Types Of Vaginitis Research Articles

Frequency of vaginitis types based on Pap smear test in patients referred to the gynecology clinic of Shahid Sadoughi hospital in Yazd

Three agents including candida, trichomonas and bacteria, are the main causes of vaginitis. According to studies conducted in Iran and other parts of the world on the increase of vaginal infections, the present study was conducted to evaluate the frequency of vaginitis based on Pap smear in patients referred to the gynecology clinic of Shahid Sadoughi hospital in Yazd, Iran. The sampling method was census and all cases referred to the gynecology clinic of Shahid Sadoughi hospital in Yazd for Pap smear during 2022 were investigated. Finally, the data were entered into SPSS and analyzed. 378 patients (45%) had vaginitis. According to the results of the study, no statistically significant difference was found between the frequency distribution of vaginitis based on age, dyspareunia, frequency of urination, dysuria and education level. The results of the present study showed a high prevalence of bacterial vaginitis compared to other types of vaginitis.

"Real-World Performance and Safety of Cerviron® Medical Device in the Treatment of Various Types of Vaginitis"

"Real-World Performance and Safety of Cerviron® Medical Device in the Treatment of Various Types of Vaginitis"

Presentation, Diagnosis and Treatment of Mixed Vaginitis

Background: Mixed vaginitis is commonly observed in many women at their fertility age which brings negative impact on women well-being. Aim: To analyze the presentation, diagnosis and treatment scheme of mixed vaginitis. Study Design: Cross sectional analytical Place and duration of study: Department of Obstetrics & Gynaecology, DHQ/Teaching Hospital Sahiwal from 1st January 2021 to 30th June 2021. Methodology: Eighty females suffering from more than one type of vaginitis were enrolled as study participant after their complete diagnosis. High vaginal swabs, culturing requiring gram staining and lab testing through PCR was performed. Results: The mean age of 26.3±3.5 years. There were 11.25% cases with aerobic vaginitis, 43.75 % of bacterial vaginitis, 25% of vulvovaginal candidiasis, 11.25% allergic vaginitis and 8.75% of trichomoniasis in a mixed presentation. 75% of cases were treated with tropical anti bacterial or antifungal agents and 33% those cases treated with metronidazole in a combination with other drugs as well. Conclusion: Mixed vaginitis is treated on basis of its presentation with various diagnosis protocols. Keywords: Presentation, Treatment, Mixed vaginitis

Comparison and Association between Different Types of Vaginitis and Risk Factors among Reproductive Aged Women in Lahore, Pakistan: a Cross-Sectional Study

HIGHLIGHTS Aerobic vaginitis (AV) is a least explored disease in Pakistan. AV is the predominant cause of vaginitis followed by bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonas vaginitis (TV). AV co-occurs significantly in higher frequency with BV and VVC as compared to TV. Patients with history of miscarriage are more prone to AV and BV. Unawareness and low socioeconomic conditions predispose women to TV.

Epidemiology and analysis of potential risk factors of high-risk human papillomavirus (HPV) in Shanghai China: A cross-sectional one-year study in non-vaccinated women.

Data regarding human papillomavirus (HPV) prevalence, its associated risk factors, and women's knowledge about this disease before the HPV vaccine was approved are limited in Shanghai, China. Therefore, we investigated these questions among females in Shanghai and aimed to provide comprehensive data to guide HPV vaccination and present the biopsychosocial risk factors that impact high-risk HPV infection, and evaluate the level of knowledge and awareness of this disease among women aged 21-65 years old. A total of 6619 (aged from 21 to 65) women from different communities volunteered to participate in the HPV screening and complete questionnaires from December 2016 to December 2017 in the Department of Obstetrics and Gynecology of nine hospitals in Shanghai. Data were analyzed using sample logistic regression to assess biopsychosocial risk factors that impact high-risk HPV infection and knowledge of HPV infection. A total of 632 (9.5%) cases were positive for high-risk HPV test, 22.6% of them were HPV 16/18 infection, 77.4% of them were non HPV 16/18 infection. 40 potential risk factors may be related to high-risk HPV infection, and there were 19 factors' p value < 0.1 from single factor logistic analysis. Finally, multivariable regression revealed education level, type of vaginitis, history of hyperlipidemias, family history of cancer, number of pregnancies, number of sex partners were independent risk factors for high-risk HPV infection (p < 0.05). When stratified by education level, women who finished graduate school had significantly greater knowledge of cervical cancer, cervical screening, and the relationship between HPV and cervical cancer than other groups (p < 0.05). The prevalence rate of high-risk HPV was a little lower than other regions in China and other countries, which may be related to regions, races, living habits, and economy. A less reported finding is that the history of vaginitis and the history of hyperlipidemias in our study were related to HPV infection. The majority of the participants had poor knowledge regarding cervical cancer, cervical screening, and the relationship between HPV and cervical cancer. Hence, these results should be served as a wake-up call for the government to increase knowledge and awareness via the media and doctors.

Recent Advances in Presentation, Diagnosis and Treatment for Mixed Vaginitis.

Mixed vaginitis is the simultaneous presence of at least two types of vaginitis, contributing to an abnormal vaginal milieu and leading to vaginal symptoms and signs. However, associations between symptoms and the type of mixed vaginitis have not been clearly elucidated, and research on mixed vaginitis is still in the preliminary stage. Therefore, the pathogenic mechanism of mixed vaginitis remains understudied. Mixed vaginitis generally involves the formation of mixed biofilms. The study of polymicrobial interactions and mixed biofilms will provide a new idea for the understanding of mixed vaginitis. Moreover, this review summarizes some effective management and laboratory diagnosis of mixed vaginitis to avoid inappropriate therapy, recurrence, and reinfection. It is of high clinical importance to obtain relevant clinical data to improve clinical knowledge about mixed vaginitis.

Vaginal pH Value for Clinical Diagnosis and Treatment of Common Vaginitis.

In modern society, 75% of all women worldwide have had vaginitis at least once in their lives. The vagina has a dynamic microbial ecosystem with varying vaginal pH levels. An imbalance in that ecosystem can alter the vaginal pH and tip the scale to the point of causing issues, such as vaginitis, that require medical attention. Although vaginitis is not an incurable disease, it causes discomfort and pain that disrupt women’s daily lives. The most common causes of vaginitis include bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis. In this review, we discuss the causes, diagnostic methods, and symptoms of different types of vaginitis, the relationship of vaginitis to the prevalence of other diseases, issues associated with recurrent vaginitis and the immune system, and a variety of effective available treatments. In our article, we summarize the relationship of pH with the vaginal ecosystem, discuss the associated factors of vaginal pH, and finally introduce the different available vaginal pH self-test products.

Nonspecific vaginitis: when is the time to act?

The imbalance of the vaginal flora, the decreased estrogen levels or certain endogenous infections cause symptomatic, nonspecific vaginitis. Nonspecific vaginitis include atrophic vaginitis, inflammatory squamous vaginitis, irritating vaginitis, and erosive planar vulvar lichen. During menopause, atrophic vaginitis has a high prevalence due to low estrogen levels, and increased vaginal pH, leading to a decrease in lactobacilli species and the multiplication of bacterial species that cause infections. Squamous inflammatory vaginitis is characterized by irritation, inflammation, the presence of purulent leukorrhea and a high degree of discomfort. It is estimated that 75% of adolescents and women experience at least one episode of vulvovaginitis during their lifetime, with the most common cases beginning in adolescence. The presence of purulent, yellow to green leukorrhea, and signs of irritation in the vagina and vulva are reasons for the urgent presentation to the gynecologist. The specialist will diagnose nonspecific vulvovaginitis by excluding candidiasis or trichomoniasis infections. In this type of vaginitis, due to the decrease in the number of lactobacilli, other types of bacteria will multiply, such as group B Streptococcus or Escherichia coli. Nonspecific vaginitis in pregnancy leads to severe complications, miscarriage or chorioamnionitis. The purpose of treatment in nonspecific vaginitis is to reduce inflammation, restore the vaginal ecosystem and, in the case of atrophic vaginitis, hormone replacement. To prevent recurrences, it is recommended to combine adjuvant treatments that support anti-infective treatment regimens and contribute to the rapid restoration of vaginal pH and to the preservation of lactobacilli species.

Determining the Prevalence of Bacterial Vaginosis &amp;amp; Vulvovaginal Candidiasis among Married and Unmarried Women &amp;amp; Evaluating the Association Socio-Demographic Risk Factors &amp;amp; Symptoms-Related Variables in Women Attending Gynecology Clinic in Hargeisa Group Hospital, Hargeisa City, Somaliland

Background: Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages, with one-third of women having at least one form of vaginitis at some time during their lives. The vagina is the muscular passageway between the uterus and the external genital area. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur. The most common types of vaginitis are: Candida or “yeast” infection, Bacterial vaginosis, Trichomoniasis vaginitis. Objectives of Study: Therefore, the present study was carried out to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) among married and unmarried women and evaluate the association socio-demographic risk factors and symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital. Methodology: A total of 150 married and unmarried women were investigated & diagnosed by a researcher in Hargeisa Group Hospital, Hargeisa City, Somaliland for determining of VVI prevalence in the present study. Vaginal swabs from these patients were processed for detection of bacterial vaginosis (BV), VVC and trichomoniasis based on guidelines of management of vagina infection. Species specific distribution of VVC was assessed by cultured of Candida on differential agar media, Germ tube test, rice meal agar and carbohydrates fermentation test and BV diagnosed by using gram staining test and biochemical testes. The nurse interviewers performed a comprehensive review of patients and completed the standardized baseline questionnaire containing information regarding the association socio-demographic risk factors and symptoms-related. Results & Discussion: The findings of the present study indicate that VVC was the most prevalent infection with 68 (45%) followed by BV 43 (29%). However, no case of trichomoniasis was detected. Candida albicans was found to be the most prevalent species with 47 (60.3%). Out of non-albicans Candida (NAC) species, C. tropicalis was found to be 9 (9.9%) and C. glabrata 7 (12.2%). On the other hand, the results of present study indicated that BV species Gardnerella vaginalis was most causative with 22 (19.5) and Lactobacillus spp. was 14 (9.3%). These results were also confirmed by gram staining test and biochemical testes. When VVI was compared among married and unmarried women, VVC was more prevalent in married women 47 (31.96) while, BV was more prevalent in unmarried women with 32 (13.76), discussed these results detected that prevalent found most highly with VVB and BV while, no case of trichomoniasis was detected. These findings are in consonance with various previous studies which have indicated VVC & BV to be the most prevalent in VI. Furthermore, the study showed statistical significant difference (P 0.005) & relationship among prevalence of VVV & BV and some socio-demographic risk factors and some symptoms which have been identified as causes of variation in the prevalence rates of bacterial vaginosis & vagina candidasis. Conclusion: VVC was the most prevalent VVI followed by BV in Hargeisa City. C. albicans was the most prevalent species in VVC while among BV species, Gardnerella vaginalis was found to occur at highest frequency. However, further studies are needed to assess specific diagnosis and role of clinical risk factors. Urgent action is required to improve vagina infection control measures to reduce the prevalence and make new policies for treatment of vagina infection in HGH.

Modern tendency of prevention and treatment of infectious processes of the lower genital tract

Issue of the treatment of mixed genital infections and prevention of reproductive health disorders caused by them has not lost medical and social significance, which is associated with a high frequency of mixed infections, absence of pathognomonic clinical manifestations, and with a constantly significant frequency of sexually transmitted infections (chlamydia, genital herpes, trichomoniasis, etc.). It should be controlled and rationally limited antibiotics use in connection with a sharp increase in microorganisms’ resistance. At the same time proven antiseptics which are used to reduce the infection risk or to treat vaginal infections do not contribute to the formation of resistant pathogens. The purpose of this literature review was to analyze publications about modern antiseptic octenidine dihydrochloride for mucous membranes, skin and wounds and the prospects for it use in obstetric and gynecological practice. Octenidine dihydrochloride (octenidine) was synthesized as a multi-functional antiseptic for skin, mucous membranes and wounds. Today octenidine is an active antiseptic with a wide scope of use and is an alternative to chlorhexidine, povidone iodine, triclosan, etc. Octenidine is a cationic antiseptic of a new chemical group (derivatives of bispyridinamine), is a safe and effective antimicrobial agent with a high level and spectrum of antimicrobial activity. The antiseptic activity of octenidine is achieved within 30 seconds, it is chemically resistant, has proven low toxicity to humans and the environment and high clinical efficacy, does not cause the pathogen resistance, is approved for use from the second trimester in pregnancy and during breastfeeding. Octenidine use with or without combinations should be considered as an integral part of the standard therapy for various types of vaginitis and bacterial vaginosis. Octenidine can become a promising agent for therapeutic indications in gynecology in future, since it surpasses povidone iodine, polyhexanide and chlorhexidine in the efficiency of microorganisms’ eradication from the mucous membranes.

Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities

Bacterial vaginosis recurrence is common, and although easily treated, it can quickly recur. This review details some of the identified biologic mechanisms that result in recurrence or treatment failure and also discusses other types of vaginitis that can co-occur, mimic bacterial vaginosis, or both, and advises the clinician on diagnosis and treatment. Bacterial vaginosis increases the risk for acquiring sexually transmitted infections, including human immunodeficiency virus, which is important to note because there are still significant racial disparities in the rates of new human immunodeficiency virus diagnosis between African American and white women. Adequately treating bacterial vaginosis may help to narrow this gap.

Incidence and types of vaginitis in pregnant women attending routine antenatal care at Tanta University Hospital: a cross-sectional study

Incidence and types of vaginitis in pregnant women attending routine antenatal care at Tanta University Hospital: a cross-sectional study

Vaginitis among married women attending primary healthcare in Tanta District, El-Gharbia governorate , Egypt

Objective The aim of this study was to improve women health through studying the causes of vaginitis and evaluating the risk factors causing the infection. Background Vaginitis is an inflammation of the vagina. It affects all age groups from adolescents to postmenopausal women and is the most common gynecological problem faced by the primary care providers. It affects women's daily activities through changes in the amount and odor of vaginal discharge, dyspareunia, dysuria, and may get complicated with cervicitis, salpingitis, endometritis, urinary tract infections, and pelvic inflammatory disease. Patients and methods The study was carried out in two randomly selected family healthcare centers in urban and rural areas in Tanta district, El-Gharbia governorate, conducted from the beginning of May 2014 till April 2015. A cross-sectional analytical study was conducted involving 160 cases, including women who experienced vaginal symptoms during child-bearing and postmenopausal period. Women who had chronic diseases or psychological problem or were taking systemic therapy were excluded. After selecting the cases, 240 women who did not have vaginal symptoms were selected as controls. Questionnaire was designed to obtain full history and analysis of vaginal complaint, speculum vaginal examination, and laboratory examination of discharge. Results The mean age of the studied group was 29.47 ± 6.9 years. Results of the cases showed that 38.8% had fungal infection, 31.3% had bacterial vaginosis, and 8% had trichomoniasis. The study showed a statistical significant difference between cases of different types of vaginitis with regard to age of patients, intrauterine device use, previous attack, vaginal douche, menstrual hygienic pads, drying after vaginal wash, and using of public water closet. Conclusion and recommendation The study showed that there is relationship between bacterial vaginosis, trichomoniasis and the use of intrauterine devices and hormonal contraception and bad menstrual hygiene, and mixed infections and did not dry vagina after wash risk factor. Health education programs are recommended.

Clinical Evaluation of the Efficacy and Safety of a Medical Vaginal Device Containing Rigenase® for the Treatment of Vaginosis: A Randomized Study

Background: Vaginitis is an inflammatory process involving the vagina, expanding often to the contiguous anatomical structures (cervix and vulva). From an etiological point of view, there are mainly two types of vaginitis: specific vaginitis (due to pathogenic microorganisms) and non-specific vaginitis (also defined vaginosis), usually caused by an alteration (disruption) of the normal vaginal microflora, usually represented by the presence of Lactobacilli due to opportunist bacteria proliferation. Whereby, the first line therapeutic approach for vaginosis (which is frequently subject to self-medication) should be focused on rebalancing the flora and not on antimicrobials, reserving the latter to persistent cases that are properly characterized by appropriate microbiological tests. A new medical device is available in different formulations for the local treatment of vaginitis and, in addition, of irritative-dystrophic states of the vaginal area. Methods: In a randomized (kind of the device used), parallel-groups, single-centered, uncontrolled design clinical study, 75 Caucasian female outpatients suffering from vaginosis were treated with the new vaginal medical device (cream, vaginal suppository, vaginal solution, gel, and foam; n = 15 in each group) for 6 days. Before (V1) and at the end of the treatment period (V2), the presence and intensity of pain, burning, itch, dry vagina sense, dyspareunia, dysuria, vaginal discharge, and vulvovaginal erythema were checked. Signs and symptoms were quantified according to the scale: absent = 0, mild = 1, moderate = 2 and severe = 3. The overall symptoms were summarized according to the total symptoms score (TSS), defined as the sum of scores of all signs and symptoms. Results: The analysis conducted on the TSS for the intention-to-treat (ITT) population showed a statistically significant improvement of symptoms in all treatment groups (P < 0.001), with an average reduction of the initial TSS similar in the different groups and ranging between 73% and 80% (with a V2/V1 ratio of 0.27 and 0.20, respectively). No clinically significant differences were observed between the different preparation used. At the starting visit, the most common signs and symptoms were burning, leukorrhea and vulvo-vaginal erythema, each present in 62/75 patients (82.7). All signs and symptoms were significantly regressed or disappeared at the final visit in most of the cases; the improvement score was statistically significant (P < 0.05) when analyzing the total of patients, and often it resulted in a significant difference in the individual treatment groups as well, except when only a few patients had a sign/symptom at baseline. None of patients discontinued the application of the device before the schedule period. Adverse events were detected in none of the patients studied. Conclusions: The medical device in vaginal formulations appear to be effective and safe for the local treatment of moderate-mild inflammatory-dystrophic gynecological diseases. J Clin Gynecol Obstet. 2017;6(1):6-11 doi: https://doi.org/10.14740/jcgo424w

Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study.

Bacterial vaginosis (BV), candidiasis, and trichomoniasis were the three established types of vaginal conditions until aerobic vaginitis (AV) was defined in the early 2000s. We sought to study the prevalence of abnormal vaginal flora (AVF) with inflammation in our hospital and to correlate it with AV. We prospectively collected vaginal smear specimens originated from symptomatic women who were examined at Iaso Obstetrics, Gynecology and Children's Hospital of Athens from April 2014 until September 2015. Amsel's criteria were used for the diagnosis of BV. The presence of leukocytes and lactobacillary grade were evaluated to classify a condition as AVF with inflammation; subsequently, bacterial cultures were performed. A total of 761 women were included. Five hundred and seventy-nine women were diagnosed with candidiasis, BV, trichomoniasis, or other types of vaginitis in which no pathogenic bacterial growth occurred in cultures. One hundred and eighty-two women (23.9%) were diagnosed with AVF with inflammation (116 non-pregnant, 66 pregnant). Escherichia coli was the most common pathogen among these women (non-pregnant: 45.7%, pregnant: 34.8%). Other common pathogens were Group-B-Streptococcus (non-pregnant: 20.7%, pregnant: 22.7% respectively), Enterococcus faecalis (14.7%, 18.2%), and Klebsiella pneumoniae (6.9%, 12.1%). The prevalence of AVF with inflammation may be high. Since inflammation criteria were applied, most cases of BV were eliminated and the majority of cases of AVF are AV. Therefore, clinicians should include AV in the differential diagnosis of vaginitis, while microbiologists should take into account the growth of aerobic bacteria in vaginal cultures originating from women with microscopic findings of AV.

Study results on the use of different therapies for the treatment of vaginitis in hospitalised pregnant women

During pregnancy, many women experience vaginal infections due to a weakened immune system and changes in hormonal status. Treating these infections is of crucial importance, because women are at high risk for serious complications such as preterm birth and late miscarriage. For this reason, the present study was conducted to investigate the effectiveness of octenidine dihydrochloride/phenoxyethanol (OHP) in comparison to antimicrobial therapies in pregnant women in hospital suffering from different types of vaginitis. A total of 1,000 patients were divided into 4 different groups according to their type of vaginal infection after smear analyses. Each group was again divided into two subgroups receiving treatment with OHP or antimicrobial therapies with neomycin/polymyxin B/nystatin, metronidazole or miconazole vaginal tablets. The most frequent causes of vaginitis were unspecific bacterial infections (42.4 %) and vaginal candidiasis (44.8 %). The average time needed to obtain negative results from smear analyses was significantly shorter when treated with OHP, both in patients with bacterial vaginosis (BV) or vaginal candidiasis (VC) compared to antimicrobial therapy (1.7 ± 0.8 vs. 2.3 ± 1.1 days; 2.3 ± 1.4 vs. 3.4 ± 1.6 days; both p < 0.001). Equally, the maximum number of days until negative results were detected was significantly lower with OHP compared to antimicrobial therapy (BV: 3 vs. 5 days; VC: 5 vs. 7 days). OHP has a great effect in the treatment of vaginitis during pregnancy and thus should be an integral part of standard therapy regimens.

Study on types of vaginitis and association between bacterial vaginosis and urinary tract infection in pregnant women

Introduction: Infectious vaginitis which includes bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis are common disorder in women. Both vaginitis and urinary tract infection (UTI) during pregnancy have risk to lives of both the mother and fetus. Present study was done to assess type of vaginitis and to evaluate the risk of UTI in pregnant women with BV. Methods: Cross sectional descriptive study of 230 pregnant women was done from 1 st July to 30 th December 2010 at Paropakar Maternity and Women’s Hospital Thapathali, Kathmandu, Nepal. Duplicate High Vaginal Swab and urine sample were collected from each patient. BV was diagnosed using Amsel’s criteria. VVC was determined by culture on Sabouraud Dextrose Agar and Candida albicans was identified by Germ tube test. Trichomoniasis was detected by observing motile trophozoites under microscope. Diagnosis of UTI was made when there were at least 10 5 organisms/ml of urine. Results: Out of 230 patients, 92 were positive for infectious vaginitis and 32 had UTI. Among 92 infected patients, BV and VVC were found in 36(39.13%) and 28(30.43%) respectively while mixed infection was found in 28(30.43%) of the infected patients. UTI was more than twice common among in pregnant women with BV than without it (p<0.05). Conclusion: Hence, BV was the most common vaginitis among pregnant women and women with BV are at increased risk for UTIs. We recommend all pregnant women during antenatal checkup should be screened for the presence of BV and UTI.

Real-time PCR improve detection of Trichomonas vaginalis compared to conventional techniques

Trichomonas vaginalis is the cause of one of the most common types of vaginitis, trichomoniasis. Clinical manifestations of symptomatic women are generally nonspecific, but include vaginal discharge, vaginitis and irritation. T. vaginalis infection has also been linked to the increased risk of human immunodeficiency virus transmission. The aim of the study was to compare a real-time polymerase chain reaction (PCR) assay with culture and wet-mount examination for the detection of T. vaginalis. This is a descriptive analytical study. Vaginal swabs from 504 female patients with suspected vaginitis were included in the study. They were subjected to culture, wet-mount microscopic examination (WM), and real-time PCR. Real-time fluorescence resonance energy transfer hybridization probe PCR assays were used in this study to test for T. vaginalis DNA, targeting the b-tubulin genes. The result of the PCR was compared with culture and wet-mount microscopy. WM were positive for T. vaginalis in 60/504 cases (11.9%) and cultures were positive for T. vaginalis in 116/504 cases (23%). Real-time PCR was done on 50/504 specimens which was randomly chosen, 33/50 (66%) cases were positive for T. vaginalis (78% sensitivity), 25/50 (50%) of them were culture and wet-mount examination positive. Of them, 1/33 (3%) were culture positive and wet examination negative, 7/33 (21%) real-time positive were negative by culture while 17/50 (34%) real-time PCR negative cases were also negative by both techniques. The time taken for PCR assay was 4 to 8 h whereas positive protozoal cultures took up to 4 days. The Real-time PCR done in this study, provide a rapid, sensitive and specific diagnosis of T. vaginalis infection.

The role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis/overactive bladder, urethral syndrome, prostatitis and gynaecological chronic pelvic pain

The traditional diagnosis of interstitial cystitis (IC) only recognizes the severe form of the disease. The far more common early and intermittent phases of the disease are not perceived to be part of IC but rather are misdiagnosed as urinary tract infection, urethral syndrome, overactive bladder, chronic prostatitis, urethritis, or a type of gynecologic pelvic pain (such as endometriosis, vulvodynia, or some type of vaginitis). All of these patient groups actually suffer from the same bladder disease. This disease results from a leaky bladder epithelium and subsequent potassium leakage into the bladder interstitium that generates the symptoms of frequency, urgency, pain or incontinence in any combination. Robust scientific data now support this important concept. These data will be reviewed herein. The conclusions derived from these data substantially alter the paradigms for urology and gynecology in the generation of frequency, urgency and pelvic pain. All the above-mentioned syndromes unite into one primary disease process, lower urinary dysfunction epithelium, or LUDE disease, and not the 10 plus syndromes traditionally recognized.

Vaginitis: Clinical and Laboratory Aspects for Diagnosis

Vaginitis is one of the most common diseases that affect women's health, with over 50% of women experiencing at least one episode of vaginal infection in their lifetime. Vaginal disease can be infectious, non-infectious, or chronic in nature. However, most cases of vaginitis are the result of infection that accounts for over 10 million physician office visits in the United States each year. Infectious vaginitis is most commonly grouped into three major categories of disease based upon microbial etiology: bacterial vaginosis, vaginal candidiasis, and vaginal trichomoniasis. Occasionally, the vulva is infected by these microorganisms, as well, and the disease is then called vulvovaginitis. Because these three infectious syndromes are caused by different groups of microorganisms, accurate and reliable diagnosis is necessary to institute appropriate treatment. The purpose of this article is to review the various types of vaginitis, discuss the pathogenesis and clinical presentation of each type of disease, and provide a brief summary of some of the various methods available for the laboratory diagnosis of infectious vaginitis.