in all bitches between days 29 and 31 after the calculated LH surge, and pregnancy status, and the number of conceptuses and corpora lutea were recorded. All bitches were pregnant. Neither the number of conceptuses, nor the ratio of conceptuses to corpora lutea (conception rate) was significantly different between groups. In this first screening, with a limited number of bitches, EG-frozen semen did not show a higher fertility than G-frozen semen when used for two intravaginal inseminations. Irrespective of the semen used, conception rate was 0.50.

  13. Effect of intravaginal dehydroepiandrosterone (DHEA) on the female sexual function in postmenopausal women: ERC-230 open-label study.

    Science.gov (United States)

    Bouchard, Céline; Labrie, Fernand; Derogatis, Leonard; Girard, Ginette; Ayotte, Normand; Gallagher, John; Cusan, Leonello; Archer, David F; Portman, David; Lavoie, Lyne; Beauregard, Adam; Côté, Isabelle; Martel, Céline; Vaillancourt, Mario; Balser, John; Moyneur, Erick

    2016-03-01

    Intravaginal DHEA (dehydroepiandrosterone, prasterone), the exclusive precursor of androgens and estrogens in postmenopausal women, has previously been shown to improve all the domains of sexual function by a strictly local action in the vagina. The well recognized female sexual function index (FSFI) questionnaire was used in the present study. The long-term effect of 52-week treatment with daily intravaginal 0.50% (6.5 mg) DHEA was evaluated on the various domains of female sexual function using the FSFI questionnaire at baseline, Week 26 and Week 52. One hundred and fifty-four postmenopausal women with at least one mild to severe symptom of vulvovaginal atrophy (VVA) and who have completed the FSFI questionnaire at baseline and at least one post-baseline timepoint were included in the analysis. The FSFI domains desire, arousal, lubrication, orgasm, satisfaction and pain were increased by 28%, 49%, 115%, 51%, 41% and 108%, respectively (p<0.0001 for all parameters) at 52 weeks vs. baseline, while the total score was increased from 13.4±0.62 at baseline to 21.5±0.82 (+60%, p<0.0001) at 52 weeks. As the serum levels of DHEA and all its metabolites, including estradiol and testosterone, show no meaningful change, the present clinical data indicate a stimulatory effect of intravaginal DHEA through a strictly local action in agreement with the preclinical data showing that the androgens made locally from DHEA in the vagina induce an increase in local nerve density.

  14. Vaginal dilator therapy for women receiving pelvic radiotherapy.

    Science.gov (United States)

    Miles, Tracie; Johnson, Nick

    2010-09-08

    Many vaginal dilator therapy guidelines advocate routine vaginal dilation during and after pelvic radiotherapy to prevent stenosis (abnormal narrowing of the vagina). The UK Gynaecological Oncology Nurse Forum recommend dilation "three times weekly for an indefinite time period". The UK patient charity Cancer Backup advises using vaginal dilators from two to eight weeks after the end of radiotherapy treatment. Australian guidelines recommend dilation after brachytherapy "as soon as is comfortably possible" and "certainly within four weeks and to continue for three years or indefinitely if possible". However, dilation is intrusive, uses health resources and can be psychologically distressing. It has also caused rare but very serious damage to the rectum. To review the benefits and harms of vaginal dilation therapy associated with pelvic radiotherapy for cancer. Searches included the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 4), MEDLINE (1950 to 2008), EMBASE (1980 to 2008) and CINAHL (1982 to 2008). Any comparative randomised controlled trials (RCT) or data of any type which compared dilation or penetration of the vagina after pelvic radiotherapy treatment for cancer. The review authors independently abstracted data and assessed risk of bias. We analysed the mean difference in sexual function scores and the risk ratio for non-compliance at six weeks and three months in single trial analyses. No trials met the inclusion criteria. Dilation during or immediately after radiotherapy can, in rare cases, cause damage and there is no persuasive evidence from any study to demonstrate that it prevents stenosis. Data from one RCT showed no improvement in sexual scores in women who were encouraged to practice dilation. Two case series and one comparative study using historical controls suggest that dilation might be associated with a longer vaginal length but these data cannot reasonably be interpreted to show that dilation

  15. 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...... and lifting 2 and 5 kg. Lifting in the walking position created a slightly higher VP compared to other lifting techniques, which did not differ. The VP did not increase when lifting 5 kg compared to 2 kg. Mean VP during coughing and Valsalva were significantly lower 1-5 days after the operation. VP...... 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....

  16. The effects of hyaluronic acid vaginal gel on the vaginal epithelium of ovariectomized rats.

    Science.gov (United States)

    Liu, Shuai-Bin; Liu, Shao-Li; Gan, Xiao-Ling; Zhou, Qin; Hu, Li-Na

    2015-03-01

    Hyaluronic acid is one of the best materials of water retention which can be used in vaginal atrophy. This study is to evaluate the role and mechanism of the hyaluronic acid vaginal gel (Hyalofemme) in the vaginal epithelium of ovariectomized rats. Sixty SD rats were randomly divided into control group (Sham ovariectomy, Sham-OVX), tendency group (ovariectomy, OVX), and experiment group (ovariectomy+Hyalofemme, OVX+Hyalofemme). The hyaluronic acid vaginal gel was administered local vaginal therapy to the experiment group with cytologicaly confirmed vaginal atrophy. The doses were adjusted by animal weight according to human dosage. After daily treatment for 14 days, VEGF and P-AKT activations were detected by Western blot in the experiment group. The hyaluronic acid vaginal gel proved to be very effective in the cytological reversal of vaginal atrophy but did not increase uterine weight. Vaginal microecosystem indicators were negative in the control group and the experiment group. By contrast, the indicators were positive in the tendency group. Hyaluronic acid vaginal gel is effective in the reversal of vaginal atrophy and is beneficial for improving vaginal microecosystem in the postmenopausal rat model. The hyaluronic acid vaginal gel can also improve the repair capacity of the vaginal epithelium.

  17. Women's experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study.

    Science.gov (United States)

    Macey, Kat; Gregory, Angela; Nunns, David; das Nair, Roshan

    2015-06-20

    Recent research has highlighted controversies in the conceptualisation, diagnosis and treatment of vaginismus. Vaginal trainers are currently the most widely used treatment. Critiques have highlighted concerns that the evidence-base of its effectiveness is limited, with controlled trials reporting disappointing results, and its prescription promotes 'performance-based' sexuality which may be detrimental. Despite this, little has been done to seek women's views about their treatment. This study set out to explore women's experiences of vaginismus treatment with vaginal trainers, and to use their voices to propose guidelines for improving treatment. 13 women who had used vaginal trainers for vaginal penetration difficulties diagnosed as vaginismus were recruited through a specialist clinic, university campuses, and online forums. The women took part in semi-structured individual interviews (face-to-face/telephone/Skype), which were audio-recorded, transcribed verbatim and analysed using Thematic Analysis. Four superordinate themes were elicited and used to draft 'better treatment' guidelines. Themes were: (1) Lack of knowledge, (2) Invalidation of suffering by professionals, (3) Difficult journey, and (4) Making the journey easier. This paper describes themes (3) and (4). Difficult Journey describes the long and arduous 'Journey into treatment', including difficulties asking for help, undergoing physical investigations and negotiating 'the system' of medical referrals. It also describes the sometimes demoralising process of 'being in treatment', which includes emotional and practical demands of treatment. Making the journey easier highlights the importance of and limits to 'partner support'. 'Professional support' comprises personal qualities of professionals/therapeutic relationship, the value of specialist skills and knowledge and the need for facilitating couple communication about vaginismus. 'Peer support/helping each other' describes the importance of

  18. Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence.

    Science.gov (United States)

    Castellani, Daniele; Saldutto, Pietro; Galica, Vikiela; Pace, Gianna; Biferi, Daniela; Paradiso Galatioto, Giuseppe; Vicentini, Carlo

    2015-01-01

    Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women. Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form. Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1. IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI. © 2015 S. Karger AG, Basel.

  19. Chlamydial Type III Secretion System Needle Protein Induces Protective Immunity against Chlamydia muridarum Intravaginal Infection

    Directory of Open Access Journals (Sweden)

    Ekaterina A. Koroleva

    2017-01-01

    Full Text Available Chlamydia trachomatis imposes serious health problems and causes infertility. Because of asymptomatic onset, it often escapes antibiotic treatment. Therefore, vaccines offer a better option for the prevention of unwanted inflammatory sequelae. The existence of serologically distinct serovars of C. trachomatis suggests that a vaccine will need to provide protection against multiple serovars. Chlamydia spp. use a highly conserved type III secretion system (T3SS composed of structural and effector proteins which is an essential virulence factor. In this study, we expressed the T3SS needle protein of Chlamydia muridarum, TC_0037, an ortholog of C. trachomatis CdsF, in a replication-defective adenoviral vector (AdTC_0037 and evaluated its protective efficacy in an intravaginal Chlamydia muridarum model. For better immune responses, we employed a heterologous prime-boost immunization protocol in which mice were intranasally primed with AdTC_0037 and subcutaneously boosted with recombinant TC_0037 and Toll-like receptor 4 agonist monophosphoryl lipid A mixed in a squalene nanoscale emulsion. We found that immunization with TC_0037 antigen induced specific humoral and T cell responses, decreased Chlamydia loads in the genital tract, and abrogated pathology of upper genital organs. Together, our results suggest that TC_0037, a highly conserved chlamydial T3SS protein, is a good candidate for inclusion in a Chlamydia vaccine.

  20. Regulatory T Cells Are Locally Induced during Intravaginal Infection of Mice with Neisseria gonorrhoeae▿

    Science.gov (United States)

    Imarai, Mónica; Candia, Enzo; Rodriguez-Tirado, Carolina; Tognarelli, Javier; Pardo, Mirka; Pérez, Tomas; Valdés, Daniel; Reyes-Cerpa, Sebastián; Nelson, Pablo; Acuna-Castillo, Claudio; Maisey, Kevin

    2008-01-01

    Neisseria gonorrhoeae is a gram-negative diplococcus that in human beings produces gonorrhea. Much clinical evidence has led to the conclusion that gonococcus has important mechanisms to evade host immune functions; however, these mechanisms are only now beginning to be elucidated. In this study, we determined that the BALB/c mouse is a good animal model to study gonococcus infection and examined the immune response against the bacteria. We determined that after intravaginal inoculation of mice with Neisseria gonorrhoeae, the bacteria reached and invaded the upper female reproductive tissues and elicited a T-cell-specific immune response associated with a very weak humoral response, altogether resembling gonococcus infection and disease in women. Remarkably, in the draining lymph nodes of the genital tracts of infected mice, we found an increase of regulatory T lymphocytes, namely, transforming growth factor β1-positive CD4+ T cells and CD4+ CD25+ Foxp3+ T cells. Altogether, results indicate that N. gonorrhoeae induces regulatory T cells, which might be related to the local survival of the pathogen and the establishment of a chronic asymptomatic infection. PMID:18824531

  1. A new method to measure vaginal sensibility.

    Science.gov (United States)

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

    2010-06-01

    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. To develop a new method to measure vaginal sensibility. We developed a technique to measure the sensibility of the vaginal wall consisting of a St Marks electrode on a gloved index finger, with a stimulating electrode mounted at the tip. Measurements were performed in four different target areas (caudal and cranial, posterior and anterior) by two independent female researchers in a random order. Subjects were 12 healthy women. The intra-observer reproducibility of both researchers was almost perfect (Pearsons-Rho correlation coefficient 0.77-0.96 sensibility in the cranial posterior vaginal wall relative to the cranial anterior vaginal wall, but for all measurements, researcher 2 obtained higher sensibility ratings than researcher 1. In addition, researcher 2 found a decreased sensibility in the cranial anterior vaginal wall for women not using oral contraceptives. Phase of the menstrual cycle did not influence vaginal sensibility. We developed a new instrument to measure vaginal sensibility. The instrument has excellent intra-observer reproducibility. This method is sufficiently sensitive so as to differentiate between anterior and posterior cranial vaginal wall sensibility, but outcome differs as a function of researcher. Further evaluation of the clinical use of this method is needed, provided that measurements are performed by the same researcher. (c) 2010 Wiley-Liss, Inc.

  2. 'Basically, it's sorcery for your vagina': unpacking Western representations of vaginal steaming.

    Science.gov (United States)

    Vandenburg, Tycho; Braun, Virginia

    2017-04-01

    Vaginal steaming made global headlines in 2015 after its promotion by celebrity Gwyneth Paltrow. One of many female genital modification practices currently on offer in Anglo-Western nations - practices both heavily promoted and critiqued - vaginal steaming is claimed to offer benefits for fertility and overall reproductive, sexual or even general health and wellbeing. We analysed a selection of online accounts of vaginal steaming to determine the sociocultural assumptions and logics within such discourse, including ideas about women, women's bodies and women's engagement with such 'modificatory' practices. Ninety items were carefully selected from the main types of website discussing vaginal steaming: news/magazines; health/lifestyle; spa/service providers; and personal blogs. Data were analysed using thematic analysis, within a constructionist framework that saw us focus on the constructions and rationalities that underpin the explicit content of the texts. Within an overarching theme of 'the self-improving woman' we identified four themes: (1) the naturally deteriorating, dirty female body; (2) contemporary life as harmful; (3) physical optimisation and the enhancement of health; and (4) vaginal steaming for life optimisation. Online accounts of vaginal steaming appear both to fit within historico-contemporary constructions of women's bodies as deficient and disgusting, and contemporary neoliberal and healthist discourse around the constantly improving subject.

  3. 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.

  4. 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

  5. Vaginal absorption of hexachlorophene during labor.

    Science.gov (United States)

    Strickland, D M; Leonard, R G; Stavchansky, S; Benoit, T; Wilson, R T

    1983-12-01

    Surgical soap that contains hexachlorophene is used as an antiseptic lubricant for vaginal examinations during labor in some centers. Theoretically, hexachlorophene can be absorbed from the vaginal mucosa and be potentially toxic to the fetus and neonate. To evaluate vaginal absorption and placental transfer of hexachlorophene, we measured levels in mixed arterial/venous cord serum and postpartum maternal serum in 28 women whose vaginal examinations were lubricated with pHisoHex during labor. The serum of 12 women had detectable levels of hexachlorophene, with a high level of 942 ng/ml. Cord serum had detectable levels in nine neonates, with a high level of 617 ng/ml. The conclusion is that hexachlorophene from vaginal lubricants is variably absorbed from the vaginal mucosa, and appreciable amounts can be detected in maternal and cord serum. Because of the potential for neonatal hexachlorophene toxicity, we recommend the use of alternative lubricants for pelvic examinations during labor.

  6. Efficacy of anti-microbial agents on vaginal microorganisms and reproductive performance of synchronized estrus ewes

    Directory of Open Access Journals (Sweden)

    Mohammed KM

    2017-05-01

    Full Text Available Objective: To isolate and identify microflora and fungal species at different phases during estrus synchronization of ewes and estimate their prevalence; compare the effectiveness of antimicrobial administration to intravaginal sponge on the changes in the vaginal microorganisms and reproductive performance. Methods: Sixty Egyptian ewes were allocated into three equal groups (G: 1, 2 and 3. G1 was inserted with vaginal sponge containing medroxyprogesterone acetate and served as control; without antimicrobial additive. The other two groups were treated as G1, but sponges were previously injected with ciprofloxacin (G2, while sponges of G3 were injected with ciprofloxacin and clotrimazole. Vaginal swabs were collected from each treated ewe, prior sponge insertion, at sponge withdrawal and 48 h later for microbiological investigation and bacterial count. On the day of sponge removal, 300 IU/eCG was administered for each treated ewe. The identified bacterial strains before sponge insertion were tested for sensitivity with antimicrobial disks. Results: Bacterial isolates before sponge insertion were more sensitive to ciprofloxacin. Frequencies of ewes in estrus; the interval from sponge withdrawal to onset estrus and the duration of estrus were statistically similar among treated groups. The pregnancy rate in G2 (100.0% was higher than G1 (66.7% and G3 (82.4%. The total bacterial count before sponge insertion was similar between all treatments and increased significantly in all groups on the day of sponge withdraw. The prevailing bacteria on D0, D14 and 48 h after sponge removal for all treated groups were Staphylococcus spp. followed by Escherichia coli. Regarding to fungus species, percentages of isolation increased from 5.00% (before sponge insertion to 100.00% and 88.89% at sponge withdraw for G1 and G2, respectively. In G3, the fungus was declined from 10% (before sponge insertion to 5% (at sponge removal. Conclusions: The concomitant treatments

  7. [Vaginal citology. Prevention and good health. Survey].

    Science.gov (United States)

    Ordonez Gomez, M

    1995-06-01

    A 1993 survey of knowledge, attitudes and practices related to sexually transmitted diseases and other conditions included a series of questions for women on vaginal cytology. The survey was based on a subsample of the PROFAMILIA master sample. 15,080 persons were interviewed, including 6949 women 18-69 years old. The section on vaginal cytology began with a description of the procedure before the questions were asked. Among the total sample, 66.2% reported having undergone cervical cytology while 33.8% had not. 4.8% did not request the results. For the 61.4% of the sample that requested the results, 49.4% were normal, 11.1% were abnormal, and 0.9% did not know or were not given their results. Of those with abnormal results, 9.3% returned for another consultation and 1.8% did not. The proportion of women having cervical cytology exceeded 80% for women 30-49 years old. 69.9% of urban and 54.2% of rural women had been tested. 28.9% underwent the most recent test due to a personal decision, 24.7% on medical recommendation, 23.2% because of symptoms, 12.0% to prevent cancer, 3.2% for safety, 2.0% because a year had passed since the last test, 2.0% in response to a campaign, 1.6% because a friend suggested it, and 1.1% because they had never had it done. The symptoms that motivated the test were a discharge for 31.4%, pain for 30.0%, bleeding for 11.8%, itching for 5.5%, postpartum problems for 2.8%, burning for 2.5%, and cyst for 1.9%. Abnormal results were obtained in 40% of the women who had the test because of symptoms. The average number of times in the past 5 years that the test was done was 2.8. 9% of respondents had not had a test in the past 5 years, 26% had 1, 18% had 2, 12% had 3, 7% had 4, 16% had 5, and 11% had 6 or more. 64.4% of women under 25 and 39% over 60 had never had vaginal cytology. Rural women and the less educated were less likely to have had the procedure.

  8. Vaginal cuff dehiscence after vaginal cuff brachytherapy for uterine cancer. A case report

    OpenAIRE

    Cattaneo, Richard; Bellon, Maria; Elshaikh, Mohamed A.

    2013-01-01

    Vaginal cuff dehiscence is a rare, but potentially serious complication after total hysterectomy. We report a case of vaginal cuff dehiscence after vaginal cuff brachytherapy. A 62 year old female underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy, and was found to have International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB endometrioid adenocarcinoma of the uterus. The patient was referred for adjuvant vaginal cuff brachytherapy. D...

  9. Evaluation of common organisms causing vaginal discharge.

    Science.gov (United States)

    Khan, Shazia A; Amir, Fauzia; Altaf, Shagufta; Tanveer, Raazia

    2009-01-01

    Vaginal discharge is very common problem among females. Alteration in balance of normal vaginal organisms can cause the overgrowth of the bacteria that creates vaginal discharge. It is common among sexually active women yet there still remain gaps in our knowledge of this infectious disorder. To evaluate the frequency of bacterial vaginosis (BV), vaginal candidiasis (VC), vaginal trichomoniasis and Group B streptococcus in women complaining of vaginal discharge in our setup. A total of 100 women of reproductive age group with the complaint of vaginal discharge were included in the study. After filling proforma patients were examined by speculum examination and two high vaginal swabs (HVS) were collected aseptically from each patient. One swab was used for making wet mount for clue cells, pus cells and for motility of Trichomonas vaginalis. The other swab was used to check pH and Amine test. The growth was confirmed by Gram staining in each case. Gardnerrella vaginalis were isolated in 28%, Group B streptococcus in 5% and T. vaginolis in 4% of women. Gardnerella vaginalis causing BV is the most common cause of vaginal discharge in otherwise healthy women of reproductive age group in our setup.

  10. Pelvic floor physical therapy: impact on quality of life 6 months after vaginal reconstructive surgery.

    Science.gov (United States)

    Pauls, Rachel N; Crisp, Catrina C; Novicki, Kathleen; Fellner, Angela N; Kleeman, Steven D

    2014-01-01

    Pelvic floor physical therapy (PFPT) is often used as a treatment of pelvic floor disorders and may improve function after pelvic reconstructive surgery. However, the long-term impact of this modality is not understood. This randomized controlled trial compared PFPT to the standard care in women undergoing vaginal reconstruction. The intervention group received PFPT biweekly until 12 weeks postoperatively, in conjunction with a physician assessment. Control subjects underwent a physician assessment alone at all postoperative intervals. The final follow-up was at 24 weeks. Physical examinations (pelvic organ prolapse quantification assessment), intravaginal electromyography, voiding diaries, and validated questionnaires were completed by all subjects. The primary outcome was change in the World Health Organization Quality of Life-BREF. Forty-nine women completed the study, 24 in the PFPT group and 25 in the control group. Although electromyography measures showed better muscular function in PFPT subjects after 12 weeks, at 6 months after surgery, this was no longer noted. However, quality of life parameters improved for the entire sample at 24 weeks, with no difference between groups. Positive change from 12 to 24 weeks was also documented in scores on the Pelvic Floor Distress Inventory-20 (P = 0.04) and Pelvic Floor Impact Questionnaire-7 (P = 0.018), corresponding with continued improvement in bladder symptoms. Finally, Prolapse and Incontinence Sexual Questionnaire-12 and Female Sexual Function Index scores improved between 12 and 24 weeks, suggesting better sexual function overall with time elapsed from surgery. Quality of life improves in all subjects after vaginal reconstructive surgery, with ongoing benefit between 3 and 6 months. Nevertheless, standardized PFPT was not associated with differences at 24 weeks in this cohort of women.

  11. Induction of potent local cellular immunity with low dose X4 SHIVSF33A vaginal exposure

    International Nuclear Information System (INIS)

    Tasca, Silvana; Tsai, Lily; Trunova, Nataliya; Gettie, Agegnehu; Saifuddin, Mohammed; Bohm, Rudolf; Chakrabarti, Lisa; Cheng-Mayer, Cecilia

    2007-01-01

    Intravaginal inoculation of rhesus macaques with varying doses of the CXCR4 (X4)-tropic SHIV SF33A isolate revealed a threshold inoculum for establishment of systemic virus infection and a dose dependency in overall viral burden and CD4+ T cell depletion. While exposure to inoculum size of 1000 or greater 50% tissue infectious dose (TCID 50 ) resulted in high viremia and precipitous CD4+ T cell loss, occult infection was observed in seven of eight macaques exposed to 500 TCID 50 of the same virus. The latter was characterized by intermittent detection of low level virus with no evidence of seroconversion or CD4+ T cell decline, but with signs of an ongoing antiviral T cell immune response. Upon vaginal re-challenge with the same limiting dose 11-12 weeks after the first, classic pathogenic X4 SHIV SF33A infection was established in four of the seven previously exposed seronegative macaques, implying enhanced susceptibility to systemic infection with prior exposure. Pre-existing peripheral SIV gag-specific CD4+ T cells were more readily demonstrable in macaques that became systemically infected following re-exposure than those that were not. In contrast, early presence of circulating polyfunctional cytokine secreting CD8+ T cells or strong virus-specific proliferative responses in draining lymph nodes and in the gut associated lymphoid tissue (GALT) following the first exposure was associated with protection from systemic re-infection. These studies identify the gut and lymphoid tissues proximal to the genital tract as sites of robust CD8 T lymphocyte responses that contribute to containment of virus spread following vaginal transmission

  12. 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

  13. Oviduct infection and hydrosalpinx in DBA1/j mice is induced by intracervical but not intravaginal inoculation with Chlamydia muridarum.

    Directory of Open Access Journals (Sweden)

    Lingli Tang

    Full Text Available Intravaginal infection with C. muridarum in mice often results in hydrosalpinx similar to that found in women urogenitally infected with C. trachomatis, making the C. muridarum lower genital tract infection murine model suitable for studying C. trachomatis pathogenesis. To our surprise, DBA1/j mice were highly resistant to hydrosalpinx following an intravaginal infection with C. muridarum although these mice were as susceptible to lower genital tract infection as other mouse strains. A significantly lower level of C. muridarum organisms was recovered from the oviduct of DBA1/j mice, correlating the resistance to hydrosalpinx with reduced ascension of C. muridarum to the oviduct. The DBA1/j resistance to hydrosalpinx was effectively overcome by intracervical inoculation with C. muridarum. The intracervically inoculated DBA1/j mice developed severe hydrosalpinx with the highest levels of live C. muridarum organisms recovered from uterine tissue on day 3 and oviduct tissue on day 7 post inoculation while in intravaginally inoculated DBA1/j mice, the peak of live organism recovery from uterine tissue was delayed to day 7 with no rise in the amount of live organisms recovered from the oviduct. These observations have not only validated the correlation between hydrosalpinx and live organism invasion in the oviduct but also demonstrated that the intracervical inoculation, by promoting rapid chlamydial replication in the uterine epithelial cells and ascension to the oviduct of DBA1/j mice, may be used for further understanding chlamydial pathogenic mechanisms. The above findings also suggest that strategies aimed at reducing tubal infection may be most effective in blocking tubal pathology.

  14. Oviduct infection and hydrosalpinx in DBA1/j mice is induced by intracervical but not intravaginal inoculation with Chlamydia muridarum.

    Science.gov (United States)

    Tang, Lingli; Zhang, Hongbo; Lei, Lei; Gong, Siqi; Zhou, Zhiguang; Baseman, Joel; Zhong, Guangming

    2013-01-01

    Intravaginal infection with C. muridarum in mice often results in hydrosalpinx similar to that found in women urogenitally infected with C. trachomatis, making the C. muridarum lower genital tract infection murine model suitable for studying C. trachomatis pathogenesis. To our surprise, DBA1/j mice were highly resistant to hydrosalpinx following an intravaginal infection with C. muridarum although these mice were as susceptible to lower genital tract infection as other mouse strains. A significantly lower level of C. muridarum organisms was recovered from the oviduct of DBA1/j mice, correlating the resistance to hydrosalpinx with reduced ascension of C. muridarum to the oviduct. The DBA1/j resistance to hydrosalpinx was effectively overcome by intracervical inoculation with C. muridarum. The intracervically inoculated DBA1/j mice developed severe hydrosalpinx with the highest levels of live C. muridarum organisms recovered from uterine tissue on day 3 and oviduct tissue on day 7 post inoculation while in intravaginally inoculated DBA1/j mice, the peak of live organism recovery from uterine tissue was delayed to day 7 with no rise in the amount of live organisms recovered from the oviduct. These observations have not only validated the correlation between hydrosalpinx and live organism invasion in the oviduct but also demonstrated that the intracervical inoculation, by promoting rapid chlamydial replication in the uterine epithelial cells and ascension to the oviduct of DBA1/j mice, may be used for further understanding chlamydial pathogenic mechanisms. The above findings also suggest that strategies aimed at reducing tubal infection may be most effective in blocking tubal pathology.

  15. Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence: randomized controlled trial.

    Science.gov (United States)

    Correia, Grasiéla N; Pereira, Vanessa S; Hirakawa, Humberto S; Driusso, Patricia

    2014-02-01

    To evaluate the effects of surface electrical stimulation (SES) and to compare them with the effects of the intravaginal electrical stimulation (IVES) in women with stress urinary incontinence (SUI). This randomized controlled study included 48 women aged over 50 years, who complained of SUI evaluated according to two structured questions of King's Health Questionnaire (KHQ) and who had not previously undergone physical therapy for SUI. The calculation of the sample size estimated a sample of 45 volunteers with a significance level of 5% and statistical power of 90%. The women were randomized to: Surface Electrical Stimulation Group (SESG) (n=15), Intravaginal Electrical Stimulation Group (IVESG) (n=15) and Control Group (CG) (n=15). Subjects in the intervention groups were treated with the same parameters of electrical stimulation for 12 sessions. The SESG had four silicone electrodes fixed in the suprapubic and ischial tuberosity regions. The IVES group used an intravaginal electrode. The CG did not receive any treatment during the corresponding time. They were evaluated before and after treatment by a physical therapist who was blind to group allocation. The primary outcomes were urinary leakage, pressure and strength of pelvic floor muscle (PFM) contraction. The secondary outcome was quality of life (QOL) evaluated by KHQ. Forty-five women completed the study and were included in the analysis. Statistical analysis was performed using the Wilcoxon test for intragroup analysis and Kruskal-Wallis and Mann-Whitney tests for intergroup analysis (purinary loss and pressure of contraction in the SESG and IVESG. PFM strength increased only in the IVESG. Intergroup analysis found differences after the treatment in: urinary leakage between the SESG and CG (pincontinence impact, limitations of daily activities, physical limitation, emotion, sleep and disposition and severity domains in the SESG (all purinary leakage, and strength and pressure of PFM contraction. Copyright

  16. Design and evaluation of mucoadhesive vaginal tablets of tenofovir disoproxil fumarate for pre-exposure prophylaxis of HIV.

    Science.gov (United States)

    Khan, Arshad Bashir; Thakur, Ram Sharnagat

    2018-03-01

    To design and evaluate novel, feasible, safe, mucoadhesive intravaginal tablets of tenofovir disoproxil fumarate (TDF). It may provide pre-exposure prophylaxis for women against HIV. TDF intravaginal tablets were formulated employing poylvinylpyrrolidone (PVP) as the matrix forming polymer and various mucoadhesive polymers such as carbopol 934, 940, chitosan, and sodium carboxymethylcellulose (SCMC). Wet granulation was used. The evaluation involved testing drug-excipient compatibility, precompression parameters such as percentage yield, bulk density and tapped density of the granules, Carr's index, Hausner ratio, angle of repose, post compression parameters such as color, shape, physical dimensions, weight variation, hardness, friability, swelling index, assay, in vitro dissolution study and ex vivo mucoadhesion studies. Based on in vitro evaluation, C1 was selected as the best formulation and evaluated further for release kinetics, curve fitting analysis, absorption studies using liquid chromatography-mass spectrometry (LC-MS) technique and histopathological assessment in female Sprague-Dawley rats. C1 followed Higuchi model kinetics. Accelerated stability study was as per ICH guidelines by keeping C1 at 40 ± 2 °C and 75 ± 5% RH for six months. C1 was selected as the best formulation due to better swelling index (65.93% at 24 h), prolonged release of 100.62% cumulative drug release (CDR) at 24 h, superior mucoadhesion force (35.93 × 10 2 dynes/cm 2 ) and retention time (16 h). The study revealed that C1 remained stable for six months. C1 showed nil systemic absorption which is desirable and according to histopathological study, C1, exhibited minimal damage on the rat vaginal epithelium indicating safety.

  17. Randomised trial of intravaginal misoprostol and intracervical Foley catheter for cervical ripening and induction of labour.

    Science.gov (United States)

    Owolabi, A T; Kuti, O; Ogunlola, I O

    2005-08-01

    Induction of labour may be indicated despite an unripe cervix. The purpose of this study was to compare the safety and efficacy of intravaginal misoprostol and an intracervical Foley's balloon catheter for preinduction cervical ripening and labour induction. A total of 120 patients requiring indicated induction of labour with an unfavourable cervix (Bishop's score intracervical Foley balloon catheter for 12 h followed by an intravenous oxytocin infusion. The two arms of the study were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop's scores. There were significant change in the Bishop's score in the two groups (5.9 +/- 0.2 and 4.0 +/- 0.2, respectively, p < 0.001) but no inter group differences. Oxytocin induction or augmentation of labour occurred more in the catheter group (95%) than in the misoprostol group (43.3%) (p < 0.0001). Induction to delivery interval was significantly shorter in the misoprostol group than in the catheter group (8.7 +/- 2.4 vs 11.9 +/- 2.7 h p < 0.0001). There was no significant difference noted in the caesarean or other operative delivery rates among patients in the two treatment groups. There was a higher incidence of tachysystole and hyperstimulation in the misoprostol group than in the catheter group (p < 0.03). No differences were observed between groups for meconium passage, 1- or 5-min Apgar scores < 7 and admission into the neonatal intensive care unit. In conclusion, the maternal and perinatal outcomes in this study have shown no difference confirming the efficacy and safety of both methods, however we observe a decrease in the induction-to-delivery interval when misoprostol is used for this purpose.

  18. Intravaginal electrical stimulation: a randomized, double-blind study on the treatment of mixed urinary incontinence.

    Science.gov (United States)

    Amaro, João L; Gameiro, Mônica O; Kawano, Paulo R; Padovani, Carlos R

    2006-01-01

    The aim of this study was to compare effective and sham intravaginal electrical stimulation (IES) in treating mixed urinary incontinence. Between January 2001 and February 2002, 40 women were randomly distributed, in a double-blind study, into two groups: group G1 (n=20), effective IES, and group G2 (n = 20), sham IES, with follow up at one month. Different parameters was studied: 1. clinical questionnaire; 2. body mass index; 3. 60-min pad test; 4. urodynamic study. The protocol of IES consisted of three 20-min sessions per week over a seven-week period. The Dualpex Uro 996 used a frequency of 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence was reduced to 15% in G1 and 31.5% in G2; there was no significant difference between the groups. In the analog wetness and discomfort sensation evaluations were reduced significantly in both groups. The pretreatment urodynamic study showed no statistical difference in urodynamic parameters between the groups. Ten percent of the women presented involuntary detrusor contractions. In the 60-min pad test, there was a significant reduction in both groups. In regards to satisfaction level, after treatment, 80% of G1 patients and 65% of G2 patients were satisfied. There was no statistically significant difference between the groups. Significant improvement was provided by effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy.

  19. Intravaginal Misoprostol Versus Intra-amniotic 15 Methyl PG F2 a for Termination of Second Trimester Pregnancy

    OpenAIRE

    N. Vimala, V. Dadhwal, S. Kumar, S. Mittal, S. Vinekar

    2005-01-01

    To compare the efficacy of intravaginal application of misoprostol and intra-amniotic injection ofprostaglandin 15-methyl F2 alpha (PG F2α) in terminating second trimester pregnancies, eightypregnant women at 14-20 weeks of gestation with single live fetuses and requesting for terminationof pregnancy were randomised into two groups.Women in group I: received four tablets of vaginalmisoprostol (200 mg/tablet) and in group II : intra-amniotic injection of (10 ml) 2.5 mg 15 methyl -PGF2α. Failur...

  20. The effect of adding hyoscine to vaginal misoprostol on abortion induction success rate

    Directory of Open Access Journals (Sweden)

    Tehranian A

    2010-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Intravaginal misoprostol has been shown to be an effective agent for cervical ripening and induction of labor. The aim of present study was to assess the effects of adding hyoscine to vaginal misoprostol on its success rate. "n"nMethods: In a clinical trial, 74 women who were referred to undergo legal induction of labor during first pregnancy trimester in Arash Hospital, in Tehran, Iran, between March 2006 and March 2007 were enrolled, and were randomly divided in to two groups of misoprostol (400 µg/4h, vaginal (n=37 or misoprostol (400 µg/4h, vaginal plus hyoscine (20 mg IV (n=37. Their complications including nausea, vomiting, fever, abdominal pain, need for analgesics, diarrhea, vaginal bleeding, decline in hemoglobin more than 3 g/dl, need for blood transfusion and failure of treatment according to the failure of induction of labor or cervical opening in 24 hours after starting treatment and the total duration of hospitalization were compared between groups. "n"nResults: There were no significant differences between groups regarding the rate of side effects like nausea, abdominal pain and vaginal bleeding. In misoprostol plus hyoscine group, the success rate in abortion was significantly higher (40

  1. No. 155-Guidelines for Vaginal Birth After Previous Caesarean Birth.

    Science.gov (United States)

    Martel, Marie-Jocelyne; MacKinnon, Catherine Jane

    2018-03-01

    To provide evidence-based guidelines for the provision of a trial of labour (TOL) after Caesarean section. Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean (VBAC) and repeat Caesarean section. MEDLINE database was searched for articles published from January 1, 1995, to February 28, 2004, using the key words "vaginal birth after Caesarean (Cesarean) section." The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam. VALIDATION: These guidelines were approved by the Clinical Practice Obstetrics and Executive Committees of the Society of Obstetricians and Gynaecologists of Canada. Copyright © 2018. Published by Elsevier Inc.

  2. 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

  3. TRIPLET GESTATION: Successfully planned vaginal delivery aided ...

    African Journals Online (AJOL)

    Intrapartum management and vaginal delivery of triplet gestation is of particular challenge to the obstetrician. It occurs more frequently of late due to the increase in the use of fertility therapies. We present three cases of triplet gestations with successful vaginal deliveries aided by the use of intrapartum ultrasound scan.

  4. Effects of hormonal contraception on vaginal flora.

    Science.gov (United States)

    De Seta, Francesco; Restaino, Stefano; De Santo, Davide; Stabile, Guglielmo; Banco, Rubina; Busetti, Marina; Barbati, Giulia; Guaschino, Secondo

    2012-11-01

    The sector of the market that deals with contraception offers a long list of different contraceptive methods. Within the estroprogestinic choice, the routes of administration are oral, transdermic and vaginal one. Even though efficacy is comparable with these methods, secondary and adverse effects are directly involved in the acceptability of the method. This was a prospective comparative study. During 1 year, we enrolled 60 asymptomatic women who voluntarily requested combined oral contraception (COC) or combined contraceptive vaginal ring (CCVR group). After a baseline study of vaginal milieu prior to starting hormonal contraception, we performed a follow-up. For each woman, we examined vaginal pH; quantification of leukocytes, lactobacilli, Candida and cocci on saline microscopy fluid; Gram stain with Nugent score and the presence of vaginal infection [culture for Trichomonas vaginalis, albicans and nonalbicans Candida, Group B Streptococcus (GBS)]. At the end of follow-up, there was a little change of vaginal milieu in both groups. We noted an increase of lactobacilli in the CCVR users and an increase of GBS in COC users. CCVR compared to COC users showed an increase of the number of lactobacilli in vaginal flora. It means that an increase of leukorrhea in that group could be protective in terms of prevention of vaginal imbalance/infection. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Characterisation of the vaginal microflora of human ...

    African Journals Online (AJOL)

    Teresa kiama

    2014-02-26

    Feb 26, 2014 ... Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. ... infants in Kenya (Farquhar et al., 2010). This study found women with BV to be three times more likely to transmit. HIV in utero. High prevalence of BV in sub-Saharan ..... Age at first sex (years). 14-15.

  6. 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....

  7. vaginal histological changes of the baboon

    African Journals Online (AJOL)

    2009-04-04

    Apr 4, 2009 ... and endogenous (normal circulating hormones) on vaginal histology. In this study, we evaluated the vaginal histological changes in the baboon during the menstrual cycle. MATERIALS AND METHODS. Animal selection: Nine healthy adult female baboons. (Papio anubis) (mean±SD [15.2±2.03 Kg], range ...

  8. 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

  9. The effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility, vaginal vasocongestion, and sexual function: a prospective single-center study.

    Science.gov (United States)

    Weber, Maaike A; Lakeman, Marielle M E; Laan, Ellen; Roovers, Jan-Paul W R

    2014-07-01

    Vaginal mesh surgery in patients with pelvic organ prolapse (POP) has been associated with sexual dysfunction. Implantation of synthetic mesh might damage vaginal innervation and vascularization, which could cause sexual dysfunction. We aim to evaluate the effects of vaginal mesh surgery on vaginal vasocongestion and vaginal wall sensibility in patients with recurrent POP. A prospective study was performed among patients with previous native tissue repair, scheduled for vaginal mesh surgery. Measurements were performed before and 6 months after surgery, during nonerotic and erotic visual stimuli, using a validated vaginal combi-probe. The combi-probe involves vaginal photoplethysmography to assess Vaginal Pulse Amplitude (VPA) (representing vaginal vasocongestion) and four pulse-generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (Female Sexual Function Index, Female Sexual Distress Scale-Revised, and Subjective sexual arousal and affect questionnaire). Sixteen women were included, 14 completed the 6-month follow-up visit. Vaginal vasocongestion under erotic conditions did not significantly alter after mesh implantation. Vaginal wall sensibility of the distal posterior wall was significantly increased after mesh surgery (preoperative threshold 6.3 mA vs. postoperative 3.4 mA, P = 0.03). Sexual function as assessed with questionnaires was not significantly affected. In women with a history of vaginal prolapse surgery, vaginal mesh surgery did not decrease vaginal vasocongestion or vaginal wall sensibility. Vaginal vasocongestion prior to mesh surgery appeared to be lower than that of women never operated on. Apparently, native tissue repair decreased preoperative vaginal vasocongestion levels to such extent that subsequent mesh surgery had no additional detrimental effect. Our findings should be interpreted cautiously. Replication of the findings in future

  10. The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial.

    Science.gov (United States)

    Elmelund, Marlene; Biering-Sørensen, Fin; Due, Ulla; Klarskov, Niels

    2018-03-24

    Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. In this investigator-blinded randomized clinical trial, we recruited women aged 18-75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence. From 27 April 2015-9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [-2.4 (95% CI -4.3--0.5), p = 0.018] and daily episodes of urinary incontinence [-0.4 (95% CI -0.8--0.1), p = 0.026] at 12 weeks. PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.

  11. Advanced preformulation investigations for the development of a lead intravaginal bioadhesive polymeric device.

    Science.gov (United States)

    Ndesendo, Valence M K; Pillay, Viness; Choonara, Yahya E; du Toit, Lisa C; Buchmann, Eckhart; Kumar, Pradeep; Khan, Riaz A; Meyer, Leith C R

    2012-03-01

    To screen various polymers through extensive preformulation investigations to ultimately obtain a lead polymer combination for designing a desirable Intravaginal Bioadhesive Polymeric Device (IBPD). Hydrophilic and hydrophobic polymers (18) at different combinations were blended and compressed into 62 caplet-shaped devices at 5 tons, one of the hydrophilic polymers being a modified synthetic product of polyamide 6,10 ((m)PA 6,10). Two sets of crosslinked PAA-based caplets comprising either allyl-sucrose (AS-PAA) or allyl-penta-erythritol (APE-PAA) were explored. The devices were subjected to in-process validation tests and thereafter to preformulation investigational screening {equilibrium swelling ratio (ESR) being a screening parameter}, using a One Variable at a Time (OVAT) approach. Molecular mechanics force field simulations in both vacuum and solvated systems were conducted to investigate the influence of addition and subsequent replacement of a polymer(s) on the spatial disposition and energetic profile of the sterically constrained and geometrically optimized multi-polymeric complex, IBPD. The developed devices were sufficiently strong (longitudinal crushing force:286 ± 0.01 N; mean weight:600 ± 0.48 mg; mean friability:0.31 ± 0.04%). Through OVAT approach, 15 lead formulations with minimal swelling tendencies (ESRs ranging from 0.011 to 0.084) were obtained out of 62 formulations. F62 {i.e. (m)PA 6,10, (150 mg), PLGA (400 mg), EC (200 mg), PVA (25 mg) and PAA (25 mg)} displayed minimal swelling tendency and therefore the highest stability. The highly stabilized conformation of the final in silico IBPD polymeric assembly PLGA-(m)PA6,10-PVA-PAA-EC corroborated the experimental results in terms of preformulation investigational screening using the OVAT approach. The results obtained suggest that (m)PA 6,10, PLGA, EC, PVA and PAA at an appropriate weight ratio may be suitable for development of an IBPD.

  12. Thermoplastic polyurethane-based intravaginal rings for prophylaxis and treatment of (recurrent) bacterial vaginosis.

    Science.gov (United States)

    Verstraete, G; Vandenbussche, L; Kasmi, S; Nuhn, L; Brouckaert, D; Van Renterghem, J; Grymonpré, W; Vanhoorne, V; Coenye, T; De Geest, B G; De Beer, T; Remon, J P; Vervaet, C

    2017-08-30

    The aim of the present study was to develop thermoplastic polyurethane (TPU)-based intravaginal rings (IVRs) for prophylaxis and treatment of bacterial vaginosis via hot melt extrusion/injection molding. Therefore, different TPU grades were processed in combination with lactic acid or metronidazole, targeting a sustained lactic acid release over a 28day-period and sustained metronidazole release over 4-7days. Hot melt extrusion of lactic acid/TPU combinations required a lower extrusion temperature due to the plasticizing properties of lactic acid, evidenced by the lower glass transition temperature (T g ) and cross-over point (T tanδ = 1 ) values. NIR-chemical imaging data showed a homogenous distribution of lactic acid in TPU matrices at drug loads up to 30% (w/w). The addition of metronidazole did not lower processing temperatures, as the active pharmaceutical ingredient remained crystalline in the TPU matrix. Hydrophobic TPUs with a low ratio between the soft and hard segments (SS/HS ratio) in the polymer structure were suitable carriers for the lactic acid-eluting device over a 28-day period, while hydrophilic TPUs were needed to achieve the required release rate of metronidazole-eluting IVRs. IVRs manufactured with a TPU grade having a higher SS/HS ratio and lactic acid/TPU ratio exhibited a more elastic behavior. The addition of 25% (w/w) metronidazole did not affect the mechanical properties of the IVRs. Hydrophilic TPUs were most prone to biofilm formation by Candida albicans and Staphylococcus aureus, but the incorporation of metronidazole in the device prevented biofilm formation. Based on the drug eluting performance and mechanical tests, a mixture of lactic acid and Tecoflex™ EG-93A (20/80, w/w) and a combination of metronidazole and Tecophilic™ SP-93A-100 (25/75, w/w) were selected to design IVRs for the prophylaxis and treatment of bacterial vaginosis, respectively. Slug mucosal irritation tests predicted low irritation potency for both devices

  13. Radioimmunoassay of serum d-Norgestrel in women following oral and intravaginal administration

    International Nuclear Information System (INIS)

    Stanczyk, F.Z.; Hiroi, M.; Goebelsmann, U.; Brenner, P.F.; Lumkin, M.E.; Mishell, D.R. Jr.

    1975-01-01

    A radioimmunoassay (RIA) method for measuring d-Norgestrel (d-Ng) in serum has been developed utilizing petroleum ether extraction, an antiserum raised against d-Norgestrel-3-(0-carboxymethyl) oxime-epsilon-aminocaproic acid--boxine serum albumin, d-Norgestrel-3-(0-carboxymethyl) imino-[ 125 I]-iodohistamine, and dextran-coated charcoal separation. Control serum blanks were undetectable, 6 pg of d-Ng was measurable in 0.1 ml of serum with a high reliability, and intra- and interassay coefficients of variation were 4.4 and 4.9 percent, respectively. d-Ng added to control serum was quantitatively recovered. This RIA proved to be highly specific for d-Ng, cross-reacting less than 0.01 percent with 1-Ng and some 4 to 8 percent with 5α- and 5β-tetrahydro-d-Ng. Serum d-Ng levels measured in 3 women after ingestion of 75 μg of dl-Ng rose to 1.5 to 2 ng/ml within 1/2 to 2-3 hours after oral intake and fell rapidly thereafter to 0.2 to 0.4 ng/ml within 24 hours. Insertion of Silastic intravaginal rings (IVRs), containing 50 or 100 mg of dl-Ng, into 3 women for periods of 3 weeks resulted in a rapid rise of serum d-Ng after insertion. Serum d-Ng levels were highest 24 to 48 hours after the first insertion of each IVR, reaching peak levels of about 5 and 7 to 11 ng/ml, respectively, and declined gradually during the ensuing 15 to 20 days to some 30 to 40 percent of the peak serum d-Ng concentration. Serum d-Ng levels attained after IVR reinsertion remained relatively constant at 1 to 3 ng/ml during each subsequent cycle in all subjects and fell rapidly after each IVR removal. Serum estradiol and progesterone concentrations, measured about 3 times a week in these patients, indicated that ovulation was consistently inhibited

  14. Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women.

    Science.gov (United States)

    Verstraelen, Hans; Verhelst, Rita; Vaneechoutte, Mario; Temmerman, Marleen

    2011-07-01

    Vaginal infection with group A streptococci (GAS) is an established cause of vaginitis amongst prepubescent girls, but largely unrecognized in adult women and therefore often misdiagnosed as vulvovaginal candidosis. We sought to give an overview of the epidemiology, risk factors, symptoms, signs, and treatment of GAS vaginitis in adult women. Systematic literature search. We identified nine case reports covering 12 patients with documented GAS vulvovaginitis. GAS vulvovaginitis in adult women is often associated with a predisposing factor: (1) household or personal history of dermal or respiratory infection due to GAS, (2) sexual contact, and (3) lactational or menopausal vaginal atrophy. Symptoms of GAS vulvovaginitis in adult women may include vaginal and/or vulvar pain, dyspareunia, burning sensation or irritation, and pruritus. In most cases, there is also profuse or copious vaginal discharge which may be watery, yellow, or even purulent. Whilst there are neither clinical trials nor treatment guidelines, treatment with oral penicillin or with vaginal clindamycin cream has been reported to result in rapid cure. In breast-feeding and postmenopausal women with vaginal atrophy, additional treatment with local estriol may be necessary to prevent recurrence. Finally, in case of recurrent GAS vulvovaginitis it will be necessary to assess the patients' asymptomatic household members for pharyngeal and anal carriage and to treat them accordingly. Vaginal infection with GAS in adult women is a clearly defined entity and should be considered a diagnosis when more common causes of vaginitis have been ruled out.

  15. Women's Intention to Prevent Vesico Vaginal Fistula Recurrence in ...

    African Journals Online (AJOL)

    Objective: The study purpose was to determine the association between intention to prevent Vesico-Vaginal Fistula recurrence and knowledge of the risk factors of Vesico Vaginal Fistula recurrence, attitude towards Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula in two repair ...

  16. Women's Intention to prevent Vesico Vaginal Fistula recurrence in ...

    African Journals Online (AJOL)

    Esem

    ABSTRACT. Objective: The study purpose was to determine the association between intention to prevent Vesico-Vaginal. Fistula recurrence and knowledge of the risk factors of. Vesico Vaginal Fistula recurrence, attitude towards. Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula ...

  17. Pyometra and complete vaginal adhesion in a miniature horse

    OpenAIRE

    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.

  18. The Vaginal Microbiota and Urinary Tract Infection.

    Science.gov (United States)

    Stapleton, Ann E

    2016-12-01

    The vagina is a key anatomical site in the pathogenesis of urinary tract infection (UTI) in women, serving as a potential reservoir for infecting bacteria and a site at which interventions may decrease the risk of UTI. The vaginal microbiota is a dynamic and often critical factor in this pathogenic interplay, because changes in the characteristics of the vaginal microbiota resulting in the loss of normally protective Lactobacillus spp. increase the risk of UTI. These alterations may result from the influence of estrogen deficiency, antimicrobial therapy, contraceptives, or other causes. Interventions to reduce adverse effects on the vaginal microbiota and/or to restore protective lactobacilli may reduce the risks of UTI.

  19. 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.

  20. Vaginal flora and correlation with cytological aspects

    OpenAIRE

    Guerreiro, Hygia Maria Nunes; Barbosa, Helenemarie Schaer; Conceição Filho, João Lycio; Tishchenko, Lúcia Maria; Hagge, Suraia

    1986-01-01

    Com a finalidade de esclarecer a patogenicidade de microorganismos que compõem a microflora vaginal, particularmente nas chamadas vaginites inespecíficas e de determinar o valor da citologia como método para identificação da flora vaginal, foram estudadas 97 pacientes, realizando cultura, exame direto a fresco, Gram e citologia do material cérvico-vaginal. Entre os microorganismos de importância clínica reconhecida, Gardnerella vaginalis foi o mais freqüentemente isolado, 48,4%, seguido de Tr...

  1. 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.

  2. 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.

  3. 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.

  4. Prevalence of vaginal candidiasis among pregnant women with abnormal vaginal discharge in Maiduguri.

    Science.gov (United States)

    Ibrahim, S M; Bukar, M; Mohammed, Y; Mohammed, B; Yahaya, M; Audu, B M; Ibrahim, H M; Ibrahim, H A

    2013-01-01

    Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. High vaginal swab samples and data on epidemiological characteristics were collected from 400 pregnant women with complaints of abnormal vaginal discharge at booking clinic of University of Maiduguri Teaching Hospital. The data was analysed using SPSS 16.0 statistical software. The prevalence of abnormal vaginal discharge in pregnancy was 31.5%. The frequency of abnormal vaginal discharge was 183 (45.8%) among those aged 20-24 years, 291 (72.8%) in multipara, 223 (55.8%) in those with Primary education and 293 (73.2%) in unemployed. Vulval pruritus 300 (75.0%) was significantly related to abnormal vaginal discharge (P vaginal discharge in pregnancy was high in this study and C. albicans was the commonest cause. It is recommended that a pregnant woman complaining of abnormal vaginal discharge be assessed and Laboratory diagnosis done in order to give appropriate treatment.

  5. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... used to diagnose vaginitis. 1 Centers for Disease Control and Prevention. (2010). Self-study STD ... Halvorson New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...

  6. What Are the Symptoms of Vaginitis?

    Science.gov (United States)

    ... Many women have no symptoms. Centers for Disease Control and Prevention. (2010). Self-study STD module—vaginitis . Retrieved ... New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...

  7. VBAC (Vaginal Birth After C-Section)

    Science.gov (United States)

    ... again, you might be able to choose between scheduling a repeat C-section or attempting vaginal birth ... date You have an unusually large baby — suspected fetal macrosomia You've had two or more C- ...

  8. Vaginal neurofibroma in a hysterectomized poodle dog.

    Science.gov (United States)

    Sontas, B H; Altun, E D; Güvenc, K; Arun, S S; Ekici, H

    2010-12-01

    A 15-year-old, spayed, female poodle dog was presented for evaluation of a mass of tissue prolapsed from the vulva. The dog had been hysterectomized when it was 5 years old. A vaginal mass had been removed approximately 10 months before presentation. Haematological and serum biochemistry analyses demonstrated mild leucocytosis and glycaemia. A vaginal smear was predominantly made up of parabasal cells and intermediate cells with no neoplastic cells. Thoracal and abdominal radiographic findings were unremarkable. The ovaries could not be identified using abdominal ultrasonography. A midline exploratory laparotomy identified both ovaries that were surgically excised. The vaginal mass was also removed following an episiotomy procedure. Histopathological examination of the mass demonstrated that it was a neurofibroma. Both ovaries had cystic changes. Four months after the surgery, the owner reported that the dog was clinically normal. To the authors’ knowledge, this is the first reported case of a vaginal neurofibroma after an incomplete ovariohysterectomy in the dog.

  9. Use of vaginal estrogen in Danish women

    DEFF Research Database (Denmark)

    Meaidi, Amani; Goukasian, Irina; Lidegaard, Oejvind

    2016-01-01

    our result to the prevalence of urogenital atrophy-related symptoms reported in the literature, our study suggests an under-diagnosis and under-treatment of this condition. Teaching women and primary-care physicians about symptomatic urogenital atrophy and its treatment options may increase......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......, living in Denmark during the period 2007-2013. The Danish Prescription Register delivered data permitting us to assess the prevalence, age and regional geographical belonging of women purchasing prescribed vaginal estradiol. The number of women using over-the-counter vaginal estriol products...

  10. 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 ...

  11. The Vaginal Microbiota and Urinary Tract Infection

    OpenAIRE

    STAPLETON, ANN E.

    2016-01-01

    The vagina is a key anatomical site in the pathogenesis of urinary tract infection (UTI) in women, serving as a potential reservoir for infecting bacteria and a site at which interventions may decrease the risk of UTI. The vaginal microbiota is a dynamic and often critical factor in this pathogenic interplay, because changes in the characteristics of the vaginal microbiota resulting in the loss of normally protective Lactobacillus spp. increase the risk of UTI. These alterations may result fr...

  12. Preactivated thiomers for vaginal drug delivery vehicles.

    Science.gov (United States)

    Friedl, Heike E; Dünnhaupt, Sarah; Waldner, Claudia; Bernkop-Schnürch, Andreas

    2013-10-01

    It was the purpose of this study to design and evaluate a chitosan derivative as mucoadhesive excipient for vaginal drug delivery systems. The chemical modification of chitosan was achieved by conjugation of thioglycolic acid (TGA) resulting in 1594 μmol thiol groups per gram of polymer followed by the linkage of mercaptonicotinic acid (MNA) to the immobilized thiol groups via disulfide bonding leading to 702 μmol ligand per gram of preactivated polymer. The mucoadhesive properties of these polymers within newly designed vaginal formulations (Chitosan-TGA and Chitosan-TGA-MNA) and commercially available vaginal formulations (Candibene®, Daktarin®, Dalacin®, GynoPevaryl®) were tested over a time period of 24 h via a mucoadhesion test system simulating vaginal conditions, tensile studies and mucus polymer interaction studies via viscosity measurements. Within the vaginal test system simulating vaginal in situ conditions, a 1.5-fold increase in mucoadhesion could be observed for preactivated thiomer formulations after 24 h in comparison to commercially available formulations. Similar results were achieved for tensile studies, as the chitosan-TGA-MNA containing formulation resulted in a 4.9-fold increase in total work of adhesion (TWA) in comparison to Candibene which showed the highest TWA value of all tested commercial formulations. Also in terms of rheology investigations of mucus/formulation mixtures, a 5.8-fold increase in dynamic viscosity for chitosan-TGA-MNA containing mixtures could be observed in comparison to the mucus-free control. In contrast, commercially available formulations achieved a maximum enhancement of 1.9-fold. These outcomes confirm that the newly developed polymer is a promising tool for vaginal drug delivery likely providing a prolonged vaginal residence time due to its comparatively high mucoadhesive properties. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. 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.

  14. EVALUACIÓN DE PROGESTERONA INTRAVAGINAL POST INSEMINACIÓN ARTIFICIAL PARA REDUCIR LA MUERTE EMBRIONARIA EN VACAS

    OpenAIRE

    Jorge Ignacio Macias; Jofre Andrés Vera Cedeño

    2014-01-01

    El objetivo de esta investigación fue evaluar el efecto de la administración de un dispositivo intravaginal de progesterona post IATF sobre la reducción de la muerte embrionaria, el cual se aplicó siete días después de la inseminación. Se utilizaron 40 vacas de aptitud cárnica de cruza mestiza Senangus x Brahman de dos-cuatro partos. Se realizó ecografía transrectal (Aquilla Vet 7.5 MHZ) previo a la sincronización. Se efectuó el inicio de ésta con el dispositivo CIDR 1.38 g progesterona. Desp...

  15. The effect of prolapse surgery on vaginal sensibility.

    Science.gov (United States)

    Lakeman, Mariëlle M E; van der Vaart, C Huub; Laan, Ellen; Roovers, Jan-Paul W R

    2011-04-01

    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 understand the effects of prolapse surgery on sexual function. To assess the effects of prolapse surgery with or without stress incontinence surgery on vaginal sensibility and to assess the relationship between vaginal wall sensibility and sexual well-being. This study was performed parallel to a randomized controlled trial comparing vaginal and abdominal prolapse surgery with or without incontinence surgery in women with uterine prolapse stage 2 or more. Vaginal wall sensibility was defined as mean sensation threshold to electrical stimulation of the vaginal wall at four standardized places, measured before and 6 months after surgery. Higher sensation thresholds postsurgery relative to presurgery indicate diminished vaginal wall sensibility. Sexual function was assessed at the same time points using a questionnaire. Data on vaginal wall sensibility were obtained from 65 patients. The sensibility of the distal posterior (P = 0.02) and distal anterior (P = 0.10) vaginal wall decreased after vaginal surgery compared to abdominal surgery. Abdominal prolapse surgery with incontinence surgery decreased sensibility of the distal part of the anterior vaginal wall significantly more than abdominal prolapse surgery only (P = 0.01). Before surgery, vaginal wall sensibility was lower in women who reported vaginal dryness or anorgasmia. The presence of genital pain was associated with higher vaginal wall sensibility. Postoperative vaginal wall sensibility was similar in women with and without sexual problems. Vaginal prolapse surgery as well as abdominal prolapse surgery with additional incontinence surgery resulted in decreased vaginal wall sensibility. This pilot study shows no influence of the

  16. 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 Hyaluronic acid vaginal tablets can be used in patients with atrophic vaginitis who do not want to or can not take local estrogen treatment.

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

    African Journals Online (AJOL)

    The intravaginal clindamycin and clotrimazole combination we used may be more effective than oral metronidazole, as it is more active against bacterial vaginosis and has the added benefit of being active against Candida, which is a significant cause of morbidity. In contrast, decreases in the rate of preterm delivery after.

  18. Douching for perceived vaginal odor with no infectious cause of vaginitis: a randomized controlled trial.

    Science.gov (United States)

    Hassan, Sarmina; Chatwani, Ashwin; Brovender, Herman; Zane, Richard; Valaoras, Thomas; Sobel, Jack D

    2011-04-01

    To demonstrate the effectiveness of medical-grade stainless steel Water Works Douching Device for treating abnormal vaginal odor in comparison with a commercially available over-the-counter plastic douching device. In a multicenter study, 140 women with perceived vaginal odor with no vaginal infection were randomized to either Water Works or control group in a 1:1 ratio and were douched daily for 4 weeks. A visual analog scale (VAS) was used to assess the intensity of vaginal odor. Primary outcome included subject assessment of odor improvement and Nugent Gram stain score of vaginal secretions. Secondary outcome compared the efficacy and safety of Water Works with control douching device. Each patient underwent baseline, week 2, and week 4 visits. The final analytic sample consisted of 96 women. Success score at 4 weeks was 78% for the Water Works group and 38.5% for the control group. Mean VAS was significantly reduced, and Nugent and Lactobacillus scores were maintained in both groups. In the Water Works group, VAS was reduced from 7.3 ± 0.3 to 1.8 ± 0.6 (p reduction of vaginal odor after douching with water for 4 weeks without any alteration of vaginal flora. The Water Works Douching Device was superior to over- the-counter device in reducing vaginal odor.

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

    Science.gov (United States)

    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.

  20. Vaginal birth after caesarean section is not a safe option in low ...

    African Journals Online (AJOL)

    Vaginal Birth After Caesarean Section (VBAC), has for a long time been practised in low resource settings using nonconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice had been informed by observational ...

  1. Risk factors for cesarean section and instrumental vaginal delivery after successful external cephalic version

    NARCIS (Netherlands)

    de Hundt, Marcella; Vlemmix, Floortje; Bais, Joke M. J.; de Groot, Christianne J.; Mol, Ben Willem; Kok, Marjolein

    2016-01-01

    Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful external cephalic version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the

  2. Efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome.

    Science.gov (United States)

    Chauhan, Vidyalaxmi; Shah, Maitri C; Patel, Sangita V; Marfatia, Yogesh S; Zalavadiya, Dhara

    2016-01-01

    In spite of a few shortcomings such as over diagnosis and over treatment, syndromic management is a recommended practice in India for sexually transmitted infections (STIs). This study tries to find out the efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome. The objective of the study is to find out the effectiveness of syndromic management in terms of symptomatic improvement among females with vaginal discharge syndrome. A longitudinal study was conducted in Gynecology Department of Tertiary Care Hospital including 180 symptomatic females having vaginal discharge syndrome. Demographic profile, presenting complaints, menstrual history, obstetric history, partner history, and contraceptive history were noted. This was followed by clinical examination and specimen collection for laboratory tests and blood tests to find out type of STI including viral STI such as human immunodeficiency virus (HIV), herpes simplex virus (HSV), and hepatitis B surface antigen (HBsAg). Treatment was given according to syndromic management on the same day. All the participants were asked to come for follow-up after 15 days and their improvement in symptoms was noted as complete improvement, some improvement or no improvement on a five point scale. 63.9% cases showed complete improvement, while 36.1% showed some improvement. None of the patients was without any improvement. Vaginal discharge syndrome was most common between 20 and 30 years (43.4%), and 67.8% of symptomatic females with vaginal discharge syndrome belonged to the lower socioeconomic group. HSV infection was the most common (15%) associated viral infection with vaginal discharge syndrome, while hepatitis B infection was the least common (0.5%). HIV was reactive in 2.8% cases only. Syndromic management was found to be effective in relieving symptoms in most of the cases of vaginal discharge syndrome.

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

    Science.gov (United States)

    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

  4. Is vaginal microscopy an essential tool for the management of women presenting with vaginal discharge?

    Science.gov (United States)

    Lascar, R M; Devakumar, H; Jungmann, E; Copas, A; Arthur, G; Mercey, D

    2008-12-01

    Point-of-care microscopy is the gold standard for the diagnosis of vaginal discharge in genitourinary (GU) medicine clinics but not used in primary care settings and reproductive health clinics to which many patients present. In our GU medicine clinic setting, we conducted an audit to assess the utility of microscopy of vaginal secretions versus clinical diagnosis alone for the differential diagnosis of uncomplicated lower vaginal infections. Clinical diagnosis (including pH) of bacterial vaginosis had a sensitivity between 85% and 88% at two clinic sites. Our results suggest that it may be safe and more cost-effective to restrict vaginal microscopy to a subgroup of women presenting with vaginal discharge.

  5. Perceptions of vaginal microbicides as an HIV prevention method among health care providers in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Mantell Joanne E

    2007-03-01

    Full Text Available Abstract Background The promise of microbicides as an HIV prevention method will not be realized if not supported by health care providers. They are the primary source of sexual health information for potential users, in both the public and private health sectors. Therefore, the aim of this study was to determine perceptions of vaginal microbicides as a potential HIV prevention method among health care providers in Durban and Hlabisa, South Africa, using a combination of quantitative and qualitative methods. Results During 2004, semi structured interviews with 149 health care providers were conducted. Fifty seven percent of hospital managers, 40% of pharmacists and 35% of nurses possessed some basic knowledge of microbicides, such as the product being used intra-vaginally before sex to prevent HIV infection. The majority of them were positive about microbicides and were willing to counsel users regarding potential use. Providers from both public and private sectors felt that an effective microbicide should be available to all people, regardless of HIV status. Providers felt that the product should be accessed over-the-counter in pharmacies and in retail stores. They also felt a need for potential microbicides to be available free of charge, and packaged with clear instructions. The media was seen by health care providers as being an effective strategy for promoting microbicides. Conclusion Overall, health care providers were very positive about the possible introduction of an effective microbicide for HIV prevention. The findings generated by this study illustrated the need for training health care providers prior to making the product accessible, as well as the importance of addressing the potential barriers to use of the product by women. These are important concerns in the health care community, and this study also served to educate them for the day when research becomes reality.

  6. Intravaginal Administration of Sildenafil Citrate Increases Blood Flow in the Bovine Uterus

    Directory of Open Access Journals (Sweden)

    Dzięcioł Michał

    2015-04-01

    Full Text Available The aim of the study was to evaluate the influence of sildenafil citrate administrated intravaginaly on the blood flow in the bovine uterus during dioestrus. Uterine blood flow was examined in six healthy adult cows. Sildenafil was administrated intravaginaly to each co w between the 6th and 8th d of the ovarian cycle, in the form of vaginal suppositories containing 100 mg of active substance at a dose of 100, 200, or 300 mg per animal. Uterine perfusion was estimated by the colour Doppler examination, and obtained results were analysed with the Pixel Flux Software (Chameleon, Germany. Moreover, cardiovascular parameters were also evaluated. Animals were examined before and five times after drug application (two times at 15 min intervals, and three times at 2 h intervals. A placebo suppository was also given to the cows. The analysis of the intensity and velocity of blood flow in the uterus proved that sildenafil administrated intravaginaly significantly increased blood flow in the uterus and the effect of increased perfusion was observed for 4 h and 30 min after administration. The effect of increased uterine perfusion was observed after low as well as high doses of sildenafil. Significant changes in the cardio-vascular parameters were not detected. There were no changes in the uterine perfusion as well as in cardiovascular parameters after placebo administration.

  7. Sildenafil vaginal suppositories: preparation, characterization, in vitro and in vivo evaluation.

    Science.gov (United States)

    Shanmugam, Srinivasan; Kim, Young-Hun; Park, Jeong-Hee; Im, Ho Taek; Sohn, Young Taek; Kim, Kyeong Soo; Kim, Yong-Il; Yong, Chul Soon; Kim, Jong Oh; Choi, Han-Gon; Woo, Jong Soo

    2014-06-01

    The main objective was to investigate the in vitro release profile/kinetics, and in vivo plasma pharmacokinetics (PK) and organ biodistribution (BD) of the prepared sildenafil vaginal suppositories (SVS). Suppositories containing 25 mg of sildenafil were prepared by the cream melting technique using Witepsol H-15 as a suppository base. The suppositories were characterized for weight variation, content uniformity, hardness, disintegration time and crystallinity change. The in vitro dissolution in pH 4.5, and in vivo plasma PK and organ BD of sildenafil from SVS in female Sprague Dawley rats, were also investigated. The mean weight variation, content uniformity, hardness and disintegration time of the prepared SVS were 1.127 ± 0.020 g, 98.25 ± 2.50%, 2.5 ± 0.08 kg and 9 ± 1.0 min, respectively. The release of sildenafil from the SVS was more than 90% at 30 min, with a release kinetic of Hixson--Crowell model and non-Fickian diffusion (n = 0.464). The plasma PK study demonstrated a significantly lower Cmax (∼10 times) and AUC0-24 h (∼13 times) of sildenafil in plasma following intravaginal (IVG) administration of suppositories compared to oral (PO) administration of sildenafil solution. Nevertheless, the organ BD study showed a phenomenally higher Cmax (∼40 times) and AUC0-24 h (∼20 times) of sildenafil in uterus following IVG administration of suppositories than PO administration of sildenafil solution. This study demonstrated enhanced sildenafil exposure in the uterus following IVG administration of SVS, which could be used to target the uterus for therapeutic benefits.

  8. A Comparative Study of Vaginal Misoprostol and High Dose Intravenous Oxytocin for Second Trimester Pregnancy Termination

    Directory of Open Access Journals (Sweden)

    M. Rajaee

    2010-04-01

    Full Text Available Introduction & Objective: Second trimester labor induction is a major problem in obstetrics and is the cause of two-thirds of all abortion related complications and more than half of the maternal deaths associated with abortion. The goal of this study was to compare the effectiveness of vaginal misoprostol and intravenous oxytocin for termination of second trimester pregnancy.Materials & Methods: One hundred women were allocated in a randomized controlled way to one of the two induction groups: oxytocin group patients initially received an infusion of 50 units of oxytocin in 500 ml of ringer over 3 hours, 1 hour of no oxytocin followed by alternating 3 hours of oxytocin with 1 hour of rest. Oxytocin was increased by 50 units in each successive period until a final concentration of 300 units per 500 ml has been reached. Another group received 200 µg misoprostol tablets in posterior fornix vagina and was repeated after 12 hours if needed. The two groups were compared for induction to delivery intervals and their safety during induction. Results: The success rate within 24 hours of induction was 94% in the misoprostol group and 86% in oxytocin group (p= 0.182. The mean induction to delivery time was significantly longer in the oxytocin group compared with the misoprostol group.(13.5 versus 9.93 hours ; P=0.0057. Retained placenta requiring curettage was lower in the misoprostol group than the oxytocin group.Conclusion: Intravaginal misoprostol is more effective than high dose intravenous oxytocin in women with second trimester termination.

  9. Vaginal delivery of carboplatin-loaded thermosensitive hydrogel to prevent local cervical cancer recurrence in mice.

    Science.gov (United States)

    Wang, Xue; Wang, Jin; Wu, Wenbin; Li, Hongjun

    2016-11-01

    Local tumor recurrence after cervical cancer surgery remains a clinical problem. Vaginal delivery of thermosensitive hydrogel may be suited to reduce tumor relapse rate with more efficacy and safety. A pilot study was carried out to evaluate the efficacy of carboplatin-loaded poloxamer hydrogel to prevent local recurrence of cervical cancer after surgery. In vivo vaginal retention evaluation of 27% poloxamer hydrogel in mice was proven to be a suitable vaginal drug delivery formulation due to its low gelation temperature. A mimic orthotopic cervical/vaginal cancer recurrence model after surgery was established by injecting murine cervical cancer cell line U14 into the vaginal submucosa to simulate the residual tumor cells infiltrated in the surgical site, followed by drug administration 24 h later to interfere with the formation/recurrence of the tumor. By infusing fluorescein sodium-loaded hydrogel into the vagina of mice, a maximized accumulation of fluorescein sodium (Flu) in the vagina was achieved and few signals were observed in other organs. When used in the prevention of the cervical cancer formation/recurrence in mice, the carboplatin-loaded poloxamer hydrogel exhibited great efficacy and systemic safety. In conclusion, thermosensitive hydrogel presents a simple, practical approach for the local drug delivery via vagina against cervical cancer recurrence.

  10. Owning the birth experience: what factors influence women's vaginal birth after caesarean decision?

    Science.gov (United States)

    Konheim-Kalkstein, Yasmine L; Kirk, Colleen P; Berish, Kristen; Galotti, Kathleen M

    2017-09-01

    Our quantitative analysis examined what factors influence pregnant women to choose a vaginal birth after a caesarean (VBAC). There is growing concern over the high rates of caesarean section; much of the high rate is driven by repeat caesareans. A trial of labour after a previous caesarean is an option for many women increasingly supported by medical literature. Survey data from 173 pregnant women who had had only one birth by caesarean were analysed using a hierarchical binary logistic regression model. Desire for the experience of a vaginal birth strongly predicted choice of VBAC; however, this relationship was dampened among women with a high (versus low) powerful others (e.g. doctors and nurses) locus of control. Prior reason for a caesarean section and practical factors also play a role. Women may be more likely to choose VBAC if they are encouraged to believe that they can help control the outcome, especially if their desire for a vaginal birth experience is high.

  11. Screening of mucoadhesive vaginal gel formulations

    Directory of Open Access Journals (Sweden)

    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.

  12. Vaginal parity and pelvic organ prolapse.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Vaginal lactobacilli profile in pregnant women with normal & abnormal vaginal flora.

    Science.gov (United States)

    Yeruva, Thirupathaiah; Rajkumar, Hemalatha; Donugama, Vasundhara

    2017-10-01

    Lactobacilli species that are better adapted to vaginal environment of women may colonize better and offer protection against vaginal pathogenic bacteria. In this study, the distribution of common Lactobacillus species was investigated in pregnant women. Sixty seven pregnant women were included in the study and vaginal samples were collected for Gram staining. Women were classified as normal vaginal flora, intermediate flora and bacterial vaginosis (BV) based on Nugent's score. Vaginal samples were also collected for the identification of Lactobacillus spp. by multiplex polymerase chain reaction (PCR) profiling of 16S rDNA amplification method. Lactobacillus crispatus (100%) was the most predominant Lactobacillus spp. present in pregnant women with normal flora, followed by L. iners (77%), L. jensenii (74%) and L. helveticus (60%). While, L. iners was commonly present across groups in women with normal, intermediate or BV flora, L. crispatus, L. jensenii and L. helveticus decreased significantly as the vaginal flora changed to intermediate and BV. In women with BV, except L. iners other species of lactobacilli was less frequently prevalent. Species such as L. rhamnosus, L. fermentum, L. paracasei and L. casei were not detected in any vaginal sample. L. crispatus, L. jensinii and L. helveticus were predominant species in women with normal flora. L. crispatus alone or in combination with L. jensinii and L. helveticus may be evaluated for probiotic properties for the prevention and treatment of BV.

  15. Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy.

    Science.gov (United States)

    Dugal, R; Hesla, K; Sørdal, T; Aase, K H; Lilleeidet, O; Wickstrøm, E

    2000-04-01

    Atrophic vaginitis is a common condition. This study compared the usefulness of estradiol vaginal tablets (EVT) and estriol vagitories (EV) in treatment of atrophic vaginitis. Ninety-six postmenopausal women with symptoms of atrophic vaginitis were treated for 24 weeks with either EVT or with EV. Patients used the medication daily for the first 2 weeks of the study, and twice-weekly thereafter. Both EVT and EV were effective in treating vaginal atrophy and patients in both treatment groups experienced a significant improvement in vaginal symptoms such as itching, irritation, dryness, and dyspareunia. At the end of the study three (6%) EVT treated women reported leakage and none needed to use sanitary towels. Among the EV treated women 31 (65%) reported leakage and 14 (29%) required sanitary protection. Furthermore, 90% in the EVT group perceived the medication as hygienic compared to 79% in the EV group, and 49% in the EVT group indicated that the product was easy to use compared to 28% in the EV group. Endometrial thickness was increased (1.1 mm with EVT and 0.5 mm on EV) in both treatment groups during the first 2 weeks of the study, but returned to baseline levels when the frequency of drug application was reduced to twice-weekly. Estradiol vaginal tablets provides an effective alternative to traditional forms of local estrogen therapy.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Vaginal rings for delivery of HIV microbicides

    Directory of Open Access Journals (Sweden)

    McCoy CF

    2012-11-01

    Full Text Available R Karl Malcolm, Susan M Fetherston, Clare F McCoy, Peter Boyd, Ian MajorSchool of Pharmacy, Queen's University Belfast, Belfast, UKAbstract: Following the successful development of long-acting steroid-releasing vaginal ring devices for the treatment of menopausal symptoms and contraception, there is now considerable interest in applying similar devices to the controlled release of microbicides against HIV. In this review article, the vaginal ring concept is first considered within the wider context of the early advances in controlled-release technology, before describing the various types of ring device available today. The remainder of the article highlights the key developments in HIV microbicide-releasing vaginal rings, with a particular focus on the dapivirine ring that is presently in late-stage clinical testing.Keywords: controlled release, sustained release, antiretroviral, dapivirine, SILCS diaphragm, silicone elastomer, thermoplastic

  18. Intravaginal contrast-enhanced MR imaging. Diagnostic value in gynecological cancer

    International Nuclear Information System (INIS)

    Brandoni, Norma; Cosci, Eduardo; Freytes, Alicia; Belizan, Adrian; Tosolini, Jorge

    2003-01-01

    Purpose: To analyze the utility of the vaginal contrast medium (VCM) in the MRI of pelvis and its impact in the diagnosis of gynecology cancer. Materials and methods: We present 30 patients with gynecological cancer (cervical carcinoma, n = 26; endometrial carcinoma, n = 3 and ovarian carcinoma, n = 1) studied with pelvic MRI before and after opacification of the vagina with echographic gel. In our series, the patient's ages ranged between 26-76 years, average 52 years. Patients were divided into Group S (Staging) and Group R (Recurrent disease). In the staging group were included: 12 cervical carcinomas (FIGO stage I, n 3; IIA, n = 1; IIB n = 8) and 2 endometrial carcinomas (FIGO stage IC). In Group R were included 14 cervical, 1 endometrial and 1 ovarian carcinomas. In 11/30 cases (36,6%) VCM caused a mild discomfort. Results: Taken into account the various anatomic structures considered as landmarks for tumor staging the VCM improved their visualization in different percentages: vagina and fornix in all cases (100%), parametrium in 15 cases (50%), bladder in 16 cases (53%), and rectum in 20 cases (67%). In only 3 cases VCM conduced to a worse definition of the rectal anterior wall. Conclusion: In our work in progress the use of VCM improved the diagnostic value of the pelvic MRI in the pre and post-therapeutic work-up of patients with gynecological cancer. The VCM administration was easy, with low cost, and without complications or any considerable discomfort. However, further experience is required to quantify the VCM contribution for MRI tumor staging in cervical and endometrial carcinomas. (author)

  19. Pregnancy's stronghold on the vaginal microbiome.

    Directory of Open Access Journals (Sweden)

    Marina R S Walther-António

    Full Text Available To assess the vaginal microbiome throughout full-term uncomplicated pregnancy.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.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.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 investigating the role of the microbiome in

  20. Vaginal delivery after one cesarean section

    Directory of Open Access Journals (Sweden)

    Bianca Totta Patrício

    2012-11-01

    Full Text Available ABSTRACT Objective: to identify the validity of trial of labor in women with second pregnancy and previous cesarean section, to observe vaginal deliverance and probable maternal and perinatal complications. Methods: prospective cohort study of labors (03/2010 - 03/2011. The dependent variables analyzed: vaginal delivery or cesarean section, puerperal and perinatal results complications. The control variables were: epidemiological data, previous maternal and perinatal history, maternal and fetal wellness, labor induction, weekly day and hour of labor, moment of information and birth justification to the patient. The statistical comparison used the chi-squared test with 5% significance and the program Statistical Package for Social Sciences. Results: significance in steady union and married women for cesareans sections, and single in vaginal births (p = 0.004; complete membranes were significant in cesareans sections and rupture of them to vaginal deliveries (p = 0,.001. There was a predominance of cesareans sections during 12:01 - 24:01 hours, and vaginal births from 00:01 - 6:00 hours (p = 0.036. There were no significant events in maternal and fetal complications. Newborns of c-sections were significantly heavier (p = 0.011; extra-uterine vital conditions of 1 and 5 minutes presented no difference between cesarean sections and vaginal births. Conclusion: the trial of labor in 80 patients with second pregnancy and one previous cesarean section avoided the second cesarean section in 42,5% in this patients. The results confirm that trial of labor should be stimulated to labor patients with second pregnancy and one previous cesarean section.

  1. Self medication with vaginal misoprostol in a term pregnancy: case ...

    African Journals Online (AJOL)

    eclampsia at term, who self administered misoprostol by the vaginal route - without its being prescribed - in an attempt to avoid repeat caesarean section, is described. She eventually had vaginal delivery of a live female infant with cardiopulmonary ...

  2. Vaginal pH: Home-Use Tests

    Science.gov (United States)

    ... a combination of: pH, microscopic examination of the vaginal discharge, amine odor, culture, wet preparation, and Gram stain. Does a positive test mean you have a vaginal infection? No, a positive test (elevated pH) could ...

  3. The role of vaginal cuff brachytherapy in endometrial cancer.

    Science.gov (United States)

    Harkenrider, Matthew M; Block, Alec M; Siddiqui, Zaid A; Small, William

    2015-02-01

    The purpose of this article is to review the data, rationale, and recommendations of vaginal brachytherapy (VBT) in the post-operative treatment of endometrial cancer patients. The authors performed a thorough review of the medical literature regarding the use of adjuvant VBT in the treatment of endometrial cancer. Relevant data are presented in this review. Additionally, personal and institutional practices from the authors are incorporated where relevant. VBT for the adjuvant treatment of early stage endometrial cancer patients results in a low rate of recurrence (0-3.1%) with very low rates of toxicity. PORTEC-2 supports the use of adjuvant VBT versus external beam radiotherapy specifically for high-intermediate risk endometrial cancer patients. VBT has low rates of acute and chronic gastrointestinal and genitourinary toxicity and very low rates of second primary malignancy. The primary toxicity of VBT is vaginal atrophy and stenosis with controversy regarding the use of vaginal dilators for prevention. Data support that patients prefer to be involved in the decision making process for their adjuvant therapy, and patients have a lower minimal desired benefit of adjuvant VBT than do physicians. Guidelines exist from the American Brachytherapy Society and American Society of Radiation Oncology with support from the Society for Gynecologic Oncologists regarding the use of adjuvant VBT. VBT decreases the risk of recurrence with minimal toxicity in the adjuvant treatment of endometrial cancer. Adjuvant therapy should be discussed in a multi-disciplinary setting with detailed counseling of the risks and benefits with the patient so that she ultimately makes an informed decision regarding her adjuvant therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Evaluation of the safety and efficacy of a monopolar nonablative radiofrequency device for the improvement of vulvo-vaginal laxity and urinary incontinence.

    Science.gov (United States)

    Lalji, Shelena; Lozanova, Paula

    2017-06-01

    Vaginal childbirth, natural process of aging, congenital factors, and surgical interventions are considered the main causes of vulvo-vaginal laxity driven by changes in collagen and elastin fibers. This causes a loss of strength and flexibility within the vaginal wall. As a result, women may experience lack of sensation and stress urinary incontinence (SUI)-the condition of involuntary loss of urine associated with activities that cause an increase in intra-abdominal pressure (eg, sneezing, coughing, and lifting). Both vaginal laxity and urinary incontinence significantly affect patients' quality of life (QoL). The aim of this study was to evaluate efficacy and safety of a noninvasive radiofrequency device when used to treat SUI and vulvo-vaginal laxity through its heating effect which stimulates collagen and elastin fibers. Twenty-seven women (average age 44.78±10.04 years) with indications of mild/moderate SUI as well as vulvo-vaginal laxity were treated with a monopolar radiofrequency device. The treatment course consisted of three once-a-week sessions. Each session included intravaginal treatment followed by treatment of labia majora and the perineum. Improvement in the SUI condition was evaluated by applying the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF). Data were collected at the baseline, after the last treatment and at 1-month follow-up visit. Vaginal laxity was assessed by subjective vulvo-vaginal laxity questionnaire (VVLQ). Data were collected before the 1st treatment and during the 1-month follow-up visit. Patient's satisfaction was recorded using a satisfaction questionnaire. Data were collected after the last treatment and at the 1-month follow-up visit. Any adverse events related to the treatments were monitored. On a scale of 0 to 5, the average frequency of urine leak improved from "2-3 times a week" (2.15±1.03 points prior to treatment) to "once a week" (1.00±0.78 points post

  5. Fanconi anemia and vaginal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Jesus Paula Carvalho

    2012-01-01

    Full Text Available Fanconi Anemia (FA is an autosomal recessive disease characterized by chromosome instability, cellular hypersensitivity to DNA cross-linking agents, and increased predisposition to malignancies. We describe here a 28 year-old female with FA and vaginal squamous cell carcinoma treated by radiation therapy alone. The patient developed arm phlebitis, pulmonary fungal infection, and severe rectal bleeding, followed by hypocalcaemia, hypokalemia, vaginal bacterial and fungal infection, with subsequent leg and arm phlebitis, perineal abscess, and sepsis. The patient died 12 weeks later.

  6. Polyethylene glycol-functionalized poly (Lactic Acid-co-Glycolic Acid and graphene oxide nanoparticles induce pro-inflammatory and apoptotic responses in Candida albicans-infected vaginal epithelial cells.

    Directory of Open Access Journals (Sweden)

    R Doug Wagner

    Full Text Available Mucous-penetrating nanoparticles consisting of poly lactic acid-co-glycolic acid (PLGA-polyethylene glycol (PEG could improve targeting of microbicidal drugs for sexually transmitted diseases by intravaginal inoculation. Nanoparticles can induce inflammatory responses, which may exacerbate the inflammation that occurs in the vaginal tracts of women with yeast infections. This study evaluated the effects of these drug-delivery nanoparticles on VK2(E6/E7 vaginal epithelial cell proinflammatory responses to Candida albicans yeast infections. Vaginal epithelial cell monolayers were infected with C. albicans and exposed to 100 μg/ml 49.5 nm PLGA-PEG nanospheres or 20 μg/ml 1.1 x 500 nm PEG-functionalized graphene oxide (GO-PEG sheets. The cells were assessed for changes in mRNA and protein expression of inflammation-related genes by RT-qPCR and physiological markers of cell stress using high content analysis and flow cytometry. C. albicans exposure suppressed apoptotic gene expression, but induced oxidative stress in the cells. The nanomaterials induced cytotoxicity and programmed cell death responses alone and with C. albicans. PLGA-PEG nanoparticles induced mRNA expression of apoptosis-related genes and induced poly (ADP-ribose polymerase (PARP cleavage, increased BAX/BCL2 ratios, and chromatin condensation indicative of apoptosis. They also induced autophagy, endoplasmic reticulum stress, and DNA damage. They caused the cells to excrete inflammatory recruitment molecules chemokine (C-X-C motif ligand 1 (CXCL1, interleukin-1α (IL1A, interleukin-1β (IL1B, calprotectin (S100A8, and tumor necrosis factor α (TNF. GO-PEG nanoparticles induced expression of necrosis-related genes and cytotoxicity. They reduced autophagy and endoplasmic reticulum stress, and apoptotic gene expression responses. The results show that stealth nanoparticle drug-delivery vehicles may cause intracellular damage to vaginal epithelial cells by several mechanisms and that

  7. Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis

    OpenAIRE

    Aytekin Tokmak; İrfan Özer; Selçuk Erkılınç; Ali İrfan Güzel; Mahmut Kuntay Kokanalı; Mustafa Uğur

    2015-01-01

    Objective: The aim of this study is to evaluate the C-reactive protein (CRP) levels in vaginal washing fluid (VWF) in women with a history of recurrent and/or treatment resistant vaginitis. Methods: This prospective case control study was conducted in the gynecology clinic of the current hospital. A total of 64 women (33 with a history of recurrent and/ or treatment resistant vaginitis as study group and 31 healthy women as control group) were enrolled in the study. The recorded parameters we...

  8. Intravaginal Administration of Interleukin 12 during Genital Gonococcal Infection in Mice Induces Immunity to Heterologous Strains ofNeisseria gonorrhoeae.

    Science.gov (United States)

    Liu, Yingru; Perez, Julianny; Hammer, Laura A; Gallagher, Heather C; De Jesus, Magdia; Egilmez, Nejat K; Russell, Michael W

    2018-01-01

    It has previously been shown that genital tract infection with Neisseria gonorrhoeae in mice does not induce a state of protective immunity against reinfection but instead suppresses the development of adaptive immune responses against N. gonorrhoeae dependent on transforming growth factor beta (TGF-β) and interleukin 10 (IL-10). Intravaginal administration during gonococcal infection of IL-12 encapsulated in biodegradable microspheres (IL-12/ms) reverses the immunosuppression and promotes the production of gamma interferon (IFN-γ) and of specific antibodies in serum and genital secretions and accelerates clearance of the infection. In this study, microspheres were shown to remain largely within the genital tract lumen and to release IL-12 over the course of 4 days. Antigonococcal IgA and IgG antibodies induced by IL-12/ms treatment reacted with antigenically different strains of N. gonorrhoeae and led to resistance to reinfection with heterologous and homologous strains. Immune resistance to reinfection persisted for at least 6 months after clearance of the primary infection. Experiments performed with immunodeficient strains of mice lacking either IFN-γ or B cells demonstrated that both IFN-γ and B cells were necessary for the IL-12-induced generation of immune responses to N. gonorrhoeae and the resulting accelerated clearance of the infection. It is therefore concluded that intravaginally administered IL-12/ms achieves its effect by the sustained release of IL-12 that promotes Th1-driven adaptive immune responses, including the production of specific antigonococcal antibodies that cross-react with multiple strains of N. gonorrhoeae . IL-12-enhanced immunity to N. gonorrhoeae can be recalled against reinfection after prolonged intervals and is dependent upon both IFN-γ and antibody production by B cells. IMPORTANCE Genital infection with Neisseria gonorrhoeae (gonorrhea) is a significant cause of reproductive tract morbidity in women, leading to

  9. Spectrum of vaginal discharge in a tertiary care setting

    OpenAIRE

    Sivaranjini, R; Jaisankar, TJ; Thappa, Devinder Mohan; Kumari, Rashmi; Chandrasekhar, Laxmisha; Malathi, M; Parija, SC; Habeebullah, S

    2013-01-01

    Introduction: Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the v...

  10. A case report of premenarchial transverse vaginal septum at the ...

    African Journals Online (AJOL)

    Diagnosis was made following a history of primary amenorrhea, cyclical low abdominal pain and pelvic examination which revealed a vaginal septum. She had surgical resection of the vaginal septum and a vaginal stent was left in-situ to keep the vagina patent during the healing process. The procedure was uneventful and ...

  11. Complete utero vaginal prolapse in a woman with prolapsed ...

    African Journals Online (AJOL)

    Case: A case of irreducible complete utero-vaginal and infected sub-mucous fibroid prolapse, in a 45-year-old grandmultiparous woman, is reported. Bed rest and antibiotics failed to relief edema and infection of the vault. Vaginal myomectomy, followed by interval vaginal hysterectomy, and pelvic floor repair a week later ...

  12. Optimal Breeding Time Determination in Bitch Using Vaginal Cytology

    African Journals Online (AJOL)

    Optimal Breeding Time Determination in Bitch Using Vaginal Cytology: Case Report. ... This result once again emphasized the accuracy of vaginal cytology as a useful tool to determine an optimal breeding time in bitch. Hence, vaginal cytology, though can not detect ovulation day, will continue to be patronized by small ...

  13. Abdominal radical trachelectomy for vaginal cancer – A case report

    OpenAIRE

    Mari Matsuoka; Rumiko Yamamoto; Natsuki Tsuji; Koichi Terakawa; Tadayoshi Nagano

    2017-01-01

    Highlights ? Vaginal cancer is most common in elderly woman and very rare in young woman. ? Stage I vaginal cancer is treated with surgery and radiotherapy. ? Vaginal cancer in a young patient was treated by intra-arterial chemotherapy followed by abdominal radical trachelectomy.

  14. Prevalence of Vaginal Candidiasis among Pregnant Women with ...

    African Journals Online (AJOL)

    BACKGROUND: Pregnancy represents a risk factor in the occurrence of vaginal candidiasis. OBJECTIVES: To determine the prevalence and clinical features associated with abnormal vaginal discharge and C. albicans infection in pregnant women. METHODS: High vaginal swab samples and data on epidemiological ...

  15. 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.

  16. Pregnancy outcome and factors affecting vaginal delivery of twins at ...

    African Journals Online (AJOL)

    2012-12-13

    Dec 13, 2012 ... and strong aversion for caesarean delivery, vaginal delivery would be more acceptable. This study aims to determine the predictors of vaginal delivery in ... vaginal delivery or loss of more than 1000 ml of blood during caesarean section. Fetal presentations were determined using clinical examination and ...

  17. a case report of premenarchial transverse vaginal septum

    African Journals Online (AJOL)

    Diagnosis was made following a history of primary amenorrhea, cyclical low abdominal pain and pelvic examination which revealed a vaginal septum. She had surgical resection of the vaginal septum and a vaginal stent was left in-situ to keep the vagina patent during the healing process. The procedure was uneventful and ...

  18. An audit of instrumental vaginal delivery in Aminu Kano Teaching ...

    African Journals Online (AJOL)

    Context: Operative vaginal delivery is used to shorten the second stage of labour. Objective: The aim of this study is to determine the incidence of instrumental vaginal deliveries in a large teaching hospital. Study design and setting: Descriptive study involving 354 women, who either had forceps or vacuum operative vaginal ...

  19. The effects of prolapse surgery on vaginal wall sensibility, vaginal vasocongestion, and sexual function: a prospective single centre study.

    Science.gov (United States)

    Lakeman, Marielle M E; Laan, Ellen; Roovers, Jan-Paul W R

    2014-11-01

    Prolapse surgery has been shown to positively alter body image and decrease pelvic floor symptoms, hereby possibly improving sexual function. However, the surgical trauma itself may adversely affect sexual function, by damaging vaginal innervation and vascularization. The aim of this study is to evaluate the effects of vaginal prolapse surgery on vaginal vasocongestion, vaginal wall sensibility, and sexual function. A prospective study was performed, including patients scheduled for vaginal prolapse surgery. Participants underwent measurements before and 6 months after surgery, during non-erotic and erotic visual stimuli. Measurements were performed using a vaginal combi-probe which includes vaginal photoplethysmography to assess vaginal pulse amplitude (VPA) (representing vaginal vasocongestion), and four pulse-generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (FSFI, FSDS-R, SSAQ). Twenty-nine women were included, 24 (83%) completed the 6 months follow-up. VPA analysis showed a significant reduction in vaginal vasocongestion during sexual stimulation post-operatively (pre-op 2.4 mV (SD 2.5) vs. post-op 1.7 mV (SD 2.4), P = 0.05). Vaginal wall sensibility in the cranial posterior vaginal wall was significantly reduced after surgery (pre-op 13.3 mA vs. post-op 17.5 mA, P sensibility in the other three locations was not affected by surgery. Sexual function as assessed with questionnaires, was not significantly affected. Prolapse surgery negatively impacted levels of vaginal vasocongestion during erotic stimuli as well as vaginal wall sensibility in the cranial posterior wall. Future studies are needed to tease out if these changes in physiological factors are relevant for subjective sexual function. © 2013 Wiley Periodicals, Inc.

  20. 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.

  1. Vaginal misoprostol versus vaginal surgical evacuation of first trimester incomplete abortion: Comparative study

    Directory of Open Access Journals (Sweden)

    Mahmoud Shokry

    2014-06-01

    Conclusion: Although vaginal surgical evacuation is more effective than misoprostol in solving the problem still medical treatment is effective and acceptable especially when surgical management is not available or risky or patients refuse to do surgical management.

  2. 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

  3. Vaginal plethysmography in women with dyspareunia

    NARCIS (Netherlands)

    Wouda, JC; Hartman, Petra M; Bakker, Riksta M; Bakker, JO; van de Wiel, HBM; Schultz, WCMW

    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

  4. Predictors of vaginal delivery in nulliparous mothers

    African Journals Online (AJOL)

    E-mail: ourgodreigns2004@yahoo.co.uk. Abstract. Background: Nulliparity is an obstetric high-risk group whose labor, compared with multiparae, are more likely to develop labor abnormalities that requires intervention. The aim of this report is todetermine factors that influence vaginal delivery in nulliparae. Materials and ...

  5. 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.

  6. vaginal histological changes of the baboon

    African Journals Online (AJOL)

    2009-04-04

    Apr 4, 2009 ... the changes on the perineal sex skin which has led to easier follow up of baboon menstrual cycle (1,5). ... of vaginal epithelial histological changes during the menstrual cycle and perineal sex skin changes. ..... In normally cycling women, Patton et al (7) showed that the thickness of the ectocervical and.

  7. Laparoscopic assisted vaginal hysterectomy for benign uterine ...

    African Journals Online (AJOL)

    Objective: To determine the acceptability and outcome of laparoscopic assisted vaginal hysterectomy at the Aga Khan Hospital, Nairobi. Design: A retrospective case analysis. Subjects: Two hundrend and twenty nine cases of laparoscopic assisted hysterectomy were undertaken at various hospitals in the presence of the ...

  8. [Severe vaginal discharge following rectal surgery

    NARCIS (Netherlands)

    Burg, L.C.; Bremers, A.J.A.; Heesakkers, J.P.; Kluivers, K.B.

    2018-01-01

    BACKGROUND: Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on

  9. The vaginal microflora in relation to gingivitis

    Science.gov (United States)

    2009-01-01

    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 gingivitis had higher counts of Prevotella bivia (p 1.0 × 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p 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. PMID:19161595

  10. Bioadhesive Controlled Release Clotrimazole Vaginal Tablets | Bhat ...

    African Journals Online (AJOL)

    Conclusion: This study indicates the possible use of suitable mixtures of natural and semi-synthetic cellulosic polymers for the preparation of clotrimazole mucoadhesive tablets for application as a vaginal controlled delivery system. Keywords: Clotrimazole, Swelling, Cellulosic polymers, Guar gum, Bioadhesion, Release ...

  11. Brachytherapy in treatment of vaginal cancer

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Characteristics of diagnosis and treatment of different types of primary vaginal cancer are highlighted, the role and place of brachytherapy as independent method or combined treatment modality for this pathology is shown in the review. Epidemiological data on incidence of vaginal cancer in Russia are represented, presumptive mechanisms for development of the disease, risk factors, histological types, features of the course, clinical presentation, diagnostic algorithm are described. Treatment methods for primary vaginal cancer according to world standards such as surgery, radiotherapy and systemic drug therapy are covered. Specifics of radiological methods of treatment (low-dose rate and high-dose rate brachytherapy, including the combination with external beam radiotherapy according to the stage of the disease, are shown in details. The results of several large foreign clinical trials for efficiency of different methods of radiotherapy are discussed. The combination of brachytherapy on primary tumor with external radiation therapy to the lymph nodes was confirmed to be the most effective modality. The conclusion on opportunities of different methods of radiotherapy in treatment of vaginal cancer was made.

  12. [Vaginal birth after cesarean. A safe option?].

    Science.gov (United States)

    García-Benítez, Carlos Quesnel; López-Rioja, Miguel de Jesús; Monzalbo-Núñez, Diana Elena

    2015-02-01

    To compare the beginning and evolution of labor variables such as demographic characteristics, obstetric and perinatal outcomes of patients with vaginal birth after cesarean (VBAC). Observational, retrospective and retro elective trial purposes of comparative analysis, were divided into groups by the onset of labor; spontaneously versus induction and by the labor evolution; spontaneously versus conduction. Being analyzing by Student's T and Fisher test. According the ACOG criteria. 136 patients with prior cesarean section were eligible to labor. The indications of previous cesarean have a trend of a non-recurring etiology, being the elective cesarean section the most common. Regarding the onset, 78% was spontaneous and 22% had an induction. Comparing the demographic characteristics it stands a greater number of deliveries, history of vaginal delivery, a higher Bishop score, fetal weight estimated lower and higher intergenesic period. As a perinatal prognosis, the study has shown be safe with a positive outcome. Conclusions:Vaginal birth after cesarean is safe, that should be offered to all women with a low transverse incision, with an intergenesic period greater than 18 months, whit a singleton pregnancy, in a cephalic presentation, with an appropriate fetal weight, and without obstetric contraindications of vaginal delivery.

  13. Toward an ethically responsible approach to vaginal birth after cesarean.

    Science.gov (United States)

    Lyerly, Anne Drapkin; Little, Margaret Olivia

    2010-10-01

    Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a taxonomy of considerations that should inform a responsible framework for guideline development and highlight critical distinctions between types of guidelines that have been blurred in the past. We then forward 2 central claims. First, in otherwise uncomplicated birth after a single previous cesarean, both vaginal birth after cesarean and repeat cesarean should be regarded as reasonable options; women, rather than policymakers, providers, insurance carriers, or hospitals, should determine delivery approach. Second, in complicated cases, providers and policymakers should carefully calibrate the strength of evidence to ensure differential risk and cost are adequate to justify directive guidelines given important variations in values women bring to childbirth. Copyright © 2010 Elsevier Inc. All rights reserved.

  14. Vaginal foreign body causing recurrent discharge and vaginal stenosis--a case report.

    Science.gov (United States)

    Gurung, Geeta; Rana, Ashma; Amatya, Archana

    2007-06-01

    Chronic vaginal discharge in children and adolescents is a common gynaecological complaint which is often resistant to antibiotic treatment. We present a 14 years old, premenarcheal girl who presented to us with the complaints of recurrent, foul smelling purulent occasionally blood stained vaginal discharge for eight years, where a foreign body in the upper vagina was found after releasing a dense adhesion of the lower vagina which was unable to detect by pelvic ultrasound.

  15. "Shotgun" versus sequential testing. Cost-effectiveness of diagnostic strategies for vaginitis.

    Science.gov (United States)

    Carr, Phyllis L; Rothberg, Michael B; Friedman, Robert H; Felsenstein, Donna; Pliskin, Joseph S

    2005-09-01

    Although vaginitis is a common outpatient problem, only 60% of patients can be diagnosed at the initial office visit of a primary care provider using the office procedures of pH testing, whiff tests, normal saline, and potassium hydroxide preps. To determine the most cost-effective diagnostic and treatment approach for the medical management of vaginitis. Decision and cost-effectiveness analyses. Healthy women with symptoms of vaginitis undiagnosed after an initial pelvic exam, wet mount preparations, pH, and the four criteria to diagnose bacterial vaginosis. General office practice. We evaluated 28 diagnostic strategies comprised of combinations of pH testing, vaginal cultures for yeast and Trichomonas vaginalis, Gram's stain for bacterial vaginosis, and DNA probes for Neisseria gonorrhoeae and Chlamydia. Data sources for the study were confined to English language literature. The outcome measures were symptom-days and costs. The least expensive strategy was to perform yeast culture, gonorrhoeae and Chlamydia probes at the initial visit, and Gram's stain and Trichomonas culture only when the vaginal pH exceeded 4.9 (330 dollars, 7.30 symptom days). Other strategies cost 8 dollars to 76 dollars more and increased duration of symptoms by up to 1.3 days. In probabilistic sensitivity analysis, this strategy was always the most effective strategy and was also least expensive 58% of the time. For patients with vaginitis symptoms undiagnosed by pelvic examination, wet mount preparations and related office tests, a comprehensive, pH-guided testing strategy at the initial office visit is less expensive and more effective than ordering tests sequentially.

  16. The value of vaginal packing in pelvic floor surgery: a randomised double-blind study.

    Science.gov (United States)

    Thiagamoorthy, G; Khalil, A; Cardozo, L; Srikrishna, S; Leslie, G; Robinson, D

    2014-05-01

    The objective of this study was to evaluate the effect of vaginal packing following pelvic floor surgery with regard to post-operative pain, bleeding and infection. This was a double-blind randomised study of women undergoing vaginal hysterectomy and/or pelvic floor repair at a tertiary urogynaecology unit. The primary outcome of day 1 post-operative pain was assessed using the short-form McGill Pain score. Secondary outcomes were haematological and infective morbidity, evaluated using changes in full blood count, and cultures of midstream urine and high vaginal swabs. A transvaginal ultrasound scan to exclude pelvic haematoma was performed at 6 weeks in all women who underwent vaginal hysterectomy with or without a pelvic floor repair. In total, 190 women were recruited: mean age 58.3 years (27-91 years), mean body mass index 27.4 kg/m(2) and median parity 3. Women were randomised into the 'pack' (n = 86) and 'no pack' (n = 87) arms with no demographic differences between the groups. No statistically significant differences in the post-operative pain scores or secondary outcome measures were demonstrated. Incidence of haematoma formation (14.8 % no pack, 7.3 % pack, p = 0.204) was not statistically significant. There were three clinically significant complications in the no pack group and none in the pack group. This is the first study to examine pain in association with post-operative vaginal packing. There is no evidence to suggest that packing increases pain scores or post-operative morbidity. A trend towards increased haematoma and significant complications was seen in the no pack group. As vaginal packing does no harm and may be of some benefit it may be argued that packing should be recommended as routine clinical practice.

  17. 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. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Vaginal bleeding in late pregnancy

    Science.gov (United States)

    ... al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178. Review Date 11/11/2016 Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University ...

  19. Vaginal bleeding in early pregnancy

    Science.gov (United States)

    ... al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178. Review Date 11/11/2016 Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University ...

  20. An unusual case of vaginal myoma presenting with postmenopausal bleeding.

    Directory of Open Access Journals (Sweden)

    Lajya Devi Goyal

    2013-06-01

    Full Text Available Vaginal leiomyomas are uncommon benign tumour with variable clinical presentation. These tumours arise most commonly from anterior vaginal wall. We report a case of 50-year old postmenopausal woman who presented with urinary retention, profuse vaginal bleeding and mass protruding into vagina. Local examination revealed a pedunculated mass attached to the posterior vaginal wall with vascular stalk one cm below the cervix. Mass was hanging outside vulva and vascular pedicle was profusely bleeding. The pedicle was ligated and tumour was excised. Subsequent histopathology revealed a vaginal myoma.

  1. Group B streptococcus exploits vaginal epithelial exfoliation for ascending infection.

    Science.gov (United States)

    Vornhagen, Jay; Armistead, Blair; Santana-Ufret, Verónica; Gendrin, Claire; Merillat, Sean; Coleman, Michelle; Quach, Phoenicia; Boldenow, Erica; Alishetti, Varchita; Leonhard-Melief, Christina; Ngo, Lisa Y; Whidbey, Christopher; Doran, Kelly S; Curtis, Chad; Waldorf, Kristina M Adams; Nance, Elizabeth; Rajagopal, Lakshmi

    2018-04-09

    Thirteen percent of pregnancies result in preterm birth or stillbirth, accounting for fifteen million preterm births and three and a half million deaths annually. A significant cause of these adverse pregnancy outcomes is in utero infection by vaginal microorganisms. To establish an in utero infection, vaginal microbes enter the uterus by ascending infection; however, the mechanisms by which this occurs are unknown. Using both in vitro and murine models of vaginal colonization and ascending infection, we demonstrate how a vaginal microbe, group B streptococcus (GBS), which is frequently associated with adverse pregnancy outcomes, uses vaginal exfoliation for ascending infection. GBS induces vaginal epithelial exfoliation by activation of integrin and β-catenin signaling. However, exfoliation did not diminish GBS vaginal colonization as reported for other vaginal microbes. Rather, vaginal exfoliation increased bacterial dissemination and ascending GBS infection, and abrogation of exfoliation reduced ascending infection and improved pregnancy outcomes. Thus, for some vaginal bacteria, exfoliation promotes ascending infection rather than preventing colonization. Our study provides insight into mechanisms of ascending infection by vaginal microbes.

  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. Maternal and neonatal outcomes of attempted vaginal compared with planned cesarean delivery in triplet gestations.

    Science.gov (United States)

    Lappen, Justin R; Hackney, David N; Bailit, Jennifer L

    2016-10-01

    The prevailing obstetric practice of planned cesarean delivery for triplet gestations is largely empiric and data on the optimal route of delivery are limited. The primary objectives of this study are to determine the likelihood of success in an attempted vaginal delivery and assess maternal and neonatal outcomes of attempted vaginal vs planned cesarean delivery of triplets using a multiinstitution obstetric cohort. We performed a retrospective cohort study using data from the Consortium on Safe Labor, identifying triplet pregnancies with delivery at a gestational age ≥28 weeks. Women with a history of cesarean delivery and pregnancies complicated by chromosomal or congenital anomalies, twin-twin transfusion syndrome, or a fetal demise were excluded. The attempted vaginal group included all women with spontaneous or induced labor and excluded all women delivering by prelabor cesarean delivery, including those coded as elective or for fetal malpresentation. Primary maternal outcomes included infection (composite of chorioamnionitis, endometritis, wound separation, and wound infection), blood transfusion, or transfer to the intensive care unit. Primary neonatal outcomes included neonatal asphyxia, mechanical ventilation, and composite neonatal morbidity, consisting of ≥1 of the following: birth injury, 5-minute Apgar delivery group was restricted to include only women with evidence of induction or augmentation or labor. 188 triplet sets were identified of which 80 sets (240 neonates) met inclusion criteria and 24 sets (30%) had an attempted vaginal delivery. The rate of successful attempted vaginal delivery was 16.7% (4 triplet sets; 12 neonates). No women had a combined mode of delivery. Women attempting vaginal delivery were more likely to have preterm labor (45.8 vs 12.5%, P delivery did not differ by mode of delivery. Attempted vaginal delivery was associated with a higher risk of maternal transfusion (20.8% vs 3.6%, P = .01) and neonatal mechanical

  4. Treatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum

    Directory of Open Access Journals (Sweden)

    I Wayan Megadhana

    2016-06-01

    Full Text Available Background: A vaginal obstruction often occurs as a complication in women who had previously undergone an excision of a transverse vaginal septum. The use of a mold coated with membranes in the correction surgery provides a good healing prognosis. Objective: To report a case of a treatment of a recurrent vaginal obstruction with a modified mold after undergoing an excision of a transverse vaginal septum in a 15-year-old woman. Result: A follow-up on the patient, four months after using the modified mold, showed a regular menstrual cycles without a sign of vaginal narrowing, an infection, nor a complaint. Conclusion: The treatment using a modified mold, for a recurrent vaginal obstruction after an excision of a transverse vaginal septum, is a new innovation with a satisfactory result.

  5. The Comparison of vaginal cream of mixing yogurt, honey and clotrimazole on symptoms of vaginal candidiasis.

    Science.gov (United States)

    Darvishi, Maryam; Jahdi, Fereshteh; Hamzegardeshi, Zeinab; Goodarzi, Saied; Vahedi, Mohsen

    2015-04-03

    Vulvovaginal candidiasis is known as one of the most common fungal infection among women of reproductive age and considered as an important public health problem. In recent years, due to resistance to common antifungal medication, the use of traditional medicine of anti-fungal and herbal treatment increased. Therefore the objective of this study was to determine the effects of vaginal cream, mixture of yogurt and honey and comparing it with clotrimazole vaginal cream on symptoms of Vulvovaginal candidiasis in patients. In this randomized, triple blind clinical trial of 70 non-pregnant women infected with Candidal vulvovaginitis were placed in two groups of Vaginal cream mixed of yogurt and honey recipients (N=35) and clotrimazole vaginal cream (N=35). Both groups were treated for 7 days. At the beginning of study, Clinical and laboratory signs and symptoms were registered 7 and 14 days after treatment by questionnaire, observation form and secretions culture results. Data by chi-square test, t test, McNemar tests were analyzed by SPSS version 21. Significance level of 0.05 was considered. The result of present study reveals the significant differences in symptom improvement of ' yogurt and honey, than clotrimazole group (Pyogurt and honey" and clotrimazole (20% versus 8.6%) and second time cultivation (14 days after treatment) (17/1% versus 8.6%) were similar and there was no significant differences between the two groups. (P>0.05) CONCLUSION: This study indicated that he therapeutic effects of vaginal cream, yogurt and honey is not only similar with clotrimazole vaginal cream but more effective in relieving some symptoms of vaginal candidiasis. Therefore, the use of this product can be suggested as an herbal remedy for candida infection treatment.

  6. Development of quantitative PCR methods for diagnosis of bacterial vaginosis and vaginal yeast infection

    OpenAIRE

    Eiderbrant, Kristina

    2011-01-01

    Vaginitis is a vaginal infection which affects many women all over the world. The disorder is characterized by an infection of the vaginal area which can cause problems like abnormal vaginal discharge, itching and redness. The two most common causes of vaginitis are bacterial vaginosis and Candida vaginitis. The prevalence of bacterial vaginosis in Sweden is around 10-20 % and approximately 75 % of all women will once in their lifetime suffer from vaginal yeast infection. The clinical symptom...

  7. Intravaginal artificial insemination in bitches using frozen/thawed semen after dilution in powdered coconut water (ACP-106c).

    Science.gov (United States)

    Uchoa, D C; Silva, T F P; Mota Filho, A C; Silva, L D M

    2012-12-01

    The aim of this study was to evaluate powdered coconut water extender (ACP-106c; ACP Serviços Tecnológicos Ltda, ACP Biotecnologia, Fortaleza, Ceará, Brazil) as a diluent for freezing dog semen and the fertility after vaginal insemination of semen frozen therein. Ten ejaculates were collected from five dogs, evaluated fresh, diluted in ACP-106c, 10% egg yolk and 6% glycerol, cooled and frozen. In the first phase of the study, straws with frozen semen were thawed and immediately subjected to the same analysis as the fresh semen and, in addition, to Computer-Assisted Semen Analysis (CASA). In phase 2, 10 bitches that had been subjected to natural breeding during a preceding oestrous cycle were vaginally inseminated with thawed semen that had been re-diluted in ACP-106c. After thawing, a mean of 77% sperm motility was obtained through subjective analysis and 77.3% through CASA. Following artificial insemination, a 60% pregnancy rate was observed, resulting in a 50% parturition rate and a mean litter size of 3.4 (SEM 0.6), with 47.1% males and 52.9% females. ACP-106c can be successfully used for freezing canine semen, and vaginal deposition of such semen yields similar pregnancy rates to those reported in other studies. © 2012 Blackwell Verlag GmbH.

  8. Vaginal douching, condom use, and sexually transmitted infections among Chinese female sex workers.

    Science.gov (United States)

    Wang, Bo; Li, Xiaoming; Stanton, Bonita; Yang, Hongmei; Fang, Xiaoyi; Zhao, Ran; Dong, Baiqing; Zhou, Yuejiao; Liu, Wei; Liang, Shaoling

    2005-11-01

    Vaginal douching has been hypothesized to increase a woman's risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities.

  9. Defibulation during vaginal delivery for women with type III female genital mutilation.

    Science.gov (United States)

    Rouzi, Abdulrahim A; Al-Sibiani, Sharifa A; Al-Mansouri, Nisma M; Al-Sinani, Nawal S; Al-Jahdali, Eetedal A; Darhouse, Khalid

    2012-07-01

    To assess the routine practice of defibulation during vaginal delivery for women who have undergone female genital mutilation or cutting. A case-control study was conducted on women from Sudan, Somalia, Ethiopia, Egypt, and Yemen who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 1, 2000, to November 30, 2011. Women who had defibulation were identified, and their records were examined. For each woman who had defibulation, a woman from the same nationality who delivered without defibulation on the same day or the next days was chosen as a control. Data collected included demographics, mode of delivery, blood loss, intraoperative and postoperative complications, and labor outcome. During the study period, 388 women underwent defibulation during vaginal delivery. Women who did not have defibulation were chosen as a control group (n=388). In the defibulation group, 300 (77.3%) women were registered during pregnancy; 88 (22.7%) women were unregistered. Defibulation during vaginal delivery was successfully performed by residents and senior residents under the care of the attending on call. No cesarean delivery was performed because of female genital mutilation or cutting, and no spontaneous rupture of the scar occurred. There were no statistically significant differences between women who had defibulation with those who did not or between infibulated registered and unregistered women in the duration of labor, episiotomy rates, blood loss, Apgar score, or fetal birth weight. Defibulation during vaginal delivery is a valid management option. Labor attendants should be trained to perform it.

  10. Biofilms of vaginal Lactobacillus in vitro test.

    Science.gov (United States)

    Wei, Xiao-Yu; Zhang, Rui; Xiao, Bing-Bing; Liao, Qin-Ping

    2017-01-01

    This paper focuses on biofilms of Lactobacillus spp. - a type of normal flora isolated from healthy human vaginas of women of childbearing age; thereupon, it broadens the research scope of investigation of vaginal normal flora. The static slide culture method was adopted to foster biofilms, marked by specific fluorescence staining. Laser scanning confocal and scanning electron microscopy were used to observe the microstructure of the biofilms. Photographs taken from the microstructure were analysed to calculate the density of the biofilms. The body of Lactobacillus spp., though red, turned yellow when interacting with the green extracellular polysaccharides. The structure of the biofilm and aquaporin within the biofilm were imaged. Lactobacillus density increases over time. This study provides convincing evidence that Lactobacillus can form biofilms and grow over time in vitro. This finding establishes an important and necessary condition for selecting proper strains for the pharmaceutics of vaginal ecology.

  11. Vaginal Evisceration: An Unexpected Complication of Conization

    Directory of Open Access Journals (Sweden)

    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. Weighted vaginal cones for urinary incontinence.

    Science.gov (United States)

    Herbison, G Peter; Dean, Nicola

    2013-07-08

    For a long time pelvic floor muscle training (PFMT) has been the most common form of conservative (non-surgical) treatment for stress urinary incontinence (SUI). Weighted vaginal cones can be used to help women to train their pelvic floor muscles. Cones are inserted into the vagina and the pelvic floor is contracted to prevent them from slipping out. The objective of this review is to determine the effectiveness of vaginal cones in the management of female urinary stress incontinence (SUI).We wished to test the following comparisons in the management of stress incontinence: 1. vaginal cones versus no treatment; 2. vaginal cones versus other conservative therapies, such as PFMT and electrostimulation; 3. combining vaginal cones and another conservative therapy versus another conservative therapy alone or cones alone; 4. vaginal cones versus non-conservative methods, for example surgery or injectables.Secondary issues which were considered included whether:1. it takes less time to teach women to use cones than it does to teach the pelvic floor exercise; 2. self-taught use is effective;3. the change in weight of the heaviest cone that can be retained is related to the level of improvement;4. subgroups of women for whom cone use may be particularly effective can be identified. We searched the Cochrane Incontinence Group Specialised Trials Register (searched 19 September 2012), MEDLINE (January 1966 to March 2013), EMBASE (January 1988 to March 2013) and reference lists of relevant articles. Randomised or quasi-randomised controlled trials comparing weighted vaginal cones with alternative treatments or no treatment. Two reviewers independently assessed studies for inclusion and trial quality. Data were extracted by one reviewer and cross-checked by the other. Study authors were contacted for extra information. We included 23 trials involving 1806 women, of whom 717 received cones. All of the trials were small, and in many the quality was hard to judge. Outcome measures

  13. Short convalescence after vaginal prolapse surgery

    DEFF Research Database (Denmark)

    Ottesen, Marianne; Sørensen, Mette; Kehlet, Henrik

    2003-01-01

    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...... for the convalescence period. RESULTS: In the retrospective study, 188 women (79%) with a median age of 66 years (range, 30-88) answered the questionnaire. They had been recommended a convalescence of median 6 weeks (range, 1-12) for most activities. The subjective recurrence rate was 22% within median 6 months (range...... 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...

  14. [Morphogenesis of vaginal aplasia. Therapeutic deductions].

    Science.gov (United States)

    Minh, H N; Smadja, A; Belaisch, J

    1985-01-01

    On the basis of the studies of the embryogenesis of the vagina, the authors consider that malformations classically described as being partial aplasia should not be separated from the total absence of the vagina. The important feature is the association of a functioning or non functioning uterus with the absence of the vagina. They believe that it is incorrect to describe the pouch of menstrual retention associated with a functioning uterus as "haematocolpos" and that is not justified to describe the cup-shaped vestibular depression as "hemi-vagina". According to the authors, although vaginal aplasia with a functioning uterus forming a pouch of menstrual retention constitutes an absolute indication for surgery, surgery is not justified in cases of vaginal aplasia with a non functioning uterus. If Frank's method fails in these cases, the patient or the couple should be referred to a sexologist, as women with this anomaly retain a perfect femininity, although unable to conceive.

  15. Spectrum of vaginal discharge in a tertiary care setting.

    Science.gov (United States)

    Sivaranjini, R; Jaisankar, Tj; Thappa, Devinder Mohan; Kumari, Rashmi; Chandrasekhar, Laxmisha; Malathi, M; Parija, Sc; Habeebullah, S

    2013-07-01

    Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Pregnancy and Vaginal Delivery after Sacrohysteropexy

    Directory of Open Access Journals (Sweden)

    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.

  18. Mesenteric venous thrombosis following vaginal delivery

    Directory of Open Access Journals (Sweden)

    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 rupture and evisceration in a dog.

    Science.gov (United States)

    Prassinos, Nikitas N; Adamama-Moraitou, Katerina K; Ververidis, Haralabos N; Anagnostou, Tilemachos L; Kladakis, Stefanos E

    2010-09-01

    A 1.5-year-old German Shepherd mixed breed dog was admitted with mild haemorrhage from the vulva and a perineal mass of 24-hour duration, which had been first observed immediately after parturition. Parturition had occurred at low ambient temperature, and only one puppy survived out of the seven oversized fetuses. The dog was in poor body condition, dehydrated, hypothermic, depressed, non-ambulatory and in a state of shock. Intestinal loops, the urinary bladder and the uterine horns and body were protruding from the vulva. A true vaginal prolapse was also observed. The abdominal viscera were flushed with warm sterile saline solution, protected and maintained wet. The laboratory findings included moderate anaemia, leukocytosis, hypoalbuminaemia, azotaemia and elevated liver enzyme activities. Stabilisation of the dog's general condition was attempted before surgery. Antimicrobial and analgesic drugs were also administered. After exploratory laparotomy the protruding organs, which were in good condition, were reduced. A recent rupture in the vaginal wall, approximately 6 cm long, was observed. Ovariohysterectomy and partial vaginectomy were performed. The preoperative course of therapy was continued, but the bitch died 12 hours later. The probable cause of vaginal rupture and evisceration in this bitch was tenesmus and/or trauma due to the oversized fetuses.

  20. Postmenopausal Vaginal Endometriotic Cyst: A Case Report

    Directory of Open Access Journals (Sweden)

    Esengul Turkyilmaz

    2016-07-01

    Full Text Available A seventy-three-year-old patient%u2019s vaginal examination revealed a semi-mobile cystic structure visualised at the middle third portion of the posterior vaginal wall. The cyst was excised and the cyst wall was sent for pathological examination. The histopathological examination of the cyst with CD10 staining and tests for nuclear estrogen receptor positivity and nuclear progesteron receptor positivity revealed that the cyst wall contained endometrial stromal cells, endometrial surface epithelial cells, and hemosiderin-laden macrophages. Endometriosis externa was diagnosed based on the above findings. The case we report here, of an isolated vaginal endometriotic cyst, is unique because of its presentation in a postmenopausal woman without any history of infertility, any gynecologic surgery, or hormone replacement therapy. The reasonable explanation for this case might include certain mechanisms such as the self-sustaining existence of endometriotic cells that were implanted during the premenopausal period to the vagina and that maintain local estrogen production. No single hypothesis can explain the pathophysiology of endometriosis, given all of its various forms and presentations.

  1. Herbal vaginal pessary induced acute renal failure.

    Science.gov (United States)

    Onyemekeihia, U R; Esume, C O; Oladele, C O; Oviasu, E

    2009-10-01

    In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society.

  2. Comparison of home-based and outpatient clinic-based intravaginal electrical stimulation for the treatment of urinary incontinence.

    Science.gov (United States)

    Gungor Ugurlucan, F; Alper, N; Ayvacikli, G; Nehir, A; Celik, R; Yalcin, O

    2014-08-01

    Aim of the study was to compare the effects of outpatient clinic-based versus home-based intravaginal electrical stimulation (ES) for the treatment of urinary incontinence. Women applying with the complaint of urinary incontinence and offered ES treatment were divided into outpatient clinic-based or home-based ES. Patients were instructed about home-based ES at the outpatient clinic by certified physiotherapy nurses. Bladder diary, 1-hour pad test, and King's-Health-Questionnaire (KHQ) were performed before and after treatment. ES was applied for 20 minutes, 6-8 weeks with pulses of 10-50 Hz square waves at a 300 μs or 1 ms pulse duration and a maximal output current of 24 to 60 mA with 5-10 Hz frequency, three times/week. Twenty-four patients received outpatient clinic-based, 22 patients received home-based ES. Pad test, bladder diary and pelvic floor muscle strength parameters in both groups improved significantly after treatment, with no significant difference between the two groups. Seven patients (31.8%) were cured, six patients (27.3%) were much improved, and seven patients (31.8%) were improved in the home-based ES group. Nine patients (37.5%) were cured, six patients (25%) were much improved, and six patients (25%) were improved and in the outpatient clinic-based ES group. There was an improvement in quality of life in all domains in both groups when the pretreatment and post-treatment KHQ results were compared, with no significant difference between the two groups. Home-based ES is as effective in the treatment of urinary incontinence as outpatient clinic-based ES with significant improvement in objective and subjective parameters.

  3. Intravaginal cytomegalovirus (CMV challenge elicits maternal viremia and results in congenital transmission in a guinea pig model

    Directory of Open Access Journals (Sweden)

    Schleiss Mark R

    2011-03-01

    Full Text Available Abstract Background The objective of this study was to compare intravaginal (ivg and subcutaneous (sc administration of the guinea pig cytomegalovirus (GPCMV in pregnant and non-pregnant guinea pigs. These studies tested the hypotheses that ivg infection would elicit immune responses, produce maternal viremia, and lead to vertical transmission, with an efficiency similar to the traditionally employed sc route. Results Four groups of age- and size-matched guinea pigs were studied. Two groups were pregnant, and two groups were not pregnant. Animals received 5x105 plaque-forming units (PFU of a GPCMV reconstituted from an infectious bacterial artificial chromosome (BAC construct containing the full-length GPCMV genome. Seroconversion was compared by IgG ELISA, and viremia (DNAemia was monitored by PCR. In both pregnant and non-pregnant animals, sc inoculation resulted in significantly higher serum ELISA titers than ivg inoculation at 8 and 12 weeks post-infection. Patterns of viremia (DNAemia were similar in animals inoculated by either sc or ivg route. However, in pregnant guinea pigs, animals inoculated by both routes experienced an earlier onset of DNAemia than did non-pregnant animals. Neither the percentage of dead pups nor the percentage of GPCMV positive placentas differed by inoculation route. Conclusions In the guinea pig model of congenital CMV infection, the ivg route is as efficient at causing congenital infection as the conventional but non-physiologic sc route. This finding could facilitate future experimental evaluation of vaccines and antiviral interventions in this highly relevant animal model.

  4. Embryo yield in llamas synchronized with two different intravaginal progesterone-releasing devices and superovulated with eCG

    Energy Technology Data Exchange (ETDEWEB)

    Aller, J.F.; Abalos, M.C.; Acuña, F.A.; Virgili, R.; Requena, F.; Cancino, A.K.

    2015-07-01

    The objectives of this study were to compare the effects of two intravaginal devices (ID) containing the same dose (0.5 g) of progesterone (P4) on subsequent ovarian response, embryo production and circulating P4 concentration profile in llamas (Lama glama) treated with equine chorionic gonadotropin (eCG) for ovarian superstimulation. Female llamas were randomly assigned (n = 10 llamas per group) to one of the following groups and treated (Day 0) with an ID containing 0.5 g of vegetal P4 to synchronize the emergence of a new follicular wave: i) DIB 0.5® and ii) Cronipres M15®. On Day 3 llamas were intramuscularly treated with 1000 IU of eCG. The IDs were removed on Day 7. Llamas were naturally mated (Day 9) and treated with GnRH analogue to induce ovulation. A second mating was allowed 24 h later. Embryos were collected between 7 and 8 days after the first mating. Blood samples were taken every day from Day 0 to Day 7 to measure circulating P4 concentrations. The results indicated that DIB device maintained greater plasma P4 levels as compared to Cronipres until Day 2. However, the mean (± SD) number of corpora lutea and recovered embryos was not affected (p < 0.05) by the type of ID (5.3 ± 2.6 vs 4.2 ± 2.2 and 3.5 ± 2.7 vs 2.6 ± 3.0 for DIB and Cronipres, respectively). In conclusion, both DIB and Cronipres devices can be successfully used to synchronize the emergence of follicular wave prior to a single dose of eCG in superovulation protocol in llamas. (Author)

  5. Embryo yield in llamas synchronized with two different intravaginal progesterone-releasing devices and superovulated with eCG

    Directory of Open Access Journals (Sweden)

    Juan F. Aller

    2015-09-01

    Full Text Available The objectives of this study were to compare the effects of two intravaginal devices (ID containing the same dose (0.5 g of progesterone (P4 on subsequent ovarian response, embryo production and circulating P4 concentration profile in llamas (Lama glama treated with equine chorionic gonadotropin (eCG for ovarian superstimulation. Female llamas were randomly assigned (n = 10 llamas per group to one of the following groups and treated (Day 0 with an ID containing 0.5 g of vegetal P4 to synchronize the emergence of a new follicular wave: i DIB 0.5® and ii Cronipres M15®. On Day 3 llamas were intramuscularly treated with 1000 IU of eCG. The IDs were removed on Day 7. Llamas were naturally mated (Day 9 and treated with GnRH analogue to induce ovulation. A second mating was allowed 24 h later. Embryos were collected between 7 and 8 days after the first mating. Blood samples were taken every day from Day 0 to Day 7 to measure circulating P4 concentrations. The results indicated that DIB device maintained greater plasma P4 levels as compared to Cronipres until Day 2. However, the mean (± SD number of corpora lutea and recovered embryos was not affected (p < 0.05 by the type of ID (5.3 ± 2.6 vs 4.2 ± 2.2 and 3.5 ± 2.7 vs 2.6 ± 3.0 for DIB and Cronipres, respectively. In conclusion, both DIB and Cronipres devices can be successfully used to synchronize the emergence of follicular wave prior to a single dose of eCG in superovulation protocol in llamas.

  6. Photoacoustic methods for in vitro study of kinetics progesterone release from the biodegradation of polyhydroxybutyrate/polycaprolactone used as intravaginal devices

    Energy Technology Data Exchange (ETDEWEB)

    Souza Filho, N. E. [Universidade Estadual de Maringá, Departamento de Física, Grupo de Estudos dos Fenômenos Fototérmicos-GEFF/DFI/UEM, Av. Colombo 5790, Maringá-PR (Brazil); Universidade Federal de Santa Maria, Departamento de Eng. Acústica, Av. Roraima 1000, CEP 97105–900, Santa Maria-RS (Brazil); Mariucci, V. V. G.; Dias, G. S.; Szpak, W.; Medina, A. N.; Baesso, M. L.; Bento, A. C. [Universidade Estadual de Maringá, Departamento de Física, Grupo de Estudos dos Fenômenos Fototérmicos-GEFF/DFI/UEM, Av. Colombo 5790, Maringá-PR (Brazil); Miguez, P. H. P.; Madureira, E. H. [Universidade de São Paulo, Departamento de Reprodução Animal–VRA/USP, Av. Prof. Dr. Orlando Marques Paiva 87, São Paulo–SP (Brazil)

    2013-09-30

    Intravaginal devices composed of polyhydroxybutyrate/polycaprolactone blends incorporating progesterone were used over eight days in crossbred cow ovariectomized, and then analyzed with photoacoustic methods, measuring the absorption spectra, thermal diffusivity, and inspecting its degradation by means of scanning electron microscopy. The characteristic time found for progesterone release was TR ∼ 53 h, and the typical time found for biodegradation was TB ∼ 30 h. Morphological analysis complements the study showing that release of progesterone and biodegradation of the blend occurs on sample surface.

  7. Photoacoustic methods for in vitro study of kinetics progesterone release from the biodegradation of polyhydroxybutyrate/polycaprolactone used as intravaginal devices

    Science.gov (United States)

    Souza Filho, N. E.; Mariucci, V. V. G.; Dias, G. S.; Szpak, W.; Miguez, P. H. P.; Madureira, E. H.; Medina, A. N.; Baesso, M. L.; Bento, A. C.

    2013-09-01

    Intravaginal devices composed of polyhydroxybutyrate/polycaprolactone blends incorporating progesterone were used over eight days in crossbred cow ovariectomized, and then analyzed with photoacoustic methods, measuring the absorption spectra, thermal diffusivity, and inspecting its degradation by means of scanning electron microscopy. The characteristic time found for progesterone release was TR ˜ 53 h, and the typical time found for biodegradation was TB ˜ 30 h. Morphological analysis complements the study showing that release of progesterone and biodegradation of the blend occurs on sample surface.

  8. Candidate biomarkers in the cervical vaginal fluid for the (self-)diagnosis of cervical precancer

    OpenAIRE

    Ostade, van, Xaveer; Dom, Martin; Tjalma, Wiebren; Raemdonck, Van, Geert

    2018-01-01

    Abstract: Purpose Despite improvement in vaccines against human papilloma virus (HPV), the causative agent of cervical cancer, screening women for cervical precancer will remain indispensable in the coming 3040 years. A simple test that could be performed at home or at a doctors practice and that informs the woman whether she is at risk would significantly help make a broader group of patients who aware that they need medical treatment. Cervical vaginal fluid (CVF) is a body fluid that is ver...

  9. Strength of preference for vaginal birth as a predictor of delivery mode among women who attempt a vaginal delivery.

    Science.gov (United States)

    Wu, Erica; Kaimal, Anjali J; Houston, Kathryn; Yee, Lynn M; Nakagawa, Sanae; Kuppermann, Miriam

    2014-05-01

    We sought to assess the relationship between strength of preference for vaginal birth and likelihood of vaginal delivery among women attempting this delivery mode. We conducted a longitudinal study of mode of delivery preferences among women who were preferred vaginal or cesarean delivery. Participants who preferred vaginal delivery completed a standard gamble exercise to assess the strength of this preference on a 0-to-1 scale (higher scores indicate stronger preference for vaginal delivery); those preferring cesarean delivery were assigned a value of 0. Data on clinical characteristics and delivery mode were obtained via telephone interview or chart review. Logistic regression was used to identify predictors of delivery mode among women who attempted a vaginal delivery. Of 210 participants, 156 attempted a vaginal delivery. Their mean and median vaginal delivery preference scores were 0.70 (SD 0.31) and 0.75 (interquartile range, 0.50-0.99), respectively. In multivariate analyses, women with a prior cesarean delivery (adjusted odds ratio [aOR], 0.08; 95% confidence interval [CI], 0.02-0.39) or who delivered an infant ≥4000 g (aOR, 0.04; 95% CI, 0.01-0.28) had significantly lower odds of having a vaginal delivery. After controlling for potential confounders, participants with a stronger preference for vaginal delivery were at significantly higher odds of having a vaginal delivery (aOR, 1.54; 95% CI, 1.01-2.34 for every 0.2 increase on the 0-to-1 scale). Among women who attempt a vaginal delivery, the strength of preference for vaginal birth is predictive of the delivery mode ultimately undergone. Copyright © 2014 Mosby, Inc. All rights reserved.

  10. Recurrent, purulent vaginal discharge associated with longstanding presence of a foreign body and vaginal stenosis.

    Science.gov (United States)

    Simon, Deborah A; Berry, Scott; Brannian, John; Hansen, Keith

    2003-12-01

    A 13-year-old presented with malodorous, purulent, vaginal discharge following each menses for the last three months since menarche. This discharge resolved following antibiotic therapy but recurred with each menses. On exam, the patient was found to have a blind ending vagina with a small, midline perforation. Ultrasound and MRI examinations done prior to surgery did not identify the vaginal foreign body. She was taken to the operating room for examination under anesthesia and vaginoscopy. During surgery this area was found to be comprised of dense adhesions which nearly obliterated the distal vagina. The vaginal adhesions were lysed and a plastic foreign body was discovered in the upper vagina. After removing the foreign body the superior vagina was undermined, pulled down, and sutured to normal inferior vagina. A Mentor mold was placed in the vagina to maintain patency.

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

    Science.gov (United States)

    2017-10-16

    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

  12. Vaginal rings for menopausal symptom relief.

    Science.gov (United States)

    Ballagh, Susan A

    2004-01-01

    The vagina is an alternative delivery site of sex steroids for menopausal women. New ring technology provides continuous and consistent delivery of steroids for up to 3 months. Rings rest on the pelvic floor muscles in a nearly horizontal position and are usually imperceptible. Steroid is delivered directly into the systemic circulation which may result in less alteration of coagulation/fibrinolysis pathways as seen with transdermal hormone therapy. Fewer adverse effects are noted when progesterone is applied vaginally, possibly due to lower serum levels of metabolites such as alloprenanolone. Women often switch to a ring for the longer dosing interval but also appreciate the reduced messiness. Over 5700 healthy US women who evaluated an unmedicated ring as a drug delivery platform found it very acceptable independent of age or prior use of barrier contraceptives. Marketed rings in the US include: (i) a ring for systemic and vaginal menopausal therapy that provides average serum estradiol levels of 40.6 pg/mL for the 0.05 mg and 76 pg/mL for the 0.1 mg dose; (ii) a ring for urogenital menopausal symptoms only that minimally elevates serum estradiol, usually within the menopausal range, treating atrophic vaginitis and urethritis; and (iii) a ring labelled for contraception that provides ethinyl estradiol 15 microg and etonogestrel 120 microg appropriate for nonsmoking perimenopausal women. A ring for combination hormone therapy and another releasing progesterone for contraception in lactating women have been reported in the literature, but are not yet available commercially. These may offer future options for hormone therapy. Women with a uterus receiving estrogen, even in low doses, should be given progestogen to prevent endometrial hyperplasia or carcinoma. Even women who have had an endometrial ablation are likely to have some endometrial tissue remaining since long-term amenorrhoea is uncommon. Since no marketed combination ring product is available, other forms

  13. An unusual cause of vaginal discharge following gender reassignment.

    Science.gov (United States)

    Sukumaran, S; Moran, P A; Makar, A

    2009-02-01

    Neovaginal reconstruction is an important part of gender reassignment surgery. We report a case of stone formation at the apex of vaginal vault constructed with sigmoid colon segment. A 48-year-old woman presented with profuse vaginal discharge for 1 year. She had a history of gender reassignment surgery (male to female) in 1994, and the neovagina had been constructed with an isolated sigmoid colon. Vaginoscopy performed using a cystoscope revealed multiple calculi at the vaginal vault on the endoscopic gastrointestinal anastomosis staples that had been used to close the vault. Colon-vaginoplasty has the advantages of providing adequate lubrication, but excessive vaginal discharge could be a problem, as colon is a mucous membrane. Stone formation in the vaginal vault should be considered in cases of gender reassignment with persistent vaginal discharge. This case also highlights the use of cystoscope in visualising the upper vagina in difficult circumstances.

  14. Comparison of pelvic floor muscle strength between women undergoing vaginal delivery, cesarean section, and nulliparae using a perineometer and digital palpation.

    Science.gov (United States)

    Batista, Elicéia Marcia; Conde, Délio Marques; Do Amaral, Waldemar Naves; Martinez, Edson Zangiacomi

    2011-11-01

    To compare pelvic floor muscle (PFM) strength between women undergoing vaginal delivery, cesarean section, and nulliparae, investigating the factors associated with PFM strength, and observing the correlation between vaginal digital palpation and use of a perineometer. A cross-sectional study was conducted, including 31 women following vaginal delivery, 30 women following cesarean section, and 30 nulliparous women. PFM strength was measured by vaginal digital palpation and use of a perineometer. Multiple linear regression analysis with adjustment for covariables was used to compare the mean PFM strength and identify its associated factors. The mean PFM strength of women undergoing vaginal delivery and cesarean section was 25.6 ± 14.5 cmH(2)O and 39.6 ± 22.0 cmH(2)O (p history of vaginal delivery compared to those undergoing cesarean section. Non-white race/ethnicity negatively affected PFM strength. Our data suggest that vaginal digital palpation may be used in clinical practice because of its expressive correlation with use of a perineometer.

  15. Comparison of outcomes between operative vaginal deliveries and spontaneous vaginal deliveries in southeast Nigeria.

    Science.gov (United States)

    Lawani, Lucky O; Anozie, Okechukwu B; Ezeonu, Paul O; Iyoke, Chukwuemeka A

    2014-06-01

    To evaluate the incidence of, indications for, and outcome of operative vaginal deliveries compared with spontaneous vaginal deliveries in southeast Nigeria. A retrospective cohort study was conducted involving cases of operative vaginal delivery performed at Ebonyi State University Teaching Hospital over a 10-year period. Data on the procedures were abstracted from the operation notes of the medical records of parturients. An incidence of 4.7% (n = 461) was recorded. The most common indications for vacuum and forceps delivery were prolonged second stage of labor (44.9%) and poor maternal effort (27.8%). The only indication for destructive operation was intrauterine fetal death (3.7%). The risk ratio (RR) for hemorrhage/vulvar hematoma was 1.14 (95% confidence interval [CI], 0.53-2.48) for vacuum-assisted delivery and 5.49 (95% CI, 0.82-36.64) for forceps delivery. The RR for genital laceration was 1.21 (95% CI, 0.44-3.30) for vacuum-assisted delivery and 9.41 (95% CI, 1.33-66.65) for forceps delivery. The risk of fetal scalp bruises and caput succedaneum was higher for operative vaginal delivery than for spontaneous vaginal delivery, with no significant difference in maternal morbidity. The perinatal mortality rate was 0.9 per 1000 live births. Operative vaginal delivery by experienced healthcare providers is associated with good obstetric outcomes with minimal risk. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. 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

  17. Oral misoprostol versus dinoprostone vaginal tablets for labor induction

    Directory of Open Access Journals (Sweden)

    Khaled Ibrahim Abu El aish

    2013-06-01

    Full Text Available Background: Induction of labour is common in obstetric practice. We conducted this study to find the appropriate and safe drug for labour induction and to compare the safety and efficacy of oral misoprostol and vaginal dinoprostone for labour induction. Methods: In a provisional, prospective and cross-sectional study, one hundred and fifty five singleton cephalic presentation full term pregnancies with medical or obstetric indication for labour induction were allocated in two groups. First group received oral 50 micrograms for nulliparas and low parity group (1-4, and 25micrograms for grand multiparas (≥ 5 misoprostol orally every 6 hours to a maximum of four doses daily. In the second group vaginal tablets of dinoprostone 3mg then 1.5mg for nulliparas and 1.5mg for low parity and grand multiparas groups were inserted in the posterior fornix, every 8 hours. Primary outcome measures were: induction success, induction-delivery interval and number of used doses. Secondary outcome measures included: maternal side effects, caesarean section rate, mode of delivery and neonatal outcome. Data was collected from patient case notes and analyzed using software SPSS (version 13.0 and p-value < 0.05 was used as statistical significance of differences. Results: In our study there were no significant differences in baseline parameters in the two groups nor in the indications for labor induction except misoprostol was used in premature rupture of membrane. Induction of labor succeeded in 123 (79.35% women without other interventions from other methods (80.26%misoprostol group versus 78.5% dinoprostone p=0.492. It was observed that there were no significant differences between the two groups in final outcomes nor in obstetrical complications. There was no significance in differences between misoprostol and dinoprostone groups in induction-delivery interval (15.2 ± 14.5 hours versus 16.4 ± 11.3 hours p=0.6 resp.. Conclusions: This study demonstrated that oral

  18. Human vaginal pH and microbiota: an update.

    Science.gov (United States)

    Godha, Keshav; Tucker, Kelly M; Biehl, Colton; Archer, David F; Mirkin, Sebastian

    2017-12-22

    A woman's vaginal pH has many implications on her health and it can be a useful tool in disease diagnosis and prevention. For that reason, the further examination of the relationship between the human vaginal pH and microbiota is imperative. In the past several decades, much has been learned about the physiological mechanisms modulating the vaginal pH, and exogenous/genetic factors that may influence it. A unified, coherent understanding of these concepts is presented to comprehend their interrelationships and their cumulative effect on a woman's health. In this review, we explore research on vaginal pH and microbiota throughout a woman's life, vaginal intermediate cell anaerobic metabolism and net proton secretion by the vaginal epithelial, and the way these factors interact to acidify the vaginal pH. This review provides foundational information about what a microbiota is and its relationship with human physiology and vaginal pH. We then evaluate the influence of physiological mechanisms, demographic factors, and propose ideas for the mechanisms behind their action on the vaginal pH.

  19. [Vaginal metastasis revealing an adenocarcinoma of the transverse colon].

    Science.gov (United States)

    Quaranta, D; Delotte, J; Bongain, A; François, E; Bereder, J-M; Bernard, J-L

    2014-09-01

    Secondary localization to vagina had a severe prognosis, suggesting a disseminated metatastic disease. We report the case of prevalent vaginal metastasis of adenocarcinoma of the transverse colon. A 65 years old patient has consulted for vaginal mass. After delayed diagnosis, she presented with disseminated metastatic disease with peritoneal carcinomatosis. After neoadjuvant chemotherapy, the following treatment consisted of complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and vaginal adjuvant radiotherapy. No recurrence occurred after one year. Vaginal metastasis of colon cancer are rare. The dark prognosis might justify a systematic gynecological examination of women presenting colorectal neoplasy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Advances in diagnosing vaginitis: development of a new algorithm.

    Science.gov (United States)

    Nyirjesy, Paul; Sobel, Jack D

    2005-11-01

    The current approach to diagnosing vulvovaginal symptoms is both flawed and inadequate. Mistakes occur at the level of the patient herself, her provider, and the sensitivity of office-based tests. Often, the differential diagnosis is so broad that providers may overlook some of the possibilities. A diagnostic algorithm which separates women into either a normal or elevated vaginal pH can successfully classify most women with vaginitis. Based on the amine test, vaginal leukocytes, and vaginal parabasal cells, those with an elevated pH can be placed into further diagnostic categories. Such an algorithm helps to prioritize different diagnoses and suggest appropriate ancillary tests.

  1. Parturition pit: the bony imprint of vaginal birth

    International Nuclear Information System (INIS)

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

    2016-01-01

    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. 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. 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 (p < 0.0001). Patients with more prominent pits (grades 2/3) had a greater number of vaginal births. As vaginal deliveries increased, the odds of having parturition pits greatly increased, adjusting for age and race at CT (p < 0.0001). No males had pits. Our study indicates that parturition pits are associated with prior vaginal birth 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. (orig.)

  2. Effects of vaginal discharge on female sexual function.

    Science.gov (United States)

    Gungor, Ayse N C; Uludag, Aysegul; Sahin, Melih; Gencer, Meryem; Uysal, Ahmet

    2014-01-01

    To assess the effects of vaginal discharge on female sexual dysfunction (FSD) by using the Female Sexual Function Index (FSFI). In a study at a university hospital in Canakkale, Turkey, women affected by vaginal discharge and age-matched healthy control women were recruited between January and December 2012. Women were grouped in accordance with their vaginal discharge complaints and each participant completed the FSFI questionnaire. A total of 114 women were included in the study. Women in the first group (n=58) had no vaginal discharge or had physiologic vaginal discharge, those in the second group (n=29) had abnormal vaginal discharge with itching, and those in the third group (n=27) had abnormal vaginal discharge without itching. Compared with the first group, women in the second and third groups had higher FSFI scores for desire, arousal, orgasm, and pain, in addition to higher overall FSFI scores. Women with genital malodor had significantly higher FSFI scores than patients without genital malodor (23.83 ± 5.07 vs 21.15 ± 4.78; P=0.008). Women with abnormal vaginal discharges were found to have better FSFI scores for some domains. This finding may be attributed to the adverse effects of sexual intercourse on vaginal infections. © 2013.

  3. Ureterovaginal fistula: A complication of a vaginal foreign body

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo

    2018-02-01

    Conclusion: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

  4. In vitro activity of farnesol against vaginal Lactobacillus spp.

    Science.gov (United States)

    Wang, Fengjuan; Liu, Zhaohui; Zhang, Dai; Niu, Xiaoxi

    2017-05-01

    Farnesol, a quorum-sensing molecule in Candida albicans, can affect the growth of certain microorganisms. The objective of this study was to evaluate the in vitro activity of farnesol against vaginal Lactobacillus spp., which play a crucial role in the maintenance of vaginal health. Growth and metabolic viability of vaginal Lactobacillus spp. incubated with different concentrations of farnesol were determined by measuring the optical density of the cultures and with the MTT assay. Morphology of the farnesol-treated cells was evaluated using a scanning electron microscope. In vitro adherence of vaginal Lactobacillus cells treated with farnesol was determined by co-incubating with vaginal epithelial cells (VECs). The minimum inhibitory concentration (MIC) of farnesol for vaginal Lactobacillus spp. was 1500μM. No morphological changes were observed when the farnesol-treated Lactobacillus cells were compared with farnesol-free cells, and 100μM farnesol would reduce the adherence of vaginal Lactobacillus to VECs. Farnesol acted as a potential antimicrobial agent, had little impact on the growth, metabolism, and cytomorphology of the vaginal Lactobacillus spp.; however, it affected their adhering capacity to VECs. The safety of farnesol as an adjuvant for antimicrobial agents during the treatment of vaginitis needs to be studied further. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Local estrogen replacement therapy in postmenopausal atrophic vaginitis: efficacy and safety of low dose 17beta-estradiol vaginal tablets.

    Science.gov (United States)

    Mainini, G; Scaffa, C; Rotondi, M; Messalli, E M; Quirino, L; Ragucci, A

    2005-01-01

    To verify the effectiveness and safety of low-dose 17beta-estradiol vaginal tablets in the treatment of the postmenopausal atrophic vaginitis. 325 postmenopausal women with atrophic vaginitis in estrogenic replacement therapy with 0.025 mg 17beta-estradiol vaginal tablets, one application each day for two weeks, and a single application two times a week for the following 22 weeks (total treatment period: 24 weeks). Most of the women reported an improvement of symptoms just after two weeks and minimal incidence of adverse reactions. No patients showed abnormal endometrial thickness and no one had to interrupt the treatment for abnormal uterine bleeding because of systemic absorption. Low-dose 17beta-estradiol vaginal tablets in the treatment of the postmenopausal atrophic vaginitis constitutes an extremely valid approach in terms of effectiveness and safety.

  6. perspectives on the practice of vaginal birth after caesarean section ...

    African Journals Online (AJOL)

    2010-08-08

    Aug 8, 2010 ... sub-Saharan African countries with a success rate of 69%. Perinatal morbidity ... countries (11). The minimum criteria for allowing a trial of scar (ToS) in mothers with a previous scar used in most countries in sub-Saharan Africa included: ... also aimed to identify possible solutions to problems encountered in ...

  7. 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.

  8. Partial Cervical Agenesis and Complete Vaginal Atresia.

    Science.gov (United States)

    Kimble, Rebecca; Molloy, Genevieve; Sutton, Bridget

    2016-06-01

    The objective of this study was to report 2 cases of the combined congenital anomalies of complete vaginal atresia and partial cervical agenesis, and highlight the limitations of magnetic resonance imaging for definitive initial diagnosis, and consequently the importance of early definitive management, to avoid life-threatening sepsis. Herein we provide a retrospective case audit of two patients with congenital abnormalities between 2005 and 2013 who were treated in a quaternary statewide pediatric and adolescent gynecology center. Two patients with the combined congenital anomalies of complete vaginal agenesis and partial cervical agenesis highlight the difficulties encountered with the limitations of magnetic resonance imaging in accuracy of diagnosis, as well as development of life-threatening sepsis that requires hysterectomy. Both patients were initially imaged as having distended endometrial cavities and cervical canals with what was thought to be an obstructive upper vaginal septum and absent lower vagina. Both required initial neovagina creation, however the cervices were never clinically or surgically visualized. Partial cervical agenesis is a relatively rare form of Müllerian abnormality which, if not diagnosed and definitively treated early, can have significant morbidity and mortality. Although magnetic resonance imaging is the diagnostic imaging gold standard for Müllerian abnormalities, it is important to recognize the limitations of this modality, the potential sequelae of these limitations, and to appreciate the importance of early accurate diagnosis and treatment of this condition. Importantly, if the imaging diagnosis does not completely correlate with the clinical and surgical findings, then a high suspicion of complete or partial cervical agenesis is prudent, because the consequences of nondefinitive early treatment can be life-threatening and potentially fatal. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  9. Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration

    Energy Technology Data Exchange (ETDEWEB)

    Koganemaru, Masamichi, E-mail: mkoganemaru@med.kurume-u.ac.jp; Nonoshita, Masaaki, E-mail: z2rs-1973@yahoo.co.jp; Iwamoto, Ryoji, E-mail: iwamoto-ryouji@kurume-u.ac.jp; Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Nabeta, Masakazu, E-mail: nabeta-masakazu@med.kurume-u.ac.jp; Kusumoto, Masashi, E-mail: kusumoto-masashi@med.kurume-u.ac.jp; Kugiyama, Tomoko, E-mail: kugiyama-tomoko@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan); Kozuma, Yutaka, E-mail: kouduma-yutaka@kurume-u.ac.jp [Kurume University School of Medicine, Department of Obstetrics and Gynecology (Japan); Nagata, Shuji, E-mail: sn4735@med.kurume-u.ac.jp; Abe, Toshi, E-mail: toshiabe@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan)

    2016-08-15

    PurposeWe evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration.Materials and MethodsWe reviewed seven cases of patients (mean age 30.9 years; range 27–35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery’s architecture, technical and clinical success rates, and complications.ResultsThe vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases.ConclusionPostpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.

  10. 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.

  11. Normal ovarian cycle in endo vaginal ultrasound

    International Nuclear Information System (INIS)

    Martinez, F.; Dualde, D.; Labrador, T.; Morales, F.J.; Vidal, P.; Gordo, G.

    1995-01-01

    The changing morphology of the endometrium and ovaries during the menstrual cycle can be viewed with great richness of image using high frequency (5-6-7.5 Mhz) probes in endo vaginal ultrasound. The radiological findings associated with the menstrual cycle are reviewed in terms of four phases (follicular, preovulatory, ovulatory and luteal) and a study is made of the changes that can lead to different morphologies, some of which, especially those of the corpus luteus, are peculiar. The need to be familiar with these changes in order to avoid confusing them with pathological signs is pointed out. (Author)

  12. Update on nonoxynol-9 as vaginal spermicide.

    Science.gov (United States)

    Iyer, Vidya; Poddar, S S

    2008-12-01

    Nonoxynol-9 (N-9) is a typical surfactant. For more than 30 years that very property of N-9 has been successfully exploited for its spermicidal action. It is available as an over-the-counter, locally acting vaginal spermicide. The suitability of N-9 as a spermicide is elaborated in this article. The reasons why N-9 may fail as a contraceptive are discussed. In spite of many drawbacks, which are mentioned in the article, N-9 is still often resorted to as a locally acting contraceptive. The review ends with suggestions to alter the molecular structure of N-9 and to adjust the dosages.

  13. Vaginal Lactobacillus isolates inhibit uropathogenic Escherichia coli.

    OpenAIRE

    Atassi , Fabrice; Brassart , Dominique; Grob , Philipp; Graf , Federico; Servin , Alain ,

    2006-01-01

    The purpose of this study was to investigate the antibacterial activities of Lactobacillus jensenii KS119.1 and KS121.1, and Lactobacillus gasserii KS120.1 and KS124.3 strains isolated from the vaginal microflora of healthy women, against uropathogenic, diffusely adhering Afa/Dr Escherichia coli (Afa/Dr DAEC) strains IH11128 and 7372 involved in recurrent cystitis. We observed that some of the Lactobacillus isolates inhibited the growth and decreased the viability of E. coli IH11128 and 7372....

  14. EVALUACIÓN DE PROGESTERONA INTRAVAGINAL POST INSEMINACIÓN ARTIFICIAL PARA REDUCIR LA MUERTE EMBRIONARIA EN VACAS

    Directory of Open Access Journals (Sweden)

    Jorge Ignacio Macias

    2014-06-01

    Full Text Available El objetivo de esta investigación fue evaluar el efecto de la administración de un dispositivo intravaginal de progesterona post IATF sobre la reducción de la muerte embrionaria, el cual se aplicó siete días después de la inseminación. Se utilizaron 40 vacas de aptitud cárnica de cruza mestiza Senangus x Brahman de dos-cuatro partos. Se realizó ecografía transrectal (Aquilla Vet 7.5 MHZ previo a la sincronización. Se efectuó el inicio de ésta con el dispositivo CIDR 1.38 g progesterona. Después de siete días de la inseminación se colocó el dispositivo usado a 20 animales tratamiento y se lo mantuvo durante 10 días. Se realizó tomas de muestras de sangre para medir los niveles de P4. Estas fueron tomadas a cinco animales del grupo tratamiento en el día que se reinsertó el dispositivo, 5 días después y al retiro. Las muestras revelaron niveles altos de progesterona que oscilaron entre 7.87 hasta 19.4 ng/mL. Se diagnosticó gestación a los 30 y 60 días. Se realizó un análisis costo beneficio al tratamiento. En los resultados se encontró una relación entre los tratamientos y la preñez a los 30 días (p=0.053; la relación del costo beneficio se manifestó económicamente viable con la aplicación de progesterona, ya que por cada dólar invertido se genera como ganancia 23 ctvs de dólar. Se concluye que la aplicación de progesterona reduce la muerte embrionaria hasta los 30 días post inseminación.

  15. Substantial variability in postoperative treatment, and convalescence recommendations following vaginal repair. A nationwide questionnaire study

    DEFF Research Database (Denmark)

    Ottesen, Marianne; Møller, Charlotte; Kehlet, H

    2001-01-01

    -employed gynecologists, and gynecologists in private practice, to patients undergoing vaginal repair. METHOD: In 1999 all Danish gynecologists (n=433) received a tested questionnaire about postoperative treatment and convalescence recommendations following vaginal repair. Non-responders received one reminder. OUTCOME...... MEASURES: Pre and postoperative treatment, and expected hospital stay. Furthermore, lifting restrictions, sick leave, and convalescence before resumption of defined activities. RESULTS: The overall response rate was 82%. The expected postoperative hospital stay was median 3 days (range, 1-7) following...... anterior repair, and 2 days (range, 1-7) following posterior repair. The recommended sick leave was median 6 weeks (range, 2-12) for patients with work with heavy lifts. There were substantial differences in recommendations. Recommended lifting restrictions were median 3 kg (range, 0-20) for median 4 weeks...

  16. Activation of β-adrenergic receptors during sexual arousal facilitates vaginal lubrication by regulating vaginal epithelial Cl(-) secretion.

    Science.gov (United States)

    Sun, Qing; Huang, Jiehong; Yang, Deng-Liang; Cao, Xiao-Nian; Zhou, Wen-Liang

    2014-08-01

    Vaginal lubrication, an indicator of sexual arousal and tissue health, increases significantly during genital sexual arousal. Adrenergic alpha-receptors (AR) are an important regulator of genital physiological responses involved in mediating vascular and nonvascular smooth muscle contractility; the role of β-AR in sexual arousal, however, has not yet been investigated. The goal of this study was to reveal the functional role of β-AR in modulating vaginal lubrication during sexual arousal and the mechanisms underlying the process. The effects of adrenaline on vaginal epithelial ion transport, intracellular cyclic adenosine monophosphate (cAMP) content ([cAMP]i ), and vaginal lubrication were investigated using short-circuit current (ISC ) of rat vaginas incubated in vitro, enzyme-linked immunosorbent assay (ELISA), and measurement of vaginal lubrication in vivo, respectively. The expressions of β-AR in vaginal epithelium were analyzed by reverse transcription-polymerase chain reaction, western blot, and immunofluorescence. Changes of ISC responses; mRNA, protein expressions and localization of β-AR; [cAMP]i ; vaginal lubrication. Serosal application of adrenaline induced an increase of ISC across rat vaginal epithelium that blocked by propranolol, a β-AR antagonist, rather than phentolamine, an α-AR antagonist. β1/2-AR were both present in rat and human vaginal epithelial cells. Removing Cl(-) or application of CFTR(inh) -172, an inhibitor of cystic fibrosis transmembrane conductance regulator (CFTR), abolished adrenaline-induced ISC responses. The elevated levels of [cAMP]i induced by adrenaline were prevented by the pretreatment with propranolol. Vaginal lubrication measured in vivo showed that adrenaline or pelvic nerve stimulation caused a marked increase in vaginal lubrication, whereas pretreatment with propranolol or CFTR(inh) -172 reduced the effect. Activation of epithelial β-AR facilitates vaginal lubrication during sexual arousal by stimulating

  17. Vacuum Assisted Vaginal Deliveries in Sagamu | Adefuye | Nigerian ...

    African Journals Online (AJOL)

    A retrospective review of all cases of vacuum assisted vaginal deliveries at the Olabisi Onabanjo University Teaching Hospital, Sagamu, between January 1990 and December 2001 is presented. During the study period there were 4962 deliveries and assisted vaginal deliveries by vacuum was 223, giving an incidence of ...

  18. Bacterial vaginosis, alterations in vaginal flora and HIV genital ...

    African Journals Online (AJOL)

    Bacterial vaginosis, alterations in vaginal flora and HIV genital shedding among HIV-1-infected women in Mozambique. ... We compared women with detectable cervical HIV viral load (≥40 copies/ml) with women with undetectable cervical HIV. Results. We enrolled 106 women. Women with abnormal vaginal flora ...

  19. [Physicopharmaceutical characteristics of ulinastatin vaginal suppositories prepared in a hospital].

    Science.gov (United States)

    Satake, Kiyoshi; Nakajima, Takanori; Iwata, Masanori; Fujikake, Yoshio; Kimura, Masayuki

    2011-01-01

    We studied a locally applied vaginal preparation (vaginal suppositories) of ulinastatin (urinary trypsin inhibitor, UTI), designed to threatened premature delivery and maintain pregnancy. Witepsol S55 was chosen as the basic component of the vaginal suppositories based on the physical pharmaceutical characteristics of three kinds of hard fats. The average particle size of the UTI aqueous injection was approximately 70% as compared with that of the UTI lyophilized product, used as the base material for the preparation of UTI vaginal suppositories. We compared the physical pharmaceutical properties of UTI vaginal suppositories with water contents of 2.5%, 5.0%, and 7.5%, respectively. Preparation strength negatively correlated with the water content. The coefficient of viscosity positively correlated with the water content of the preparation. UTI vaginal suppositories with a water content of 5.0% had the highest average drug release rate on moment analysis. A comprehensive evaluation of the properties of UTI vaginal suppositories, including high strength due to disintegration resistance, the coefficient of viscosity and its influence on local retention, and drug release and its influence on the duration of effect, indicated that a 5.0% UTI aqueous solution for injection combined with Witepsol S55 as the base was the optimal formulation for the hospital preparation of vaginal suppositories.

  20. The threat of aerobic vaginitis to pregnancy and neonatal morbidity ...

    African Journals Online (AJOL)

    Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. Its early diagnosis and treatment during pregnancy may reduce the risk of negative pregnancy outcomes. The aim of this review was to report on the aerobic bacteria most prevalent in AV and to ...

  1. Pregnancy outcome and factors affecting vaginal delivery of twins at ...

    African Journals Online (AJOL)

    Objective: The study aims to determine the differences in maternal and perinatal outcomes between caesarean and vaginal deliveries and the factors affecting vaginal delivery in twin pregnancy. Materials and Methods: An observational study to audit twin pregnancies delivered at the University of Nigeria Teaching Hospital ...

  2. Vaginal drug delivery systems: A Review of Current Status | Dobaria ...

    African Journals Online (AJOL)

    Among the various routes of drug delivery, the vaginal route offers many advantages due to its large permeation area, rich vascularization, avoidance of first pass metabolism and relatively low enzymatic activity. Several studies have shown that the vaginal cavity is an effective route for drug administration intended mainly ...

  3. Large and small cells non-keratinizing epidermoid vaginal carcinoma

    International Nuclear Information System (INIS)

    Maso Anaya, Ofelia; Morales Larramendi, Maria Elena; Diaz Perez, Dolores

    2012-01-01

    Five case reports of patients who were assisted at the cervix Pathology Department from 'Mariana Grajales Coello' Provincial Gynecological Obstetrical Hospital in Santiago de Cuba due to vaginal bleeding, low abdominal pain, leukorrhea and vaginal injuries are presented. The pathological study confirmed the diagnosis of squamous or epidermoid cells carcinoma

  4. The stimulation of the vaginal immune system with short-term administration of a vaginal gel containing fraction of Propionibacterium acnes, hyaluronic acid and polycarbophil is efficacious in vaginal infections dependent on disorders in the vaginal ecosystem.

    Science.gov (United States)

    Melis, Gian Benedetto; Piras, Bruno; Marotto, Maria Francesca; Neri, Manuela; Corda, Valentina; Vallerino, Valerio; Saba, Alessandra; Lello, Stefano; Pilloni, Monica; Zedda, Pierina; Paoletti, Anna Maria; Mais, Valerio

    2018-04-12

    The vaginal immune system (VIS) is the first defense against antigens recognized as foreign. Substances capable of locally activating the VIS could be a valid strategy to treat vulvo-vaginal infections (VVI), caused by changes in the vaginal ecosystem, such as bacterial vaginosis (BV), vulvo-vaginal candidiasis (CA), and mixed vaginitis (MV). Bacterial lysates, obtained by crushing bacterial cultures, exert immuno-modulatory activities. The parietal fraction from Propionibacterium acnes is a patent of Depofarma (MoglianoVeneto, Italy). The preparation that associates such fraction to hyaluronic acid and polycarbophil is a registered trademark, commercially available in Italy as vaginal gel, Immunovag ® . The study aimed to evaluate whether a 5-day-treatment with Immunovag ® improves the symptoms and signs of VVI, in 60 women with Gardnerella vaginalis (GV), 154 with CA, 95 with MV, diagnosed with vulvar vaginal swab (VVS), and in 283 with BV, diagnosed with the Amsel criteria. At the end of the treatment (visit 2), the symptoms and signs of VVI disappeared in a significant number of subjects (χ 2 p < .02 vs pre-treatment) in all VVI groups, and their intensity was significantly (p < .0002) reduced in the subjects in which they were still present. Immunovag ® represents a valid treatment of VVI induced by changes in the vaginal ecosystem.

  5. Evaluation of vaginal implant transmitters in elk (Cervus elaphus nelsoni).

    Science.gov (United States)

    Bruce K. Johnson; Terrance McCoy; Christopher O. Kochanny; Rachel C. Cook

    2006-01-01

    The effects of vaginal implant transmitters for tissue damage after 11 wk in 13 captive adult elk (Cervus elaphus nelsoni) and subsequent reproductive performance in 38 free-ranging elk were evaluated. Vaginal implant transmitters are designed to be shed at parturition and are used to locate birth sites of wild ungulates; however, potential adverse...

  6. Randomization of two dosing regimens of vaginal misoprostol for ...

    African Journals Online (AJOL)

    Objectives: To compare the effectiveness of two dosing regimens of vaginal misoprostol for cervical ripening and induction of labour. Materials and Methods: Pregnant women with singleton low risk pregnancy at term scheduled for elective induction of labour were randomized to receive either 25 µg or 50 µg of vaginal ...

  7. huge abdominal mass secondary to a transverse vaginal septum ...

    African Journals Online (AJOL)

    2011-12-01

    Dec 1, 2011 ... A diagnosis of Transverse Vaginal septum with prob- able vaginal atresia was made. A two-stage surgery was planned: laparotomy to drain the haemorrhagic ... through a low vertical uterine incision. A probe passed through the uterine incision towards the cervix ended blindly. The tubes were distended ...

  8. The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

    African Journals Online (AJOL)

    USER

    Microbial Endogenous Infections Studies, Department of Medical Biosciences, University of the Western Cape,. Bellville, South ... Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. ..... A, Salembier G and Spitz B. Definition of a type of abnormal ...

  9. Radiotherapy-induced vaginal fibrosis in cervical cancer survivors.

    Science.gov (United States)

    Hofsjö, Alexandra; Bohm-Starke, Nina; Blomgren, Bo; Jahren, Helen; Steineck, Gunnar; Bergmark, Karin

    2017-05-01

    Cervical cancer survivors treated with radiotherapy report vaginal inelasticity and decreased lubrication that may affect their sexual health, but it is unknown which normal tissue reactions mediate these symptoms. The aim of this study was to investigate the morphology of the connective tissue of the vaginal wall in cervical cancer survivors treated with radiotherapy. We recruited 34 cervical cancer survivors treated with radiotherapy and 37 age-matched controls. Via clinical examination the degree of vaginal atrophy and pelvic fibrosis were estimated. We collected vaginal biopsies, which underwent morphometric analysis focused on elastin and collagen. Additionally, radiation dose at biopsy site were calculated and correlated to the clinical and morphological findings. The survivors had marked morphological vaginal changes, most prominent in the survivors that had received the highest radiation dose at the biopsy site. Mucosal atrophy was observed in 91% and pelvic fibrosis in 97%. A shorter vagina was measured; 7.0 cm versus 10.3 cm in controls (p cancer survivors that had received external radiation. We found drastic differences in the vaginal wall between the irradiated cervical cancer survivors and the controls, indicating that radiotherapy-induced vaginal symptoms are mediated by connective tissue fibrosis and elastosis. Our results also support that patients treated with external radiation have the highest risk of developing vaginal fibrosis with impairment of their sexual health.

  10. Prevalence of Vaginal Trichomoniasis: An Assessment of Sensitivity ...

    African Journals Online (AJOL)

    This study which was conducted on 400 females patients aged 15 to 60 years who complained of vaginal discharge and itching in some selected health centers in Yola between 2003 and March 2005, is a comparative study of the relative accuracies of three techniques for diagnosing vaginal trichomoniasis. Three sterile ...

  11. Sore throat · vaginal discharge · labial ulcer · Dx?

    Science.gov (United States)

    Caravelli, Ashley; Bhatnagar, Rupal; Ashaye, Adelola

    2016-06-01

    The patient complained of worsening vaginal pain and increased vaginal discharge, but reported resolution of her back and chest pain. She also said that a week earlier, she'd had a fever that reached 104° F and a sore throat. She denied urinary frequency/urgency, sexual activity, or sexual abuse.

  12. Life threatening vaginal haemorrhage from coital laceration in a post ...

    African Journals Online (AJOL)

    Case report: A 55-year-old woman who presented as an emergency with haemorrhagic shock following vaginal bleeding from consensual coitus is presented. She was resuscitated with intravenous fluids and blood transfusions. The vaginal laceration of about 5 cm on the right side of the posterior fornix was sutured ...

  13. Large Vesico‑Vaginal Fistula Caused by a Foreign Body

    African Journals Online (AJOL)

    A plastic container approximately 4 cm in diameter was found invading into the vaginal musculature. With the successful removal of the container, a mid‑sized vesico‑vaginal fistula was noted measuring 2 cm in diameter with significant surrounding fibrosis and debris. A small stone was visualized in the bladder.

  14. The effect of introduction of a guideline on the management of vaginal discharge and in particular bacterial vaginosis in primary care.

    Science.gov (United States)

    Langsford, M J; Dobbs, F F; Morrison, G M; Dance, D A

    2001-06-01

    Bacterial vaginosis (BV) is the commonest cause of vaginal discharge, and its association with obstetric and gynaecological complications is being recognized increasingly. It was our impression that BV was poorly understood and underdiagnosed in family practice. The aim of this study was to explore the management of patients with vaginal symptoms by family practitioners and to see if the management changed after the assimilation of best practice guidelines. Family practitioners were invited to complete a baseline questionnaire of their perceived practice, and to record actual practice when consulted about vaginal symptoms, for a minimum of 4 weeks. Consensus best practice guidelines were then provided and practice recorded for a similar period. Baseline data was received from 34 practitioners and suggested that the symptoms and signs of different vaginal infections were not well known. Most symptomatic patients were only investigated at re-presentation with unresolved symptoms or at recurrence, and 43% of respondents treated with empirical antifungals as a first line approach. Pregnant patients were only occasionally asked about symptoms and only occasionally examined if symptomatic. Pre-guideline practice data from 30 practitioners showed 1.2 patient consultations/week, of which 60% were examined and 55% had a high vaginal swab (HVS) sent. Only 2% had near-patient tests done. Post-guideline data from 23 family practitioners showed a lower recorded consultation rate at 0.7/week, but 90% of these were examined, 77% had an HVS sent and 69% had near-patient tests done. Of the 36 HVS examined by Gram stain, 19 (53%) showed Lactobacillus predominant flora and 10 (28%) suggested BV. Seven (19%) were borderline or ungradable. Only three (8%) showed yeasts, one of which also showed BV. Baseline data supported our impression that BV was under-recognized. Guidelines appeared to improve the rate of investigation of women consulting with vaginal symptoms.

  15. Ureterovaginal fistula: A complication of a vaginal foreign body.

    Science.gov (United States)

    Lo, Tsia-Shu; Jaili, Sukanda Bin; Ibrahim, Rami; Kao, Chuan Chi; Uy-Patrimonio, Ma Clarissa

    2018-02-01

    To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome. A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered. Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications. Copyright © 2018. Published by Elsevier B.V.

  16. Vaginal Primary Malignant Melanoma: A Rare and Aggressive Tumor

    Directory of Open Access Journals (Sweden)

    Georgios Androutsopoulos

    2013-01-01

    Full Text Available Vaginal primary malignant melanoma is a rare and very aggressive tumor. It most commonly occurs in postmenopausal women, with a mean age of 57 years. Our patient is an 80-year-old, postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. On gynecologic examination there was a pigmented, raised, ulcerated, and irregular lesion  cm in the upper third of anterior vaginal wall. She underwent a wide local excision of the lesion. The histopathology revealed vaginal primary malignant melanoma with ulceration and no clear surgical margins. She denied any additional surgical interventions and underwent to postoperative adjuvant radiotherapy. Follow up 5 months after initial diagnosis revealed no evidence of local recurrence or distant metastasis. The prognosis of vaginal primary malignant melanoma is very poor despite treatment modality, because most of the cases are diagnosed at advanced stage. Particularly patients with no clear surgical margins and tumor size >3 cm needed postoperative adjuvant radiotherapy.

  17. Aerobic vaginitis: no longer a stranger.

    Science.gov (United States)

    Donders, Gilbert G G; Bellen, Gert; Grinceviciene, Svitrigaile; Ruban, Kateryna; Vieira-Baptista, Pedro

    Aerobic vaginitis (AV) is the name given in 2002 to a vaginal infectious entity which was not recognized as such before. It is characterized by abnormal (dysbiotic) vaginal microflora containing aerobic, enteric bacteria, variable levels of vaginal inflammation and deficient epithelial maturation. Although AV and bacterial vaginosis (BV) share some characteristics, such as a diminished number or absence of lactobacilli, increased discharge (fishy smelling in BV, while in severe forms of AV, a foul, rather rotten smell may be present) and increased pH (often more pronounced in AV), there are also striking differences between the two. There is no inflammation in women with BV, whereas the vagina of women with AV often appears red and edematous, and may even display small erosions or ulcerations. The color of the discharge in BV is usually whitish or gray and of a watery consistency, whereas in AV it is yellow to green and rather thick and mucoid. Women with BV do not have dyspareunia, while some women with severe AV do. Finally, the microscopic appearance differs in various aspects, such as the presence of leucocytes and parabasal or immature epithelial cells in AV and the absence of the granular aspect of the microflora, typical of BV. Despite all these differences, the distinction between AV and BV was not recognized in many former studies, leading to incomplete and imprecise diagnostic workouts and erroneous management of patients in both clinical and research settings. The prevalence of AV ranges between 7 and 12%, and is therefore less prevalent than BV. Although still largely undiagnosed, many researchers and clinicians increasingly take it into account as a cause of symptomatic vaginitis. AV can co-occur with other entities, such as BV and candidiasis. It can be associated with dyspareunia, sexually transmitted infections (such as human papilloma virus, human immunodeficiency virus, Trichomonas vaginalis and Chlamydia trachomatis), chorioamnionitis, fetal

  18. 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

  19. Clinical Practice Guideline Selection, Development, Implementation, and Evaluation

    Science.gov (United States)

    2000-02-01

    Dispositions 1. 391 Normal Newborn 606 2. 373 Vaginal Delivery w/o Complications 502 3. 630 Neonate, Birth weight 2499G 165 4. 372 Vaginal Delivery w...Esophagitis, gastroent & 44 15. 358 Uterine & Adnexa Proc f 43 16. 138 Cardiac Arrhythmia & co 39 17. 204 Disorders of Pancreas 37 Clinical Practice

  20. Evaluation of pregnancy rates of Bos indicus cows subjected to different synchronization ovulation protocols using injectable progesterone or an intravaginal device

    Directory of Open Access Journals (Sweden)

    Jefferson Tadeu Campos

    2016-12-01

    Full Text Available This study evaluated the pregnancy rate in Nelore cows (Bos indicus that were subjected to fixed-time artificial insemination (FTAI using different protocols consisting of injectable progesterone (P4 or an intravaginal device (impregnated with P4. Multiparous cows 72-84 months in age, 30-45 days postpartum, were selected on the basis of the absence of a corpus luteum (CL and follicles < 8 mm after transrectal palpation and ultrasound examinations. On a random day of the estrus cycle (D0, the selected animals (n = 135 were randomly assigned to one of three experimental groups (n = 45 each. Group I (injectable P4/FTAI 36 hours received 250 mg of injectable P4 and 2 mg EB on D0; on D7, they received 500 µg of cloprostenol; on D8, 300 IU of eCG and 1 mg of EB were administered; and finally, FTAI was performed 36 hours after the application of EB. Group II (injectable P4/FTAI 48 hours received the same protocol as Group I, except that the FTAI was performed 48 hours after ovulation induction. The animals of Group III (Control/CIDR received a conventional protocol for FTAI using an intravaginal device (D0: P4 and 2 mg EB; D8: device removal, 500 µg cloprostenol, 300 IU eCG, 1 mg EB; and FTAI performed 48 hours after removal of the device. The results showed that cows synchronized with the conventional protocol for FTAI (Control/CIDR had a higher pregnancy rate (60 %, 27/45 than those synchronized with an injectable P4/FTAI 36 hours (33.33 %; 15/45, P = 0.010. However, the group receiving injectable P4 group/FTAI 48 hours had a similar pregnancy rate (48.9 %; 22/45; P = 0.290 when compared to both the group receiving the conventional protocol and that receiving injectable P4/FTAI 36 hours (P = 0.134. Although the injectable P4 may affect pregnancy rate with the FTAI performed in 36 hours, we found similar pregnancy rates from cows inseminated 48 hours after induction ovulation, considering injectable or intravaginal P4. Therefore, we suggest that

  1. Prolapso vaginal e uterino em ovelhas

    Directory of Open Access Journals (Sweden)

    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.

  2. A safe method of vaginal longitudinal morcellation of bulky uterus with endometrial cancer in a bag at laparoscopy.

    Science.gov (United States)

    Montella, Fabio; Riboni, Francesca; Cosma, Stefano; Dealberti, Davide; Prigione, Stefano; Pisani, Carla; Rovetta, Enrico

    2014-06-01

    Total laparoscopic hysterectomy (TLH) is becoming an increasingly popular treatment in endometrial cancer. Intra-abdominal or vaginal uterus morcellation are well described and routinely practiced techniques in removing a benign bulky uterus but contraindicated in endometrial cancer. In malignancy, the uterus needs to be removed intact to avoid intraperitoneal spillage of the endometrial cancer cells, and a uterine size of 12 gestational weeks (g.w.) or larger has been considered a contraindication for the laparoscopic approach. The aim of our study was to evaluate the feasibility and safety of a sealed vaginal morcellation technique in a bag for endometrial cancer laparoscopic treatment. We prospectively scheduled 12 patients affected by endometrial cancer with uterus bigger than 12 g.w. for endometrial cancer laparoscopic treatment. After performing TLH, a sterile plastic wrapping bag was inserted by a 12 mm camera port by rolling it onto the blunt probe. The uterus was covered from the fundus to the cervix, placing the free edges of the bag down into the manipulator cup with two blunt graspers. The specimen completely covered by the bag was then pushed down under direct laparoscopic vision through colpotomy and pulled out from the vagina. The uterus was morcellated by the vaginal route. All patients underwent laparoscopic treatment with vaginal uterine morcellation. The mean uterus weight was 290.8 ± 79.7 g with a mean morcellation operative time of 12.1 min. All vaginal morcellations were completed successfully. All patients were without evidence of local or distant recurrence at the median follow-up time of 18 months. This technique allows the surgeon to morcellate a bulky uterus in cases of endometrial cancer and reduces the chance of neoplastic cell spillage during debulking at TLH. Vaginal morcellation following oncologic rules permits a rapid uterine extraction and may avoid a number of unnecessary laparotomies.

  3. Selective versus routine use of episiotomy for vaginal birth

    Science.gov (United States)

    Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

    2017-01-01

    Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

  4. 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

  5. Uterus didelphys with partial vaginal septum and distal vaginal agenesis: an unusual anomaly

    International Nuclear Information System (INIS)

    Singhal, S.R.; Lakra, P.; Bishnoi, P.; Rohilla, S.; Dahiya, P.

    2013-01-01

    Complex malformations of female genital tract are not so common. Their correct identification is of paramount importance for appropriate management. A thorough knowledge of embryology, pre-operative imaging with MRI and examination under anaesthesia is essential to identify accurately the constellation of anomalies and to plan appropriate management. This case reports the coexistence of Mullerian abnormality with vaginal agenesis in an 18 years old girl which was managed by dissecting the lower half of vagina and pull-through vaginoplasty. (author)

  6. Antibiotic prophylaxis for episiotomy repair following vaginal birth.

    Science.gov (United States)

    Bonet, Mercedes; Ota, Erika; Chibueze, Chioma E; Oladapo, Olufemi T

    2017-11-02

    Bacterial infections occurring during labour, childbirth, and the puerperium may be associated with considerable maternal and perinatal morbidity and mortality. Antibiotic prophylaxis might reduce wound infection incidence after an episiotomy, particularly in situations associated with a higher risk of postpartum perineal infection, such as midline episiotomy, extension of the incision, or in settings where the baseline risk of infection after vaginal birth is high. However, available evidence is unclear concerning the role of prophylactic antibiotics in preventing infections after an episiotomy. To assess whether routine antibiotic prophylaxis before or immediately after incision or repair of episiotomy for women with an uncomplicated vaginal birth, compared with either placebo or no antibiotic prophylaxis, prevents maternal infectious morbidities and improves outcomes. We searched the Cochrane Pregnancy and Childbirth's Trials Register, LILACS, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) on 24 July 2017, and screened reference lists of retrieved studies. We considered randomised controlled trials, quasi-randomised trials, and cluster-randomised trials that compared the use of routine antibiotic prophylaxis for incision or repair of an episiotomy for women with otherwise normal vaginal births, compared with either placebo or no antibiotic prophylaxis. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked them for accuracy. We only found one quasi-randomised trial that met the inclusion criteria and was included in the analysis, therefore, we did not perform a meta-analysis. We included one quasi-RCT (with data from 73 women) in the review. The trial, which was conducted in a public hospital in Brazil, compared oral chloramphenicol 500 mg four times daily for 72 hours after episiotomy repair (N = 34) and no treatment (N = 39). We assessed most of the domains at high

  7. 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

  8. 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

  9. Circulating progesterone concentrations in nonlactating Holstein cows during reuse of intravaginal progesterone implants sanitized by autoclave or chemical disinfection.

    Science.gov (United States)

    Melo, L F; Monteiro, P L J; Oliveira, L H; Guardieiro, M M; Drum, J N; Wiltbank, M C; Sartori, R

    2018-04-01

    The aim of this study was to compare plasma progesterone (P4) concentrations in nonlactating, multiparous Holstein cows (n = 24) treated with 2 types of intravaginal implants containing either 1.0 or 1.9 g of P4 either at the first use or during reuse of the implants after sanitizing the implant by autoclave or chemical disinfection. In a completely randomized design with a 2 × 3 factorial arrangement and 2 replicates, every cow underwent 2 of 6 treatments. Two sources of P4 [controlled internal drug release (1.9 g of P4) from Zoetis (São Paulo, Brazil), and Sincrogest (1.0 g of P4) from Ourofino (Cravinhos, Brazil)] and 3 types of processing, new (N), reused after autoclave (RA), and reused after chemical disinfection (RC), were used. After inducing luteolysis to avoid endogenous circulating P4, the cows were randomized in 1 of 6 treatments (1.9 g of N, 1.9 g of RA, 1.9 g of RC, 1.0 g of N, 1.0 g of RA, and 1.0 g RC). Cows were treated with the implants for 8 d and during this period blood samples were collected at 0, 2, 12, 24, 48, 72, 96, 120, 144, 168, and 192 h. Statistical analyses were performed using Proc-Mixed and the mean ± standard error of the mean P4 concentrations were calculated using the Proc-Means procedures of SAS 9.4 (SAS Institute Inc., Cary, NC). No interaction between treatments was observed. Comparing types of implant, average P4 concentrations during treatments were greater for 1.9 g than 1.0 g (1.46 vs. 1.14 ± 0.04 ng/mL). When types of processing were compared, average P4 concentrations did not differ between autoclaved and new inserts (1.46 vs. 1.37 ± 0.05 ng/mL; respectively), but both were greater than chemically disinfected implants (1.09 ± 0.04 ng/mL). Within 1.9-g P4 inserts, P4 concentrations from autoclaved implants were greater than new, which were greater than chemically disinfected (1.67 ± 0.06 vs. 1.49 ± 0.07 vs. 1.21 ± 0.05 ng/mL; respectively). For 1.0-g P4 implants, P4 concentrations from autoclaved did not differ

  10. From "sex toy" to intrusive imposition: a qualitative examination of women's experiences with vaginal dilator use following treatment for gynecological cancer.

    Science.gov (United States)

    Cullen, Kimberley; Fergus, Karen; Dasgupta, Tracey; Fitch, Marg; Doyle, Catherine; Adams, Lauran

    2012-04-01

    Regular use of vaginal dilators has been recommended as a prophylactic measure following radiation treatment for gynecological cancers in order to minimize vaginal stenosis and promote optimal healing of the vagina. Despite the well-established reluctance of women to adopt this practice, little is known about the difficulties and concerns associated with vaginal dilator use. To investigate women's experiences with the vaginal dilator and to understand the psychosocial factors that influence women's adoption of rehabilitative dilator use. This is an exploratory qualitative study using semi-structured interviews with a sample of 10 women with a history of gynecological cancer and who were prescribed a vaginal dilator. Interviews were analyzed using the grounded theory method and examined for recurrent themes. The main outcome measure was a semi-structured interview comprised of open-ended questions designed to elicit information concerning topic areas relevant to gynecological cancer, vaginal dilator use, and sexuality. The analysis resulted in five main categories underlying the core category of "From 'sex toy' to intrusive imposition." These were: (i) embarrassing sex toy; (ii) reliving the invasion of treatment; (iii) aversive "hands-on" experience; (iv) not at the forefront of my recovery; and (v) minimizing the resistance. Rehabilitative vaginal dilator use is a complex, multifaceted, and personal phenomenon that carries deep psychological and emotional implications that make it intrusive. These findings may enhance the way in which vaginal dilators are introduced and help healthcare providers address better women's difficulties and concerns with the dilators. Ultimately, it may also lead to improved health maintenance and quality of life for women recovering from gynecological cancer. © 2012 International Society for Sexual Medicine.

  11. Surgery for vaginal hydroceles: an update

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    N Ananthakrishnan

    2005-01-01

    Full Text Available In men, vaginal hydrocele is the most common morbidity due to Wuchereria bancrofti . Diagnosis is straightforward most of the time but when the swelling is not transilluminant, patients in whom the diagnosis is in doubt, children with hydroceles and those with co-morbid conditions should have ultrasonography to differentiate these swellings. Studies on the effect of medical treatment with diethylcarbamazine on the size of hydroceles are inconclusive. The only effective treatment for hydrocele is surgery as the minimally invasive therapy like aspiration and sclerotherapy are known to have high recurrence rates. Several surgical options are available for managing hydrocele but the recommended operation is hydrocelectomy, i.e. a subtotal excision of the parietal layer of the tunica vaginalis leaving a rim of approximately one-centimeter width around the testis and epididymis.

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

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    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

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

    Science.gov (United States)

    Huang, Yongmei; Merkatz, Ruth B.; Hillier, Sharon L.; Roberts, Kevin; Blithe, Diana L.; Sitruk-Ware, Régine; Creinin, Mitchell D.

    2015-01-01

    Background 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. Methods 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. Results 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. Conclusion Sustained use of the NES/EE CVR did not increase the risk of vaginal infection and was not disruptive to

  14. Dynamics of the Vaginal Ecosystem—Hormonal Influences

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    Miranda A. Farage

    2010-01-01

    Full Text Available The vagina is a dynamic and finely tuned ecosystem in which homeostasis depends on mutually beneficial interactions between a human female and her resident microorganisms, an ecosystem that can be thrown off balance by a wide variety of both intrinsic and extrinsic factors. Although a functional equilibrium provides stability to the ecosystem considered crucial to maintaining vaginal health, “normal flora” is a concept currently being redefined. New methodologies enable molecular analyses of the vaginal microbiota which have widened the definition of “normal” from a single specific microbiological profile to a range of functional microbial equilibria dependent upon pertinent host and microbial factors. One of the strongest influences on the vaginal microbiota is the hormonal changes that define the reproductive phases of a woman's life. The vaginal environment is particularly responsive to estrogen, a hormone that creates distinctive changes in the vaginal microbiota. This review summarizes the components of a healthy vaginal ecosystem during the reproductive years, including the characteristics of a healthy equilibrium and factors that can disturb a functional balance. It also summarizes what is known about the vaginal microbiota in childhood and after menopause. Healthful ecosystems at any stage of a female's reproductive life will be characterized by a microbiota that both maintains physiological function and though changeable, adapts to normal perturbation without succumbing to disease.

  15. The vaginal microbiota, host defence and reproductive physiology.

    Science.gov (United States)

    Smith, Steven B; Ravel, Jacques

    2017-01-15

    The interaction between the human host and the vaginal microbiota is highly dynamic. Major changes in the vaginal physiology and microbiota over a woman's lifetime are largely shaped by transitional periods such as puberty, menopause and pregnancy, while daily fluctuations in microbial composition observed through culture-independent studies are more likely to be the results of daily life activities and behaviours. The vaginal microbiota of reproductive-aged women is largely made up of at least five different community state types. Four of these community state types are dominated by lactic-acid producing Lactobacillus spp. while the fifth is commonly composed of anaerobes and strict anaerobes and is sometimes associated with vaginal symptoms. The production of lactic acid has been associated with contributing to the overall health of the vagina due to its direct and indirect effects on pathogens and host defence. Some species associated with non-Lactobacillus vaginal microbiota may trigger immune responses as well as degrade the host mucosa, processes that ultimately increase susceptibility to infections and contribute to negative reproductive outcomes such as infertility and preterm birth. Further studies are needed to better understand the functional underpinnings of how the vaginal microbiota affect host physiology but also how host physiology affects the vaginal microbiota. Understanding this fine-tuned interaction is key to maintaining women's reproductive health. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

  16. The effect of pessaries on the vaginal microenvironment.

    Science.gov (United States)

    Collins, Sarah; Beigi, Richard; Mellen, Colleen; O'Sullivan, David; Tulikangas, Paul

    2015-01-01

    The objective of the study was to evaluate the differences in vaginal culture, microscopy, and Gram stain between postmenopausal women who wear pessaries and those who do not to explain pessary-related, bothersome vaginal discharge. Postmenopausal women not using exogenous estrogen who had either been wearing a pessary for at least 3 months or who were undergoing their first pessary fittings were approached for enrollment. Symptoms were assessed, and vaginal fluid was collected for culture, microscopy, and Gram stain. A cross-sectional analysis was performed, comparing the new and return pessary wearers. The new pessary users were also sampled at 2 weeks, 3 months, and 6 months after fitting. Women who wore pessaries were more likely to be bothered by discharge (30.0% vs 2.1%, P vaginal inflammation and vaginitis. Prospective data showed that these changes developed during the first 2 weeks of pessary use. Aerobic and anaerobic organisms were nearly identical in women with and without bothersome vaginal discharge in the cross-sectional analysis and at all time points in the prospective analysis. Pessary-related, bothersome vaginal discharge develops early and may be due to an inflammatory process in the vagina. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. The Vaginal Acquisition and Dissemination of HIV-1 Infection in a Novel Transgenic Mouse Model Is Facilitated by Coinfection with Herpes Simplex Virus 2 and Is Inhibited by Microbicide Treatment.

    Science.gov (United States)

    Seay, Kieran; Khajoueinejad, Nazanin; Zheng, Jian Hua; Kiser, Patrick; Ochsenbauer, Christina; Kappes, John C; Herold, Betsy; Goldstein, Harris

    2015-09-01

    Epidemiological studies have demonstrated that herpes simplex virus 2 (HSV-2) infection significantly increases the risk of HIV-1 acquisition, thereby contributing to the expanding HIV-1 epidemic. To investigate whether HSV-2 infection directly facilitates mucosal HIV-1 acquisition, we used our transgenic hCD4/R5/cT1 mouse model which circumvents major entry and transcription blocks preventing murine HIV-1 infection by targeting transgenic expression of human CD4, CCR5, and cyclin T1 genes to CD4(+) T cells and myeloid-committed cells. Productive infection of mucosal leukocytes, predominantly CD4(+) T cells, was detected in all hCD4/R5/cT1 mice intravaginally challenged with an HIV-1 infectious molecular clone, HIV-Du151.2env-NLuc, which expresses an env gene (C.Du151.2) cloned from an acute heterosexually infected woman and a NanoLuc luciferase reporter gene. Lower genital tract HIV-1 infection after HIV-Du151.2env-NLuc intravaginal challenge was increased ~4-fold in hCD4/R5/cT1 mice coinfected with HSV-2. Furthermore, HIV-1 dissemination to draining lymph nodes was detected only in HSV-2-coinfected mice. HSV-2 infection stimulated local infiltration and activation of CD4(+) T cells and dendritic cells, likely contributing to the enhanced HIV-1 infection and dissemination in HSV-2-coinfected mice. We then used this model to demonstrate that a novel gel containing tenofovir disoproxil fumarate (TDF), the more potent prodrug of tenofovir (TFV), but not the TFV microbicide gel utilized in the recent CAPRISA 004, VOICE (Vaginal and Oral Interventions to Control the Epidemic), and FACTS 001 clinical trials, was effective as preexposure prophylaxis (PrEP) to completely prevent vaginal HIV-1 infection in almost half of HSV-2-coinfected mice. These results also support utilization of hCD4/R5/cT1 mice as a highly reproducible immunocompetent preclinical model to evaluate HIV-1 acquisition across the female genital tract. Multiple epidemiological studies have reported that

  18. Vaginal hysterectomy in patients with uterus prolapse

    International Nuclear Information System (INIS)

    Garcia Rodriguez, Miguel Emilio; Romero Sanchez, Ramon Ezequiel.

    2011-01-01

    INTRODUCTION. In the medical literature is quoted the nulliparity, the existence of previous operations and the uterus size as exclusion factors to choice the hysterectomy technique. The aim of present research was to determine the effectiveness and feasibility of vaginal hysterectomy by Heaney's technique, carried out in patients without uterus prolapse even in presence of the above mentioned factors. METHODS. A multivariate, descriptive and observational study was conducted in a sample including 1 000 patients operated on in the General Surgery service of the 'Martin Chang Puga' University Hospital in Nuevitas municipality (Camaguey province, between May, 1994 and December, 2006. A database was designed in Excel transferred to SPSS professional statistical package to carry out univaried, bivaried and multivariate analyses, which finally were represented in frequency and percentages tables. A significance of p= 0.05 was used. RESULTS. The 6 % of patients were nulliparous and the 23,5 % had previous surgeries of pelvis. A 82,6 % of patients had uteri with no more than an approximate value of 12 weeks of pregnancy and the uterine fibroma was the leading cause (88,5 %) of intervention. Only a 4,1 % of patients need blood transfusion. The perioperative and postoperative complications accounted for the 1,7 % and the 19,3 %, respectively. The 97,2 % of patients stayed less than 48 hours in the hospital and the 99,4 % go back to normal life. CONCLUSIONS. The nulliparity, the uterus size and the previous operations were not considered like isolated and excluding factors for the vaginal route. However, the type of hysterectomy will depends of the decision of the attending physician and the patient, according the costs and benefits involved in each case. (author)

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

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    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 .

  20. The effect of clindamycin vaginal cream on prevention of preterm labor

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    Farahnaz Changaee

    2016-09-01

    Full Text Available Background: Preterm delivery is one of the most common causes of perinatal mortality around the world. The purpose of this study was to determine the effect of clindamycin vaginal cream in the prevention of preterm labor. Materials and Methods: This study was a control trial carried out on 236 pregnant women, referred to private practice office of a physician,with 13-20 weeks of gestational age. Samples of vaginal smear were gathered, and in the case of abnormal results, subjects were randomly assigned to either a control or case group. Clindamycin group treated with vaginal cream for three nights in the first turn and seven night at the second turn. But the control group received no treatment. Then, all subjects were followed up. Data wero collected using a questionnair and analyzed. Results:The incidence of premature birth in the control group was higher than the group under treatment with clindamycin (12% vs 7%, but this difference was not enough to be statistically significant. It was also shown that the higher incidence of preterm delivery in the control group was lower than the age of pregnancy termination. Mortality in the control group was significantly higher than the control group. Conclusion: Although no significant difference was observed in the rate of preterm labor between the two groups, but in control group gestational age was less and mortality rate was high. It seems that clindamycin in decreasing prenatal mortality is associated with preterm labor effectively.

  1. Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section.

    Science.gov (United States)

    Kayman-Kose, Seda; Arioz, Dagistan Tolga; Toktas, Hasan; Koken, Gulengul; Kanat-Pektas, Mine; Kose, Mesut; Yilmazer, Mehmet

    2014-10-01

    The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation (TENS) in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2), while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4). The patients in Group 2 had statistically lower visual analog scale (VAS) and verbal numerical scale (VNS) scores than the patients in Group 1 (p TENS (p = 0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p = 0.830). TENS is an effective, reliable, practical and easily available modality of treatment for postpartum pain.

  2. Anterior vaginal wall tenderness (AVWT) as a physical symptom in chronic pelvic pain.

    Science.gov (United States)

    Paulson, John D; Paulson, Joseph N

    2011-01-01

    Chronic pelvic pain is often difficult to diagnose and treat properly. Physicians called on to treat this problem may not be able to give a specific diagnosis. The aim of this study was to see whether the physical presence of anterior vaginal wall tenderness could help narrow down and elucidate diagnoses in a practice focusing on diagnosis and treatment of chronic pelvic pain. The study cohort comprised 284 patients with chronic pelvic pain limited to gynecologic and lower urinary problems. Histories, physical examinations, and endoscopic procedures were performed on each patient. An analysis of this information was conducted. Of the chronic pelvic pain patients, 78% had endometriosis, 81% had interstitial cystitis, and 61% had both concurrently. The sensitivity of anterior vaginal wall tenderness (AVWT) in patients with interstitial cystitis was 95%, and in those with only endometriosis and no interstitial cystitis, the sensitivity was 17%. The positive predictive value for interstitial cystitis was 85%, and for endometriosis it was 67%. Examination of the anterior vaginal wall with an empty bladder at the initial examination can lead one to suspect interstitial cystitis and possibly either concomitant or singular endometriosis and allow the physician to approach the workup accordingly.

  3. 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. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

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

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    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.

  5. Effects of estroprogestins containing natural estrogen on vaginal flora.

    Science.gov (United States)

    De Seta, Francesco; Restaino, Stefano; Banco, Rubina; Conversano, Ester; De Leo, Rossella; Tonon, Maddalena; Maso, Gianpaolo; Barbati, Giulia; Lello, Stefano

    2014-11-01

    Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG - Klaira®) in a quadriphasic regimen, while the other 30 women were administered 17-β estradiol with nomestrol acetate (EV+NOMAC - Zoely®) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs.

  6. 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

    relações sexuais semanais apresentaram maior freqüência de vaginose bacteriana e alterações da flora vaginal. O hábito de duchas vaginais não interferiu com o ecossistema vaginal das mulheres estudadas.PURPOSE: to verify if the high frequency of vaginal intercourses and the use of doushing interferes with vaginal microbiota. METHODS: ninety-seven women were examined at a health center located in the prostitution area of the city of Campinas, and evaluated in a prospective cross-sectional study. Anamnesis determined the frequency of vaginal intercourse and the use of douching in the 44 sex professionals and 53 non-professionals studied. The vaginal content was collected with a sterile Dacron swab, from the right vaginal wall, and placed on to two glass laminas. The vaginal microbiota smear stained by the Gram technique was studied with light microcopy using immersion lens and the data were analyzed. The sex professionals and non-professionals presented mean age of 24.9±6.4 and 31.5±9.7, habit of smoking in 52.2 and 24.5%, the use of vaginal lubricants in 56.8 and 0%, and the use of condoms in 100 and 41.5% of the cases, respectively. RESULTS: only 1.8% of the women in the control group had seven or more sexual intercourses per week, contrasting evidently with the sex professionals (97.7%. There were no significant differences regarding race, educational level and number of pregnancies. Bacterial vaginosis and abnormal vaginal flora were more observed in sex professionals (p=0.02 and 0.001 and were associated with the high frequency (seven times or more of weekly vaginal intercourses (p=0.04 and 0.001. Cytolytic vaginosis was more related to non-professionals (p=0.04 and to a lower frequency of sexual intercourses (p=0.04. The use of doushing was more common in the sex professionals (p=0.002. However, this practice was not associated either with the vaginal microbiota problems or with the presence of vulvovaginitis. CONCLUSIONS: sex professionals with seven or

  7. Comparison of barbed unidirectional suture with figure-of-eight standard sutures in vaginal cuff closure in total laparoscopic hysterectomy.

    Science.gov (United States)

    Karacan, Tolga; Ozyurek, Eser; Usta, Taner; Odacilar, Eylem; Hanli, Ulviye; Kovalak, Ebru; Dayan, Huseyin

    2018-03-24

    The aim of the study was to compare postoperative vaginal cuff complications due to the use of barbed sutures (V-Loc™ 180 unidirectional suture; Covidien, Mansfield, MA) and standard braided sutures (Vicryl ® ; Ethicon Inc., Somerville, MA) during vaginal cuff closure of patients undergoing a total laparoscopic hysterectomy (TLH) due to benign diseases. Eighty-nine patients were in the standard suture group and 208 patients were included in the barbed suture group. Vaginal cuff dehiscence was identified in only three (3.3%) patients within the standard suture group and none in the barbed suture group. Five (5.6%) patients in the standard suture group and two (0.9%) patients in the barbed suture group developed postoperative cuff infection/cellulitis. Duration of the surgery was significantly shorter in the barbed suture group than in the standard suture group (p barbed suture, which is used during TLH for vaginal cuff closure, is an applicable, safe and tolerable alternative to a standard suture. IMPACT STATEMENT What is already known on this subject: Barbed sutures are a relatively new type of suture that include sharp barbs inserted on monofilament material in various configurations, and are used for approximating tissues without any need for surgical knotting. They have increasingly been used in obstetrics and gynaecology in recent years, particularly in total laparoscopic hysterectomy and laparoscopic myomectomy. At present, there are a limited number of studies of V-Loc™ suture in the literature. What the results of this study add: We demonstrated that barbed sutures used for enabling vaginal cuff integrity did not cause major morbidity and mortality for the patient. We suggest that V-Loc™ 180 barbed sutures offer a practical, safe and tolerable alternative for surgeons because they are easy to use, do not cause a significant increase in vaginal cuff complications, and shorten the operating time. Our study with V-Loc™ 180 unidirectional barbed

  8. 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....

  9. Spontaneous de novo vaginal adenosis resembling Bartholin’s ...

    African Journals Online (AJOL)

    Adebayo Alade Adewole

    Keywords: Vaginal adenosis. Bartholin's cyst. Diethylstilbesterol. Vaginal adenocarcinoma. a b s t r a c t. Background: Vaginal adenosis is a rare benign condition with a small percentage of patients at risk of ... Diagnosis can be made from colposcopically directed biopsy of ... there was no vaginal discharge or bleeding.

  10. Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy

    Directory of Open Access Journals (Sweden)

    L. Mettler

    1997-01-01

    Full Text Available Between 1993 and 1994, 368 women underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomy Classic Intrafascial Supracervical Hysterectomy (CISH. Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by Intrafascial Vaginal Hysterectomy (IVH, 12.2% by Vaginal Hysterectomy (VH, and only 0.05% by Laparoscopic Assisted Vaginal Hysterectomy (LAVH. Comparative data of these six surgical techniques concerning patients characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weights and postoperatively used analgesics are described.

  11. Outpatient vaginal hysterectomy: optimizing perioperative management for same-day discharge.

    Science.gov (United States)

    Zakaria, Mark A; Levy, Barbara S

    2012-12-01

    To present tactics for optimizing outpatient vaginal hysterectomy and describe perioperative outcomes in a large consecutive case series. This is a descriptive study and review of clinical outcomes in 1,071 patients selected to undergo vaginal hysterectomy for benign indications from 2000 to 2010. The setting is a single-surgeon private practice in a community hospital. Outcome measures include length of hospital stay, estimated blood loss, operative time, uterine weight, and perioperative complications, including hospital readmissions and emergency room visits. One thousand seventy-one of 1,162 cases (92%, 95% confidence interval [CI] 90.5-93.7) were total vaginal hysterectomies, of which 1,029 (96%, 95% CI 94.9-97.3) were discharged the same day after surgery. The median operative time was 34 minutes (range 17-210 minutes), and estimated blood loss was 45 mL (range 5-800 mL). The median patient age was 46 years (range 27-86 years), and median uterine weight was 160 g (range 25-1,380 g). One hundred ninety-three patients (18%, 95% CI 15.8-20.5) were nulliparous and 218 (20%, 95% CI 18-22.9) had prior pelvic surgery. Five patients (0.5%, 95% CI 0.2-1.1) required readmission or emergency room evaluation within the first 30 days. Vaginal hysterectomy can be successfully adopted as a same-day discharge procedure. In this population, regardless of previous pelvic surgery or nulliparity, good perioperative outcomes have been achieved.

  12. Implementation of vaginal cleansing prior to cesarean delivery to decrease endometritis rates.

    Science.gov (United States)

    Felder, Laura; Paternostro, Amanda; Quist-Nelson, Johanna; Baxter, Jason; Berghella, Vincenzo

    2018-01-17

    Endometritis is a postpartum complication that is more common after cesarean delivery. It frequently requires intravenous antibiotic administration, prolonged hospital stays, and carries a risk of sepsis or abscess formation. Precesarean vaginal preparation has been shown to decrease the risk of endometritis in patients who have labored or have ruptured membranes. The objective of this study was to assess the practical implementation of a protocol for vaginal cleansing prior to cesarean delivery and the subsequent effect on endometritis rates in a clinical setting. This is a before-after retrospective cohort study evaluating the first 6 months of implementation of a vaginal cleansing protocol at a single institution. The primary outcome was the rate of implementation. Secondary outcomes included endometritis and other postoperative complications. The rate of implementation after 6 months was 68.3% (p < .001) and postoperative endometritis rates decreased from 14.0% before implementation to 11.7% after implementation (p .49, OR 0.77, CI 0.36-1.62). Postoperative fever decreased from 22.3% to 18.3% (p .256, OR 0.70, CI 0.37-1.30) and infectious wound complications were 4.5% and 5.8%, respectively (p .76, OR 1.07, CI 0.69-3.64). Implementation of a protocol for vaginal cleansing prior to cesarean delivery in women with ruptured membranes or in labor has high uptake, but in almost a third of eligible women it was not performed. The implementation, has led to a clinical, although not statistical, decrease in postoperative endometritis. Continued research is needed to explore how to improve uptake of this quality improvement measure.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Pre-puncture ultrasound guided epidural insertion before vaginal delivery.

    Science.gov (United States)

    Nassar, Mahmoud; Abdelazim, Ibrahim A

    2015-10-01

    Palpation method is widely used in clinical practice to identify the puncture site during combined spinal-epidural (CSE) blocks. Tuffier's line, is an anatomical landmark between two iliac crests (inter-cristal), which is widely used to identify the puncture site during CSE blocks is not always an indicator for specific vertebral level or inter-vertebral space. One hundred and Ten (110) women were scheduled for normal vaginal delivery and were randomized into two equal groups; palpation group and an ultrasound guided group to detect the efficacy of puncture ultrasound before CSE blocks to increase chances of successful CSE procedure on the first attempt and to reduce the number of attempts or punctures during insertion of CSE catheter. There were no significant differences between two studied groups regarding; maternal age, weight and height, while, there was a significant difference between two studied groups regarding; parity. Percentage of successful CSE procedure on the first attempt was significantly higher (67.27%) in ultrasound compared to palpation group (40%). Number of punctures (attempts) were significantly less in ultrasound (1.2 ± 0.6) compared to palpation group (2.3 ± 0.8) and the number of redirections was also significantly less in ultrasound (1.4 ± 0.5) compared to palpation group (2.8 ± 1.6). Although, time to identify puncture site was significantly longer in ultrasound compared to palpation group and total procedure time was longer in ultrasound (9.1 ± 1.5 min) compared to palpation group (6.2 ± 1.2 min), there was no significant difference between two studied groups regarding; time to identify puncture site and total procedure time. Two cases of dural puncture in palpation versus no cases in ultrasound group and two cases of intravascular catheter placement (one in each group), with no significant difference between two groups. Pre- puncture ultrasound guided epidural insertion before vaginal delivery, increases the chance of a

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

    OpenAIRE

    Ruth Medina; Adolfo Rechkemmer; Marco Garcia-Hjarles

    1999-01-01

    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 d...

  16. How is the high vaginal swab used to investigate vaginal discharge in primary care and how do GPs' expectations of the test match the tests performed by their microbiology services?

    Science.gov (United States)

    Noble, H; Estcourt, C; Ison, C; Goold, P; Tite, L; Carter, Y H

    2004-06-01

    To describe the management of vaginal discharge in general practice, with particular regard to the use of the high vaginal swab (HVS), and to compare GPs' expectations of this test with the processing and reporting undertaken by different laboratories. A postal questionnaire survey of 2146 GPs in the North Thames area and postal questionnaire study of the 22 laboratories serving the same GPs were carried out. GPs were asked how they would manage a young woman with vaginal discharge and what information they would like on an HVS report. Laboratories were asked how they would process and report on the HVS sample from the same patient. Response rate was 26%. 72% of GPs would take an HVS and 62% would refer on to a genitourinary medicine (GUM) clinic. 45% would offer empirical therapy and 47% of these would treat for candida initially. 75% of GPs routinely request "M,C&S" on HVS samples but 55% only want to be informed about specific pathogens. Routine processing of HVS samples varies widely between laboratories and 86% only report specific pathogens. 78% of GPs would like to be offered a suggested diagnosis on HVS reports, and 74% would like a suggested treatment. 43% of laboratories ever provide a diagnosis, and 14% provide a suggested treatment. GPs frequently manage vaginal discharge and most of them utilise the HVS. GPs' expectations of the test are not well matched to laboratory processing or reporting of the samples.

  17. THERMOGRAVIMETRIC INVESTIGATIONS OF VAGINAL SUPPOSITORY WITH THYME OIL

    Directory of Open Access Journals (Sweden)

    N. V. Melnikova

    2015-04-01

    ,45 mg at 26,14º С, then the thyme oil mass has been decreased on 1,41% at 50,2º С and on 4,14% at 69,48 ºСaccordingly. In accordance with results of thermogravimetric study of suppository with thyme oil and placebo vaginal dosage form (base it was revealed that both objects of investigation don’t reach the critical temperature within 100ºС. That fact isindicated by the insignificant mass loss (3,35% and 3,44%accordingly. Derivatography of compositions upper 100ºС wasn’t carried out because such high temperatures aren’t used in technological process of suppository manufacturing. Melting process of suppository base is going at 53,41°С. Addition of thyme oil in suppository base insignificantly decrease melting temperature of composition to 51,25°С, moreover the mass loss of sample is practically absent (0,04%. Conclusion. Character of the thermal effects of vaginal suppository with thyme oil on the derivatogrammcoincides with the thermal effects of suppository base. This fact indicates the absence of any chemical interactions between active substance and excipients of application dosage form.

  18. Uso del profiláctico entre la juventud en sus relaciones de coito vaginal Condom use among the young engaging in vaginal intercourse

    Directory of Open Access Journals (Sweden)

    J.L. Bimbela

    2002-08-01

    Full Text Available Objetivo: Describir el uso del profiláctico entre jóvenes en sus relaciones de coito vaginal e identificar los factores asociados a dicho uso. Método: La información se recogió mediante un cuestionario realizado en domicilio y con presencia del entrevistador, a 1.000 jóvenes (14-24 años residentes en Andalucía (España. Se llevó a cabo un análisis bifactorial y se ajustaron las ecuaciones de regresión logística jerárquica para verificar asociaciones entre la variable dependiente «uso del profiláctico en el coito vaginal» y las variables clasificadas por el modelo PRECEDE (predisponentes, facilitadores y reforzantes. El ajuste del modelo fue de un 38% según el estadístico de Nagelkerke. Resultados: 750 jóvenes mantuvieron relaciones afectivas y/o sexuales con contacto físico y un 63% de ellos practicó el coito vaginal (47% del total de la muestra. Los que tuvieron una sola relación de coito vaginal (12% del total de la muestra usaron profiláctico el 83% (un 10,3% del total de la muestra, y entre los que tuvieron más de una relación con coito vaginal (34% del total de la muestra, utilizaron siempre profiláctico un 49% (16,9% del total de la muestra. Las variables asociadas a su utilización siempre fueron dos: tener una intención de conducta «segura» con la pareja habitual y una baja frecuencia de la práctica. Las variables asociadas a no utilizarlo nunca fueron: estar emancipado, pensar que infectarse depende de factores externos (locus de control externo, identificar pocas zonas del cuerpo como sensibles al placer, pensar que no es necesario usar profiláctico si se confía en la pareja, tener una intención de conducta «insegura» con la pareja habitual y no hablar con la pareja sobre métodos preventivos antes de llevar a cabo la práctica sexual. Discusión: Los factores más asociados con el uso o no del profiláctico en el coito vaginal son predisponentes (actitudes, valores y creencias relacionados con el

  19. Effects of vaginal lubricants on in-vitro progressive spermatozoa ...

    African Journals Online (AJOL)

    . Wilson, Jamila K. Adam, Suresh Babu Naidu Krishna. Abstract. Vaginal lubricants are used to solve intercourse difficulties or as sexual enhancers, but recent reports raise questions about their safety in terms of fertility. In this study, twenty ...

  20. 21 CFR 884.5900 - Therapeutic vaginal douche apparatus.

    Science.gov (United States)

    2010-04-01

    ... douche solutions. The apparatus is intended and labeled for use in the treatment of medical conditions... solution, the patient uses the device to direct a stream of solution into the vaginal cavity. (b...