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Frontiers in Cellular and Infection... 2021The vaginal microbiome is a well-defined compartment of the human microbiome. It has unique conditions, characterized by the dominance of one bacterial species, the... (Review)
Review
The vaginal microbiome is a well-defined compartment of the human microbiome. It has unique conditions, characterized by the dominance of one bacterial species, the This microbiota manifests itself by a low degree of diversity and by a strong dynamic of change in its composition under the influence of various exogenous and endogenous factors. The increase in diversity may paradoxically be associated with dysbiosis, such as bacterial vaginosis (BV). BV is the result of a disturbance in the vaginal ecosystem; i.e., a sudden replacement of by anaerobic bacteria such as , and others. It is the most common cause of vaginal discharge in women of childbearing age, approximately 30% of all causes. The etiology of this dysbiosis remains unknown, but its health consequences are significant, including obstetrical complications, increased risk of sexually transmitted infections and urogenital infections. Its diagnosis is based on Amsel's clinical criteria and/or a gram stain based on the Nugent score. While both of these methods have been widely applied worldwide for approximately three decades, Nugent score are still considered the "gold standard" of BV diagnostic tools. Given the limitations of these tools, methods based on molecular biology have been developed as alternative rational strategies for the diagnosis of BV. The treatment of BV aims at restoring the balance of the vaginal flora to stop the proliferation of harmful microorganisms. Prescription of antibiotics such as metronidazole, clindamycin, etc. is recommended. Faced with the considerable uncertainty about the cause of BV, the high rate of recurrence, the unacceptable treatment options, and clinical management which is often insensitive and inconsistent, research on this topic is intensifying. Knowledge of its composition and its associated variations represents the key element in improving the therapeutic management of patients with the most suitable treatments possible.
Topics: Ecosystem; Female; Gardnerella vaginalis; Humans; Lactobacillus; Vagina; Vaginosis, Bacterial
PubMed: 35118003
DOI: 10.3389/fcimb.2021.672429 -
Journal of Controlled Release :... Mar 2005Exhaustive efforts have been made toward the administration of drugs, via alternative routes, that are poorly absorbed after the oral administration. The vagina as a... (Review)
Review
Exhaustive efforts have been made toward the administration of drugs, via alternative routes, that are poorly absorbed after the oral administration. The vagina as a route of drug delivery has been known since ancient times. In recent years, the vaginal route has been rediscovered as a potential route for systemic delivery of peptides and other therapeutically important macromolecules. However, successful delivery of drugs through the vagina remains a challenge, primarily due to the poor absorption across the vaginal epithelium. The rate and extent of drug absorption after intravaginal administration may vary depending on formulation factors, vaginal physiology, age of the patient and menstrual cycle. Suppositories, creams, gels, tablets and vaginal rings are commonly used vaginal drug delivery systems. The purpose of this communication is to provide the reader with a summary of advances made in the field of vaginal drug delivery. This report, therefore, summarizes various vaginal drug delivery systems with an introduction to vaginal physiology and factors affecting drug absorption from the vaginal route.
Topics: Administration, Intravaginal; Animals; Drug Delivery Systems; Female; Humans; Vagina
PubMed: 15763615
DOI: 10.1016/j.jconrel.2004.11.034 -
Current Opinion in Infectious Diseases Feb 2020The cause of bacterial vaginosis, the most common cause of vaginal discharge in women, remains controversial. We recently published an updated conceptual model on... (Review)
Review
PURPOSE OF REVIEW
The cause of bacterial vaginosis, the most common cause of vaginal discharge in women, remains controversial. We recently published an updated conceptual model on bacterial vaginosis pathogenesis, focusing on the roles of Gardnerella vaginalis and Prevotella bivia as early colonizers and Atopobium vaginae and other bacterial vaginosis-associated bacteria (BVAB) as secondary colonizers in this infection. In this article, we extend the description of our model to include a discussion on the role of host-vaginal microbiota interactions in bacterial vaginosis pathogenesis.
RECENT FINDINGS
Although G. vaginalis and P. bivia are highly abundant in women with bacterial vaginosis, neither induce a robust inflammatory response from vaginal epithelial cells. These early colonizers may be evading the immune system while establishing the bacterial vaginosis biofilm. Secondary colonizers, including A. vaginae, Sneathia spp., and potentially other BVAB are more potent stimulators of the host-immune response to bacterial vaginosis and likely contribute to its signs and symptoms as well as its adverse outcomes.
SUMMARY
Elucidating the cause of bacterial vaginosis has important implications for diagnosis and treatment. Our current bacterial vaginosis pathogenesis model provides a framework for key elements that should be considered when designing and testing novel bacterial vaginosis diagnostics and therapeutics.
Topics: Bacteria; Biofilms; Female; Host-Pathogen Interactions; Humans; Microbiota; Vagina; Vaginosis, Bacterial
PubMed: 31789672
DOI: 10.1097/QCO.0000000000000620 -
Lakartidningen Oct 1996
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Advances in Experimental Medicine and... 2021The vagina is a fibromuscular elastic tubular tract that connects the cervix with the outer genitals and has an important function discharging uterine secretions, sexual...
The vagina is a fibromuscular elastic tubular tract that connects the cervix with the outer genitals and has an important function discharging uterine secretions, sexual intercourse and acts as the passage for the full-term fetus. Currently, a new field of investigation which aims to design tissues and organs similar to their native origin has been developed recently and was named regenerative medicine (tissue engineering and bioengineering). Malformations in cervix tissue represent a hard challenge for medicine. Experts in bioengineering have tried to reconstruct vaginas or cervix with the aim to achieve cervicovaginal disorders, most of them with congenital cause. However, only few research groups have launched themselves upon the decellularization. The aim of this chapter is investigating the decellularization methods for cervix and vaginal tissues.
Topics: Cervix Uteri; Female; Humans; Regenerative Medicine; Tissue Engineering; Uterus; Vagina
PubMed: 34582021
DOI: 10.1007/978-3-030-82735-9_13 -
Maturitas Dec 1995This paper reviews basic facts on vagina histology and ultrastructure with respect to passage of different substances and drugs through the epithelium. Particular... (Review)
Review
This paper reviews basic facts on vagina histology and ultrastructure with respect to passage of different substances and drugs through the epithelium. Particular interest is devoted to the action mechanism of topically-applied vaginal estrogen, its binding to receptors in different vaginal cell types, and possible local metabolic routes. Differences in estrogen sensitivity between uterus and vagina are discussed as well as the background for the high vaginal sensitivity.
Topics: Absorption; Aging; Animals; Estrogen Replacement Therapy; Estrogens; Female; Growth Substances; Humans; Mice; Mucous Membrane; Rats; Receptors, Estrogen; Regional Blood Flow; Vagina
PubMed: 8775771
DOI: 10.1016/0378-5122(95)00957-4 -
International Urogynecology Journal Jun 2018
Topics: Female; Humans; Prostheses and Implants; Surgeons; Surgical Mesh; Vagina
PubMed: 29556675
DOI: 10.1007/s00192-018-3612-8 -
Sexual Medicine Reviews Jul 2020Androgens have been shown to exert beneficial effects on vaginal physiology, at least partially independent of their aromatization to estrogens. Androgen deficiency in... (Review)
Review
INTRODUCTION
Androgens have been shown to exert beneficial effects on vaginal physiology, at least partially independent of their aromatization to estrogens. Androgen deficiency in the vagina and in the other genitourinary tissues contributes to the development of vulvovaginal atrophy and genitourinary syndrome of menopause, resulting in impaired arousal and lubrication and dyspareunia.
OBJECTIVES
To summarize the role of testosterone in modulating vaginal structure and function.
METHODS
A qualitative review of the relevant literature on the topic was performed using the PubMed database. We present a summary of preclinical and clinical evidence supporting the involvement of testosterone (T) in vaginal physiopathology and discuss it in terms of the role of the vagina in female sexual response.
RESULTS
Androgens are important in the differentiation of the vagina and in maintaining trophic and functional actions in postnatal life, as suggested by the detection of the androgen receptor and of the key enzymes involved in androgen synthesis. T is essential for the integrity of vaginal tissue structure (including non-vascular smooth muscle thickness and contractility and collagen fiber compactness) and for the complex neurovascular processes that regulate arousal and lubrication (vascular smooth muscle relaxation via the NO/cGMP/PDE5 pathway, nerve fiber density and neurotransmission). T has also been reported to modulate nociception, inflammation, and mucin secretion within the vagina. Available and potential androgen-based treatments for vulvovaginal atrophy/genitourinary syndrome of menopause and for other conditions leading to female genital arousal disorder and dyspareunia are presented.
CONCLUSIONS
The vagina is both an androgen-target and synthesis organ. Preclinical and clinical data consistently suggest that T plays an important role in maintaining vaginal health and genital sexual function. Maseroli E, Vignozzi L. Testosterone and Vaginal Function. Sex Med 2020;8:379-392.
Topics: Androgens; Female; Humans; Male; Sex Determination Processes; Sexual Dysfunction, Physiological; Sexuality; Testosterone; Vagina
PubMed: 32434695
DOI: 10.1016/j.sxmr.2020.03.003 -
Urology Apr 2000OBJECTIVES. To present our experience with 3 girls with complete duplication of the bladder, urethra, vagina, and uterus, a very rare anomaly, and review published... (Review)
Review
UNLABELLED
OBJECTIVES. To present our experience with 3 girls with complete duplication of the bladder, urethra, vagina, and uterus, a very rare anomaly, and review published reports. Associated anomalies in these cases represent a wide spectrum.
METHODS
We report 3 girls with complete duplication of the bladder, urethra, vagina, and uterus. The associated anomalies were different in each child. The first patient had a symphysis diastasis creating an abdominal hernia with two bladders dislocated into this space. The second patient had anal atresia with colon duplication. The third had cloacal exstrophy with one opened bladder and a second closed, with persistent urogenital sinus. Each patient was carefully evaluated, but the anatomy in 2 patients was not completely defined until surgical exploration.
RESULTS
Each girl underwent surgical repair. In the first patient, iliac osteotomy, approximation of the symphysis pubis, and excision of the hernia was done. In the second, excision of the common wall between the two descending colons and posterior sagittal anorectoplasty were performed. In the third patient, staged reconstruction of the cloacal exstrophy with anastomosis of the bladders and vaginas was done.
CONCLUSIONS
Complete duplication of the urogenital system in girls is associated with different anomalies. Which surgical procedures will be required depends on the multiple anatomic variables.
Topics: Abnormalities, Multiple; Adolescent; Adult; Anus, Imperforate; Cesarean Section; Child; Child, Preschool; Cloaca; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Pregnancy; Urinary Bladder; Urography; Uterus; Vagina
PubMed: 10736507
DOI: 10.1016/s0090-4295(99)00470-7 -
Radiographics : a Review Publication of... 1997High-resolution magnetic resonance (MR) imaging with pelvic phased-array and endoluminal coils provides information on vaginal abnormalities heretofore not available...
High-resolution magnetic resonance (MR) imaging with pelvic phased-array and endoluminal coils provides information on vaginal abnormalities heretofore not available with other imaging modalities. Congenital anomalies of the vagina can result from disorders of lateral fusion of the descending müllerian ducts and ascending urogenital sinus, developmental absence of the müllerian ducts, or disorders of vertical fusion. In these conditions, MR imaging can depict the presence or absence of the vagina, cervix, and uterus and help determine whether these structures contain a septum or are duplicated or distended with blood. Gartner duct cysts and Bartholin gland cysts have the same signal intensity characteristics, but the former are located in the anterolateral aspect of the proximal third of the vagina and the latter are in the posterolateral portion of the lower vagina. Entero-, vesico-, and ureterovaginal fistulas result from obstetric and surgical trauma, radiation therapy, or inflammatory bowel disease. MR imaging has great potential for detection and characterization of these fistulas. MR imaging can be used to detect and stage primary and secondary vaginal tumors. However, neither signal intensity nor patterns of enhancement enable confident prediction of the histologic subtype of vaginal malignancy.
Topics: Adult; Aged; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Vagina; Vaginal Diseases; Vaginal Neoplasms
PubMed: 9308110
DOI: 10.1148/radiographics.17.5.9308110