Use of cervical cytology, vaginal ph and colposcopy as adjuncts to clinical evaluation of ayurvedic vaginal Douche, Panchavalkal, in Leucorrhoea

Abstract

The use of cytology, vaginal pH and colposcopy as adjuncts to clinical assessment of efficacy of traditional Ayurvedic douche alone in treatment of uncomplicated leucorrhoea, has been evaluated in this study. Forty two cases of uncomplicated leucorrhoea without pelvic inflammatory disease or associated gynaecological or systemic pathology formed the study group. History, clinical examination, Papanicolaou (Pap) smear, gram stain, vaginal pH, and colposcopy were carried out before treatment, at 2 weeks post treatment and monthly examination. Daily douches with modified Panchavalkal (decoction from barks of F bengalensis, F religiosa, F infectoria, F glomerata and Alebbeck 25gms each), were given for 14 days. Symptoms were evaluated by a diagrammatic visual grading score. Thirty six cases (85.7%) had clinical relief or cure (p < 0.001; Chi square test). The symptom score was reduced from 5.4 ± 1.9 to 2.2 ± 2.2 (Mean ± SD) at 2 weeks and 2.3 ± 2.2 (Mean ± SD) at 1 month (p < 0.001; paired ‘t’ test) at 2 weeks post treatment. Out of 29 cases who had cervical erosion, 20 cases showed reduction in area of erosion whilst no change was seen in 9 cases. Colposcopy (n=21) confirmed reduced vascularity, inflammation, discharge and epithelialisation of transformation zone in 19 cases. Vaginal pH (n=28) was reduced in 13 and remained normal in 7 and remained same in 4 cases. In 4 cases there was a nonsignificant rise. Pap smears (n=37) showed improvement in severity of inflammatory changes in 25 cases. Specific infections were seen in 24 cases initially, and in 15 cases at 1 month. Apart from symptoms and signs cervical cytology, colposcopy and vaginal pH were very useful in evaluation of the traditional Panchavalkal douche treatment of uncomplicated leucorrhoea. Multiple infections and resistant cases were identified. Panchavalkal provided symptomatic relief in 85.7% of cases.