-
Archives of Gynecology and Obstetrics Nov 2023This study aimed to perform a systematic review of patients with Herlyn-Werner-Wunderlich syndrome (HWWS) and present the prevalence of symptoms, anatomical variants,... (Review)
Review
PURPOSE
This study aimed to perform a systematic review of patients with Herlyn-Werner-Wunderlich syndrome (HWWS) and present the prevalence of symptoms, anatomical variants, endometriosis, surgical interventions, and short- and long-term outcomes.
METHODS
A structured search was performed in PubMed, Scopus, Embase, and China National Knowledge Infrastructure, and studies published between 1 January, 2000 and 19 April, 2022 were included. The following data on HWWS were recorded: symptoms, anatomical variations, surgical interventions and short- and long-term outcomes.
RESULTS
A total of 1673 patients were included in our analysis. The main symptoms were dysmenorrhea (53.8%), abnormal uterine bleeding (28.9%), and vaginal discharge (26.6%). The principal anomalies were right-obstructed hemivagina (57.3%), haematocolpos (81.7%), uterus didelphys (88.8%), and ipsilateral renal agenesis (93.1%). A majority of patients belonged to classification 1.1 (46.7%), with a blind hemivagina, and classification 2.1 (39.2%), with a small communication between two vaginas. The mainstay of treatment was vaginal septum excision (91.8%). Minimally invasive surgery (48.5%) was performed only after vaginal surgery (61.9%), and only a few patients required a second surgery (2.2%). Endometriosis was found in 9.6% of the patients. Fifty-two percent of them had ipsilateral ovarian endometriosis cysts. Pregnancy rate of these patients was 72.1%. The rate of adverse pregnancy outcomes was 22.4%. The caesarean section rate was 61.2%.
CONCLUSIONS
Patients with HWWS presented with nonspecific symptoms and demonstrated various combinations of anomalies. The most common anatomical variants are classifications 1.1 and 2.1. Vaginal septum excision is effective in relieving symptoms and preventing complications, with hysteroscopic surgery as an option where there is concern about protecting the hymen from minor injury. The pregnancy rate for these patients after surgery was satisfactory, and the rate of adverse pregnancy outcomes after surgery was acceptable. We advise females with urological anomalies to be screened for Müllerian anomalies because of the close association between these two types of anomalies. Thus, HWWS contributes to the occurrence of endometriosis; however, more research is required to investigate the relationship between pelvic endometriosis and HWWS.
Topics: Humans; Pregnancy; Female; Cesarean Section; Endometriosis; Kidney; Uterus; Vagina; Abnormalities, Multiple; Treatment Outcome
PubMed: 36823415
DOI: 10.1007/s00404-022-06856-y -
International Urogynecology Journal Dec 2013The pathophysiology of pelvic organ prolapse (POP) is incompletely understood. The purpose of this study is to describe the current knowledge about histology of the... (Review)
Review
INTRODUCTION AND HYPOTHESIS
The pathophysiology of pelvic organ prolapse (POP) is incompletely understood. The purpose of this study is to describe the current knowledge about histology of the vaginal wall and its possible involvement in the pathogenesis of pelvic organ prolapse.
METHODS
Eligible studies were selected through a MEDLINE search covering January 1986 to December 2012. The research was limited to English-language publications.
RESULTS
Investigations of changes in the vaginal tissue that occur in women with genital prolapse are currently still limited and produced contrary results. The heterogeneity of the patients and the control groups in terms of age, parity and hormonal status, of the localization of biopsies and the histological methods as well as the lack of validation of the quantification procedures do not allow clear and definitive conclusions to be drawn.
CONCLUSIONS
This review shows that current knowledge of the histological changes observed in women with POP are inconclusive and relatively limited. More studies are needed in this specific field to better understand the mechanisms that lead to POP.
Topics: Collagen; Connective Tissue; Elastin; Female; Humans; Pelvic Organ Prolapse; Vagina
PubMed: 23649687
DOI: 10.1007/s00192-013-2111-1 -
Plastic and Reconstructive Surgery Mar 1977
Topics: Female; History of Medicine; History, Ancient; History, Medieval; History, Modern 1601-; Humans; Vagina
PubMed: 320610
DOI: 10.1097/00006534-197703000-00002 -
Journal of the National Medical... Jul 1970
Topics: Adolescent; Adult; Child; Congenital Abnormalities; Female; Humans; Skin Transplantation; Surgery, Plastic; Transplantation, Autologous; Vagina
PubMed: 4912543
DOI: No ID Found -
Vojnosanitetski Pregled Jun 2008Congenital absence of vagina is a failure present in Mayer-Küster-Rokitansky-Hauser syndrome. Treatment of this anomaly includes nonoperative and operative procedures....
BACKGROUND/AIM
Congenital absence of vagina is a failure present in Mayer-Küster-Rokitansky-Hauser syndrome. Treatment of this anomaly includes nonoperative and operative procedures. McIndoe procedure uses split skin graft by Thiersch. The aim of this study was to determine sensitivity (touch, warmness, coldness) of a vagina reconstructed by McIndoe method in Mayer-Küster-Rokitansky-Hauser syndrome and compare it with the normal vagina.
METHODS
A total of 21 female persons with reconstructed vagina by McIndoe method and 21 female persons with normal vagina were observed. All female persons were devided into groups and subgroups (according to age). Sensibility to touch, warmness and coldness were examined, applying VonFrey's esthesiometer and termoesthesiometer for warmness and coldness in three regions of vagina (enter, middle wall, bothom). The number of positive answers was registrated by touching the mucosa regions for five seconds, five times.
RESULTS
The obtained results showed that female patients with a reconstructed vagina by McIndoe method, felt touch at the middle part of wall and in the bottom of vagina better than patients with normal one. Also, the first ones felt warmness at the middle part of wall and coldness in the bottom of vagina, better than the patients with normal vagina. Other results showed no difference in sensibility between reconstructed and normal vagina.
CONCLUSION
Various types of sensibility (touch, warmness, coldness) are better or the same in vaginas reconstructed by McIndoe method, in comparison with normal ones. This could be explaned by the fact that skin grafts are capable of recovering sensibility.
Topics: Adolescent; Adult; Female; Humans; Middle Aged; Plastic Surgery Procedures; Sensation; Syndrome; Temperature; Touch; Vagina
PubMed: 18672701
DOI: 10.2298/vsp0806449v -
Archives of Gynecology and Obstetrics Jul 2019Bacterial vaginosis (BV) is the most common vaginal disorder in reproductive-age women. The condition is characterised by the replacement of a healthy,... (Review)
Review
INTRODUCTION
Bacterial vaginosis (BV) is the most common vaginal disorder in reproductive-age women. The condition is characterised by the replacement of a healthy, lactobacilli-dominated vaginal microbiota by anaerobic and facultative anaerobic bacteria. BV increases the risk of acquisition of STIs and is associated with pregnancy complications. Although the composition of the bacteria in BV varies between individuals, there are some species such as Gardnerella, Atopobium, Mycoplasma, Snethia, Megasphera, Dialister, etc., that are found most frequently.
MATERIAL AND METHODS
Literature research to the importance of Atopobium vaginae in BV and treatment options.
RESULTS
Atopobium (A.) vaginae is an important component of the complex abnormal vaginal flora in BV; even though A. vaginae, like Gardnerella vaginalis, has also been detected in the normal flora, it is much more common in BV patients. A. vaginae has been shown to play an important role in the pathophysiology of BV and is thought to be at least a partial cause of the known negative sequelae. The presence of A. vaginae in the BV-associated biofilms and its resistance to some antimicrobial substances has been described - this seems to have a major impact on treatment outcome.
CONCLUSION
Current scientific data demonstrate that dequalinium chloride (Fluomycin) is one of the valid therapeutic options for BV treatment, since it displays a broad antimicrobial spectrum against relevant vaginal pathogens, especially against G. vaginalis and A. vaginae, without having safety concerns.
Topics: Actinobacteria; Anti-Infective Agents; Female; Humans; Vagina; Vaginosis, Bacterial
PubMed: 30953190
DOI: 10.1007/s00404-019-05142-8 -
Geburtshilfe Und Frauenheilkunde Sep 1966
Topics: Adult; Female; Humans; Models, Structural; Radiography; Silicones; Vagina
PubMed: 5996487
DOI: No ID Found -
Shujutsu. Operation Jul 1967
Topics: Female; Humans; Methods; Prostheses and Implants; Vagina
PubMed: 5583932
DOI: No ID Found -
Molecular and Cellular Endocrinology Sep 2002Perinatal treatment of female mice with natural or synthetic estrogens including diethylstilbestrol (DES) results in estrogen-independent persistent proliferation and...
Perinatal treatment of female mice with natural or synthetic estrogens including diethylstilbestrol (DES) results in estrogen-independent persistent proliferation and cornification of the vaginal epithelium. However, the molecular mechanisms of the estrogen-independent changes have not been elucidated. To analyze the mechanism of estrogen-independent cell proliferation and cornification of the vaginal epithelium, we used differential display and determined specific genes expressed in neonatally DES-treated vagina. A candidate clone that designated DDV5 was identical to the serine protease, neuropsin that is reportedly expressed in the mouse central nervous system. We then analyzed the expression pattern of DDV5/neuropsin using Northern blot analysis. We found: (1). DDV5/neuropsin mRNA is expressed in vaginae from neonatally DES-treated ovariectomized mice but not in vaginae from ovariectomized control mice, (2). its expression is not detected in uteri from neonatally DES-treated mice, (3). DDV5/neuropsin is expressed in vaginae from normal intact mice during estrus. Furthermore, we found that DDV5/neuropsin mRNA rapidly decreased in vaginae after ovariectomy. DDV5/neuropsin was detected in vaginae from ovariectomized mice 48 h after estrogen treatment. These results suggest that DDV5/neuropsin is expressed in estrogen-stimulated mouse vagina, and its gene expression is regulated by estrogen. Neonatal DES exposure affects transcriptional control of DDV5/neuropsin in the mouse vagina, which results in persistent expression of DDV5/neuropsin even after ovariectomy, thus, DDV5/neuropsin may play a role in estrogen-independent persistent proliferation and cornification of the vaginal epithelium. Using in situ hybridization method, we found DDV5/neuropsin mRNA localized in epithelial cells but not stromal cells in vaginae. This is the first report on the gene expression of a serine-protease neuropsin in the mouse vagina, and as a marker of the estrogen-independent persistent proliferation and cornification of the vaginal epithelium.
Topics: Animals; Animals, Newborn; Base Sequence; Cell Division; DNA, Complementary; Diethylstilbestrol; Epithelium; Estrogens; Female; Gene Expression Profiling; Gene Expression Regulation; Kallikreins; Mice; Molecular Sequence Data; RNA, Messenger; Serine Endopeptidases; Vagina
PubMed: 12354676
DOI: 10.1016/s0303-7207(02)00184-3 -
Journal of Obstetrics and Gynaecology :... Jan 2017This 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...
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.
Topics: Adult; Biofilms; Female; Humans; Lactobacillus; Microscopy, Confocal; Microscopy, Electron, Scanning; Optical Imaging; Vagina
PubMed: 27625157
DOI: 10.1080/01443615.2016.1217508