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Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Vulvovaginal itching and burning are the most common symptoms of Candida vulvovaginitis (reported by 60% of women with positive yeast cultures) (11) along with external dysuria and a white, curdled vaginal discharge. One-third of females with positive vaginal Candida cultures are asymptomatic, while one-fourth of women with negative cultures have symptoms (11). The symptom spectrum of vulvovaginal candidiasis goes from acute/exudative (sudden onset, heavy discharge loaded with yeast) to progressive/inflammatory (minimal discharge, few organisms, severe itching). The pruritus may be a hypersensitivity reaction and may worsen with occlusive clothing and in the premenstrual phase of the cycle (14).
Infectious disease
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Vaginal discharge with a fishy smell. No evidence that it is a sexually transmitted disease. Aetiology: alteration of the bacterial flora in the vagina with increase in species such as Gardnerella vaginalis and anaerobes. Clue cells are seen. Treatment: antibiotics such as metronidazole.
Cloaca
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
The procedure continues with the placement of traction sutures in the single uterus or in both hemiuteri. Traction sutures are also placed in the dome of the bladder. With the use of traction on both structures, dissection is initiated between the urinary tract and the vagina. This dissection is continued all the way down to meet the previous dissection initiated from below. The vagina is thus separated from the urinary tract, with care being taken to preserve its blood supply from the uterine vessels. Once the vagina(s) has/have been separated from the bladder and urethra, the surgeon should make decisions based on the specific anatomic findings. The vagina at this point may reach the perineum. If it is found to be too short, some form of vaginal replacement or vaginoplasty is required.
Vaginal mucositis in patients with gynaecological cancer undergoing (chemo-)radiotherapy: a retrospective analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Jolien Robijns, Sandrine Censabella, Heleen Bollen, Stefan Claes, Leen Van Bever, Jindra Becker, Luc Pannekoeke, Paul Bulens, Evelyn Van de Werf
One concern based on our results is that still 27% of patients rate one or more VM symptoms with a score of 4 or higher at the end of external (C)RT. This implies that this group of patients needs more supportive care measures consisting of the use of analgesics and a stricter follow-up by the RT team. One of the frequently described VM symptoms is pruritus, as confirmed in other trials (Kirchheiner et al. 2014; Zolciak-Siwinska et al. 2015). This symptom could be aggravated since pelvic RT makes the patients more vulnerable to yeast infections due to damage to the vaginal mucosa. Vaginal yeast infections are characterised by itchiness, a burning sensation, irritation, odour, and vaginal discharge. In case of yeast infections special measures have to be taken into account such as antifungal creams, ointments or suppositories with miconazole or clotrimazole (Hainer and Gibson 2011). Pain and a burning sensation are two symptoms, which are hard to differentiate. A burning sensation during urination could also be caused by cystitis, which is a common complication of patients undergoing pelvic RT (Hainer and Gibson 2011). Moreover, the pain score could have been influenced by the general pain felt by the patient due to dermatological, gastrointestinal, skeletal, or genitourinary toxicity (Viswanathan et al. 2014).
Outcomes of surgical treatments for acquired gynatresia in a tertiary institution in Ibadan, Nigeria
Published in Journal of Obstetrics and Gynaecology, 2022
Oluwasomidoyin Olukemi Bello, Imran Oludare Morhason-Bello, Olatunji Okikiola Lawal, Rukiyat Adeola Abdus-Salam, Ayodele Olukayode Iyun, Oladosu Akanbi Ojengbede
The commonest cause of AG was scarring from vaginal chemical burns (SVCBs) (71.0%) while (29.1%) had non- chemical AG. The reasons for insertion of caustic substance into the vagina were for treatment of fibroids (68.2%), infertility (54.5%), prevention of abortion (9.1%), effluvium seminis and abnormal vaginal bleeding (4.5%) each (Table 1). The presenting symptoms were dyspareunia (77.4%), infertility (54.8%), amenorrhoea (51.6%), abdominal swelling (45.2%), and cyclical lower abdominal pain (38.7%) (Figure 1). The main clinical findings were vaginal/cervical stenosis (64.5%), haematocolpos/haematometria (45.2%), and abdominal swelling (45.2%). The vaginal length and width at presentation vary, ranging from 1–6 cm and 1–4 cm, respectively. A higher proportion (66.7%) of the nine women who were treated at another facility prior to presentation had previous unsuccessful surgical intervention (Table 2).
A non-gravid incarcerated uterus following a suction dilation and curettage: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Marie-Claire Leaf, Melissa Perez, Katherine Coakley
A 34 year-old gravida 2 para 1 presented to the emergency department with severe abdominopelvic pain radiating to her back on post-operative day zero following an apparent uncomplicated D and C at twelve weeks gestational age. The patient reported minimal bleeding following her procedure. Upon initial evaluation, pelvic exam was challenging secondary to pain but notable for a 5 × 5 cm mass within the vagina. The cervix was unable to be visualised or palpated. A trans-abdominal ultrasound demonstrated an enlarged uterus with displacement and compression of the bladder anteriorly. A CT abdomen and pelvis showed an enlarged uterus with a large endometrial haematoma and mass effect compressing the bladder and distal right ureter with associated mild to moderate right hydroureteronephrosis. Additionally, an ultrasound performed two weeks prior demonstrated an intrauterine pregnancy with an anterior 5 cm submucosal fibroid. Given the concerning bedside pelvic examination and CT imaging findings, the patient was taken to the operating room for suspicion of prolapsing fibroid, hematometra, and incarcerated uterus.