Douching Research Articles

Bridging the GAP: Probiotic Douches Redefining the Feminine Hygiene.

Vaginal douching is a centuries-old practice which is still in use, especially among adolescents. "Probiotic douches" are the vaginal douches that are formulated with probiotics and are intended to restore or maintain the vaginal microbiome balance. Probiotic douches are a new type of feminine hygiene product that claims to promote a balanced vaginal microbiome and improve overall well-being. However, the evidence supporting the use of probiotics for vaginal health is limited because of the variability in probiotic strains and dosages studied, and the lack of more comprehensive, long-term clinical trials. Most of the existing scientific literature on probiotics focuses on oral probiotic supplements and vaginal probiotic suppositories. Some potential benefits of probiotic douches include restoring a balanced vaginal microbiota, preventing, or managing infections, supporting local immune function, reducing odor and discharge, and enhancing overall vaginal comfort. However, it is important to note that these benefits have not been definitively proven and remain a subject of ongoing research. There are also potential risks associated with their use including disruption of the natural vaginal ecosystem by introducing foreign substances, risk of infection, and stability issues with the formulation that may lead to negative consequences. This review attempts to comprehend the critical need for robust scientific research to guide the safe and effective incorporation of probiotic douches into modern feminine hygiene practices, revolutionizing women's health, and well-being.

Identifying changes in vaginal fluid using SERS: Advancing diagnosis of vulvovaginal candidiasis

Vaginal infections, medically termed vaginitis, encompass a spectrum of symptomatic presentations arising from disturbances within the vaginal microflora. The conventional diagnostic approach relies on microscopic examination of wet preparation of vaginal discharge, considered the ‘gold standard’ in clinical practice. Complementary to this, culture-based methodologies are often employed to reinforce diagnostic accuracy. However, challenges such as subjectivity in result interpretation, resource-intensive requirements regarding skilled personnel, and reagent utilization underscore the need for alternative diagnostic strategies.In this article, we demonstrate surface-enhanced Raman spectroscopy (SERS) and partial least squares regression (PLSR) techniques to elucidate the molecular signatures present in vaginal fluids, accounting for various influencing factors, including disruptions in the natural microflora, vaginal irrigation practices, and contraceptive usage. Furthermore, we investigated the spectral manifestations associated with vulvovaginal candidiasis (VVC) relative to control samples. Each clinical specimen underwent meticulous characterization encompassing microbial composition, pH levels, purity, and other pertinent parameters.Our findings unveil significant associations between extraneous inflammatory factors such as vaginal irrigation and diminished sample purity with alterations in SERS signals. Conversely, the day of the menstrual cycle phase exhibits negligible influence on spectral profiles. Notably, VVC samples demonstrated diverse spectral responses correlating with the abundance of pathogenic bacteria. These explorations hold promise in paving the path towards developing a novel intrinsic framework for the diagnosis of vaginitis.

Etiology and Risk Factors in Patients with Vulvovaginal Candidiasis in Abidjan (Côte d'Ivoire)

Background: Limited data on the molecular identification of vulvovaginal candidiasis (VVC) pathogenesis in Côte d'Ivoire are available. Objective: We sought to update the data on the causes of VVC in Abidjan, Côte d'Ivoire. Methods: Conducted between May 2023 and January 2024, this cross-sectional study focused on patients with symptoms suggestive of VVC in Abidjan. Each patient underwent swab collection, direct examination, and culture. Candida chromatic agar and Auxacolor®-based identification tests were performed. A molecular-based polymerase chain reaction (PCR) targeting the hyphal wall protein 1 (hwp1) gene was used to differentiate between C. albicans, C. africana, and C. dubliniensis. Results: The overall prevalence of fungal VVC was 53.6% (222/414 patients). After PCR, no C. africana or C. dubliniensis were observed. C. albicans isolates exhibited two PCR profiles: 941 bp and 941+850 bp, with C. albicans being the most frequently isolated species (70.7%) after C. tropicalis (9.9%). The most affected groups were patients younger than 25 (p = 0.018), those living in precarious housing (p < 0.0001), and pregnant women (p = 0.006). In addition, the presence of vulvovaginal candidiasis was significantly associated with vaginal irrigation (i.e., douching) frequency (p = 0.003), douche used (e.g., antibacterial or not) (p = 0.003), and underwear type (p = 0.037). The most common symptom reported was vaginal itching (46.4%). Conclusion: No strains of C. africana and C. dubliniensis were found. The increased prevalence of VVC in Abidjan warrants further studies.

Bacterial Vaginosis and Its Associated Factor Among Pregnant Women Receiving Prenatal Care at Bonga Gebretsadik Shoawo General Hospital, South West Ethiopia

One of the most frequent causes of irregular vaginal discharge in pregnant women is bacterial vaginosis (BV), which is characterized by a rise of various anaerobic bacteria and a decrease in important bacteria, the lactobacilli. The variation in the prevalence and its contributing causes among various populations, and nations is well known. Hence, in this study, the prevalence and characteristics associated with BV in pregnant women were determined. Descriptive cross-sectional study was conducted on pregnant women who visited the obstetric and gynecological units at Bonga general hospital in Bonga, south west Ethiopia. Nugent’s scoring method was used for the diagnosis of BV. The prevalence of BV was 19.7% (48/244) [95% CI 17.2–23.2]. Vaginal douching with soap was significantly linked to BV in women (AOR, 3.6; 95% CI: 1.4–9.1). Pregnant women with vaginal discharge and with a foul-smelling odor were four times more likely to have BV (AOR, 4.2; 95% CI: 1.7–10.3; p = 0.001). Furthermore, women who had multiple sexual partners were three times more likely to get BV. It was noted that pregnant women in this study had a high prevalence of BV. We revealed that the majority of women with BV had vaginal discharge and an unpleasant odor. We were able to verify the association between BV in pregnant women with multiple sexual partners and women who practiced vaginal douching with soap. Therefore, additional research may be required to validate and assess the reason for this correlation. Planning a preventive approach for BV that discourages vaginal douching with soap and multiple sexual partners during pregnancy may reduce the prevalence of BV.

A qualitative study of women’s experiences of vaginal douching in Türkiye

Vaginal douching, a practice that has existed for many years, is defined as the process of intravaginal cleansing using a liquid solution. Despite its negative consequences with respect to health, vaginal douching is widely practised in many countries. This study sought to examine the vaginal douching experiences of women in the southeastern region of Türkiye. We used a phenomenological approach with semi-structured, in-depth interviews conducted between January and June 2022. Participants were 20 women who either currently practised vaginal douching or had stopped practising it at some point in their lives. The women were admitted to the obstetrics and gynaecology outpatient clinic of a district state hospital in Eastern Turkey for care and treatment. The data collected from the respondents were categorised into five thematic areas: sources of information about douching; reasons for doing so; as well as frequency, methods, and feelings about douching. The findings provide a rich source of information about each of these areas. These findings may help inform future studies on the prevention of vaginal douching in women.

Carex meyeriana Kunth Extract Is a Novel Natural Drug against Candida albicans.

As a widely distributed plant in Northeast China, Carex meyeriana Kunth (CMK) is generally considered to have antibacterial properties; however, there is a lack of scientific evidence for this. Therefore, we investigated the chemical composition of CMK extract and its effect against C. albicans. A total of 105 compounds were identified in the alcohol extracts of CMK by UPLC-Q-TOF-MS. Most were flavonoids, with Luteolin being the most represented. Among them, 19 compounds are found in the C. albicans lysates. After treatment with CMK ethanol extract, a significant reduction in the number of C. albicans colonies was observed in a vaginal douche solution from day 5 (p < 0.05). Furthermore, the CMK extract can reduce the number of C. albicans spores. The levels of IL-4, IL-6, IL-10, IL-1β, and TNF-α in vaginal tissues all exhibited a significant decrease (p < 0.05) compared to those in the model group as determined by ELISA. The results of HE staining showed that CMK extract can eliminate vaginal mucosa inflammation. CMK adjusts the vaginal mucosa cells by targeting twenty-six different metabolites and five specific metabolic pathways in order to effectively eliminate inflammation. Simultaneously, the CMK regulates twenty-three types of metabolites and six metabolic pathways against C. albicans infection. So, CMK strongly inhibits the growth of C. albicans and significantly reduces vaginal inflammation, making it a promising candidate for treating C. albicans infection.

FEATURES OF THE MANAGEMENT OF PATIENTS WITH POSTPARTUM PURULENT-SEPTIC COMPLICATIONS

Postpartum purulent-septic diseases are one of the topical issues of modern obstetrics due to their high prevalence and absence of a downward trend toward reduction in the disease incidence.Aim. Іmprove the management of high risk puerperas to prevent the development of purulent-septic complications in the postpartum period.Material and methods. The cohort prospective comparative study included 78 puerperas who experienced spontaneous labour complicated by injuries to birth canals. The patients were divided into two groups according to the risk of developing purulent-septic complications and the management of patients. Group 1, (n = 20) included the puerperas who did not show any signs of inflammatory diseases of the genital tract during pregnancy. Group 2 included patients, who were diagnosed with various forms of vaginal dysbiosis based on the results of bacterioscopic and bacteriological examination of the genital tract. The group was further divided into two subgroups depending on the type of treatment. Subgroup 1 of Group 2 (n = 28) only received standard hygiene care, and Subgroup 2 (n = 30) received standard hygiene procedures combined with vaginal irrigation using chlorhexidin solution for 3 days in the obstetric hospital.Research results. The study resulted in improving postpartum care of high-risk puerperas to prevent purulent-septic complications.Discussion. The test results showed that the use of chlorhexidin in the postpartum period prevents the purulent-septic complications of puerperium, such as inflammation and disruption of perineal muscle sutures and endometritis, as well as relieves pain and discomfort, and improves the puerperas’ quality of life.Conclusion. Based on the study results, we recommend the use of this drug in the early postpartum period to prevent purulentseptic complications in the high-risk groups.

Using unsupervised machine learning to classify behavioral risk markers of bacterial vaginosis.

This study used an unsupervised machine learning algorithm, sidClustering and random forests, to identify clusters of risk behaviors of Bacterial Vaginosis (BV), the most common cause of abnormal vaginal discharge linked to STI and HIV acquisition. METHODS: Participants were 391 cisgender women in Miami, Florida, with a mean of 30.8 (SD = 7.81) years of age; 41.7% identified as Hispanic; 41.7% as Black and 44.8% as White. Participants completed measures of demographics, risk behaviors [sexual, medical, and reproductive history, substance use, and intravaginal practices (IVP)], and underwent collection of vaginal samples; 135 behavioral variables were analyzed. BV was diagnosed using Nugent criteria. We identified four clusters, and variables were ranked by importance in distinguishing clusters: Cluster 1: nulliparous women who engaged in IVPs to clean themselves and please sexual partners, and used substances frequently [n = 118 (30.2%)]; Cluster 2: primiparous women who engaged in IVPs using vaginal douches to clean themselves (n = 112 (28.6%)]; Cluster 3: primiparous women who did not use IVPs or substances [n = 87 (22.3%)]; and Cluster 4: nulliparous women who did not use IVPs but used substances [n = 74 (18.9%)]. Clusters were related to BV (p < 0.001). Cluster 2, the cluster of women who used vaginal douches as IVPs, had the highest prevalence of BV (52.7%). Machine learning methods may be particularly useful in identifying specific clusters of high-risk behaviors, in developing interventions intended to reduce BV and IVP, and ultimately in reducing the risk of HIV infection among women.

Vaginal douching and health risks among young women.

Vaginal douching is practiced by women for various reasons. Studies have shown that this practice can upset the normal vaginal flora, increasing susceptibility to certain sexually transmitted diseases (STIs). This study aimed to assess the health risks associated with this practice among women aged 15-54 years in a densely populated community in Kumasi, the second capital city of Ghana. A cross-sectional survey was conducted to gather data on the prevalence of vaginal douching among young women and their beliefs, motivations, and knowledge about the practice. A structured questionnaire was used in recruiting participants. One-hundred and fifteenstructured questionnaires were administered to women aged between 15 and 54 after their consent was sought. The study established that more than half of the participants (69.6%) engaged in douching with a midpoint of 19.5. The study indicated no significant difference between the age of participants and douching (p < 0.93). However, there was an indication of a significant association between educational status, marital status, and perception in relation to douching (p < 0.003, 0.0015, and 0.00, respectively), which also influenced the frequency of douching and contraction of STIs. Most women in the study community recruited, regardless of their educational and marital status, believed that douching is necessary and considered part of feminine hygiene practices. Practicing douching may lead to most health complications including pelvic inflammatory disease and infertility which must be given serious attention by researchers, health personnel, and various women's groups.

Impact of Vaginal Douching on Women's Health; Benefits and Potential Health Risk

For decades, vaginal douching, the practice involving the cleansing of the vaginal canal with water or mixture of fluids has ignited controversy, sparking debates about its potential benefits and detrimental impacts on women's health. The risks of vaginal douching far outweigh any unproven benefits as this procedure provides a pressurized fluid vehicle for pathogen transport, helping lower genital tract infections ascend above the cervix, into the uterus, fallopian tubes and abdominal cavity, disrupting natural equilibrium of the vagina and leading to a wide range of adverse outcomes including pelvic inflammatory disease, bacterial vaginosis, cervical cancer, poor pregnancy outcomes, sexually transmitted infections, recurrent vulvovaginal candidiasis, and infertility. Additionally, douching may interfere with the body's natural defense mechanisms against pathogens, making it easier for infections to take hold. Furthermore, some douching products contain harsh chemicals that can irritate the vaginal tissue and cause discomfort or pain and therefore, a strict reevaluation of the practice's necessity for women's health is recommended as the best way to support vaginal health is to ensure good overall hygiene and let the body's natural processes do their job. Keywords: Douching, Women, Benefits and Health risk

Maintaining vulvar, vaginal and perineal health: Clinical considerations.

Knowledge of female genital anatomy and physiology is often inadequate or incorrect among women. Precise patient-physician conversations can be inhibited by a reluctance or inability to speak accurately about the vulva and vagina, with the terms often being used interchangeably. There is a paucity of scientific evidence and clinical guidelines to support women and physicians in ensuring best practices in feminine hygiene. In this review, the unmet needs in the field are highlighted. Evidence is provided for the complex array of physiological and pathological systems, mechanisms and behaviours that either protect or, if inappropriate, predispose the vulva and vagina to infections, irritation or other conditions. The need for attention to perineal health is recommended, given the interdependence of perineal and vulvar microbiota and the risk of colonic pathogens reaching the vulva and the vagina. Differences in feminine hygiene practices can vary widely across the world and among varying age groups, and suboptimal habits (such as vaginal douching or the use of certain cleansers) can be associated with increased risks of vulvar and vaginal conditions. Critical areas for discussion when advising women on their intimate health include: advice surrounding aesthetic vulvar cosmetic trends (such as depilation and genital cosmetic surgery), bowel health and habits, and protection against sexually transmitted infections. Routine, once-daily (maximum twice-daily) washing of the vulva with a pH-balanced, mild cleanser is optimal, ideally soon after bowel voiding, when feasible. Due to the finely balanced ecosystems of the vulva, the vagina and the perineal area, a scientific and clinical perspective is essential when determining the most appropriate vulvar cleansers based on their components. Correct intimate care may contribute to improved genital and sexual health and overall well-being. An increased awareness of correct practices will empower women to be the advocates of their own intimate health.

Effect of vaginal douching with normal saline before insertion of dinoprostone vaginal insert for labor induction.

Vaginal pH has been suggested to be one of the causative factors, responsible for variation in prostaglandin efficacy for induction of labour. The purpose of this study was to analyse the effect of vaginal douching with normal saline before insertion of dinoprostone vaginal insert for induction of labour. This randomised controlled study was done in the Department of Obstetrics and Gynaecology for a period of 1 year. Using a computer-generated random number table, subjects were allocated in two groups. In group A (study group), vaginal douching was done with 20 cc of sterile 0.9% NaCl and vaginal pH was again measured with pH paper strips just before inserting dinoprostone pessary. Dinoprostone pessary was inserted without douching in group B (control group). There was a significant increase in the vaginal pH after douching with normal saline (4.91 vs 5.52, P < 0.001). Mean intrinsic vaginal pH (pH before inserting dinoprostone insert) in women who delivered vaginally was significantly higher than that of the women who had a caesarean section (5.10 vs 4.63, P < 0.001). Time interval between dinoprostone insertion to active phase of labour, duration of active phase of labour, time interval between dinoprostone insertion, and complete cervical dilatation and mode of delivery were not significantly different between the two groups. Although douching with normal saline increases vaginal pH, douching does not help in increasing the chances of vaginal delivery because it gives a transient effect. Rather, it is intrinsic vaginal pH, which is a better decisive factor for successful vaginal delivery.

The effect of genital hygiene behaviors and vaginal douching of pregnant women on preterm labor.

To determine the effect of genital hygiene behavior (GHB) and vaginal douching (VD) of pregnant women on preterm labor (PTL). This study, which was conducted with 365 pregnant women, is a cross-sectional study. Data were collected using a questionnaire and the Genital Hygiene Behavior Inventory (GHBI) was applied. The ratios of PTL diagnosis and VD practice, and mean GHBI scores of the pregnant women were 35.1%, 9.6%, and 64.42 ± 10.44, respectively. The prevalence of receiving a diagnosis of PTL was significantly higher in those who changed their underwear two to three times a week, took baths while sitting, cleansed their perineum with water using their hands, removed pubic hair at intervals of 2 months or longer, and performed VD. It was found that poor GHB and VD practices increased the rate of PTL and, in particular, VD was found to increase the risk of PTL around eight-fold. These results can help pregnant women to understand the relationship between genital hygiene and PTL and show the importance of being educated by health professionals about this issue.

Examining differences in menstrual and intimate care product use by race/ethnicity and education among menstruating individuals.

United States consumers spend over two billion dollars a year on intimate care products. These products, along with scented menstrual products, are marketed for odor control, perceived "freshness," and vaginal/vulvar cleanliness. However, these scent-altering products may increase exposure to carcinogenic and endocrine-disrupting chemicals. Prior research has not adequately characterized demographic differences in product use. The objective of our study is to examine racial/ethnic and educational differences in menstrual and intimate care product use among people who menstruate. We pooled data from two US-based cross sectional studies to examine demographic characteristics and product use in 661 participants aged 18-54 years. Participants reported use of scented and unscented menstrual products (tampons, sanitary pads, and menstrual cups) and intimate care products (vaginal douches, sprays, wipes, and powders). We examined differences by race/ethnicity and education using log-binomial regression and latent class analysis (LCA), which can identify groups based on product use patterns. Our sample was 33.4% Black, 30.9% Latina, 18.2% White, and 16.2% another identity. Approximately half the population had a bachelor's degree or more; 1.4% identified as transgender and 1.8% as non-binary. In adjusted models, scent-altering products (i.e., scented menstrual and intimate care products) were more likely to be used by those with less formal education (p < 0.05). Unscented menstrual products were more likely to be used by those with more formal education. Compared to Black participants, White participants were more likely to use unscented tampons and menstrual cups and less likely to use douches and wipes (p < 0.05). Using LCA we identified two groups: one more likely to use scent-altering products, and a second more likely to use unscented menstrual products. Less education and older age, but not race/ethnicity, was significantly associated with membership in the group more likely to use scent-altering products. While sex/gender composition did not statistically vary across groups, all non-binary participants fell in the unscented menstrual product group. Lower educational attainment was consistently associated with greater use of scent-altering menstrual and intimate care products. Future research should examine associations between body odor stigma, product use, and health risks at intersections of race, class, and gender.

Evaluation of Genital Hygiene Behaviors and Vaginal Douching Practices of Married Women Aged 15-49 in Fertile Period

Objective: Analyzing the genital hygiene behaviors and vaginal douching practices of married women aged 15-49 in the fertile period. Materials and Methods: Married women aged 15-49 in the fertile period (N: 142) registered to the Family Health Center No 11 in Bornova District of İzmir province constituted the universe of the study, while 120 women accepting to participate in the study constituted its sample. Data were collected through the "Women's Descriptive Features Questionnaire" and "Genital Hygiene Behavior Inventory (GHBI)". The t-test, Kruskal-Wallis H test, and Mann-Whitney U test were used in independent samples with percentage calculations in evaluating data, while the correlation between variables was assessed with the chi-squared test. Results: The mean GHBI score of women is 78.36±9.3. A statistically significant difference between women’s educational background, income status, family type, vaginal douching, and complaints about a malodorous vaginal discharge experience among their socio-demographic features, and their mean GHBI score (p

AYURVEDIC APPROACH TO YONI KANDA WITH RESPECT TO BARTHOLIN’S CYST-A SINGLE CASE STUDY

Bartholin’s cyst is a condition of Bartholin's glands which are located deep to posterior aspect of labia majora on either side. Bartholin’s cyst form when duct becomes obstructed with fluid. Further when the cyst becomes in-fected and if untreated, it develops in abscess. This causes irritation and pain during walking, sitting and during intercourse. According to Ayurveda it can be correlated to Yonikanda (Bartholin’s cyst), which was mentioned in Madhavanidana, where Yonikanda is described as disease of vagina presenting with protuberant mass like struc-ture which resembles Nikucha or Lakucha (Monkey jack fruit) shape. In present case study, A female aged 22 years, unmarried, occupation by student, came to OPD of Dr. BRKR GOVT AYURVEDIC HOSPITAL, complaining of swelling and mild pain in right labia majora since 10days. For this condition she took allopathy medicine for 5days but no relief. She has a previous history of the same complaints on left side of labia 1year ago, which was treated surgically. Considering all the factors this condition can be correlated with Yonikanda and managed by Aushada (Drug) which are Vata-kapha hara, Shotha ha-ra(Anti-inflammatory), Raktha shodaka(Blood purifier), Shula hara(Analgesic),Janthugna (Anti-microbial) properties. Sthanika chikitsa like Yonidhavana (Vaginal douche), Yoni lepa(Vaginal anointment), Yoni dhu-pa(Vaginal fumigation), Ahara(Diet), Vihara(Conduct). In contemporary sciences, antibiotics, surgical draining, marsupialization, removal of Bartholin glands is only the line of treatment, whereas in Ayurveda it can be man-aged through Aushada, Sthanika chikitsa, Ahara, Vihara, Dinacharya (Daily regimen). The patient got relieved completely after 15days of treatment.

Vital issue of intimate care for women

The vulva and vagina are a unique anatomical region, which anatomy and physiology changes throughout a woman's life. The most noticeable changes are hormone-mediated and are associated with the onset of puberty, menstrual cycle, pregnancy and menopause. The microbiome changes over time due to various factors, such as hormones, which leads to a change in pH. Various hygiene practices and habits also have a huge impact on the microflora of the vulva and vagina, and therefore on a woman’s health. Today, the market offers a huge number of care and hygiene products designed for the genital area of women. But, unfortunately, information about their correct use and safety of use is limited. For example, various health behaviours, such as vaginal douching and pubic hair removal are still widely used, although there is some evidence of their negative impacts on the health of the vulva and vagina. Despite the abundance of specialized intimate hygiene products, the use of general care products that are not intended for the genital area and therefore can cause irritation, itching and other unpleasant effects is reported. Foreign guidelines for intimate female hygiene practices resolve itself to recommendations of daily vulva cleansing with a gentle hypoallergenic liquid wash. There is a need to increase women's awareness about rational choice of feminine hygiene products and disorders of the vulva and vagina to improve their intimate health.

Shallow-depth vaginoplasty: preoperative goals, postoperative satisfaction, and why shallow-depth vaginoplasty should be offered as a standard feminizing genital gender-affirming surgery option.

Shallow-depth vaginoplasty (SDV), also referred to as vaginoplasty without creation of a vaginal canal, is an understudied alternative to full-depth vaginoplasty (FDV), or vaginoplasty with creation of a vaginal canal. SDV is associated with fewer short- and long-term risks and shorter recovery, and does not require a lifelong commitment to vaginal dilation and douching. To describe a surgical technique for SDV that creates a dimpled introitus, together with clinical outcomes, decision-making prioritization, and satisfaction data. We hypothesize that SDV patients prioritize comparable appearance and sexual function to FDV over shorter-term risk factors, and experience high satisfaction. We describe (1) a surgical technique for SDV; (2) the proportion of patients who underwent SDV vs. FDV, with SDV complication rates; and (3) the results of an anonymous, electronic questionnaire administered via Qualtrics that assessed SDV patient demographics, terminology preferences, prioritization of decision-guiding factors for choosing SDV over FDV, and postoperative satisfaction across various domains. A total of 110 patients underwent primary feminizing genital gender-affirming surgery at a single institution between April 2017 and July 2022: 35 (32%) of 110 underwent SDV and 75 (68%) underwent FDV. The 35 SDV patients were invited to answer the study questionnaire, of which 29 (83%) completed it (mean age 51.9 ± 16.7 years, mean body mass index 27.3 ± 5.3 kg/m2). All but one survey respondent met one or more of the following characteristics: (1) ≥40years of age, (2) exclusively feminine-identifying sexual partners, and/or (3) significant aversion to performing long-term vaginal dilation and douching. Ranking of 8 decision-guiding factors revealed prioritization of long-term over short-term outcomes. Postoperatively, patients reported high satisfaction across all 3 domains. When asked if they had to choose between SDV and FDV over again, 86% reported that they would choose SDV. While 14% would choose FDV, all but one reported new interest in receptive vaginal intercourse due to finding masculine-identifying partners post-SDV surgery. A total of 27% of SDV patients experienced complications that required additional surgeries; 82% of complications were related to urinary spraying. SDV is a lower-risk alternative to FDV and is associated with reduced postoperative maintenance and high postoperative satisfaction. This study describes the clinical outcomes of the largest documented cohort of patients to undergo SDV to date. Limitations include recall bias due to the retrospective survey and use of nonvalidated questions attributed to the paucity of validated gender-affirming surgery questionnaires. SDV's appeal to a large subset of patients (32% in this study), low complication rate, high satisfaction, and low decisional regret suggests that this surgical option should be offered to all patients seeking feminizing genital gender-affirming surgery.

Holistic Approach to Female Uttar Basti - A Review Article

In Ayurveda, Basti is considered as Ardhchikitsa by some Acharyas and as a complete therapeutic procedure by others due to its Vast areas of action. As defined by Acharya Charak, Basti is of three types and among them; Uttar Basti has been highlighted for most of the uro-genital disorders in both males and females. As it gives quick relief and can easily be practiced in OPD basis, it outpowers other systems of medicine and can be used as alternative for invasive intervention. Vaginal douching and Urethral douching have been practiced already but Uttar Basti has a far wider scope in terms of disease diversity. Through this article, an attempt has been made to review Uttarbasti through classical texts to understand the concept of Uttarbasti and to understand its mode of action with its importance in clinical practice.

Internal vaginal douching increases the incidence of vaginal infection among IUD users: a cross-sectional study

BackgroundWe compared the rate, type and severity of vulvovaginitis in women who are practicing internal vaginal douching (IVD) or not while using an intrauterine contraceptive device (IUCD).It is a cross-sectional study on 604 consecutive attendees of the outpatient clinics using IUCD for at least 6 months prior to recruitment. Eligible participants were divided into two groups: group 1 (302 women) performing IVD and group 2 (302 women) not practicing this habit (NIVD). The frequency of vaginal infections in IUCD users who perform IVD compared to women who were abstaining from this habit was our primary outcome.ResultsThey are IUCD users who were practicing IVD more frequent history of vaginal infection (VI) compared with NIVD-IUCD users [260 (88.1%) versus 151(43.4%); respectively] (P < 0.001). Current diagnosis of VI was significantly higher in IVD group (275; 91.05%) compared to NIVD group (115; 38.1%) (P < 0.001). Bacterial vaginosis was the most common infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infections were significantly more common in IVD.ConclusionThe use of IUCD may not increase occurrence of vulvovaginitis, but IVD does increase vaginal infection rate either with or without IUCD use. When vaginal infection happens with IUCD, BV is the most common type of infection followed by Candida albicans.