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Interventional Ultrasound in Diagnosis and Treatment of Female Infertility
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Premedication of the patient is the same. Each patient should have a full bladder and is placed in the lithotomy position. There is no need for either abdominal wall or probe sterilization. The vagina is cleaned with an antiseptic solution (Betadine®). The operator holds the probe with one hand and the needle with the other. Local anesthesia of the vaginal wall may be used, but seems not to be necessary. The needle is introduced into the vagina through the speculum. The probe is placed on the lower abdomen and a longitudinal or slightly oblique scan is then employed to visualize the ovary and the needle in the vagina. The lowest-lying follicle should be selected as the initial target. Penetration of the needle through the posterior vaginal fornix into the follicle is continuously monitored. Therefore, transabdominally monitored transvaginal puncture also represents a kind of “free hand” technique, and a steering device is not used (Figure 4C).
Incontinence Pessaries
Published in Teresa Tam, Matthew F. Davies, Vaginal Pessaries, 2019
After the initial fitting, we recommend a follow-up appointment within 2–4 weeks for assessment of comfort and continuation. After that, the patient is seen at 3- to 6-month intervals if she prefers the clinician to remove and clean the pessary or 6- to 12-month intervals if self-managing. Follow-up visits should include an assessment of pain, comfort, and continence. The clinician should inquire about the presence of vaginal bleeding and discharge. The examination should include evaluation of the vaginal wall for epithelial abnormalities including granulation tissue, pressure sores, ulcerations, and atrophy. Pessary size and type should also be evaluated with changes made as needed based on patient symptoms and examination.
The rectum
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
In many cases where the neoplasm is situated within 7-8 cm of the anal verge it can be felt on digital rectal examination as an elevated, irregular and hard endoluminal mass. When the centre ulcerates, a shallow depression will be felt with raised and everted edges. An attempt should be made to determine whether the neoplasm is mobile, tethered or fixed, and to estimate the distance of the lower margin from the top of the anal sphincter complex: these factors are important in assessing resectablility and methods of reconstruction following excisional surgery. In females, a vaginal examination may be useful if involvement of the posterior vaginal wall is suspected. Digital rectal examination also affords the opportunity to evaluate the anal sphincter complex, which is important in cases where resection and low anastomosis are being considered.
Low genitourinary tract risks in women living with the human immunodeficiency virus
Published in Climacteric, 2023
F. R. Pérez-López, A. M. Fernández-Alonso, E. Mezones-Holguín, P. Vieira-Baptista
The most frequent genital expression of menopause in the general population is vaginal dryness and dyspareunia, associated with vaginal irritation and lack of enjoyment of sex [59]. Dyspareunia is highly prevalent among HIV-positive women, and even more common in postmenopausal women. The appropriate treatment would reduce vaginal wall lesions that may favor the entry of other infections [60]. In WLHIV, those symptoms may be due to or exacerbated by addictive drug use (crack, cocaine and/or heroin) rather than menopause [61]. Among Thai postmenopausal WLHIV, there is a significant reduction in sexual acts (related to more night sweats, reduced sexual desire and avoidance of intimacy) compared to non-postmenopausal women. In addition, other general menopause-related symptoms are also severe [62]. The general recommendations for management of vulvovaginal atrophy are applicable in WLHIV [63,64].
Utilization of propranolol hydrochloride mucoadhesive invasomes as a locally acting contraceptive: in-vitro, ex-vivo, and in-vivo evaluation
Published in Drug Delivery, 2022
Mahmoud H. Teaima, Moaz A. Eltabeeb, Mohamed A. El-Nabarawi, Menna M. Abdellatif
The human vagina appears as an S-shaped fibromuscular collapsible tube between 6 and 10 cm long. The vaginal wall consists of three layers: the epithelial layer, the muscular coat, and the tunica adventitia. The vaginal route can be used for both local and systemic administration (Daoud et al., 2017). In a topical technique of contraception, the bio-actives are transported through the vaginal wall into fluids and mucus present in the vagina resulting in the maintenance of a concentration sufficient to immobilize or kill sperms (Iyer & Poddar, 2008). Vaginal products must be designed for women’s convenience and must have the following criteria: no side effects during intercourse; colorless and odorless; might be topically applied before coitus; no leakage, no irritation, burning, or swelling; and suitable to be inserted easily (Vermani & Garg, 2000).
Alteration of vaginal microbiota in patients with recurrent miscarriage
Published in Journal of Obstetrics and Gynaecology, 2022
Xuejuan Jiao, Lanling Zhang, Danli Du, Lingling Wang, Qianqian Song, Shuyu Liu
Vaginal secretions of 16 women with RM (group: RM) and 20 healthy volunteers (group: Control) were collected from the First Affiliated Hospital of Bengbu Medical College. The detailed information of these samples are shown in Table 1. Statistical analysis showed that there was no significant difference in age between the RM group and the control group, but there was a significant difference in the number of abortions (Supplementary Figure 1). We collected samples in accordance with the relevant guidelines and individuals provided signed informed consent for use of their samples in the present study. All women were not pregnant, were of reproductive age, regularly menstruating, with a history of sexual activity, and had not taken any antibiotics or antimycotic compounds in the past 30 days. Women were asked to refrain from sexual activity in the 3 days prior to the visit. Women were excluded from the study if they had used douches, vaginal medications or suppositories, feminine sprays, genital wipes or contraceptive spermicides, or had reported vaginal discharge in the past 48 h (Ravel and Gordon 2011). The flowchart for inclusion and exclusion criteria were shown in Supplementary Figure 2. The secretions of the vaginal wall were scraped from RM patients and healthy controls using swabs aseptically. Two vaginal swabs were collected from each subject. The sample centrifuge tubes were placed immediately in a prepared ice box or in a foam box filled with ice packs to maintain a low temperature. Then, the samples were transferred from the hospital clinic to the −80 °C refrigerator.