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Clinical Obstetrics and Gynecology Jun 1999There are many problems in the diagnosis and treatment of vaginitis. Often, the patient is not examined (telephone treatment) or examined improperly with lack of... (Review)
Review
There are many problems in the diagnosis and treatment of vaginitis. Often, the patient is not examined (telephone treatment) or examined improperly with lack of attention to the wet prep. In patients with recurrent vaginitis, it should not be assumed that the current infection is the same as a previous infection without a thorough examination. At times, there is an overuse of topical steroids for all vulvar symptoms or use of antifungals for all vulvar symptoms. The various abnormalities in vulvovaginitis have unique physical findings, laboratory tests, and treatments. It should be remembered that unusual conditions of the vagina and vulva may resemble vulvovaginitis. Many vulvar conditions must be considered when a patient reports discharge and itching. It is important to remember that if the treatment is not working, reconsider the diagnosis.
Topics: Ambulatory Care; Candidiasis, Vulvovaginal; Chronic Disease; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Recurrence; Trichomonas Vaginitis; Vaginitis; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 10370840
DOI: 10.1097/00003081-199906000-00004 -
Beneficial Microbes Dec 2019Disruption of vaginal microbiota equilibrium promotes infectious clinical syndromes with annoying symptoms, such as vaginal discharge, odour, irritation, pruritus, and...
Disruption of vaginal microbiota equilibrium promotes infectious clinical syndromes with annoying symptoms, such as vaginal discharge, odour, irritation, pruritus, and vulvar burning. Although identifying and eradicating the pathogen involved has been the standard of care, regional microbiota restoration with probiotics has been gaining ground in recent years. This study aimed to assess the effectiveness of topical treatment for patients exhibiting vaginal discomfort symptoms. A clinical trial was conducted on the use of a topical regimen among reproductive-age women (n=70) with vaginal discomfort symptoms. We assessed their symptoms using a questionnaire, measured vaginal pH, and performed vaginal swabs for microscopy and cultivation. Over the next 4 days, patients received vaginal douches and suppositories with appropriate antibiotic treatment being added on the fourth day based on vaginal swab results. Patients returned 16 days later to fill out in the questionnaire again. The Wilcoxon signed-ranked test was then used to assess differences in symptomatology and pH between appointments. A reduction in vaginal pH was reported between the first and second visit (<0.001). The probiotic regimen exerted a beneficial effect in all vaginal manifestations: vulvovaginal itching, burning sensation, vaginal irritation, and vaginal discharge (<0.001 for all symptoms). Additionally, three out of the four symptoms were alleviated to a greater extent during the first four days of exclusive probiotic use than during the second phase (=0.007, =0.004, and =0.033). Our sample provided significant results regarding the benefits of for vaginal discomfort. We postulate that the greatest symptom improvement was achieved within the first 4 days of exclusive probiotic use, before the addition of antibiotics. This study agrees with the increasing literature on the contribution of probiotics toward vaginitis treatment.
Topics: Administration, Intravaginal; Adolescent; Adult; Anti-Infective Agents; Bacillus coagulans; Female; Humans; Hydrogen-Ion Concentration; Middle Aged; Probiotics; Treatment Outcome; Vagina; Vulvovaginitis; Young Adult
PubMed: 31965832
DOI: 10.3920/BM2019.0048 -
Obstetrics and Gynecology Aug 1985In a majority of patients with candidal vulvovaginitis, drug therapy is convenient and effective. A small but significant group of patients remain symptomatic with...
In a majority of patients with candidal vulvovaginitis, drug therapy is convenient and effective. A small but significant group of patients remain symptomatic with recurrent, chronic candidiasis. A study of 805 patients was undertaken to delineate microbiologically candidal species. The study revealed that the recurrence rate for Candida tropicalis was twice the rate for Candida albicans, and that despite continuous medical care and multiple therapies, the recurrent C tropicalis patients remained symptomatic with persistence of the organism. The difficulty encountered with eradication of C tropicalis may have been due to the lack of susceptibility of the cell membrane to the commonly used antifungal agents.
Topics: Antifungal Agents; Bacteriological Techniques; Candida; Candida albicans; Candidiasis, Vulvovaginal; Female; Humans; Recurrence
PubMed: 3895072
DOI: No ID Found -
Clinical Pediatrics Aug 1974
Topics: Child, Preschool; Female; Gonorrhea; Humans; Neisseria gonorrhoeae; Vulvovaginitis
PubMed: 4217236
DOI: 10.1177/000992287401300813 -
Chemotherapy 1982
Topics: Candidiasis, Vulvovaginal; Female; Humans; Metronidazole; Recurrence
PubMed: 7160241
DOI: 10.1159/000238152 -
Brazilian Journal of Biology = Revista... 2024
Topics: Female; Humans; Vulvovaginitis
PubMed: 38422261
DOI: 10.1590/1519-6984.275237 -
Journal of Pediatric Urology Dec 2019Vulvovaginitis is described as a common self-limiting paediatric gynaecological condition. Parents' experiences of their child being diagnosed with this condition and...
INTRODUCTION
Vulvovaginitis is described as a common self-limiting paediatric gynaecological condition. Parents' experiences of their child being diagnosed with this condition and subsequent treatment have not previously been described.
AIM
The aim of this study was to explore parents' experiences of their child's diagnosis and management of vulvovaginitis.
STUDY DESIGN
The study was conducted in the north west of England over a two-year period. Qualitative data were generated by semistructured in-depth interviews. Mothers of nine children with vulvovaginitis consented to participate. Data were analysed using thematic analysis.
RESULTS
The analysis of the data resulted in four themes: trauma and uncertainty of initial symptoms, seeking a diagnosis; an uncertain journey, managing the symptoms; a process of trial and error and managing the impact; keeping it private. Parents experienced a difficult and protracted journey to their child's diagnosis and were involved in a process of trial and error to try and monitor and manage what can be a difficult ongoing condition.
DISCUSSION
Clinical reports suggest that vulvovaginitis is a minor childhood condition; this is not necessarily the perceptions and experiences of parents, who can experience uncertainty and ongoing difficulty after their child's diagnosis.
CONCLUSION
The diagnosis of vulvovaginitis can have a major and ongoing impact on children's and their family's lives.
Topics: Child; Child, Preschool; Disease Management; England; Female; Follow-Up Studies; Humans; Infant; Parents; Qualitative Research; Time Factors; Vulvovaginitis
PubMed: 31451410
DOI: 10.1016/j.jpurol.2019.07.018 -
Population Health Management Oct 2020Vulvovaginitis is a frequent reason for women to see a health care provider and has been linked to adverse reproductive and psychosocial consequences. Accurate diagnosis...
Vulvovaginitis is a frequent reason for women to see a health care provider and has been linked to adverse reproductive and psychosocial consequences. Accurate diagnosis is a cornerstone of effective treatment, yet misdiagnosis of this condition approaches 50%, raising the risk of recurrence. The past 3 decades have seen few improvements over the traditional means of diagnosing the 3 main causes of vaginitis: bacterial vaginosis, infections, and trichomoniasis. Newer molecular tests, which are both more sensitive and specific, have introduced the potential to transform the diagnosis of vaginitis-ensuring more accurate diagnoses and timely interventions, while reducing health care costs and enhancing patients' quality of life. Clinical approaches and professional guidelines should be updated to reflect advances in molecular testing and improve the diagnosis and management of acute and recurrent vulvovaginitis.
Topics: Candidiasis, Vulvovaginal; Female; Humans; Quality of Life; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 32997581
DOI: 10.1089/pop.2020.0265 -
European Journal of Clinical... Oct 2021Vulvovaginitis is a common problem in the GP's practice. Causes are bacterial vaginosis (BV), Candida infection and sexually transmitted infections (STIs). Only if...
Vulvovaginitis is a common problem in the GP's practice. Causes are bacterial vaginosis (BV), Candida infection and sexually transmitted infections (STIs). Only if empirical treatment fails, a vaginal swab is sent in for culture and BV detection. However, without culture essential, bacterial pathogens may escape diagnosis. Many molecular BV assays have recently appeared on the marketplace, all quite differing in price and targets. However, for years, the Nugent score has been the gold standard for BV detection. We analysed retrospectively 10 years of microbiology results of vulvovaginal swabs, focusing on less frequently reported bacterial pathogens, and assessed the characteristics of BV diagnostics. Vulvovaginal swabs sent in between 2010 and 2020 from > 11,000 GP patients with vulvovaginitis associated symptoms, but negative STI tests, were analysed. First cultures and repeat cultures after at least 6 months were included in four age groups: < 12, 12-17, 18-51 and > 51 years. Candida species and BV were most frequently found, with the highest prevalence in premenopausal women. Haemophilus influenzae, beta-haemolytic streptococci, Streptococcus pneumoniae and Staphylococcus aureus were isolated in 5.6% of all cultures, with the highest percentages in children and postmenopausal women. If empirical treatment of vulvovaginitis fails, bacterial culture should be performed to detect all potentially pathogenic microorganisms to obtain a higher rate of successful diagnosis and treatment, avoiding unnecessary antimicrobial use and costs. For BV detection, molecular testing may seem attractive, but Nugent scoring still remains the low-cost gold standard. We recommend incorporating the above in the appropriate guidelines.
Topics: Adolescent; Adult; Bacteria; Child; Female; Humans; Middle Aged; Netherlands; Prevalence; Retrospective Studies; Vagina; Vaginal Discharge; Vulvovaginitis; Young Adult
PubMed: 33942163
DOI: 10.1007/s10096-021-04265-8 -
The Journal of Sexual Medicine Jan 2008Vulvodynia is increasingly recognized as a cause of sexual pain. Aim. The goal of this Continuing Medical Education article was to provide a comprehensive review of... (Review)
Review
INTRODUCTION
Vulvodynia is increasingly recognized as a cause of sexual pain. Aim. The goal of this Continuing Medical Education article was to provide a comprehensive review of vulvodynia including terminology, possible etiologies, and offer treatment options.
METHODS
A Medline search was conducted using several terms related to and including the terms vulvodynia, vulvar vestibulitis, vestibulodynia, and pudendal neuralgia.
RESULTS
A thorough review of vulvodynia.
CONCLUSION
Vulvodynia most likely represents several disorders without an identifiable cause in many cases. The management of these patients requires a sensitive provider who can coordinate a multidisciplinary approach to their care. Despite the lack of large-scale, placebo-controlled trials, several new treatment options exist.
Topics: Dyspareunia; Female; Gynecologic Surgical Procedures; Humans; Pain Measurement; Quality of Life; Severity of Illness Index; Vulva; Vulvar Diseases; Vulvovaginitis
PubMed: 18173761
DOI: 10.1111/j.1743-6109.2007.00679.x