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Results for “Vaginitis”

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At least 19 recordsLinked to original sources

PubMed1992

Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting.

OBJECTIVE: To compare outpatient laparoscopy-assisted vaginal hysterectomy with standard outpatient vaginal hysterectomy. METHODS: Fifty-six women scheduled for vaginal hysterectomy were randomly assigned to undergo either a laparoscopy-assisted vaginal hysterectomy with endoscopic staples (N = 29) or a standard vaginal hysterectomy (N = 27). There were no differences between the study groups with regard to age, gravidity, parity, preoperative indications, and previous operations. RESULTS: Twenty-eight of 29 laparoscopy-assisted vaginal hysterectomies and all 27 vaginal hysterectomies were completed without incident. When indicated, unilateral or bilateral oophorectomies were completed. The mean operating time was significantly longer for laparoscopy-assisted vaginal hysterectomy (120.1 versus 64.7 minutes). Fifty-three of the 55 patients completing surgery were discharged home by 12 hours from the time of admission. Complications with laparoscopic hysterectomy were related to the technical aspects of laparoscopy. The incidence of febrile morbidity was similar in the groups. Although patients having laparoscopy-assisted hysterectomy required statistically significantly more pain medication and had lower postoperative hematocrit measurements, this did not make a clinical difference in the postoperative courses. The mean hospital charge for laparoscopy-assisted vaginal hysterectomy was $7905 and for vaginal hysterectomy $4891. CONCLUSION: Other than cost, laparoscopy-assisted vaginal hysterectomy and standard vaginal hysterectomy appear comparable in patients who could otherwise undergo a vaginal hysterectomy.

Adult↗

PubMed1979

Amine content of vaginal fluid from untreated and treated patients with nonspecific vaginitis.

We examined the vaginal washings from patients with nonspecific vaginitis (NSV) to seek biochemical markers and possible explanations for the signs and symptoms of this syndrome. Seven amines were identified including methylamine, isobutylamine, putrescine, cadaverine, histamine, tyramine, and phenethylamine. These amines may contribute to the symptoms of NSV and may contribute to the elevated pH of the vaginal discharge. They may also be partly responsible for the "fishy" odor that is characteristic of vaginal discharges from these patients. Among the seven amines, putrescine and cadaverine were the most abundant and were present in all vaginal discharges from each of ten patients before treatment. These amines are produced in vitro during growth of mixed vaginal bacteria in chemically defined medium, presumably by decarboxylation of the corresponding amino acids. We hypothesize the anaerobic vaginal organisms, previously shown to be quantitatively increased in NSV, are responsible for the amine production, because metronidazole inhibited the production of amines by vaginal bacteria in vitro, and Haemophilus vaginalis did not produce amines. H. vaginalis did release high concentrations of pyruvic acid and of amino acids during growth in peptone-starch-dextrose medium, whereas, other vaginal flora consumed both pyruvic acid and amino acids in the same medium during growth. These findings suggest that a symbiotic relationship may exist between H. vaginalis and other vaginal flora in patients with NSV.

Amines↗

PubMed1992

[Use of a local antibiotic combination in the treatment of mycotic vaginitis and mixed vaginitis].

This open clinical trial in 121 patients carried out by gynaecologists shows the difficulty in establishing the clinical diagnosis of vaginal candidosis or vaginal infectious candidosis. On the other hand, specific vaginitis can easily be identified, without carrying out vaginal smear. Bacteriological and clinical arguments show the efficacy of using an antibiotic association by the vaginal route for the treatment of these types of vaginitis (candidosis or infectious candidosis). The product is particularly interesting in all cases where vaginal smear have not been taken.

Adolescent↗

PubMed1992

Retrohymenal vaginal atresia with perforate transverse vaginal septum.

A transverse vaginal septum is the most common congenital anomaly of the vagina. Vaginal atresia is seen less frequently. There have been some variations in cases of transverse vaginal septum and vaginal atresia. This is the first report of a patient with retrohymenal vaginal atresia and perforate transverse vaginal septum.

Abnormalities, Multiple↗

PubMed1992

Vesico-vaginal and recto-vaginal fistulae.

A personal series of 716 patients with vesico-vaginal and/or recto-vaginal fistulae is presented. Five hundred and seventy-eight patients were managed in Africa, mainly at the Addis Ababa Fistula Hospital, while 138 were kindly referred to me from various parts of Britain. The main cause of such fistulae in the developing world is pressure necrosis from obstructed labour. In the developed world the aetiology is surgery, malignancy, radiotherapy or a combination of these. Other causes include neglected foreign bodies, coital injury and local treatment by an unqualified practitioner. A vesico-vaginal fistula alone was present in 78.8%, a recto-vaginal fistula alone in 4.3%, while 16.9% of patients had both a vesico-vaginal and a recto-vaginal fistula. Six hundred and six (84.6%) patients were cured at the first attempt at repair, 45 (6.3%) failed and 65 (9.1%) had stress incontinence.

Adolescent↗

PubMed1992

Induction of labor by vaginal prostaglandin E2. A randomized study comparing pessaries with vaginal tablets.

A prospective randomized study of 267 pregnant women was undertaken to compare the efficacy of a pharmacy-prepared 3-mg prostaglandin E2 (PGE2) vaginal suppository with a 3-mg PGE2 vaginal tablet for induction of labor and cervical ripening. No statistically significant difference in success frequency was found between the two groups, either on the first day (72% and 74%, respectively; p greater than 0.05) or on the second day (89% in both groups). There was an equal proportion of women requiring oxytocin augmentation in the two groups, but the slower releasing properties of the vaginal tablet were reflected in a longer mean induction--delivery interval of about 4 h for this group. In both the pessary and the vaginal tablet groups, women who had not gone into labor on the first day showed a statistically significant increment in the Bishop score on the morning of the second day. The frequency of cesarean section was the same in both groups, but instrumental deliveries were more frequent in the vaginal tablet group. It is concluded that PGE2 vaginal tablets--a chemically stable alternative to pharmacy prepared pessaries--appear to be effective as regards cervical ripening as well as for labor induction.

Administration, Intravaginal↗

PubMed1992

Characteristics of three vaginal flora patterns assessed by gram stain among pregnant women. Vaginal Infections and Prematurity Study Group.

This study was undertaken to define the characteristics and persistence of vaginal flora in 7918 pregnant women at 23 to 26 weeks' gestation. Vaginal smears were categorized as normal (predominant lactobacilli), intermediate (reduced lactobacilli), or positive for bacterial vaginosis. The women with normal flora were least likely to have elevated vaginal pH, amine odor, milky discharge, or colonization by Gardnerella, Bacteroides, or genital mycoplasmas. Women with intermediate vaginal flora had intermediate frequencies of these clinical signs and microorganisms. Group B streptococci and yeast were associated with normal or intermediate flora, whereas Neisseria gonorrhoeae and Chlamydia trachomatis were recovered more frequently from women with intermediate flora or bacterial vaginosis. Trichomonas vaginalis was most associated with intermediate flora. At follow-up, 81% of the women with normal flora had remained normal. Of the women with intermediate flora, 32% acquired bacterial vaginosis and 30% shifted to normal flora. Only 12% of the women with bacterial vaginosis had shifted to normal flora. We conclude that there are two primary stable vaginal flora patterns (normal flora or bacterial vaginosis) and a third less distinct transitional flora pattern between these two.

Adolescent↗

PubMed1992

The effects of a combined contraceptive vaginal ring releasing ethinyloestradiol and 3-ketodesogestrel on vaginal flora.

Fifty nine women with documented normal ovulatory cycles and with no symptoms of vaginal infection were divided into four groups. Each group used a combined contraceptive vaginal ring (CCVR) with a mean daily release rate of 0.015 mg of ethinyloestradiol (EE) and 0.120 mg of 3-ketodesogestrel (3-KDG) per day, for one cycle of either 21, 28, 42, or 56 days. Cultures from the posterior vaginal fornix and from the endocervical canal were obtained immediately before insertion of the ring and on removal of the ring. Changes in the numbers of vaginal cells, aerobic and anaerobic bacteria, Chlamydia trachomatis, Gardnerella vaginalis, yeasts and Trichomonas vaginalis were documented at the end of each treatment. Intra- and inter- group changes in the vaginal flora were assessed at the end of each treatment. The comparison between the number and type of flora showed no significant change between the pre-treatment population and the post-treatment population. The results of this study suggest that the use of this CCVR for 21, 28, 42 and 56 days is not associated with an increase in inflammatory cells or pathogenic bacteria.

Administration, Intravaginal↗

PubMed1992

Benign vaginal polyp: a histological, histochemical and immunohistochemical study of 20 polyps with comparison to normal vaginal subepithelial layer.

Twenty benign vaginal polyps from 18 patients, together with sections from normal vaginal epithelium, were studied histologically, histochemically using elastic van Gieson stain and immunohistochemically using monoclonal antibodies against vimentin, desmin and actin. The striking finding was the similarity, both histologically and immunohistochemically, of the stroma of vaginal polyps to that of the loose subepithelial layer found in normal vagina. The important difference was the marked degeneration of the elastic tissue, increased number of stellate and giant fibroblasts and subepithelial condensation of fibroblasts in the polyps. These findings support the hypothesis that vaginal polyps may represent a reactive hyperplasia of the loose subepithelial zone of the vaginal wall.

Adult↗

PubMed1992

Human vaginal leukocytes and the effects of vaginal fluid on lymphocyte and macrophage defense functions.

OBJECTIVES: The purpose of this study was to quantify, characterize, and further define the role of vaginal white blood cells in defense mechanisms and human immunodeficiency virus infection. STUDY DESIGN: Vaginal lavages were obtained from five healthy women throughout three menstrual cycles. Lymphocyte subpopulations, macrophages, and granulocytes were characterized and quantified by an immunohistologic technique. Vaginal lavage fluid was added to peripheral blood mononuclear cells, and effects on cell viability, lymphocyte proliferation, macrophage phagocytosis, and expression of various cell surface molecules critical to immunologic functions were assessed. Data were analyzed by Student's t test. RESULTS: Few lymphocytes were found at any stage of the menstrual cycle; however, granulocytes and macrophages were abundant at menstruation and present at low levels through the proliferative phase. Vaginal lavage fluid collected during menses, at midcycle, and after coitus suppressed mitogen-induced lymphocyte proliferation but had no effect on surface expression of human leukocyte antigen or CD4 antigens, or on macrophage function. Likewise, low pH (less than 5.0) medium significantly inhibited lymphocyte proliferation but had no effect on macrophage phagocytosis. The spermicide nonoxynol 9 was toxic to both lymphocytes and macrophages. CONCLUSION: White blood cells, including lymphocytes and macrophages, are infrequently present in cervicovaginal secretions of healthy women except during menses; the vaginal environment may effect their function.

Adult↗

PubMed1992

The effect of amoxycillin on vaginal colonization resistance and normal vaginal flora in monkeys.

Previous studies have shown that vaginal colonization resistance in monkeys can be eliminated by amoxycillin and restored by flushing vaginal flora from a healthy monkey into the vagina of a monkey colonized with Escherichia coli. The hypothesis that the effect of amoxycillin resulted from elimination of parts of the normal flora was tested in the present study. Nine monkeys were flushed vaginally with amoxycillin daily for six days. The number of anaerobic bacteria decreased during amoxycillin administration, as did the number of species isolated. The most obvious effects were observed among the genera Bacteroides and Peptostreptococcus, while Lactobacillus spp. were less affected. Restoration of the flora after amoxycillin administration was slow in most of the monkeys. During amoxycillin administration, all monkeys became colonized spontaneously with E. coli. This was not, however, associated with increased adherence in vitro. The colonization persisted throughout the study period (29 days). It was concluded that amoxycillin disturbs vaginal colonization resistance by eliminating at least part of the normal vaginal flora, thereby promoting periurethral colonization with enterobacteria.

Amoxicillin↗

PubMed1979

Quantitative bacteriology of the vaginal flora in vaginitis.

Vaginal flora was studied quantitatively in 29 sexually active women, 16 to 33 years of age, to define the role of C. vaginale in vaginitis. Seventeen were asymptomatic and 12 complained of symptoms of vaginitis. Seven asymptomatic women had scant secretions: four of these seven had C. vaginale at log10 6 to 9 CFU per milliliter, none of whom had "clue" cells; none had trichomonas or candida; six had lactobacilli at log10 7 to 9.7 per milliliter; only one had Bacteroidaceae at greater than log10 5 per milliliter. Ten asymptomatic women had easily collectable secretions; eight of 10 had C. vaginale at log10 6.5 to 9.6 per milliliter, three of whom had "clue" cells; four had trichomonas and none candida; nine had Lactobacilli at log10 7 to 9.3 per milliliter; four had Bacteroidaceae at greater than log10 5 per milliliter. Twelve had vaginitis: five of 12 had C. vaginale at log10 7.9 to 11 per milliliter, one of whom had "clue" cells; nine had either trichomonas or candida or both and three had no pathogen, including C. vaginale; 10 had Lactobacilli at log10 7 to 10 per milliliter; six had Bacteriodaceae at greater than log10 5 per milliliter. Three had "clue" cells in absence of C. vaginale.

Adolescent↗

PubMed1992

Primary vaginal tuberculosis after vaginal carcinoma.

A case of primary vaginal tuberculosis is reported. A 62-year-old woman presented with a slightly eroded, granular vaginal lesion 10 months after radiation therapy for Stage II vaginal squamous cell carcinoma. She had previously undergone a total abdominal hysterectomy and left salpingo-oophorectomy at age 37 for abnormal uterine bleeding. This presentation of genital tract tuberculosis is unusual because of the location of the primary lesion, the age at presentation, the occurrence after radiation therapy, and the possible means of infection. We emphasize the need to maintain a high index of suspicion and to biopsy any suspicious vaginal lesions.

Aged↗

PubMed1976

[Results of vaginal cytology studies and examination of the arborization phenomenon of the vaginal mucus for the determination of estrus cycle activity in sheep].

Vaginal smears were taken by means of a metal spatula from the dorsal part of the vaginal vestibule of sexually mature sheep with intach genitals for the purpose of following up changes in the vaginal cell structure. The smears were taken daily over the whole testing period of 35 days. The cells were defferentiated by means of the dyeing method according to Papanicolaou as well as by using Shorr's staining which had been modified according to Pundel. Differentiation was made between occurrences ob basal, parabasal, intermediary, and superficial cells, with the view to figuring out the cycle phases. That vaginal smear method, when used in two or three folloow-up examinations on the basis of random checks, has proved to enable determination of cyclic activity of a complete herd. This is of great importance to heart synchronization or heart induction, since all results so far have shown that all success depended strongly on the given degree of cyclic activity of the sheep concerned.

Animals↗

PubMed1977

Hydrocolpos, vaginal atresia, and urethrovaginal fistula in a neonate: abdomino-perineal-vaginal pull-through.

The combination of high maternal estrogenic stimulation of the secretory glands of the reproductive tract of the newborn female and vaginal obstruction results in an abdominal mass due to vaginal distention (hydrocolpos). Prior experience with two infants with hydrocolpos (LG) led us to perform abdomino-perineal-vaginal pull-through, as advocated by Ramenofsky and Raffensperger, in the newborn period. So far as we can ascertain this is only the second infant so reported in the literature.

Abdomen↗

PubMed1978

Clinical evaluation of econazole nitrate in 1% vaginal cream for treatment of vaginal candidosis.

30 patients with mycologically confirmed vaginal candidosis on culture were treated with econazole vaginal cream (Gyno-Pevaryl) applied intravaginally once a day for 2 wk. 8 days after the end of treatment, mycological and clinical cures were demonstrated in 26 patients. Symptoms generally subsided rapidly, and the drug was well tolerated. This study confirms the efficacy of econazole in the treatment of vaginal candidosis.

Adolescent↗

PubMed1978

The prevalence and clinical diagnosis of vaginal candidosis in non-pregnant patients with vaginal discharge and pruritus vulvae.

Two hundred and thirteen nonpregnant female patients complaining of vaginal discharge or pruritus vulvae were recruited to the study by 45 general practitioners in the Yorkshire region. Of these patients, 102 (48 per cent) were found to have demonstrable vaginal mycosis on an initial swab and a further 10 to be swab positive after one week of placebo treatment. The total prevalence in this population of women consulting their practitioner was thus 52.6 per cent.Analysis of symptomatology and of physical findings showed that a clinical diagnosis of vaginal mycosis cannot be made with acceptable reliability.The occurrence of spontaneous swab conversion is noted, and its possible origins are discussed.

Female↗

PubMed2026

Vaginal Hysterectomy Versus Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery Hysterectomy; Results of a Randomised Controlled Trial.

OBJECTIVE: To compare Vaginal Hysterectomy (VH) with Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery (NOTES) hysterectomy (VANH) as a day-care procedure. DESIGN: Single-blind, multicentre randomised controlled trial. SETTING: Two Dutch non-academic teaching hospitals. POPULATION: Women aged ≥ 18 years undergoing hysterectomy for benign indications. METHODS: Women were randomised 1:2 (VH or VANH). Primary outcome was SDD. Secondary outcomes included operative time, rate of elective salpingectomies, intraoperative blood loss, complications (Clavien-Dindo), pain scores (NRS) and analgesic use, post-operative recovery (RI-10), and quality of life (EQ-5D-5L). Analyses were performed on an intention-to-treat basis. RESULTS: A total of 113 patients were included in the analyses (n = 42 VH, and n = 71 VANH). SDD occurred significantly more frequently in the VANH group (87.3%) than VH group (71.4%; OR 2.76, 95% CI 1.04-7.25; p = 0.04). VANH was associated with a significantly shorter operative time (median 55 min versus 65 min; p = 0.005), less blood loss (median 50 mL vs. 150 mL; p < 0.001) and more often elective opportunistic salpingectomy compared to VH (100% vs. 77.4%; p = 0.008). NRS were significantly lower in the VANH group the first hour post-operative (3 vs. 1, p < 0.001). Post-operative complications (VH 9.5% vs. VANH 15.5%; p = 0.34), readmission (VH 4.8% vs. VANH 8.5%; p = 0.47), analgesic use, recovery, and quality of life were not statistically significant. CONCLUSIONS: VANH is a safe and effective alternative to VH, offering a higher likelihood of SDD, shorter operative time, reduced blood loss, and more often an elective salpingectomy, without increased complications or differences in pain, recovery, or quality of life.

Humans↗