Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vagi...Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vaginal swab examinations on 56 women with complaints of vaginal discharge in Bareng Lor Village,Klaten,and Sewugalur,Kulon Progo,Indonesia.A vaginal swab was carried out with a Gram examination.Data were coded and analyzed using the chi-c test.Results:The color of vaginal discharge was divided into:non-vaginal discharge 16.1%(9/56),white/clear/mucoid 50%(28/56),greenish/white 14.3%(8/56),brownish white/brown 3.6%(2/56),powdery and white 3.6%(2/56),post coitus bleeding 7.1%(4/56),and other complaints(itching,odor,erosion)5.4%(3/56).The volume of vaginal discharge was divided into:normal 16.1%(9/56),a little 48.2%(27/56),and a lot 35.7%(20/56).The types of microorganisms obtained were:no microorganisms growing 8.9%(5/56),Gram positive cocci/bacilli 7.1%(4/56),Gram negative cocci/bacilli 19.6%(11/56),Gram positive/negative coccobacilli 7.1%(4/56),growth of>2 bacteria 42.9%(24/56),and fungus/yeast cells/clue cells 14.3%(8/56).There is a significant relationship between volume and type of microorganisms(P=0.011),while the relationship between color/type of vaginal discharge and microorganisms is not significantly related.Conclusions:The volume of vaginal discharge reflects the presence of risky microorganisms.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
Objective:To evaluate the clinical efficacy of vaginal repair as a salvage treatment for cesarean scar defects in patients with previously failed repair surgery.Methods:This retrospective cohort study included 16 pati...Objective:To evaluate the clinical efficacy of vaginal repair as a salvage treatment for cesarean scar defects in patients with previously failed repair surgery.Methods:This retrospective cohort study included 16 patients with cesarean scar defects who underwent vaginal repair as salvage therapy after prior repair surgery failure between March 2019 and September 2022 at the Department of Obstetrics and Gynecology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine.The previous failed procedures included vaginal repair,hysteroscopic repair,and laparoscopic repair.A control group of 108 patients who underwent primary vaginal repair during the same period was also analyzed.Perioperative outcomes and post-operative repair efficacy were compared.The length,width,and depth of the cesarean scar defect,as well as the thickness of the residual myometrium,were measured by transvaginal ultrasonography.Results:No significant differences were observed between the two groups in demographic characteristics.In both groups,the duration of menstruation significantly decreased after vaginal repair(from 12.8±5.3 to 6.75±1.8 days in the salvage therapy group,and from 13.5±3.8 to 7.1±1.7 days in the primary surgery group),while the thickness of the residual myometrium significantly increased(from 3.0±2.0 to 7.7±2.6 mm in the salvage therapy group,and from 2.6±1.2 to 7.7±2.5 mm in the primary surgery group).Post-operatively,there were no significant differences between the two groups in either menstrual duration(6.8±1.8vs.7.1±1.7 days)or residual myometrial thickness(7.7±2.6vs.7.7±2.5 mm).The data also indicated that performing salvage therapy within≤21 months of the initial surgery was associated with a better prognosis.Conclusions:Vaginal repair as salvage therapy is a feasible and effective option for patients with cesarean scar defects after failed repair surgery.展开更多
Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between...Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between the microbiome and sows with longevity in reproduction.Results In this study,we collected and sequenced rectal and vaginal swabs from 48 sows,nine of which completed up to four parities(U4P group),exhibiting reproductive longevity.We first identified predictors of sow longevity in the rectum(e.g.,Akkermansia)and vagina(e.g.,Lactobacillus)of the U4P group using RandomForest in the early breeding stage of the first parity.Interestingly,these bacteria in the U4P group showed decreased predicted KEGG gene abundance involved in the biosynthesis of amino acids.Then,we tracked the longitudinal changes of the micro-biome over four parities in the U4P sows.LEfSe analysis revealed parity-associated bacteria that existed in both the rectum and vagina(e.g.,Streptococcus in Parity 1,Lactobacillus in Parity 2,Veillonella in Parity 4).We also identi-fied patterns of bacterial change between the early breeding stage(d 0)and d 110,such as Streptococcus,which was decreased in all four parties.Furthermore,sows in the U4P group with longevity potential also showed better reproductive performance.Finally,we discovered bacterial predictors(e.g.,Prevotellaceae NK3B31 group)for the total number of piglets born throughout the four parities in both the rectum and vagina.Conclusions This study highlights how the rectal and vaginal microbiome in sows with longevity in reproduc-tion changes within four parities.The identification of parity-associated,pregnancy-related,and reproductive performance-correlated bacteria provides the foundation for targeted microbiome modulation to improve animal production.展开更多
This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach withou...This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach without complications, and the material was sent for anatomopathological examination, which confirmed the diagnosis of leiomyoma. Vaginal leiomyomas are a rare lineage of tumors at this gynecological site, with just over 300 reports worldwide. Symptoms can range from totally asymptomatic to genitourinary complaints, such as urinary incontinence to dyspareunia. The diagnosis is based on a physical examination and preoperative imaging tests (MRI, transvaginal ultrasound, cystoscopy, computed tomography), but the definitive diagnosis is histopathological analysis of the specimen. The treatment of choice is surgery with complete excision of the lesion, and in 90% of cases, the transvaginal approach is chosen.展开更多
Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Provinc...Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.展开更多
Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,...Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,including the abdominal wall,gastrointestinal tract,vagina,bladder,scrotum,mediastinum,and the oral cavity.Cerebrospinal fluid(CSF)leakage through the vagina is an uncommon complication of VP shunts;however,its exact incidence remains unknown.Such complications can result in failure of the shunt procedure,often requiring revision or reinsertion in affected patients[2].展开更多
In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult t...In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult to perform a vaginal trial delivery smoothly.The combined approach of ADIET communication and delivery rehearsal for vaginal trial delivery can provide a reference for reducing prenatal anxiety,shortening labor duration,facilitating a smooth delivery,and ensuring the safety of both mothers and babies.AIM To analyze the effect of AIDET communication combined with labor rehearsal on vaginal trial delivery.METHODS A study conducted between January 2023 and December 2023 included 200 vaginal trials.Women were randomly assigned to an observation group(100 women),which received ADIET communication plus delivery intervention,and a control group(100 women),which received routine communication plus delivery intervention.This study aimed to compare antenatal anxiety status as measured using the Maternal Anxiety Scale,labor duration,delivery efficacy as assessed using the simplified Chinese version of the Childbirth Self-Efficacy Inventory,and delivery outcomes.RESULTS After the intervention,the observation group had a lower Maternal Anxiety Scale score and higher Childbirth Self-Efficacy Inventory score(P<0.05)than the control group(P<0.05),whereas the observation group had higher natural delivery,cesarean delivery,vaginal delivery,and neonatal asphyxia rates(P<0.05).CONCLUSION For women undergoing vaginal trial delivery,a combination of AIDET communication and delivery rehearsal can relieve prenatal anxiety,enhance delivery efficiency,shorten labor duration,and somewhat improve delivery outcomes.展开更多
BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious c...BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.展开更多
The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits s...The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits stable bacterial diversity,influenced by age and gonadal hormone levels,and is classified into distinct Community-State Types.A healthy vaginal microbiome is typically characterized by a predominance of Lactobacillus spp.,which acidifies the vaginal environment and is essential in defending against invading microbial pathogens.This review examines the evolution of the vaginal microbiome’s composition throughout a woman’s life.It also explores how exogenous factors influence the homeostasis of this microbiome,leading to either a state of eubiosis or dysbiosis.The main factors supporting eubiosis of the vaginal microbiome include diet,probiotic intake,certain personal hygiene practices,and hormonal contraceptives,while the major contributors to dysbiosis are psychosocial stress,tobacco smoking,and sexual activity.This state of dysbiosis is strongly associated with a range of adverse vaginal health outcomes,including preterm birth,bacterial vaginosis,pelvic inflammatory disease,and a higher risk of sexually transmitted infections.展开更多
Foreign body retained for long duration sometimes causes vesico-vaginal and recto-vaginal fistula. We report a 60-year-old woman with vaginal foreign body causing vesico-vaginal and recto-vaginal fistula;she died afte...Foreign body retained for long duration sometimes causes vesico-vaginal and recto-vaginal fistula. We report a 60-year-old woman with vaginal foreign body causing vesico-vaginal and recto-vaginal fistula;she died after foreign body removal due to septic shock. The patient had vaginal purulent discharge, abdominal pain, and a septic shock. A fragment of stone (limestone) was present in the vagina, which was removed. The patient developed urinary incontinence and fecal incontinence after removal of the foreign body. The examination demonstrated the presence of vesico-vaginal and recto-vaginal fistula. The patient died four days after removal of the foreign body due to septic shock and multi-visceral failure. During the extraction foreign body, bacteria could be disseminated into the systemic circulation and might cause septic shock. Thus, wide-spectrum antibiotic therapy must be used before the procedure, which may decrease the chance of septic shock.展开更多
Cellular angiofibroma is a rare mesenchymal tumor that most commonly presents as an asymptomatic well-circumscribed mass in the vulva. Very few cases have been found in the vagina and even fewer presented with vaginal...Cellular angiofibroma is a rare mesenchymal tumor that most commonly presents as an asymptomatic well-circumscribed mass in the vulva. Very few cases have been found in the vagina and even fewer presented with vaginal bleeding. A 54-year-old female presented to the emergency department with five months of vaginal bleeding and symptomatic anemia requiring blood transfusion. Upon physical examination, she was found to have a firm 4<span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">cm posterior vaginal mass, distinctly distal to the cervix. The mass was resected and diagnosed as a vaginal cellular angiofibroma on pathologic evaluation. The patient did well post</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">operatively with recommended follow-up every six months. The common differential diagnosis for a bleeding vaginal mass includes leiomyoma, angiofibroblastoma, aggressive angiomyxoma, squamous cell carcinoma, and adenocarcinoma. In this case, cellular angiofibroma presented as a vaginal mass with heavy bleeding leading to severe anemia. Early involvement of gynecologic oncology can help to optimize patients’ evaluation and management.</span></span></span>展开更多
Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal...Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding.In our current case,a 76-year-old woman presented with irregular vaginal bleeding.The final pathological diagnosis of the mass was APA.APA is not easy to diagnose before surgery.On the one hand,there was no obvious particularity in imaging features and clinical features,especially for uncomfortably identifying endometrial cancer.On the other hand,APA has a pedicle,attaching to any part of the uterine cavity,which can cause pseudocoel between the mass with the uterine cavity wall.So,when it comes to getting the pathological tissue in the absence of hysteroscopy,it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass.Therefore,preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA.In the meantime,pathological tissue of APA can be obtained by hysteroscopy in visual conditions.展开更多
BACKGROUND The vaginal microbiome plays a critical role in the health of pregnant women and their newborns.Group B Streptococcus(GBS)and vaginal cleanliness significantly affect the vaginal microecosystem and are clos...BACKGROUND The vaginal microbiome plays a critical role in the health of pregnant women and their newborns.Group B Streptococcus(GBS)and vaginal cleanliness significantly affect the vaginal microecosystem and are closely associated with vaginal diseases.AIM To explore the effects of GBS status and vaginal cleanliness on vaginal microecosystems.METHODS We collected 160 vaginal swabs from pregnant women and divided them into the following four groups based on GBS status and vaginal cleanliness:GBS-positive+vaginal cleanliness I–II degree,GBS-negative+vaginal cleanliness I–II degree,GBS-positive+vaginal cleanliness III–IV degree,and GBS-negative+vaginal cleanliness III–IV degree.Samples were subjected to 16S rRNA gene amplicon sequencing.RESULTS Alpha diversity analysis showed that the Shannon index did not significantly differ between the four groups.We identified significant variation in taxa abundance between the GBS-positive and GBS-negative groups and between the vaginal cleanliness I–II degree and III–IV degree groups.Principal coordinate analysis and non-metric multidimensional scaling analysis further confirmed the microbial diversity of the four groups.Moreover,the linear discriminant analysis demonstrated that Lactobacillus jensenii and Actinobacteria were strongly associated with GBS-positive status,and Lactobacillus iners,Lactobacillaceae,Lactobacillus,Lactobacillales,Bacilli and Firmicutes were closely correlated with GBS-negative status.CONCLUSION GBS status and vaginal cleanliness significantly affect vaginal microbiome differences in pregnant women.Our findings provide instructional information for clinical antibiotic treatment in pregnant women with different GBS statuses and vaginal cleanliness degrees.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>展开更多
Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women wi...Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.展开更多
Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to...Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to evaluate this effect of extract of Oak Gall for vaginal tightening and rejuvenation in women with vaginal relaxation. Methods: This double blind clinical trial was performed on women with vaginal relaxation at Asali Hospital in Khorramabad from May to October 2012 and was candidate for colporrhaphy due to different types of pelvic organ prolapse. Sampling method was done on nonprobability basis according to the number of patients referred to clinic. Using blocked random allocation method, the participants were divided into 4 groups of 30 patients (three intervention group and one control group) who were age-matched. Then, an extract of Oak Gall in specified concentrations (10 - 15 and 20 grams in 1.5%, 2% and 2.5% jells) were administered to each intervention group. Finally, the obtained data were analyzed with Chi-square, Pearson, Fisher’s exact test and ANOVA using SPSS software version 19. Results: A total of 120 patients entered into the study with mean age of 36 ± 5.4 years. The evaluation of mean scores showed that sense of sexual satisfaction and orgasm, sense of vaginal tightness during intercourse, sense of vaginal lubrication and loss of vaginal dryness was significantly improved in patients in intervention group. Also other parameters including urinary incontinence, sense of vaginal mass exit, lack of orgasm, sense of air outflow during intercourse, sense of calmness after sex and loss of libido were significantly reduced in the group of patients who received jell 2.5% compared to other groups (P Conclusion: Our findings show that using topical jell of Oak Gall not only is associated with contracting effects, but also improves vaginal lubrication and reduces its dryness. Regarding the lack of previous studies in this field and considering some limitations of this study, we suggest that Oak Gall to be used for management of women with vaginal relaxation.展开更多
Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective s...Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length - 4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.展开更多
BACKGROUND Currently,the advancement cancer treatment technology improves overall survival,however,adverse events are still a challenge for health professional.Genitourinary syndrome of menopause and vaginal stenosis ...BACKGROUND Currently,the advancement cancer treatment technology improves overall survival,however,adverse events are still a challenge for health professional.Genitourinary syndrome of menopause and vaginal stenosis are conditions that impact the quality of life of patients undergoing radiotherapy.We present two such cases in patients with previous cervical and endometrial cancer.These conditions were handled with an innovative method using an energy-based device with blue light emitting diode for concomitant vaginal and vulvar irradiation.Positive impact in clinical findings,cytologic changes,and referred symptoms were documented.CASE SUMMARY One patient diagnosed with vaginal severe vaginal stenosis with previous cervix cancer treatment and other patient diagnosed with mild stenosis with severe dyspareunia and recent endometrium cancer treatment were considered for vulvovaginal treatment with weekly blue led device and closely evaluated with repeated validated questionnaires and cytological samples.CONCLUSION This innovative technique showed an improvement in all areas of the examiner's criteria,the cytological criteria,and most bothered symptoms.展开更多
Introduction: Vaginal adenosis is one of the rare diseases of the vagina, and almost all patients are asymptomatic. We report a case of spontaneous vaginal adenosis, which caused vesicovaginal fistula. Case Presentati...Introduction: Vaginal adenosis is one of the rare diseases of the vagina, and almost all patients are asymptomatic. We report a case of spontaneous vaginal adenosis, which caused vesicovaginal fistula. Case Presentation: Our patient was a 25-year-old Japanese woman. She was admitted to our hospital, and her chief complaint was continuous urine flow from the vagina. We found a tumor with a vesicovaginal fistula in her vagina. Subsequent cytological analysis of vaginal smears showed a normal vaginal mucosa. The patient underwent tumor resection and a fistula patch. Pathological diagnosis was adenosis of the vagina, even though the patient had no known history of intrauterine diethylstilbestrol exposure or Müllerian developmental abnormalities. Conclusion: The clinical course of our case was a malignant tumor, which invasively bored a hole in the vaginal wall forming a vesicovaginal fistula, even though it was a benign lesion. Therefore, overzealous treatment should be avoided in this case.展开更多
基金supported by Hibah pengabdian masyarakat internal UMY tahun 2023/2024(No.ID CJ4487-MyHAM).
文摘Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vaginal swab examinations on 56 women with complaints of vaginal discharge in Bareng Lor Village,Klaten,and Sewugalur,Kulon Progo,Indonesia.A vaginal swab was carried out with a Gram examination.Data were coded and analyzed using the chi-c test.Results:The color of vaginal discharge was divided into:non-vaginal discharge 16.1%(9/56),white/clear/mucoid 50%(28/56),greenish/white 14.3%(8/56),brownish white/brown 3.6%(2/56),powdery and white 3.6%(2/56),post coitus bleeding 7.1%(4/56),and other complaints(itching,odor,erosion)5.4%(3/56).The volume of vaginal discharge was divided into:normal 16.1%(9/56),a little 48.2%(27/56),and a lot 35.7%(20/56).The types of microorganisms obtained were:no microorganisms growing 8.9%(5/56),Gram positive cocci/bacilli 7.1%(4/56),Gram negative cocci/bacilli 19.6%(11/56),Gram positive/negative coccobacilli 7.1%(4/56),growth of>2 bacteria 42.9%(24/56),and fungus/yeast cells/clue cells 14.3%(8/56).There is a significant relationship between volume and type of microorganisms(P=0.011),while the relationship between color/type of vaginal discharge and microorganisms is not significantly related.Conclusions:The volume of vaginal discharge reflects the presence of risky microorganisms.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.
基金Ministry of Science and Technology of China(2020YFC2002800,2020YFC2002803)。
文摘Objective:To evaluate the clinical efficacy of vaginal repair as a salvage treatment for cesarean scar defects in patients with previously failed repair surgery.Methods:This retrospective cohort study included 16 patients with cesarean scar defects who underwent vaginal repair as salvage therapy after prior repair surgery failure between March 2019 and September 2022 at the Department of Obstetrics and Gynecology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine.The previous failed procedures included vaginal repair,hysteroscopic repair,and laparoscopic repair.A control group of 108 patients who underwent primary vaginal repair during the same period was also analyzed.Perioperative outcomes and post-operative repair efficacy were compared.The length,width,and depth of the cesarean scar defect,as well as the thickness of the residual myometrium,were measured by transvaginal ultrasonography.Results:No significant differences were observed between the two groups in demographic characteristics.In both groups,the duration of menstruation significantly decreased after vaginal repair(from 12.8±5.3 to 6.75±1.8 days in the salvage therapy group,and from 13.5±3.8 to 7.1±1.7 days in the primary surgery group),while the thickness of the residual myometrium significantly increased(from 3.0±2.0 to 7.7±2.6 mm in the salvage therapy group,and from 2.6±1.2 to 7.7±2.5 mm in the primary surgery group).Post-operatively,there were no significant differences between the two groups in either menstrual duration(6.8±1.8vs.7.1±1.7 days)or residual myometrial thickness(7.7±2.6vs.7.7±2.5 mm).The data also indicated that performing salvage therapy within≤21 months of the initial surgery was associated with a better prognosis.Conclusions:Vaginal repair as salvage therapy is a feasible and effective option for patients with cesarean scar defects after failed repair surgery.
基金funded by the National Key Research and Development Program of China (2023YFE0124400)the Specific university discipline construction project (2023B10564001)+1 种基金grants administered by the Arkansas Biosciences Institute and the USDAa core grant (P20GM121293, proteogenomics core)。
文摘Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between the microbiome and sows with longevity in reproduction.Results In this study,we collected and sequenced rectal and vaginal swabs from 48 sows,nine of which completed up to four parities(U4P group),exhibiting reproductive longevity.We first identified predictors of sow longevity in the rectum(e.g.,Akkermansia)and vagina(e.g.,Lactobacillus)of the U4P group using RandomForest in the early breeding stage of the first parity.Interestingly,these bacteria in the U4P group showed decreased predicted KEGG gene abundance involved in the biosynthesis of amino acids.Then,we tracked the longitudinal changes of the micro-biome over four parities in the U4P sows.LEfSe analysis revealed parity-associated bacteria that existed in both the rectum and vagina(e.g.,Streptococcus in Parity 1,Lactobacillus in Parity 2,Veillonella in Parity 4).We also identi-fied patterns of bacterial change between the early breeding stage(d 0)and d 110,such as Streptococcus,which was decreased in all four parties.Furthermore,sows in the U4P group with longevity potential also showed better reproductive performance.Finally,we discovered bacterial predictors(e.g.,Prevotellaceae NK3B31 group)for the total number of piglets born throughout the four parities in both the rectum and vagina.Conclusions This study highlights how the rectal and vaginal microbiome in sows with longevity in reproduc-tion changes within four parities.The identification of parity-associated,pregnancy-related,and reproductive performance-correlated bacteria provides the foundation for targeted microbiome modulation to improve animal production.
文摘This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach without complications, and the material was sent for anatomopathological examination, which confirmed the diagnosis of leiomyoma. Vaginal leiomyomas are a rare lineage of tumors at this gynecological site, with just over 300 reports worldwide. Symptoms can range from totally asymptomatic to genitourinary complaints, such as urinary incontinence to dyspareunia. The diagnosis is based on a physical examination and preoperative imaging tests (MRI, transvaginal ultrasound, cystoscopy, computed tomography), but the definitive diagnosis is histopathological analysis of the specimen. The treatment of choice is surgery with complete excision of the lesion, and in 90% of cases, the transvaginal approach is chosen.
基金supported by Xiamen University,which played a key role in the collection and analysis of the datafunded by National Natural Science Foundation of China(grants 82341031,82173584,and 82222062)+2 种基金Major Research Plan of the National Natural Science Foundation of China(grant 92269205)Science Fund for Distinguished Young Scholars of Jiangsu Province(grant BK20220064)Jiangsu Provincial Key Project of Science and Technology Plan(grants BE2021738 and BE2023601)。
文摘Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.
文摘Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,including the abdominal wall,gastrointestinal tract,vagina,bladder,scrotum,mediastinum,and the oral cavity.Cerebrospinal fluid(CSF)leakage through the vagina is an uncommon complication of VP shunts;however,its exact incidence remains unknown.Such complications can result in failure of the shunt procedure,often requiring revision or reinsertion in affected patients[2].
文摘In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult to perform a vaginal trial delivery smoothly.The combined approach of ADIET communication and delivery rehearsal for vaginal trial delivery can provide a reference for reducing prenatal anxiety,shortening labor duration,facilitating a smooth delivery,and ensuring the safety of both mothers and babies.AIM To analyze the effect of AIDET communication combined with labor rehearsal on vaginal trial delivery.METHODS A study conducted between January 2023 and December 2023 included 200 vaginal trials.Women were randomly assigned to an observation group(100 women),which received ADIET communication plus delivery intervention,and a control group(100 women),which received routine communication plus delivery intervention.This study aimed to compare antenatal anxiety status as measured using the Maternal Anxiety Scale,labor duration,delivery efficacy as assessed using the simplified Chinese version of the Childbirth Self-Efficacy Inventory,and delivery outcomes.RESULTS After the intervention,the observation group had a lower Maternal Anxiety Scale score and higher Childbirth Self-Efficacy Inventory score(P<0.05)than the control group(P<0.05),whereas the observation group had higher natural delivery,cesarean delivery,vaginal delivery,and neonatal asphyxia rates(P<0.05).CONCLUSION For women undergoing vaginal trial delivery,a combination of AIDET communication and delivery rehearsal can relieve prenatal anxiety,enhance delivery efficiency,shorten labor duration,and somewhat improve delivery outcomes.
文摘BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.
文摘The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits stable bacterial diversity,influenced by age and gonadal hormone levels,and is classified into distinct Community-State Types.A healthy vaginal microbiome is typically characterized by a predominance of Lactobacillus spp.,which acidifies the vaginal environment and is essential in defending against invading microbial pathogens.This review examines the evolution of the vaginal microbiome’s composition throughout a woman’s life.It also explores how exogenous factors influence the homeostasis of this microbiome,leading to either a state of eubiosis or dysbiosis.The main factors supporting eubiosis of the vaginal microbiome include diet,probiotic intake,certain personal hygiene practices,and hormonal contraceptives,while the major contributors to dysbiosis are psychosocial stress,tobacco smoking,and sexual activity.This state of dysbiosis is strongly associated with a range of adverse vaginal health outcomes,including preterm birth,bacterial vaginosis,pelvic inflammatory disease,and a higher risk of sexually transmitted infections.
文摘Foreign body retained for long duration sometimes causes vesico-vaginal and recto-vaginal fistula. We report a 60-year-old woman with vaginal foreign body causing vesico-vaginal and recto-vaginal fistula;she died after foreign body removal due to septic shock. The patient had vaginal purulent discharge, abdominal pain, and a septic shock. A fragment of stone (limestone) was present in the vagina, which was removed. The patient developed urinary incontinence and fecal incontinence after removal of the foreign body. The examination demonstrated the presence of vesico-vaginal and recto-vaginal fistula. The patient died four days after removal of the foreign body due to septic shock and multi-visceral failure. During the extraction foreign body, bacteria could be disseminated into the systemic circulation and might cause septic shock. Thus, wide-spectrum antibiotic therapy must be used before the procedure, which may decrease the chance of septic shock.
文摘Cellular angiofibroma is a rare mesenchymal tumor that most commonly presents as an asymptomatic well-circumscribed mass in the vulva. Very few cases have been found in the vagina and even fewer presented with vaginal bleeding. A 54-year-old female presented to the emergency department with five months of vaginal bleeding and symptomatic anemia requiring blood transfusion. Upon physical examination, she was found to have a firm 4<span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">cm posterior vaginal mass, distinctly distal to the cervix. The mass was resected and diagnosed as a vaginal cellular angiofibroma on pathologic evaluation. The patient did well post</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">operatively with recommended follow-up every six months. The common differential diagnosis for a bleeding vaginal mass includes leiomyoma, angiofibroblastoma, aggressive angiomyxoma, squamous cell carcinoma, and adenocarcinoma. In this case, cellular angiofibroma presented as a vaginal mass with heavy bleeding leading to severe anemia. Early involvement of gynecologic oncology can help to optimize patients’ evaluation and management.</span></span></span>
文摘Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding.In our current case,a 76-year-old woman presented with irregular vaginal bleeding.The final pathological diagnosis of the mass was APA.APA is not easy to diagnose before surgery.On the one hand,there was no obvious particularity in imaging features and clinical features,especially for uncomfortably identifying endometrial cancer.On the other hand,APA has a pedicle,attaching to any part of the uterine cavity,which can cause pseudocoel between the mass with the uterine cavity wall.So,when it comes to getting the pathological tissue in the absence of hysteroscopy,it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass.Therefore,preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA.In the meantime,pathological tissue of APA can be obtained by hysteroscopy in visual conditions.
文摘BACKGROUND The vaginal microbiome plays a critical role in the health of pregnant women and their newborns.Group B Streptococcus(GBS)and vaginal cleanliness significantly affect the vaginal microecosystem and are closely associated with vaginal diseases.AIM To explore the effects of GBS status and vaginal cleanliness on vaginal microecosystems.METHODS We collected 160 vaginal swabs from pregnant women and divided them into the following four groups based on GBS status and vaginal cleanliness:GBS-positive+vaginal cleanliness I–II degree,GBS-negative+vaginal cleanliness I–II degree,GBS-positive+vaginal cleanliness III–IV degree,and GBS-negative+vaginal cleanliness III–IV degree.Samples were subjected to 16S rRNA gene amplicon sequencing.RESULTS Alpha diversity analysis showed that the Shannon index did not significantly differ between the four groups.We identified significant variation in taxa abundance between the GBS-positive and GBS-negative groups and between the vaginal cleanliness I–II degree and III–IV degree groups.Principal coordinate analysis and non-metric multidimensional scaling analysis further confirmed the microbial diversity of the four groups.Moreover,the linear discriminant analysis demonstrated that Lactobacillus jensenii and Actinobacteria were strongly associated with GBS-positive status,and Lactobacillus iners,Lactobacillaceae,Lactobacillus,Lactobacillales,Bacilli and Firmicutes were closely correlated with GBS-negative status.CONCLUSION GBS status and vaginal cleanliness significantly affect vaginal microbiome differences in pregnant women.Our findings provide instructional information for clinical antibiotic treatment in pregnant women with different GBS statuses and vaginal cleanliness degrees.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>
文摘Objective To investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis （R VVC） and its etiological risk in vaginal health. Methods Totally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram＇s staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community＇s bacteria density, species diversity and predominant species were evaluated at 1 000 X magnification. Results The vaginal pH （4.53 ~ 0.30） and Nugent score （4.31 ___＋ O. 73） in RVVC group were significantly increased compared with vaginal pH （4.11 __＋ 0.30） and Nugent score （1.32 _＋ 1.29） in control group （P〈O.05, respectively）. The density of Lactoba- cillus in RVVC group was significantly lower than that in control group （P〈O.05）, while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group （P〈O. 05）. Species diversity of women with RVVC significantly exceeded that of control group （P〈O.05）. More than half of vaginal communities in R VVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-domi- nating communities in RVVC group （37.55% and 19.83%） were significantly higher than those in control group （1.30% and 1.73%） （P〈0.05）. Conclusion The significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, doubleblind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.
文摘Background and Objectives: The Quercus (oak) fruit and especially the internal layer of the fruit (jaft) is rich in tannin (polyphenolic compound) and due to its astringent effects on the smooth muscles, we decided to evaluate this effect of extract of Oak Gall for vaginal tightening and rejuvenation in women with vaginal relaxation. Methods: This double blind clinical trial was performed on women with vaginal relaxation at Asali Hospital in Khorramabad from May to October 2012 and was candidate for colporrhaphy due to different types of pelvic organ prolapse. Sampling method was done on nonprobability basis according to the number of patients referred to clinic. Using blocked random allocation method, the participants were divided into 4 groups of 30 patients (three intervention group and one control group) who were age-matched. Then, an extract of Oak Gall in specified concentrations (10 - 15 and 20 grams in 1.5%, 2% and 2.5% jells) were administered to each intervention group. Finally, the obtained data were analyzed with Chi-square, Pearson, Fisher’s exact test and ANOVA using SPSS software version 19. Results: A total of 120 patients entered into the study with mean age of 36 ± 5.4 years. The evaluation of mean scores showed that sense of sexual satisfaction and orgasm, sense of vaginal tightness during intercourse, sense of vaginal lubrication and loss of vaginal dryness was significantly improved in patients in intervention group. Also other parameters including urinary incontinence, sense of vaginal mass exit, lack of orgasm, sense of air outflow during intercourse, sense of calmness after sex and loss of libido were significantly reduced in the group of patients who received jell 2.5% compared to other groups (P Conclusion: Our findings show that using topical jell of Oak Gall not only is associated with contracting effects, but also improves vaginal lubrication and reduces its dryness. Regarding the lack of previous studies in this field and considering some limitations of this study, we suggest that Oak Gall to be used for management of women with vaginal relaxation.
文摘Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length - 4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.
文摘BACKGROUND Currently,the advancement cancer treatment technology improves overall survival,however,adverse events are still a challenge for health professional.Genitourinary syndrome of menopause and vaginal stenosis are conditions that impact the quality of life of patients undergoing radiotherapy.We present two such cases in patients with previous cervical and endometrial cancer.These conditions were handled with an innovative method using an energy-based device with blue light emitting diode for concomitant vaginal and vulvar irradiation.Positive impact in clinical findings,cytologic changes,and referred symptoms were documented.CASE SUMMARY One patient diagnosed with vaginal severe vaginal stenosis with previous cervix cancer treatment and other patient diagnosed with mild stenosis with severe dyspareunia and recent endometrium cancer treatment were considered for vulvovaginal treatment with weekly blue led device and closely evaluated with repeated validated questionnaires and cytological samples.CONCLUSION This innovative technique showed an improvement in all areas of the examiner's criteria,the cytological criteria,and most bothered symptoms.
文摘Introduction: Vaginal adenosis is one of the rare diseases of the vagina, and almost all patients are asymptomatic. We report a case of spontaneous vaginal adenosis, which caused vesicovaginal fistula. Case Presentation: Our patient was a 25-year-old Japanese woman. She was admitted to our hospital, and her chief complaint was continuous urine flow from the vagina. We found a tumor with a vesicovaginal fistula in her vagina. Subsequent cytological analysis of vaginal smears showed a normal vaginal mucosa. The patient underwent tumor resection and a fistula patch. Pathological diagnosis was adenosis of the vagina, even though the patient had no known history of intrauterine diethylstilbestrol exposure or Müllerian developmental abnormalities. Conclusion: The clinical course of our case was a malignant tumor, which invasively bored a hole in the vaginal wall forming a vesicovaginal fistula, even though it was a benign lesion. Therefore, overzealous treatment should be avoided in this case.
