What Is Vulvovaginitis?

Vulvovaginitis is an inflammation and irritation of the vagina and vulva, most of which are caused by pathogenic microorganisms. Infection usually begins in the vagina. The most common symptoms are itchiness and / or burning sensation in the vulva, increased vaginal secretions, and abnormal odors. Not all vaginal inflammatory states (vaginitis) necessarily cause vulvar irritation. Patients with chlamydia infection in the cervix may also complain of increased vaginal secretions. Atrophic vaginitis is a non-infectious cause of vaginal irritation secondary to estrogen deficiency in postmenopausal women.

Vulvovaginitis

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vulva

1. Medical history, symptoms and signs.

2. Microbiological examinations include bacteria, viruses, protozoa, Borrelia, CT, UU smear examinations, bacterial and virus cultures, serological and immunological examinations. It is known that characteristic clue cells appear in bacterial vaginosis (BV) secretions, pH> 4.5, potassium hydroxide test (+) and proline aminopeptidase (+). It is worth pointing out that modern advanced cell and molecular biological detection methods such as polymerase chain reaction (PCR) protein blot, enzyme-linked immunosorbent assay (ELISA), and monoclonal antibody detection technology have been widely used in clinical practice. Accurate and timely diagnosis of gynecological infectious diseases provides an effective means.

3. Histopathological examination of certain specific infection lesions, in order to determine its etiology and pathological changes should be performed histological examination. Such as tuberculosis, amoeba, syphilis, genital warts and so on. The pathological features of condyloma acuminatum are squamous epithelial papillary hyperplasia, spinal cell layer hypertrophy, and cell abnormalities, that is, typical koilocyte characteristics. The spiny cell nucleus stained deeply and irregularly, and there was an oval blank area around the nucleus, which was PAS stained (-). Under the electron microscope, glycogen particles and organelles were absent in the hollowed-out area, with only a few ribosomes. Nuclear chromatin agglutinates, virus particles are visible in the nucleus. Immunohistochemistry and in situ PCR can diagnose HPV intracellular localization.

4. Vaginal functional examination includes sperm cell biology and vaginal reproductive immunology.

(1) Sperm cell biological examination: Smis-Huhner test, see cervical infertility section for details.

(2) Reproductive immunological examination: including vaginal secretions

1. Develop a good habit of washing your hands before going to the toilet. The investigation found that a large number of pathogenic microorganisms, such as chlamydia and mycoplasma, adhere to human hands. They can invade the urethra through infection to cause infection. Therefore, it is important to develop good hygiene habits. 2. Master the correct vulva and anal cleaning sequence. Wash the vulva and anus frequently. Pay attention to the order when washing. Wash the vulva and then the anus. Never do the opposite. Towels and basins should be used by special persons, otherwise bacteria can easily invade the urethral opening. 3. Choice of vulvar lotion and sanitary napkin. Be sure to buy products from regular manufacturers, so as to prevent the inferior products from damaging the normal flora of the human body and reducing the local resistance. Pay attention to product quality when purchasing sanitary napkins, and should not be stored for a long time, so as not to breed bacteria and cause vulvar and vaginal infections. Yuxueqing should be used in time when symptoms of vulvar itching and leucorrhea increase. 4. Adequate sleep and reasonable sexual life arrangements. Get enough sleep every day, don't stay up late, otherwise it will reduce the body's resistance to disease. Pay attention to the frequency of sexual life, those who have sex more than 3 times a week, the incidence of urinary tract infections is greatly increased, the frequency should be appropriately reduced in this special stage in summer. 5. Pay attention to personal hygiene. Bathe regularly, wash basins are not recommended, and clothes should be stored separately. Always change and wash underwear, especially new underwear or long-wearing underwear. Wash and air dry before wearing. Penetrate cotton underwear with good air permeability and strong hygroscopicity. Wearing tight pants or jeans, and more penetrative skirts are very important to protect women's health. ^[1]

1. Sexual intercourse pain.

2. Itching of the vulva.

3. Mucosal hyperemia.

4, redness and congestion. ^[2]

1. Routine inspection of leucorrhea.

2. Mycoplasma chlamydia detection.

3. Bacterial culture inspection. ^[2]

1. The patient first feels vulva discomfort, and then itching and pain, or a burning sensation. ^[2]

Complex vulvovaginal candidiasis varies according to its type, and treatment can refer to the following schemes:

(1) Severe vulvovaginal candidiasis: Oral medication is preferred, and those with severe symptoms should apply local low-concentration glucocorticoid ointment or azole cream.

1. Oral administration: 200mg of itraconazole, 1 capsule in the morning and evening, 2 days in total: 150mg of fluconazole, taken by mouth, repeated once every 3 days.

2. Vaginal medication: based on the treatment of simple vulvovaginal candidiasis, the treatment course is extended.

(2) Pregnancy with vulvovaginal candidiasis: We should weigh the pros and cons with caution in the early pregnancy. You can choose azole drugs that are not harmful to the fetus, and vaginal medication is appropriate, instead of oral antifungal therapy. The specific scheme is the same as that of simple vulvovaginal candidiasis.

(3) Recurrent vulvovaginal candidiasis: treatment principles include intensive treatment and consolidation treatment. Drug selection based on secretion culture and drug sensitivity tests. After intensive treatment reached mycological cure, consolidation treatment was given for six months.

Intensive treatment can be used in either oral or topical regimens. The specific regimens are as follows:

1. Oral medication: 200mg itraconazole, one capsule in the morning and one evening, for a total of 2 to 3 days; 150mg fluconazole, taken once daily, and repeated once every 3 days.

2. Vaginal administration: Miconazole suppository 400mg once every night for 6 days; Panconazole suppository 200mg once every night for 7N14 days; Clotrimazole suppository 500mg, repeated once every 3 days; Clotrimazole Suppository 100mg, once a night for 7-14 days.

Consolidation treatment: Given that there are no mature programs at home and abroad, the following programs are for reference only.

1. Oral medication: small dose, long course of treatment up to 6 months.

2. Vaginal drugs: Miconazole suppository 400mg once a day for 3-6 days a month for a total of 6 months; Clotrimazole suppository 500mg once a month for a total of 6 months.

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