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1

Vaginitis  

MedlinePLUS

... serious diseases. The most common vaginal infections are Bacterial Vaginosis Trichomoniasis Vaginal Yeast Infection Some vaginal infections are ... most vaginal infections in women are due to bacterial vaginosis, trichomoniasis, or yeast, there may be other causes ...

2

Clindamycin Vaginal  

MedlinePLUS

... an infection caused by an overgrowth of harmful bacteria in the vagina). Clindamycin is in a class ... works by slowing or stopping the growth of bacteria. Vaginal clindamycin cannot be used to treat vaginal ...

3

Vaginal Cancer  

MedlinePLUS

Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human ... test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its ...

4

Estrogen Vaginal  

MedlinePLUS

... estradiol vaginal ring is also used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) ... mild soap and warm water. Do not use hot water or boil the applicator. Ask your pharmacist ...

5

Vaginal Pessary  

MedlinePLUS

... your vagina). A pessary can also help many women who have stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women who have incontinence can also use a vaginal ...

6

Vaginal Bleeding  

MedlinePLUS

Menstruation, or period, is a woman's monthly bleeding. Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, lasts several weeks, or happens before ...

7

Vaginal Discharge  

MedlinePLUS

... on the lookout for symptoms of yeast infections, bacterial vaginosis and trichomoniasis, 3 infections that can cause changes ... vulva Intense itching Painful sexual intercourse Signs of bacterial vaginosis A white, gray or yellowish vaginal discharge A ...

8

Vaginal reconstruction  

SciTech Connect

Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

Lesavoy, M.A.

1985-05-01

9

Vaginal Cancer  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a The vagina can be a common site of secondary involvement, either through direct extension from the cervix and vulva or by\\u000a lymphatic and vascular spread.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Invasive cancers most commonly present with irregular vaginal bleeding or discharge (often postcoital), followed by vaginal\\u000a discharge or dysuria. Vaginal intraepithelial neoplasia (VaIN) is diagnosed on routine screening.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Diagnostic workup should include

Nitika Thawani; Subhakar Mutyala; Aaron H. Wolfson

10

Vaginal Birth  

NSDL National Science Digital Library

This patient education program reviews female reproductive anatomy and explains vaginal birth. It also discusses the stages of labor and delivery, as well as potential risks and complications. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

11

Vaginal and Vulvar Cancer  

MedlinePLUS

... sixth type of gynecologic cancer is the very rare fallopian tube cancer.) This fact sheet about vaginal ... get them. Vaginal and vulvar cancers are very rare. Together, they account for 6-7 percent of ...

12

What Is Vaginal Cancer?  

MedlinePLUS

... cancer There are several types of vaginal cancer. Squamous cell carcinoma About 70 of every 100 cases of vaginal cancer are squamous cell carcinomas . These cancers begin in the squamous cells that ...

13

Management of persistent vaginitis.  

PubMed

With vaginitis remaining a common condition that leads women to seek care, it is not surprising that some women develop chronic vulvovaginal problems that are difficult to diagnose and treat. With a differential diagnosis that encompasses vulvar disorders and infectious and noninfectious causes of vaginitis, accurate diagnosis is the cornerstone of choosing effective therapy. Evaluation should include a symptom-specific history, careful vulvar and vaginal examination, and office-based tests (vaginal pH, amine test, saline and 10% potassium hydroxide microscopy). Ancillary tests, especially yeast culture with speciation, are frequently crucial to obtaining a correct diagnosis. A heavy but normal physiologic discharge can be determined by excluding other causes. With vulvovaginal candidiasis, differentiating between Candida albicans and non-albicans Candida infection has important treatment ramifications. Most patients with C albicans infections can be successfully treated with maintenance antifungal therapy, usually with fluconazole. Although many non-albicans Candida, particularly Candida glabrata, may at times be innocent bystanders, vaginal boric acid therapy is an effective first choice for many true non-albicans Candida infections. Recurrent bacterial vaginosis, a difficult therapeutic challenge, can often be controlled with maintenance therapy. Multiple options, especially high-dose tinidazole, have been used for metronidazole-resistant trichomoniasis. With the aging of the U.S. population, atrophic vaginitis and desquamative inflammatory vaginitis, both associated with hypoestrogenism, are encountered frequently in women with persistent vaginitis. PMID:25415165

Nyirjesy, Paul

2014-12-01

14

Vaginal yeast infection  

MedlinePLUS

... help prevent and treat vaginal discharge: Keep your genital area clean and dry. Avoid soap and rinse ... feminine hygiene sprays, fragrances, or powders in the genital area. Avoid wearing tight-fitting pants or shorts, ...

15

Vaginal birth - series (image)  

MedlinePLUS

This presentation illustrates key stages of a normal vaginal delivery. Please keep in mind that every birth is unique, ... fluid, blood, and mucus from his nose and mouth. More contractions and pushing help deliver the baby's ...

16

Vaginal sponge and spermicides  

MedlinePLUS

Birth control - over the counter; Contraceptives - over the counter ... Spermicides and vaginal sponges do not work as well at preventing ... control at all. SPERMICIDES Spermicides are chemicals that stop ...

17

How Is Vaginitis Treated?  

MedlinePLUS

... to learn the specific type of vaginitis. 1 Bacterial Vaginosis Bacterial vaginosis (BV) is treated with an antibiotic that gets ... Date: 05/21/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) ...

18

Vaginal bleeding in early pregnancy  

MedlinePLUS

Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception ( ... out of every 10 pregnant women have vaginal bleeding during their first 20 weeks of pregnancy.

19

Vaginal Toxic Shock Reaction Triggering Desquamative Inflammatory Vaginitis  

PubMed Central

Objective To report two cases of desquamative inflammatory vaginitis (DIV) associated with toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus strains. Materials and Methods Case report of two patients, one with an acute and one with a chronic presentation, diagnosed with DIV on the basis of clinical findings and wet mount microscopy. Pre- and posttreatment vaginal bacterial and yeast cultures were obtained. Results Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial cultures following oral antibiotic therapy were negative. Conclusions DIV may be triggered through TSST-1-mediated vaginal toxic shock reaction. PMID:23222054

Pereira, Nigel; Edlind, Thomas D.; Schlievert, Patrick M.; Nyirjesy, Paul

2012-01-01

20

Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief?  

PubMed

In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0.31). At V2, the percentage improvement rates were 84 and 89 % (p = 0.13), respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream (p[0.05), respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. In the majority of women, the vaginal microenvironment remained unaffected by treatment. However, the proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events (suspected to be) related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggest using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause. PMID:24178484

Stute, Petra

2013-12-01

21

Vaginitis in adolescents.  

PubMed

Vaginitis is a common complaint of adolescent females. It can cause extreme distress for some patients, especially those with recurrent symptoms. Thus, it is important to take care when evaluating these patients and to acknowledge their frustration when appropriate. A thoughtful and thorough history will determine most causes, with the most common being yeast, trichomoniasis, and BV. PMID:15449843

Syed, Tahniat S; Braverman, Paula K

2004-06-01

22

Pyomyositis after vaginal delivery  

PubMed Central

Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted. PMID:22693277

Gaughan, Eve; Eogan, Maeve; Holohan, Mary

2011-01-01

23

Vaginal Vault Prolapse  

PubMed Central

Introduction. Vaginal vault prolapse is a common complication following vaginal hysterectomy with negative impact on women's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanism for the uterus and vagina is important in making the right choice of corrective procedure. Management should be individualised, taking into consideration the surgeon's experience, patients age, comorbidities, previous surgery and sex life. Result. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced at hysterectomy to prevent vault prolapse. Studies have shown the McCall's culdoplasty under direct visualisation to be superior. Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future. PMID:19936123

Uzoma, Azubuike; Farag, K. A.

2009-01-01

24

Vaginal immunity in bacterial vaginosis  

Microsoft Academic Search

Vaginal immunity in response to microbial perturbation is still poorly understood and may be crucial for protection from adverse\\u000a outcomes associated with bacterial vaginosis (BV). BV is the most prevalent vaginal disorder in adult women worldwide. However,\\u000a its pathogenesis is still elusive. In BVpositive women, inflammatory signs are scant—approximately 50% of women are asymptomatic.\\u000a The number of vaginal neutrophils in

Sabina Cauci

2004-01-01

25

Vaginal Discharge: What's Normal, What's Not  

MedlinePLUS

... Dealing With Anger Vaginal Discharge: What's Normal, What's Not KidsHealth > Teens > Sexual Health > For Girls > Vaginal Discharge: What's Normal, What's Not Print A A A Text Size Normal vaginal ...

26

Newly developed vaginal atrophy symptoms II and vaginal pH: a better correlation in vaginal atrophy?  

PubMed

Objectives The primary objective of this study was to evaluate the correlation among symptoms, signs, and the number of lactobacilli in postmenopausal vaginal atrophy. The secondary objective was to develop a new parameter to improve the correlation. Study design A cross-sectional descriptive study. Methods Naturally postmenopausal women aged 45-70 years with at least one clinical symptom of vaginal atrophy of moderate to severe intensity were included in this study. All of the objective parameters (vaginal atrophy score, vaginal pH, the number of lactobacilli, vaginal maturation index, and vaginal maturation value) were evaluated and correlated with vaginal atrophy symptoms. A new parameter of vaginal atrophy, vaginal atrophy symptoms II, was developed and consists of the two most bothersome symptoms (vaginal dryness and dyspareunia). Vaginal atrophy symptoms II was analyzed for correlation with the objective parameters. Results A total of 132 naturally postmenopausal women were recruited for analysis. Vaginal pH was the only objective parameter found to have a weak correlation with vaginal atrophy symptoms (r = 0.273, p = 0.002). The newly developed vaginal atrophy symptoms II parameter showed moderate correlation with vaginal pH (r = 0.356, p < 0.001) and a weak correlation with the vaginal atrophy score (r = 0.230, p < 0.001). History of sexual intercourse within 3 months was associated with a better correlation between vaginal atrophy symptoms and the objective parameters. Conclusion Vaginal pH was significantly correlated with vaginal atrophy symptoms. The newly developed vaginal atrophy symptoms II was associated with a better correlation. The vaginal atrophy symptoms II and vaginal pH may be better tools for clinical evaluation and future study of the vaginal ecosystem. PMID:25374401

Tuntiviriyapun, P; Panyakhamlerd, K; Triratanachat, S; Chatsuwan, T; Chaikittisilpa, S; Jaisamrarn, U; Taechakraichana, N

2015-04-01

27

Treatment of vaginal atrophy.  

PubMed

Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced lubrication, itching, burning, irritable bladder symptoms and painful intercourse. This impacts quality of life and sexual health, but increases with time rather than reduces, as with most other menopausal symptoms. With early identification, treatments can improve these symptoms and reverse the physical changes. However, when embedded, bladder and sexual changes have occurred and these may be more difficult to remedy. Therefore, it is important to educate both healthcare professionals and women about these symptoms and advise on the range of interventions available. PMID:24601810

Domoney, Claudine

2014-03-01

28

Vaginal vein thrombosis in pregnancy.  

PubMed Central

Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly described. Surgical management is suggested as being both simple and effective. Images Fig. 1 PMID:6634550

Gitstein, S.; Ballas, S.; Peyser, M. R.

1983-01-01

29

Predictors of the vaginal microflora  

Microsoft Academic Search

Objective: Our purpose was to define influences on the patterns of the vaginal microflora. Study Design: We enrolled 617 African American and Mexican American women in a 1-year longitudinal study of sexual behaviors and the vaginal microflora on the basis of the presence of gonorrhea, chlamydial infection, trichomoniasis, or syphilis at the initial visit. The patients were assigned randomly to

Edward R. Newton; Jeanna M. Piper; Rochelle N. Shain; Sondra T. Perdue; William Peairs

2001-01-01

30

Episiotomy for vaginal birth  

PubMed Central

Background Episiotomy is done to prevent severe perineal tears, but its routine use has been questioned. The relative effects of midline compared with midlateral episiotomy are unclear. Objectives The objective of this review was to assess the effects of restrictive use of episiotomy compared with routine episiotomy during vaginal birth. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2008). Selection criteria Randomized trials comparing restrictive use of episiotomy with routine use of episiotomy; restrictive use of mediolateral episiotomy versus routine mediolateral episiotomy; restrictive use of midline episiotomy versus routine midline episiotomy; and use of midline episiotomy versus mediolateral episiotomy. Data collection and analysis The two review authors independently assessed trial quality and extracted the data. Main results We included eight studies (5541 women). In the routine episiotomy group, 75.15% (2035/2708) of women had episiotomies, while the rate in the restrictive episiotomy group was 28.40% (776/2733). Compared with routine use, restrictive episiotomy resulted in less severe perineal trauma (relative risk (RR) 0.67, 95% confidence interval (CI) 0.49 to 0.91), less suturing (RR 0.71, 95% CI 0.61 to 0.81) and fewer healing complications (RR 0.69, 95% CI 0.56 to 0.85). Restrictive episiotomy was associated with more anterior perineal trauma (RR 1.84, 95% CI 1.61 to 2.10). There was no difference in severe vaginal/perineal trauma (RR 0.92, 95% CI 0.72 to 1.18); dyspareunia (RR 1.02, 95% CI 0.90 to 1.16); urinary incontinence (RR 0.98, 95% CI 0.79 to 1.20) or several pain measures. Results for restrictive versus routine mediolateral versus midline episiotomy were similar to the overall comparison. Authors’ conclusions Restrictive episiotomy policies appear to have a number of benefits compared to policies based on routine episiotomy. There is less posterior perineal trauma, less suturing and fewer complications, no difference for most pain measures and severe vaginal or perineal trauma, but there was an increased risk of anterior perineal trauma with restrictive episiotomy. PMID:19160176

Carroli, Guillermo; Mignini, Luciano

2014-01-01

31

Drugs Approved for Vaginal Cancer  

Cancer.gov

This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

32

Vaginal itching and discharge - child  

MedlinePLUS

... girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed. A foreign body ... abdominal pain or has a fever. You suspect sexual abuse. Also call if: There are blisters or ulcers ...

33

Vaginal bleeding in late pregnancy  

MedlinePLUS

One out of 10 women will have vaginal bleeding during their third trimester. At times, it may ... few months of pregnancy, you should always report bleeding to your health care provider right away. You ...

34

Can Vaginal Cancer Be Prevented?  

MedlinePLUS

... can be spread during sex – including vaginal intercourse, anal intercourse, and oral sex – but sex doesn’t ... not letting others come in contact with your anal or genital area, but even then there could ...

35

Vaginal films for drug delivery.  

PubMed

Vaginal dosage forms have been studied in relation to many drugs as the vagina presents several advantages as a site for drug delivery, such as large surface area, rich blood supply, avoidance of the first-pass effect, relatively high permeability to several drugs, and self-insertion. Traditional vaginal dosage forms have been associated with disadvantages such as low residence time and discomfort and have been surpassed by newly designed drug delivery systems, particularly those based on bioadhesive polymers. Vaginal films are solid dosage forms that rapidly dissolve in contact with vaginal fluids and are unlikely to be associated with leakage and messiness. They have been studied for some female genital problems, aiming either contraceptive, antimicrobial, or microbicide effects. Precise and complex processes of manufacturing and characterization are required to achieve successful film formulation. Although scarce, the available user's acceptability studies show promising results. Vaginal films gather a lack of opportunities for both therapeutic and prophylactic actions, and therefore should be considered when designing and developing new vaginal drug delivery systems. PMID:23649325

Machado, Rita M; Palmeira-de-Oliveira, Ana; Martinez-De-Oliveira, José; Palmeira-de-Oliveira, Rita

2013-07-01

36

Vaginal Treatment of Vaginal Cuff Dehiscence with Visceral Loop Prolapse: A New Challenge in Reparative Vaginal Surgery?  

PubMed Central

Vaginal cuff dehiscence is a rare, but potentially morbid, complication of total hysterectomy and refers to separation of the vaginal cuff closure. The term vaginal cuff dehiscence is frequently interchanged with the terms of cuff separation or cuff rupture. All denote the separation of a vaginal incision that was previously closed at time of total hysterectomy. After dehiscence of the vaginal cuff, abdominal or pelvic contents may prolapse through the vaginal opening. Bowel evisceration, outside the vulvar introitus, can lead to serious sequelae, including peritonitis, bowel injury and necrosis, or sepsis. Therefore, although prompt surgical and medical intervention is required to replace prolapsed structures, the main problem remains the reconstruction of vaginal vault. In case of recent hysterectomy, vaginal reparation only requires the approximation of vaginal walls, including their fascia, while if dehiscence occurs after a long time from hysterectomy, the adequate suspension of the vaginal vault has to be taken into consideration. In this report we describe the case of a postmenopausal patient, undergoing surgical emergency because of the evisceration of an intestinal loop through a dehiscence of vaginal vault, after numerous reconstructive vaginal surgeries for vaginal prolapse. This paper analyzes clinical circumstances, risk factors, comorbidity, and clinical and surgical management of this complication. PMID:25525534

Di Naro, Edoardo; Schonauer, Luca Maria; Loverro, Maria Teresa; Indellicati, Beatrice; Barnaba, Mario; Loverro, Giuseppe

2014-01-01

37

High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse  

Microsoft Academic Search

Objective: The purpose of this study was to review retrospectively the functional and anatomic outcomes of women who underwent vaginal repair of enterocele and vault prolapse with the use of an intraperitoneal suspension of the vaginal vault to the uterosacral ligaments in conjunction with fascial reconstruction of the anterior and posterior vaginal wall. Study Design: Two hundred two women with

M. Karram; S. Goldwasser; S. Kleeman; A. Steele; B. Vassallo; P. Walsh

2001-01-01

38

Vaginitis: current microbiologic and clinical concepts.  

PubMed Central

Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID:3510698

Hill, L V; Embil, J A

1986-01-01

39

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the...

2010-04-01

40

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2011 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the...

2011-04-01

41

21 CFR 884.3575 - Vaginal pessary.  

Code of Federal Regulations, 2012 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3575 Vaginal pessary. (a) Identification. A vaginal pessary is a removable structure...

2012-04-01

42

A Universal Combination Treatment for Vaginitis  

Microsoft Academic Search

Background: We compared a novel vaginal tablet consisting of 100 mg of clotrimazole and 100 mg of metronidazole (‘Clo-Met’) to a 100-mg clotrimazole tablet in the treatment of vaginitis. Methods: A multicenter, double-blind, randomized controlled study. Women with vaginal discharge and diagnosed as suffering from vaginitis caused by Trichomonas vaginalis, bacterial vaginosis or Candida albicans, or any combination of the

Jacob Bornstein; Doron Zarfati

2008-01-01

43

Identifying vaginitis in general practice.  

PubMed

Clinicians conducted a study of 154 women who presented themselves at a health center of the University of Wales College of Medicine with symptoms of vaginitis. A nurse examined the vagina with a speculum to note the appearance of the cervix, the color and amount of discharge, and the presence of odor and inquired about soreness during the examination. The nurse took 3 endocervical swabs and 2 high vaginal swabs. Upon microscopic examination, any vaginal discharge with epithelial cells stippled with small coccobacilli indicated a possible Gardnerella vaginalis infection. Laboratory personnel identified G. vaginalis either alone or in combination with other organisms in 53% of the women. Those with G. vaginalis alone or in combination with anaerobes reported more symptoms than those women who had negative cultures. In addition, women with G. vaginalis alone and those G. vaginalis in combination with other organisms had more discharge, described as yellow and runny, than those with negative cultures. 77% of the women infected with G. vaginalis had a high cheese or fishy odor. 75% of the women with G. vaginalis came to the health center between 2-4 weeks or even longer after they 1st noticed symptoms. On the other hand, women who were infected with C. albicans presented to the health center within a week of the start of the symptoms. Clinicians had previously treated erroneously many of the women with G. vaginalis with an antifungal agent. These women should be treated with metronidazole or, if a yeast infection is also present, with an antifungal agent and metronidazole. All women who present themselves to a nurse or physician with vaginal symptoms should have a history taken, an examination, and vaginal discharge samples taken and evaluated in the laboratory. PMID:3498151

Smail, J

44

The vaginal microbiome: rethinking health and diseases  

PubMed Central

Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others comprise a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal conditions and is vaguely characterized as the disruption of the equilibrium of the ‘normal’ vaginal microbiots. A better understanding of ‘normal’ and ‘healthy’ vaginal ecosystems that is based on its ‘true’ function and not simply on its composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases. PMID:22746335

Ma, Bing; Forney, Larry J.; Ravel, Jacques

2013-01-01

45

Fluconazole Susceptibility of Vaginal Isolates Obtained from Women with Complicated Candida Vaginitis: Clinical Implications  

Microsoft Academic Search

Despite considerable evidence of azole resistance in oral candidiasis due to Candida species, little is known about the azole susceptibilities of the genital tract isolates responsible for vaginitis. The fluconazole suscep- tibilities of vaginal isolates obtained during a multicenter study of 556 women with complicated Candida vaginitis were determined by evaluating two fluconazole treatment regimens. Of 393 baseline isolates of

J. D. Sobel; M. Zervos; B. D. Reed; T. Hooton; D. Soper; P. Nyirjesy; M. W. Heine; J. Willems; H. Panzer

2003-01-01

46

Results of tension-free vaginal tape in patients with or without vaginal hysterectomy  

Microsoft Academic Search

Objective: To assess complications and cure rates of tension-free vaginal tape (TVT) procedure performed with or without vaginal hysterectomy. Study design: Retrospective comparison of 41 women with urinary incontinence treated by a TVT procedure alone and 40 combined with vaginal hysterectomy. Objective cure was evaluated by clinical and urodynamic examination and by the contilife questionnaire. All patients were operated under

Louis Jeffry; Bruno Deval; Anca Birsan; Olivier Kadoch; David Soriano

2002-01-01

47

The changing landscape of the vaginal microbiome.  

PubMed

Deep sequence analysis of the vaginal microbiome is revealing an unexpected complexity that was not anticipated as recently as several years ago. The lack of clarity in the definition of a healthy vaginal microbiome, much less an unhealthy vaginal microbiome, underscores the need for more investigation of these phenomena. Some clarity may be gained by the careful analysis of the genomes of the specific bacteria in these women. Ongoing studies will clarify this process and offer relief for women with recurring vaginal maladies and hope for pregnant women to avoid the experience of preterm birth. PMID:25439274

Huang, Bernice; Fettweis, Jennifer M; Brooks, J Paul; Jefferson, Kimberly K; Buck, Gregory A

2014-12-01

48

What Are the Key Statistics about Vaginal Cancer?  

MedlinePLUS

... factors for vaginal cancer? What are the key statistics about vaginal cancer? Vaginal cancer is rare. Only ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

49

Is a Vaginal Birth Possible After a Cesarean Delivery?  

MedlinePLUS

... Resources and Publications En Español Is a vaginal birth possible after a cesarean delivery? Skip sharing on social media links Share this: Page Content Vaginal birth after cesarean (VBAC) describes vaginal delivery by a ...

50

Supracervical hysterectomy – the vaginal route  

PubMed Central

Removal of the cervix during hysterectomy is not mandatory. There has been no irrefutable evidence so far that total hysterectomy is more beneficial to patients in terms of pelvic organ function. The procedure that leaves the cervix intact is called a subtotal hysterectomy. Traditional approaches to this surgery include laparoscopic and abdominal routes. Vaginal total hysterectomy has been proven to present many advantages over the other approaches. Therefore, it seems that this route should also be applied in the case of subtotal hysterectomy. We present 9 cases of patients who underwent subtotal hysterectomy performed through the vagina for benign gynecological diseases. PMID:25097688

Cie?lak, Jaros?aw; Malinowski, Andrzej

2014-01-01

51

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn  

PubMed Central

Background The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. Methods Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. Results One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. Conclusions One-year postoperative findings for patients in this series indicate that patients with stage II–III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique. PMID:24973955

2014-01-01

52

Effect of vaginal or systemic estrogen on dynamics of collagen assembly in the rat vaginal wall.  

PubMed

The objective of this study was to compare the effects of systemic and local estrogen treatment on collagen assembly and biomechanical properties of the vaginal wall. Ovariectomized nulliparous rats were treated with estradiol or conjugated equine estrogens (CEEs) either systemically, vaginal CEE, or vaginal placebo cream for 4 wk. Low-dose local CEE treatment resulted in increased vaginal epithelial thickness and significant vaginal growth without uterine hyperplasia. Furthermore, vaginal wall distensibility increased without compromise of maximal force at failure. Systemic estradiol resulted in modest increases in collagen type I with no change in collagen type III mRNA. Low-dose vaginal treatment, however, resulted in dramatic increases in both collagen subtypes whereas moderate and high dose local therapies were less effective. Consistent with the mRNA results, low-dose vaginal estrogen resulted in increased total and cross-linked collagen content. The inverse relationship between vaginal dose and collagen expression may be explained in part by progressive downregulation of estrogen receptor-alpha mRNA with increasing estrogen dose. We conclude that, in this menopausal rat model, local estrogen treatment increased total and cross-linked collagen content and markedly stimulated collagen mRNA expression in an inverse dose-effect relationship. High-dose vaginal estrogen resulted in downregulation of estrogen receptor-alpha and loss of estrogen-induced increases in vaginal collagen. These results may have important clinical implications regarding the use of local vaginal estrogen therapy and its role as an adjunctive treatment in women with loss of vaginal support. PMID:25537371

Montoya, T Ignacio; Maldonado, P Antonio; Acevedo, Jesus F; Word, R Ann

2015-02-01

53

Vaginitis  

MedlinePLUS

... itching, burning, and pain on the vulva. What causes it? » Last Updated Date: 11/15/2013 Last Reviewed Date: 05/21/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) ...

54

Large posterior vaginal cyst in pregnancy.  

PubMed

A 20-year-old primigravida presented in labour with a mass protruding from her vagina during uterine contractions. The mass was a large tense cyst measuring 8 × 8 cm arising from the posterior vaginal wall. The cyst was present since puberty but increased in size during pregnancy. It collapsed following aspiration and uneventful vaginal delivery was conducted. Following delivery, the cyst was excised and vaginal wall repaired. On histopathology the cyst was identified as a Müllerian cyst. The patient recovered and remained asymptomatic on follow-up. PMID:25604504

Lallar, Meenakshi; Nandal, Rajesh; Sharma, Deepak; Shastri, Sweta

2015-01-01

55

Vaginal rings for delivery of HIV microbicides  

PubMed Central

Following the successful development of long-acting steroid-releasing vaginal ring devices for the treatment of menopausal symptoms and contraception, there is now considerable interest in applying similar devices to the controlled release of microbicides against HIV. In this review article, the vaginal ring concept is first considered within the wider context of the early advances in controlled-release technology, before describing the various types of ring device available today. The remainder of the article highlights the key developments in HIV microbicide-releasing vaginal rings, with a particular focus on the dapivirine ring that is presently in late-stage clinical testing. PMID:23204872

Malcolm, R Karl; Fetherston, Susan M; McCoy, Clare F; Boyd, Peter; Major, Ian

2012-01-01

56

Angiomyofibroblastoma of the Vaginal Portion  

PubMed Central

Introduction: Angiomyofibroblastoma is a tumor which is consists of two components: blood vessels and stromal cells, with always prominent vascular component. Angiomyofibroblastoma is benign tumor, but in literature is reported a case of recurrence and one case with sarcomatous transformation, which shoved that these tumors may rarely be associated with malignant component. Case report: A 78-year-old multiparous housewife was hospitalized at University Clinical Center because of painless, asymptomatic tumor of vaginal portion (posterior side). Tumor size was 7 millimeters in diameter. Internal genital organs did not present abnormalities. The patient underwent operative removal of the tumor and went to home at some day. At the histological examination the tumor presented as a angiomyofibroblastoma cervices uteri. PMID:25648716

Fatusic, Jasenko; Hudic, Igor; Fatusic, Zlatan; Mustedanagic-Mujanovic, Jasminka

2014-01-01

57

Vaginal indicators of amniotic fluid infection in preterm labor  

Microsoft Academic Search

Objective: To determine whether vaginal interleukin-6, interleukin-8, neutrophils, bacterial vaginosis, and selected vaginal bacteria are predictors of amniotic fluid (AF) infection among women in preterm labor.Methods: One hundred ninety-seven afebrile women in preterm labor with intact membranes had vaginal and AF samples collected for Gram stain, culture, and interleukin-8 and interleukin-6 determinations. Vaginal interleukin-6, interleukin-8, neutrophils, and vaginal flora were

Jane Hitti; Sharon L Hillier; Kathy J Agnew; Marijane A Krohn; Dale P Reisner; David A Eschenbach

2001-01-01

58

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2013 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2013-04-01

59

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2014 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2014-04-01

60

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2012 CFR

...Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II (performance...

2012-04-01

61

Vaginal childbirth and pelvic floor disorders  

PubMed Central

Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study. PMID:23638782

Memon, Hafsa U; Handa, Victoria L

2013-01-01

62

Adherence of Human Vaginal Lactobacilli to Vaginal Epithelial Cells and Interaction with Uropathogens  

Microsoft Academic Search

Three strains of Lactobacillus, identified as Lactobacillus acidophilus, Lactobacillus gasseri, and Lactobacillus jensenii, were selected from among 70 isolates from the vaginas of healthy premenopausal women for properties relevant to mucosal colonization or antagonism. All three self-aggregated and adhered to epithelial vaginal cells, displacing well-known vaginal pathogens, such as G. vaginalis, and inhibiting the growth in vitro of Escherichia coli

SOLEDAD BORIS; JUAN E. SUAREZ; FERNANDO VAZQUEZ; COVADONGA BARBES

1985-01-01

63

EMAS clinical guide: low-dose vaginal estrogens for postmenopausal vaginal atrophy.  

PubMed

Vaginal atrophy is common in postmenopausal women. This clinical guide provides the evidence for the clinical use of vaginal estrogens for this condition focussing on publications since the 2006 Cochrane systematic review. Use after breast cancer, before assessment of cervical cytology and prolapse surgery is also discussed. PMID:22818886

Rees, Margaret; Pérez-López, Faustino R; Ceasu, Iuliana; Depypere, Herman; Erel, Tamer; Lambrinoudaki, Irene; Schenck-Gustafsson, Karin; Simoncini, Tommaso; van der Schouw, Yvonne; Tremollieres, Florence

2012-10-01

64

Semaphorin 4D induces vaginal epithelial cell apoptosis to control mouse postnatal vaginal tissue remodeling.  

PubMed

The opening of the mouse vaginal cavity to the skin is a postnatal tissue remodeling process that occurs at approximately five weeks of age for the completion of female genital tract maturation at puberty. The tissue remodeling process is primarily composed of a hormonally triggered apoptotic process predominantly occurring in the epithelium of the distal section of the vaginal cavity. However, the detailed mechanism underlying the apoptotic induction remains to be elucidated. In the present study, it was observed that the majority of BALB/c mice lacking the class 4 semaphorin, semaphorin 4D (Sema4D), developed imperforate vagina and hydrometrocolpos resulting in a perpetually unopened vaginal cavity regardless of a normal estrogen level comparable with that in wild?type (WT) mice. Administration of ??estradiol to infant Sema4D?deficient (Sema4D?/?) mice did not induce precocious vaginal opening, which was observed in WT mice subjected to the same ??estradiol administration, excluding the possibility that the closed vaginal phenotype was due to insufficient estrogen secretion at the time of vaginal opening. In order to assess the role of Sema4D in the postnatal vaginal tissue remodeling process, the expression of Sema4D and its receptor, plexin?B1, was examined as well as the level of apoptosis in the vaginal epithelia of five?week?old WT and Sema4D?/? mice. Immunohistochemical analyses confirmed the localization of Sema4D and plexin?B1 in the mouse vaginal epithelia. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay and immunohistochemistry detecting activated caspase?3 revealed significantly fewer apoptotic cells in situ in the vaginal mucosa of five?week?old Sema4D?/? mice compared with WT mice. The addition of recombinant Sema4D to Sema4D?/? vaginal epithelial cells in culture significantly enhanced apoptosis of the vaginal epithelial cells, demonstrating the apoptosis?inducing activity of Sema4D. The experimental reduction of plexin?B1 expression in vaginal epithelial cells demonstrated the integral role of plexin?B1 in Sema4D?induced apoptotic cell death. These results suggest a non?redundant role of Sema4D in the postnatal tissue remodeling process in five?week?old BALB/c mice, which involves the induction of vaginal epithelial cell apoptosis through Sema4D binding to plexin?B1. PMID:25351707

Ito, Takuji; Bai, Tao; Tanaka, Tetsuji; Yoshida, Kenji; Ueyama, Takashi; Miyajima, Masayasu; Negishi, Takayuki; Kawasaki, Takahiko; Takamatsu, Hyota; Kikutani, Hitoshi; Kumanogoh, Atsushi; Yukawa, Kazunori

2015-02-01

65

A comprehensive review of vaginitis phytotherapy.  

PubMed

To overview phytotherapy of vaginitis in order to identify new approaches for new pharmacological treatments. All related literature databases were searched for herbal medicinal treatment in vaginitis. The search terms were plant, herb, herbal therapy, phytotherapy, vaginitis, vaginal, anti-candida, anti-bacterial and anti-trichomonas. All of the human, animal and in vitro studies were included. Anti-candida, anti-bacterial and anti-trichomonas effects were the key outcomes. The plants including carvacrol, 1,8-cineole, geranial, germacrene-D, limonene, linalool, menthol, terpinen-4-ol and thymol exhibited anti-candida effects. A very low concentration of geranium oil and geraniol blocked mycelial growth, but not yeast. Tea tree oil including terpinen-4-ol, alpha-terpinene, gamma-terpinene and alpha-terpineol showed anti-bacterial, anti-fungal and anti-protozoal properties against trichomonas. Allium hirtifolium (persian shallot) comparable to metronidazole exhibited anti-trichomonas activity due to its components such as allicin, ajoene and other organosulfides. The plants having beneficial effects on vaginitis encompass essential oils that clear the pathway that future studies should be focused to standardize theses herbs. PMID:22514885

Azimi, Hanieh; Fallah-Tafti, Mehrnaz; Karimi-Darmiyan, Maliheh; Abdollahi, Mohammad

2011-11-01

66

Administration of oral and vaginal prebiotic lactoferrin for a woman with a refractory vaginitis recurring preterm delivery: appearance of lactobacillus in vaginal flora followed by term delivery.  

PubMed

Lactoferrin (LF) is one of the prebiotics present in the human body. A 38-year-old multiparous woman with poor obstetrical histories, three consecutive preterm premature rupture of membrane at the 19th, 23rd and 25th week of pregnancy, was referred to our hospital. She was diagnosed as having refractory vaginitis. Although estriol vaginal tablets were used for 4 months, the vaginitis was not cured. We administrated vaginal tablets and oral agents of prebiotic LF, resulting in a Lactobacillus predominant vaginal flora. When she was pregnant, she continued to use the LF, and the Lactobacillus in the vaginal flora was continuously observed during pregnancy. An elective cesarean section was performed at the 38th week of pregnancy. When the administration of LF was discontinued after the delivery, Lactobacillus in the vaginal flora was disappeared. PMID:24118573

Otsuki, Katsufumi; Tokunaka, Mayumi; Oba, Tomohiro; Nakamura, Masamitsu; Shirato, Nahoko; Okai, Takashi

2014-02-01

67

What Should You Ask Your Doctor about Vaginal Cancer?  

MedlinePLUS

... for vaginal cancer? What should you ask your doctor about vaginal cancer? It’s important to have honest, ... cancer care team. Keep in mind, too, that doctors are not the only ones who can provide ...

68

Vaginitis: How Many Women Are Affected/at Risk?  

MedlinePLUS

... and Publications How many women are affected/at risk? Skip sharing on social media links Share this: ... trichomoniasis. Who gets vaginitis and who is at risk? Vaginitis affects women of all ages, races, and ...

69

Necrotizing ruptured vaginal leiomyoma mimicking a malignant neoplasm  

PubMed Central

Leiomyomas are common benign uterine tumors. However, the incidence of vaginal myoma is very rare and may be confused with a variety of vaginal tumors. We report a case of 43-year-old nulligravida who presented with a protruding painful vaginal mass for 7 days. The mass had initially appeared 3 years prior, as 2 to 3 cm that had not subsequently increased. However suddenly, there was rapid severe enlargement over the course of 7 days. Physical exam revealed a monstrous shaped, black color with focal necrosis, odorous protruding vaginal mass about 7 cm in size. The vaginal mass was infected and degenerated. And vaginal wall was also destroyed by the enlarged mass. Because of the clinical features and radiologic findings, the preoperative diagnosis was a vaginal malignancy. We reported an extremely rare case of vaginal myoma that had several characteristics of malignancy, with a brief review of the literature. PMID:25469351

Sim, Chae Hee; Lee, Jin Hee; Kwak, Jyung Sik

2014-01-01

70

[Vaginal sonography versus vaginal palpation: initial experiences in 120 pregnant patients with suspected cervix insufficiency].  

PubMed

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 120 pregnant women with cervical insufficiency between 16th and 33rd week of gestation were examined by a 5-MHz vaginal sectorscanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Another group of 50 pregnant women with unsuspicious obstetrical findings were also examined to gain information about normal sonographical morphology and length of the competent uterine cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage. In case of suspected cervical incompetence continuous sonographical examination can supervise the development of the uterine cervix during pregnancy. In future the number of prophylactic cerclage-operations perhaps decreases by using the technique of transvaginal sonography. PMID:2669397

Böhmer, S; Degenhardt, F; Gerlach, C; Jagla, K; Schneider, J

1989-01-01

71

A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn  

PubMed Central

Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method. PMID:23476121

Köse, Osman; Sa?lam, Hasan S.; Kumsar, ?ükrü; Budak, Salih; Adsan, Öztu?

2013-01-01

72

Biofilm formation by vaginal Lactobacillus in vivo.  

PubMed

Biofilm formation by nonpathogenic bacteria is responsible for their stable maintenance in vivo ecosystems as it promotes long-term permanence on the host's vaginal mucosa. Biofilm formation by Lactobacilli has been reported in vitro but not in vivo. We hypothesize the presence of biofilm formation in vivo could be also documented by microscope photographs (MP) of wet mounts obtained from uninfected vaginal samples satisfying rigorous scientific identification criteria. We analyzed 400 MP from our database, and we were able to determine that 12 MP from 6 different patients contained clues of the formation of biofilm by Lactobacilli. The most probable lactobacillus involved is presumed to be Lactobacillus jensenii. The documentation of biofilm formation by vaginal Lactobacilli at fresh wet mount preparation is significant and has several important clinical preventive and therapeutic implications. PMID:25725906

Ventolini, G; Mitchell, E; Salazar, M

2015-05-01

73

The preterm prediction study: Significance of vaginal infections  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the association of bacterial vaginosis, trichomonas vaginitis, and monilial vaginitis with spontaneous preterm birth at<35 weeks 0 days.STUDY DESIGN: A total of 2929 women at 10 centers were studied at 24 and 28 weeks' gestation by Gram stain of vaginal smear, wet mount, and 10% potassium hydroxide preparations to detect vaginal infections.RESULTS: The rates

Paul J. Meis; Robert L. Goldenberg; Brian Mercer; Atef Moawad; Anita Das; Donald McNellis; Francee Johnson; Jay D. Iams; Elizabeth Thom; William W. Andrews

1995-01-01

74

Anaerobes and Gardnerella vaginalis in non-specific vaginitis  

Microsoft Academic Search

Clinical evidence of bacterial vaginosis was present in 25 (35%) of 72 patients attending a London venereology clinic and correlated significantly with abnormal organic acids in vaginal secretions (24\\/25), with Gardnerella vaginalis on culture (17\\/25), with complaints of vaginal malodour (15\\/25), and with a relative scarcity of white blood cells in vaginal secretions. Anaerobic vaginal flora were presumptively identified by

L V Hill

1985-01-01

75

Pregnancy's Stronghold on the Vaginal Microbiome  

PubMed Central

Objective To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. Methods Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8–12, 17–21, 27–31, and 36–38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3–V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. Results Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n?=?8), the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. Conclusion Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for investigating the role of the microbiome in complications of pregnancy such as preterm labor and preterm delivery. PMID:24896831

Walther-António, Marina R. S.; Jeraldo, Patricio; Berg Miller, Margret E.; Yeoman, Carl J.; Nelson, Karen E.; Wilson, Brenda A.; White, Bryan A.; Chia, Nicholas; Creedon, Douglas J.

2014-01-01

76

[HPV contamination of endocavity vaginal ultrasound probes].  

PubMed

While the use of endovaginal ultrasound probes is increasing, the risk of contamination of women with endocavity vaginal probes was not assessed. In particular, the clinical significance of detection of human papillomavirus (HPV) infection, the most common sexually transmitted viral infection, on endovaginal ultrasound probes is uncertain. The recommendations of good practice for decontamination of these probes developed by the High Council for Public Health and the Academy of Medicine have not been evaluated. The objective of this article was to review recent publications concluding to the detection of HPV and human cellular DNA after gynecological examination and disinfection of vaginal ultrasound probes. PMID:24930727

Heard, I; Favre, M

2015-02-01

77

Reviewing the options for local estrogen treatment of vaginal atrophy  

PubMed Central

Background Vaginal atrophy is a chronic condition with symptoms that include vaginal dryness, pain during sex, itching, irritation, burning, and discharge, as well as various urinary problems. Up to 45% of postmenopausal women may be affected, but it often remains underreported and undertreated. This article aims to review the current recommendations for treatment of vaginal atrophy, and current data on the effectiveness and safety of local vaginal estrogen therapies. Methods Literature regarding vaginal atrophy (2007–2012) was retrieved from PubMed and summarized, with emphasis on data related to the treatment of vaginal atrophy with local vaginal estrogen therapy. Results Published data support the effectiveness and endometrial safety of low-dose local estrogen therapies. These results further support the general recommendation by the North American Menopause Society that a progestogen is not needed for endometrial protection in patients using low-dose local vaginal estrogen. Benefits of long-term therapy for vaginal atrophy include sustained relief of symptoms as well as physiological improvements (eg, decreased vaginal pH and increased blood flow, epithelial thickness, secretions). Conclusion Currently available local vaginal estrogen therapies are well tolerated and effective in relieving symptoms of vaginal atrophy. Recent data support the endometrial safety of low-dose regimens for up to 1 year. PMID:24648775

Lindahl, Sarah H

2014-01-01

78

Correlation of Behaviors with Microbiological Changes in Vaginal Flora  

Microsoft Academic Search

Bacterial vaginosis (BV) is characterized by dramatic changes in the vaginal ecosystem. Women without evidence of vaginal infection may exhibit transient changes in their flora. We prospectively followed up women by using diaries and self-obtained vaginal smears to correlate behaviors with changes in flora. The majority of women (38\\/51, 78%) had significant, although transient, changes. Behaviors associated with unstable flora

1999-01-01

79

Adherence of Human Vaginal Lactobacilli to Vaginal Epithelial Cells and Interaction with Uropathogens  

PubMed Central

Three strains of Lactobacillus, identified as Lactobacillus acidophilus, Lactobacillus gasseri, and Lactobacillus jensenii, were selected from among 70 isolates from the vaginas of healthy premenopausal women for properties relevant to mucosal colonization or antagonism. All three self-aggregated and adhered to epithelial vaginal cells, displacing well-known vaginal pathogens, such as G. vaginalis, and inhibiting the growth in vitro of Escherichia coli and Streptococcus agalactiae. The surface components involved in self-aggregation appeared to be proteins for L. gasseri and lipoproteins for L. acidophilus and L. jensenii, as judged by susceptibility to treatment with appropriate degrading enzymes. The factors responsible for adherence to epithelial vaginal cells seemed to be glycoproteins (L. acidophilus and L. gasseri) and carbohydrate (L. jensenii). The receptors of the vaginal cells were glycolipids, which presumably were the targets of the competition observed between the lactobacilli and the pathogenic microbes. PMID:9573080

Boris, Soledad; Suárez, Juan E.; Vázquez, Fernando; Barbés, Covadonga

1998-01-01

80

Phenotypic and Functional Characterization of Vaginal Dendritic Cells in a Rat Model of Candida albicans Vaginitis  

Microsoft Academic Search

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62 VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62 VDCs

Flavia De Bernardis; Roberta Lucciarini; Maria Boccanera; Consuelo Amantini; Silvia Arancia; Stefania Morrone; Michela Mosca; Antonio Cassone; Giorgio Santoni

2006-01-01

81

Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections  

Microsoft Academic Search

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion\\u000a experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for\\u000a an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4),\\u000a which is an attribute of a healthy vagina.

Mohd Aftab Alam; Farhan Jalees Ahmad; Zeenat Iqbal Khan; Roop Krishen Khar; Mushir Ali

2007-01-01

82

Vaginal Lactobacillus: biofilm formation in vivo – clinical implications  

PubMed Central

Vaginal lactobacilli provide protection against intrusive pathogenic bacteria. Some Lactobacillus spp. produce in vitro a thick, protective biofilm. We report in vivo formation of biofilm by vaginal Lactobacillus jensenii. The biofilm formation was captured in fresh wet-mount microscopic samples from asymptomatic patients after treatment for recurrent bacterial vaginitis. In vivo documentation of biofilm formation is in our opinion noteworthy, and has significant clinical implications, among which are the possibility to isolate, grow, and therapeutically utilize lactobacilli to prevent recurrent vaginal infections and preterm labor associated with vaginal microbial pathogens. PMID:25733930

Ventolini, Gary

2015-01-01

83

Vaginal mesh erosion after abdominal sacral colpopexy  

Microsoft Academic Search

Objective: Our goal was to compare the prevalence of vaginal mesh erosion between abdominal sacral colpopexy and various sacral colpoperineopexy procedures. Study Design: We undertook a retrospective analysis of all sacral colpopexies and colpoperineopexies performed between March 1, 1992, and February 28, 1999. The patients were divided into the following 4 groups: abdominal sacral colpopexy, abdominal sacral colpoperineopexy, and 2

Anthony G. Visco; Alison C. Weidner; Matthew D. Barber; Evan R. Myers; Geoffrey W. Cundiff; Richard C. Bump; W. Allen Addison

2001-01-01

84

Aggressive vaginal angiomyxoma mimicking urethral tumor  

Microsoft Academic Search

This is a case report of a 32-year-old female patient with a neoplasia mimicking a urethral tumor. Following anterior pelvic exanteration, vulvectomy, bilateral inguinal lymphadenectomy, the pathological study established the diagnosis of aggressive vaginal angiomyxoma, CD-34 labeled.

Lucio F. Gonzaga; Fernando C. M. Freitas; Jose M. Tavares

2005-01-01

85

Vaginal Lacerations from Consensual Intercourse in Adolescents  

ERIC Educational Resources Information Center

Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

2011-01-01

86

Vaginal itching and discharge - Adult and adolescent  

MedlinePLUS

... or thin Clear, cloudy, bloody, white, yellow, or green Odorless or have a bad odor Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It can also occur on its own.

87

Primary vaginal adenocarcinoma arising in vaginal adenosis after CO2 laser vaporization and 5-fluorouracil therapy.  

PubMed

We present a case of a 45-year-old woman with a long-standing history of persistent cervical dysplasia that resulted in a hysterectomy. Subsequent vaginal smears revealed high-grade vaginal intraepithelial neoplasia (VAIN III) on Pap smear with positive human papilloma virus (HPV) testing. Over the course of 2 years, the patient underwent 2 CO(2) laser vaporization procedures of the upper vagina and intermittent 5-fluorouracil therapy. A biopsy performed at the time of the second laser procedure revealed endocervical-type well-differentiated adenocarcinoma, associated with VAIN III. HPV in situ hybridization for HPV types 16 and 18 was positive in both the glandular and squamous mucosa. The patient has no known history of intrauterine diethylstilbestrol exposure or mullerian developmental abnormalities. Subsequently, the patient underwent a radical upper vaginetcomy with bilateral pelvic lymph nodes dissection and bilateral salpingo-oophorectomy. The vaginectomy specimen showed residual adenocarcinoma associated with VAIN-III and extensive vaginal adenosis with free resection margins. This is the second reported case in the literature of adenocarcinoma arising in vaginal adenosis after 5-fluorouracil. Herein, we highlight these important findings and shed some light on the pathogenesis of vaginal adenosis and the subsequent development of vaginal adenocarcinoma. PMID:20173507

Paczos, Tamera A; Ackers, Stacey; Odunsi, Kunle; Lele, Shashikant; Mhawech-Fauceglia, Paulette

2010-03-01

88

Vaginal Douching Among Latinas: Practices and Meaning  

PubMed Central

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices. PMID:18297379

Baquero, María; Anderson, Matthew R.; Alvarez, Adelyn; Karasz, Alison

2009-01-01

89

The vaginal microflora in relation to gingivitis  

PubMed Central

Background Gingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty. Methods Vaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range: 18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at ? 20% of tooth sites. Results A Nugent score of 0–3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women (27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had higher counts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginal samples (> 1.0 × 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8–7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001). Conclusion Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections. PMID:19161595

2009-01-01

90

Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer  

ClinicalTrials.gov

Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

2014-04-21

91

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles.  

PubMed

Background: The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05). Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively). Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment. PMID:25317769

Pereira, Vanessa S; Hirakawa, Humberto S; Oliveira, Ana B; Driusso, Patricia

2014-10-10

92

Vaginal Evisceration: An Unexpected Complication of Conization  

PubMed Central

Background. Large loop excision of the transformation zone (LLETZ) is routinely performed for the management of high grade intracervical neoplasia (CIN). Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management. Case. A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair. Conclusions. Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management. PMID:25506010

Ghassani, Ali; Andre, Benoit; Simon-Toulza, Caroline; Tanguy le Gac, Yann; Martinez, Alejandra; Vidal, Fabien

2014-01-01

93

Instrumental vaginal delivery--back to basics.  

PubMed

Assisted vaginal delivery using forceps or a vacuum extractor is an essential part of obstetric practice. Operative vaginal delivery rates in the UK have remained stable between 10% and 15%, yielding safe and satisfactory outcomes for the majority of mothers and their babies. However, there has been an increase in medico-legal cases due to an increasing awareness of the potential morbidity for both the mother and the baby. There are many factors that can play a part in both the maternal and fetal complications resulting from instrumental deliveries. The aim of this educational review is to address these factors and identify measures to reduce them by adherence to the basics and relevant evidence. PMID:24219713

Keriakos, R; Sugumar, S; Hilal, N

2013-11-01

94

Adolescent Experiences with the Vaginal Ring  

PubMed Central

Purpose To understand racial/ethnic minority adolescent females’ experiences with the vaginal ring. Methods We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15–24 years who had used the vaginal ring. Results Qualitative analysis using grounded theory revealed that adolescents undergo a multi-stage process when trying the ring and adopting ring use. These stages include hearing about the ring, initial reactions, first experiences with insertion and removal, and first sexual experiences. Adolescents subsequently enter an assessment and adjustment stage in which they decide whether to adopt or discontinue ring use. Ultimately they share their experiences with friends. Conclusions The model developed provides a context within which providers may advise adolescents as they begin use of the ring. Some specific recommendations are offered. PMID:18565439

Epstein, Laura B.; Sokal-Gutierrez, Karen; Ivey, Susan L.; Raine, Tina; Auerswald, Colette

2011-01-01

95

Vaginal Intercourse Frequency and Heart Rate Variability  

Microsoft Academic Search

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck

STUART BRODY; RAGNAR PREUT

2003-01-01

96

Posterior vaginal prolapse and bowel function  

Microsoft Academic Search

Objective: This study’s objectives were to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse. Study Design: One hundred forty-three women completed a questionnaire assessment of bowel function and underwent standardized physical examination according to the International Continence Society’s system for grading uterovaginal prolapse. Results: The

Anne M. Weber; Mark D. Walters; Lester A. Ballard; Delbert L. Booher; Marion R. Piedmonte

1998-01-01

97

VARIATION AND PREDICTORS OF VAGINAL DOUCHING BEHAVIOR  

PubMed Central

Introduction Vaginal douching is a widespread practice among American women. Little research has been done examining variation in the practice or identifying risk factors. Methods We collected data on douching, as well as hypothesized predictors of vaginal douching, as part of a cohort study on preterm birth. African-American women residing in Baltimore City, Maryland, were enrolled if they received prenatal care or delivered at The Johns Hopkins Medical Institution. Interview data were collected on 872 women between March 2001 and July 2004, with a response rate of 68%. Logistic regression analysis was selected to identify factors associated with douching in the 6 months prior to pregnancy. Results Almost two thirds of women reported ever douching and more than two thirds of those women reported douching in the 6 months prior to pregnancy. Variation was seen in the practice of douching with regard to frequency as well as technique. After adjusting for several confounders, prenatal enrollment (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.29, 2.53), more unmet needs for time for “nonessentials” (OR, 1.83; 95% CI, 1.27, 2.63), smoking in the year prior to the birth (OR, 1.78; 95% CI, 1.22, 2.60), and age > 19 years (OR, 2.60; 95% CI, 1.36, 4.97) were significant predictors of douching in the 6 months prior to pregnancy. Discussion We identified considerable heterogeneity in the practice of vaginal douching in a cohort of low income African-American women. Conclusions Future studies should incorporate measures of the predictors of douching and detailed exposure information to determine the independent contribution of vaginal douching to health outcomes. PMID:17055380

Misra, Dawn P.; Trabert, Britton; Atherly-Trim, Shelly

2007-01-01

98

Vaginal Drug Delivery Systems for HIV Prevention  

Microsoft Academic Search

Microbicides have become a principal focus for HIV prevention strategies. The successful design of drug delivery systems for\\u000a vaginal microbicide drug candidates brings with it a multitude of challenges. It is imperative that the chemical and physical\\u000a characteristics of the drug candidate and its mechanism of action be clearly understood and considered to successfully deliver\\u000a and target drug candidates efficiently.

Lisa Cencia Rohan; Alexandra B. Sassi

2009-01-01

99

Complications of anterior compartment vaginal surgery  

Microsoft Academic Search

Many complications can be associated with anterior compartment surgery of the vagina. With the integration of synthetic materials\\u000a into the surgical armamentarium for the repair of stress urinary incontinence in the form of midurethral slings, and for the\\u000a repair of vaginal prolapse as a primary procedure or to augment an existing repair, the spectrum of complications related\\u000a to this type

Eric S. Rovner

2007-01-01

100

Strength of Preference for Vaginal Birth as a Predictor of Delivery Mode Among Women who Attempt a Vaginal Delivery  

PubMed Central

OBJECTIVE To assess the relationship between strength of preference for vaginal birth and likelihood of vaginal delivery among women attempting this delivery mode. STUDY DESIGN We conducted a longitudinal study of mode of delivery preferences among women who were less than 36 weeks pregnant. Participants completed a sociodemographic and clinical questionnaire and were asked if they preferred vaginal or cesarean delivery. Participants who preferred vaginal delivery completed a standard gamble exercise to assess the strength of this preference on a 0-to-1 scale (higher scores indicate stronger preference for vaginal delivery); those preferring cesarean delivery were assigned a value of 0. Data on clinical characteristics and delivery mode was obtained via telephone interview or chart review. Logistic regression was used to identify predictors of delivery mode among women who attempted a vaginal delivery. RESULTS Of 210 participants, 156 attempted a vaginal delivery. Their mean and median vaginal delivery preference scores were 0.70 (SD 0.31) and 0.75 (IQR 0.50–0.99), respectively. In multivariate analyses, women with a prior cesarean delivery (aOR 0.08, CI 0.02–0.39) or who delivered an infant ?4000 grams (aOR 0.04, CI 0.01–0.28) had significantly lower odds of having a vaginal delivery. After controlling for potential confounders, participants with a stronger preference for vaginal delivery were at significantly higher odds of having a vaginal delivery (aOR 1.54, CI 1.01–2.34 for every 0.2 increase on the 0-to-1 scale). CONCLUSION Among women who attempt a vaginal delivery, the strength of preference for vaginal birth is predictive of the delivery mode ultimately undergone. PMID:24246523

WU, Erica; KAIMAL, Anjali; HOUSTON, Kathryn; YEE, Lynn; NAKAGAWA, Sanae; KUPPERMANN, Miriam

2014-01-01

101

Urinary tract infection in vaginitis: a condition often overlooked.  

PubMed

Despite the differences between the organisms that cause vaginitis and urinary tract infections (UTI), it is possible that women with vaginitis develop UTI. The main objective of the study was to find the association of the common types of infectious vaginitis with UTI. Cross sectional study was conducted for six months in a referral hospital at Lalitpur, Nepal. Three hundred and sixmid-stream urine samples and high vaginal swabs (HVS) collected from non pregnant women were investigated by standard microbiological techniques. Among the women with bacterial vaginosis (BV), 75% also had UTI. Similarly, 46% and 13% of those with vaginal candidiasis and trichomoniasis respectively had concurrent UTI. Considering this strong association of UTI and vaginitis, women with either of these conditions should be tested for the other. PMID:24592798

Amatya, R; Bhattarai, S; Mandal, P K; Tuladhar, H; Karki, B M S

2013-03-01

102

Differential tissue-specific protein markers of vaginal carcinoma  

Microsoft Academic Search

The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant

K Hellman; A A Alaiya; S Becker; M Lomnytska; K Schedvins; W Steinberg; A-C Hellström; S Andersson; U Hellman; G Auer

2009-01-01

103

Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device  

PubMed Central

Objectives To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery. Design A prospective observational study Setting Two tertiary referral Urogynaecology practices. Population Ninety-five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD. Methods Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality-of-life (QOL) questionnaires preoperatively and at 6 and 12 months. Main outcome measures Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients’ satisfaction. Results Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001). Conclusion Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study. Please cite this paper as:Carey M, Slack M, Higgs P, Wynn-Williams M, Cornish A. Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device. BJOG 2008;115:391–397. PMID:18190377

Carey, M; Slack, M; Higgs, P; Wynn-Williams, M; Cornish, A

2008-01-01

104

Protocols for Vaginal Inoculation and Sample Collection in the Experimental Mouse Model of Candida vaginitis  

PubMed Central

Vulvovaginal candidiasis (VVC), caused by Candida species, is a fungal infection of the lower female genital tract that affects approximately 75% of otherwise healthy women during their reproductive years18,32-34. Predisposing factors include antibiotic usage, uncontrolled diabetes and disturbance in reproductive hormone levels due to pregnancy, oral contraceptives or hormone replacement therapies33,34. Recurrent VVC (RVVC), defined as three or more episodes per year, affects a separate 5 to 8% of women with no predisposing factors33. An experimental mouse model of VVC has been established and used to study the pathogenesis and mucosal host response to Candida3,4,11,16,17,19,21,25,37. This model has also been employed to test potential antifungal therapies in vivo13,24. The model requires that the animals be maintained in a state of pseudoestrus for optimal Candida colonization/infection6,14,23. Under such conditions, inoculated animals will have detectable vaginal fungal burden for weeks to months. Past studies show an extremely high parallel between the animal model and human infection relative to immunological and physiological properties3,16,21. Differences, however, include a lack of Candida as normal vaginal flora and a neutral vaginal pH in the mice. Here, we demonstrate a series of key methods in the mouse vaginitis model that include vaginal inoculation, rapid collection of vaginal specimens, assessment of vaginal fungal burden, and tissue preparations for cellular extraction/isolation. This is followed by representative results for constituents of vaginal lavage fluid, fungal burden, and draining lymph node leukocyte yields. With the use of anesthetics, lavage samples can be collected at multiple time points on the same mice for longitudinal evaluation of infection/colonization. Furthermore, this model requires no immunosuppressive agents to initiate infection, allowing immunological studies under defined host conditions. Finally, the model and each technique introduced here could potentially give rise to use of the methodologies to examine other infectious diseases of the lower female genital tract (bacterial, parasitic, viral) and respective local or systemic host defenses. PMID:22215135

Yano, Junko; Fidel, Jr., Paul L.

2011-01-01

105

Systemic Effects of Vaginally Administered Estrogen Therapy: A Review  

PubMed Central

Hormone Therapy (HT) was considered the standard of care prior to the publication of the Women’s Health Initiative (WHI). After the study was published, the use of systemic HT dramatically decreased resulting in an increased incidence of menopausal symptoms such as hot flashes, vaginal dryness and dyspareunia experienced by women. Use of vaginal estrogen offers women a unique alternative for relief of these symptoms. This article reviews the systemic effects of vaginally administered estrogen. Effects on serum hormone levels, vasomotor symptoms, lipid profiles and use in women with breast cancer are reviewed. An accompanying review examines the local effects of vaginally administered estrogen. PMID:22453284

Krause, Megan; Wheeler, Thomas L.; Richter, Holly E.; Snyder, Thomas E.

2015-01-01

106

21 CFR 884.5940 - Powered vaginal muscle stimulator for therapeutic use.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Powered vaginal muscle stimulator for therapeutic use. 884...Devices § 884.5940 Powered vaginal muscle stimulator for therapeutic use. (a) Identification. A powered vaginal muscle stimulator is an electrically...

2014-04-01

107

75 FR 3745 - NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice  

Federal Register 2010, 2011, 2012, 2013, 2014

...Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice...Consensus Development Conference on Vaginal Birth After Cesarean: New Insights'' to be...it will be open to the public. Vaginal birth after cesarean (VBAC) is the...

2010-01-22

108

Vault Prolapse II: Restoration of Dynamic Vaginal Supports by Infracoccygeal Sacropexy, an Axial Day-Case Vaginal Procedure  

Microsoft Academic Search

:   Our objective was to present and critically analyze the first 75 infracoccygeal sacropexy (ICS) operations for cure of vault\\u000a prolapse. Level 1 reconstruction was achieved by the insertion of a tension-free vaginal tape (nylon) via the ischiorectal\\u000a fossa into a transversely incised posterior vaginal fornix. Level 2 defects were repaired by cutting a central ‘bridge’ in\\u000a the posterior vaginal

P. E. Papa Petros

2001-01-01

109

Vaginal fold histology reduces the variability introduced by vaginal exfoliative cytology in the classification of mouse estrous cycle stages  

PubMed Central

Vaginal exfoliative cytology is commonly used in biomedical and toxicological research to classify the stages of the rodent estrous cycle. However, mouse vaginal exfoliative cytology is commonly used as a stand-alone tool and has not been evaluated in reference to vaginal histology and serum sex hormone levels. In this study, the direct and Giemsa-stained methods of vaginal exfoliative cytology were compared in reference to vaginal fold histology and serum sex hormone levels. Both methods predicted the estrous stages similarly with mean discordance rates of 55%, 77%, 46% and 31%, for diestrus, proestrus, estrus and metestrus, respectively. From these results we conclude that vaginal exfoliative cytology may be used as a general guide to determine the desired estrous stage endpoint, and that a definitive confirmation of the estrous stage should obtained from evaluation of vaginal fold histology. Confirmation of the stage of the estrous cycle by vaginal fold histology will decrease the variability otherwise introduced by misclassification of estrous cycle stages with vaginal exfoliative cytology. PMID:24705880

Arnon, Gal; Po-Ching, Lin; Anne M, Barger; Amy L, MacNeill; CheMyong, Ko

2015-01-01

110

Fibroepithelial vaginal polyp in a newborn  

PubMed Central

A fibroepithelial polyp of the vagina (FEPV) is a mucosal polypoid lesion with a connective tissue core covered by a benign squamous epithelium. A vaginal polyp must be considered in the evaluation of interlabial masses in prepubertal girls. This article describes a newborn girl with an interlabial mass that the histological analysis revealed to be an FEPV. Surgical excision of the mass was performed, and the patient has not experienced recurrence after 1-year of follow-up. A review of the literature revealed that our case was the third reported case of a fibroepithelial polyp in a neonate.

Alotay, Abdulhakim A.; Sarhan, Osama; Alghanbar, Mustafa; Nakshabandi, Ziyad

2015-01-01

111

Pathology Case Study: Bloody Vaginal Discharge  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman experienced bloody vaginal discharge long after menopause. Visitors are given both the microscopic pap smear and biopsy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

Dickson, H.

112

Update in management of vaginal mesh erosion.  

PubMed

Mesh erosion is one of the major complications of prolapse surgery conducted by transvaginal approach. Following the extensive use of meshes and warning about potential complications, a new classification of mesh-related adverse events has been proposed. Due to the wide scope of clinical features, no standardized approach has been proposed. Surgery is required after failure of conservative management, mostly based on mesh partial or total excision by transvaginal route, following the classic rules of re-do vaginal surgery. Complex cases are best managed in tertiary reference centers. PMID:23873511

Cornu, Jean-Nicolas; Peyrat, Laurence; Haab, François

2013-10-01

113

Microbiology of vaginal discharge in Nairobi, Kenya.  

PubMed Central

Among women attending a sexually transmitted disease (STD) clinic in Nairobi with vaginal discharge, Neisseria gonorrhoeae and Chlamydia trachomatis were isolated from the cervix in 32 (26%) of 122 and four (7%) of 58 women respectively. Infection with Trichomonas vaginalis, Candida albicans, Gardnerella vaginalis, and Mycoplasma spp were diagnosed in 42 of 122 (34%), 26 of 110 (24%), 75 of 100 (75%), and 42 of 89 (47%) women respectively. Mixed infections with at least two pathogens were found in 23 (26%) of 89 women examined for all microorganisms. Infection with N gonorrhoeae was significantly associated with abdominal pain. PMID:6405973

Mirza, N B; Nsanze, H; D'Costa, L J; Piot, P

1983-01-01

114

Vaginal mass following uncemented total hip arthroplasty  

PubMed Central

A 53-year-old woman developed a vaginal mass following an uncemented total hip arthroplasty. The mass was in direct communication with the hip through an acetabular medial wall defect after loosening of the acetabular component. The mass formation was caused simultaneously by changes secondary to polyethylene wear, a tiny delamination of the porous titanium mesh coating and a broken antirotational tab on the acetabular cup, all of which may have served as sources of metal particles. A careful evaluation of the patient's history, symptoms, X-ray findings and computed tomography scans should always be performed to ensure accurate diagnosis. PMID:25404779

Shin, Young-Soo; Jung, Tae-Wan; Han, Seung-Beom

2014-01-01

115

Vaginal "fisting" as a cause of death.  

PubMed

We describe the death of a young girl that resulted from the insertion of a clenched hand and forearm into her vagina during heterosexual activity. (The male homosexual practice of rectal fist insertion has been described previously.) We believe this death to be the first reported case of a "fisting" death due to vaginal fist insertion during heterosexual activity. This death is reported to alert forensic pathologists, medicolegal death investigators, and coroners aware of the role of aberrant sexual activity and its potential to cause death. PMID:2929548

Fain, D B; McCormick, G M

1989-03-01

116

Pharmacological profiling of neuropeptides on rabbit vaginal wall and vaginal artery smooth muscle in vitro  

PubMed Central

Background and purpose: Hypothalamic neuropeptides centrally modulate sexual arousal. However, the role of neuropeptides in peripheral arousal has been ignored. Vascular and non-vascular smooth muscle relaxation in the vagina is important for female sexual arousal. To date, in vitro studies have focused on vaginal strips with no studies on vaginal arteries. The aim of this study was to compare the effects of sexual hypothalamic neuropeptides on rabbit vaginal wall strips and arteries. Experimental approach: Tissue bath and wire myography techniques were used to measure isometric tension from strips and arteries, respectively. Key results: Pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) relaxed both preparations, effects that were only antagonized by the VIP/PACAP antagonist VIP6–28 (10?nM) and the PAC1 antagonist PACAP 6–38 (1??M). The melanocortin agonist ?-melanocortin-stimulating hormone (1??M), but not bremelanotide (1??M), also relaxed both preparations. Oxytocin and vasopressin contracted vaginal preparations, which could be antagonized by the V1A antagonist SR 49059. Neuropeptide Y (NPY) and the NPY Y1 agonist Leu31, Pro34 NPY only contracted arteries, which was antagonized by the NPY Y1 receptor antagonist BIBP 3226. Melanin-concentrating hormone (MCH; 1??M) contracted arteries. Conclusion and implications: Hypothalamic neuropeptides can exert contractile and relaxant effects on vaginal strips and arteries. NPY Y1, V1A, MCH1 antagonists as well as VIP/PAC1 agonists may have therapeutic potential in both central and peripheral female sexual arousal. Differences in effect of neuropeptides between preparations raise the question of which preparation is important for female sexual arousal. PMID:18587425

Aughton, K L; Hamilton-Smith, K; Gupta, J; Morton, J S; Wayman, C P; Jackson, V M

2008-01-01

117

Fluconazole Susceptibility of Vaginal Isolates Obtained from Women with Complicated Candida Vaginitis: Clinical Implications  

PubMed Central

Despite considerable evidence of azole resistance in oral candidiasis due to Candida species, little is known about the azole susceptibilities of the genital tract isolates responsible for vaginitis. The fluconazole susceptibilities of vaginal isolates obtained during a multicenter study of 556 women with complicated Candida vaginitis were determined by evaluating two fluconazole treatment regimens. Of 393 baseline isolates of Candida albicans, 377 (96%) were highly susceptible to fluconazole (MICs, <8 ?g/ml) and 14 (3.6%) were resistant (MICs, ?64 ?g/ml). Following fluconazole therapy, one case of in vitro resistance developed during 6 weeks of monitoring. In accordance with the NCCLS definition, in vitro fluconazole resistance correlated poorly with the clinical response, although a trend of a higher mycological failure rate was found (41 versus 19.6% on day 14). By using an alternative breakpoint of 1 ?g/ml, based upon the concentrations of fluconazole achievable in vaginal tissue, no significant differences in the clinical and mycological responses were observed when isolates (n = 250) for which MICs were ?1 ?g/ml were compared with isolates (n = 30) for which MICs were >1 ?g/ml, although a trend toward an improved clinical outcome was noted on day 14 (odds ratio, >2.7; 95% confidence interval, 0.91, 8.30). Although clinical failure was uncommon, symptomatic recurrence or mycological relapse almost invariably occurred with highly sensitive strains (MICs, <1.0 ?g/ml). In vitro fluconazole resistance developed in 2 of 18 initially susceptible C. glabrata isolates following fluconazole exposure. Susceptibility testing for women with complicated Candida vaginitis appears to be unjustified. PMID:12499165

Sobel, J. D.; Zervos, M.; Reed, B. D.; Hooton, T.; Soper, D.; Nyirjesy, P.; Heine, M. W.; Willems, J.; Panzer, H.

2003-01-01

118

Vaginal Eroticism and Female Orgasm: A Current Appraisal  

Microsoft Academic Search

In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and

Heli Alzate

1985-01-01

119

Gestational trophoblastic disease: the significance of vaginal metastases.  

PubMed

Six patients with gestational trophoblastic disease whose presenting symptom was hemorrhage from vaginal metastases are discussed. The clinical features, management, and response to treatment are outlined and it is suggested that the presence of vaginal metastases should be regarded as a poor prognostic factor and an indication for multiple cytotoxic agent chemotherapy. PMID:6313492

Bloch, B; Atad, J

1983-10-01

120

What Are the Risk Factors for Vaginal Cancer?  

MedlinePLUS

... know what causes vaginal cancer? What are the risk factors for vaginal cancer? A risk factor is anything that affects your chance of getting ... disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is ...

121

Vaginal delivery in patients with a prior cesarean section.  

PubMed

To assess the risks and benefits of vaginal delivery in patients with prior cesarean section, the English literature on this subject from 1950 to 1980 was reviewed. The following conclusions were reached: 1) Properly conducted vaginal delivery after cesarean section is relatively safe, with a 0.7% incidence of uterine rupture, 0.93 perinatal mortality, and no maternal deaths due to uterine rupture. 2) Of those patients allowed a trial of labor, 66.7% were successfully delivered vaginally. Successful vaginal delivery occurred in 74.2% of those patients with a nonrecurrent indication for their previous cesarean section and in 33.3% of those patients whose indication for previous cesarean section was cephalopelvic disproportion. Sixty-seven percent of those patients with a prior vaginal delivery versus 47.1% of those patients without a prior vaginal delivery subsequently delivered vaginally. 3) A classic uterine scar clearly increases the probability of uterine rupture. However, the precise magnitude of the increased risk cannot be accurately determined. 4) Certain basic safety requirements such as available operating room facilities and adequate personnel for careful observation are mandatory, but other management policies that remain controversial include use of regional anesthesia, oxytocin administration, timing of hospital admission, artificial rupture of membranes, mode of delivery, proper method to evaluate the uterine scar, and delivery of fetuses in breech presentation and twins. 5) A policy of selective vaginal deliveries among patients with prior cesarean sections will result in cost reductions due to decreased postpartum hospitalization. PMID:7078857

Lavin, J P; Stephens, R J; Miodovnik, M; Barden, T P

1982-02-01

122

Women's Psychological Adjustment Following Emergency Cesarean versus Vaginal Delivery.  

ERIC Educational Resources Information Center

Investigated psychological adjustment and satisfaction in women who had given birth vaginally or by cesarean section. Cesarean mothers reported significantly less satisfaction with the delivery than did vaginal mothers; however no differences were found in postpartum psychological adjustment as measured by depression, anxiety, and confidence in…

Padawer, Jill A.; And Others

1988-01-01

123

Vaginal breech delivery: results of a prospective registration study  

PubMed Central

Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar?vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p?vaginal delivery group (p?vaginal group without long-term sequelae. PMID:23883361

2013-01-01

124

Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery  

PubMed Central

The presence of an abnormal vaginal microflora in early pregnancy is a risk factor for preterm delivery. There is no investigation on vaginal flora dominated by lactic acid bacteria and possible association with preterm delivery. We assessed the dominant vaginal Lactobacillus species in healthy pregnant women in early pregnancy in relation to pregnancy outcome. We observed 111 low risk pregnant women with a normal vaginal microflora 11 + 0 to 14 + 0 weeks of pregnancy without subjective complaints. Vaginal smears were taken for the identification of lactobacilli using denaturing gradient gel electrophoresis (DGGE). Pregnancy outcome was recorded as term or preterm delivery (limit 36 + 6 weeks of gestation). The diversity of Lactobacillus species in term vs. preterm was the main outcome measure. L. iners alone was detected in 11 from 13 (85%) women who delivered preterm. By contrast, L. iners alone was detected in only 16 from 98 (16%) women who delivered at term (p < 0.001). Fifty six percent women that delivered at term and 8% women that delivered preterm had two or more vaginal Lactobacillus spp. at the same time. This study suggests that dominating L. iners alone detected in vaginal smears of healthy women in early pregnancy might be associated with preterm delivery. PMID:24875844

Petricevic, Ljubomir; Domig, Konrad J.; Nierscher, Franz Josef; Sandhofer, Michael J.; Fidesser, Maria; Krondorfer, Iris; Husslein, Peter; Kneifel, Wolfgang; Kiss, Herbert

2014-01-01

125

Effects of estroprogestins containing natural estrogen on vaginal flora.  

PubMed

Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG - Klaira®) in a quadriphasic regimen, while the other 30 women were administered 17-? estradiol with nomestrol acetate (EV+NOMAC - Zoely®) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs. PMID:24993504

De Seta, Francesco; Restaino, Stefano; Banco, Rubina; Conversano, Ester; De Leo, Rossella; Tonon, Maddalena; Maso, Gianpaolo; Barbati, Giulia; Lello, Stefano

2014-11-01

126

A comparative study of Neo Sampoon, Ortho Vaginal Tablets and Emko Vaginal Tablets in Accra, Ghana.  

PubMed

Neo Sampoon is an effervescent contraceptive vaginal tablet manufactured in Japan that contains 60 mg of the spermicide menfegol. Ortho Vaginal Tablets (OVT) and Emko Vaginal Tablets (EVT), both containing 100 mg of the spermicide nonoxynol-9, were manufactured in the USA. The three products were compared in a randomized clinical trial conducted at the family planning clinics of the Korle-Bu Teaching Hospital and the Kotobaabi Polyclinic in Accra, Ghana. Three-hundred volunteers participated. At 12 months, the life-table pregnancy rates were 9.6, 11.3 and 12.5 per 100 women in the Neo Sampoon, OVT and EVT groups, respectively (p greater than 0.10). More EVT than Neo Sampoon or OVT users discontinued because of discomfort as well as for other product-related reasons (p less than 0.01). The most common reason for discontinuation was the temporary absence of sexual partner, with more than 40% of the women overall terminating for this reason. The 12-month life-table continuation rates per 100 women were higher for the Neo Sampoon group (62.4) than the OVT group (48.6) or the EVT group (38.5) (p less than 0.01). The effectiveness of the three products seems to be similar, but Neo Sampoon and OVT appear to be more acceptable than EVT in this Ghanaian population. PMID:3002720

Lamptey, P; Klufio, C; Smith, S C; Feldblum, P J

1985-11-01

127

A system-wide initiative to prevent retained vaginal sponges.  

PubMed

As any perinatal nurse knows, retained vaginal sponges are an obstetrical and postpartum patient safety problem. As surgical sponge counts are not routine in some obstetrical units for vaginal births, our healthcare system chose to institute a rigorous process to eliminate retained sponges in all vaginal births. This article describes this process, along with the lessons learned, when Catholic Healthcare West implemented the Sponge ACCOUNTing System in its 32 hospitals in California, Arizona, and Nevada. Implementation of this process involved the standardization of practice for obstetricians, certified nurse midwives, nurses, obstetric technicians, radiologists, and radiology technicians in the management and accounting of surgical sponges. PMID:21857202

Chagolla, Brenda A; Gibbs, Verna C; Keats, John P; Pelletreau, Barbara

2011-01-01

128

Vaginal intercourse frequency and heart rate variability.  

PubMed

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck Personality Inventory were excluded from analyses). As in a previous smaller study, greater HRV was associated with greater FSI (but not masturbation or non-coital sex with a partner) and rated importance of intercourse. There were no sex differences in the HRV-FSI relationship, and the relationship was not explained by including measures of Extraversion, Neuroticism, Depression, Trait Anxiety, or partnership satisfaction. However, the previously obtained negative association of FSI with DBP was not replicated. PMID:14504008

Brody, Stuart; Preut, Ragnar

2003-01-01

129

Improving Vaginal Examinations Performed by Midwives  

PubMed Central

A vaginal examination (VE) is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant, embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE) using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management of pain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE. PMID:23984031

Muliira, Rhoda S.; Seshan, Vidya; Ramasubramaniam, Shanthi

2013-01-01

130

[Vaginal sonography as a method of study in the evaluation of cervix insufficiency. A useful complement to vaginal palpation?].  

PubMed

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 53 pregnant women between 20th und 31st week of gestation were examined by a 5 MHz vaginal sector-scanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage. PMID:2652287

Böhmer, S; Degenhardt, F; Gerlach, C; Behrens, O; Mühlhaus, K

1989-02-01

131

Human epididymis protein 4 and secretory leukocyte protease inhibitor in vaginal fluid: relation to vaginal components and bacterial composition.  

PubMed

Human epididymis protein 4 (HE4) is a protease inhibitor and a recently identified serum biomarker for ovarian cancer. Properties of HE4 in the genital tract of healthy women have not been evaluated. We evaluated associations between HE4 and a second vaginal protease inhibitor, secretory leukocyte protease inhibitor (SLPI), with vaginal concentrations of innate immune mediators or proteases and with the types of vaginal bacterial communities. Vaginal secretions were collected from 18 healthy reproductive age women and assayed by enzyme-linked immunosorbent assay for concentrations of HE4, SLPI, kallikrein 5, cathepsin B, interleukin 1? (IL-1), IL-1 receptor antagonist (IL-1 ra), mannose-binding lectin (MBL), the inducible 70-kDa heat shock protein, and matrix metalloproteinase (MMP)-8. The species composition of vaginal bacterial communities in 16 women was characterized by sequencing amplicons derived from 16S bacterial ribosomal RNA genes. Correlations between any 2 assays were analyzed by the Spearman rank correlation tests. Differences in the concentrations of HE4 and SLPI, and between soluble components and vaginal community types, were analyzed by the Mann-Whitney U tests. Vaginal HE4 concentrations, but not SLPI levels, were positively correlated with levels of IL-1? (P = .0152), IL-1ra (P = .0061), MBL (P = .0100), and MMP-8 (P = .0315). The median vaginal HE4 level, as well as concentrations of MBL, IL-1?, IL-1ra, and MMP-8, was highest when Gardnerella vaginalis dominated a vaginal community. The association between HE4, elevated levels of proteases, immune mediators and high proportions of G vaginalis strongly suggests that HE4 is a component of the proinflammatory immune response in the female genital tract. PMID:24023032

Orfanelli, Theofano; Jayaram, Aswathi; Doulaveris, Georgios; Forney, Larry J; Ledger, William J; Witkin, Steven S

2014-04-01

132

[The meshes in the cure of cystocele by vaginal way].  

PubMed

The advantages of vaginal way in the treatment of cystocele are simplicity, rapidity, peritoneal security. Raphy is subject to recidive. The meshes replace the weak fascia in its role of hammock (Delancey) for the bladder. The mesh covers the central and lateral fascial defects. The procedure consists in a short vertical colpotomy, vesicovaginal dissection, uterine preservation (if uterus is not pathologic), no vaginal excision. The mesh can be spread without fixation, fixed or anchored by arms in the obturator foramen. The results show a significative improvement in the risk of redux cystocele. Complications become less frequent with the expertise and quality of new meshes. Implants are a new vaginal evolving surgery: it must be evaluated by experts and practiced by experienced in vaginal approach surgeons. PMID:19969274

Delmas, V; Haab, F; Costa, P

2009-12-01

133

Martius graft for management of exposed vaginal prolapse mesh.  

PubMed

Although the use of vaginal mesh kits in treatment of pelvic organ prolapse (POP) has decreased the number of surgical failures, mesh exposure can occur. When conservative management fails, removing the exposed material is associated with the risk of recurrence of POP and could be challenging. We report a successful outcome of treatment of exposed mesh via use of a Martius bulbocavernosus fat pad. A 46-year-old woman had urinary incontinence and POP, which was treated using a vaginal mesh kit and tension-free vaginal tape. At 2 months after the procedure, the mesh was found to be exposed. After failed conservative management, use of a Martius graft was used, with preservation of the mesh. At 2-, 5-, and 10-month follow-up, the patient was completely asymptomatic and continent. This procedure may be a practical alternative in patients with synthetic mesh-induced vaginal erosion after failed conservative management. PMID:23295200

Al-Badr, Ahmed

2013-01-01

134

Mucus-penetrating nanoparticles for vaginal and gastrointestinal drug delivery  

NASA Astrophysics Data System (ADS)

A method that could provide more uniform and longer-lasting drug delivery to mucosal surfaces holds the potential to greatly improve the effectiveness of prophylactic and therapeutic approaches for numerous diseases and conditions, including sexually transmitted infections and inflammatory bowel disease. However, the body's natural defenses, including adhesive, rapidly cleared mucus linings coating nearly all entry points to the body not covered by skin, has limited the effectiveness of drug and gene delivery by nanoscale delivery systems. Here, we investigate the use of muco-inert mucus-penetrating nanoparticles (MPP) for improving vaginal and gastrointestinal drug delivery. Conventional hydrophobic nanoparticles strongly adhere to mucus, facilitating rapid clearance from the body. Here, we demonstrate that mucoadhesive polystyrene nanoparticles (conventional nanoparticles, CP) become mucus-penetrating in human cervicovaginal mucus (CVM) after pretreatment with sufficient concentrations of Pluronic F127. Importantly, the diffusion rate of large MPP did not change in F127 pretreated CVM, implying there is no affect on the native pore structure of CVM. Additionally, there was no increase in inflammatory cytokine release in the vaginal tract of mice after daily application of 1% F127 for one week. Importantly, HSV virus remains adherent in F127-pretreated CVM. Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that hypotonically-induced fluid uptake could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We evaluated hypotonic formulations for delivering water-soluble drugs and for drug delivery with MPP. Hypotonic formulations markedly increased the rate at which drugs and MPP reached the epithelial surface. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that isotonic formulations failed to reach. However, hypotonic formulations caused free drugs to be drawn through the epithelium, reducing vaginal retention. In contrast, hypotonic formulations caused MPP to accumulate rapidly and uniformly on vaginal surfaces, ideally positioned for sustained drug delivery. Using a mouse model of vaginal genital herpes (HSV-2) infection, we found that hypotonic delivery of free drug led to improved immediate protection, but diminished longer-term protection. Minimally hypotonic formulations provided rapid and uniform delivery of MPP to the entire vaginal surface, thus enabling formulations with minimal risk of epithelial toxicity. We then describe an ex vivo method for characterizing particle transport on freshly excised mucosal tissues. By directly observing MPP transport on vaginal, gastrointestinal, and respiratory tissue, we were able to determine an innate difference in mucus mesh size at different anatomical locations. In addition, we were able to optimize particle size for gastrointestinal delivery in mice. As described here, there are numerous barriers to effective drug delivery in the gastrointestinal tract, including the mucus barrier. We go on to demonstrate that MPP can improve delivery in the gastrointestinal tract, both by rectal and oral administration. Finally, we describe the use of MPP for improving vaginal drug delivery. Incomplete drug coverage and short duration of action limit the effectiveness of vaginally administered drugs, including microbicides for preventing sexually transmitted infections. We show that MPP provide uniform distribution over the vaginal epithelium, whereas CP are aggregated by mouse vaginal mucus, leading to poor distribution. By penetrating into the deepest mucus layers in the rugae, more MPP were retained in the vaginal tract compared to CP. After 24 h, when delivered in a conventional vaginal gel, patches of a model drug remained on the vaginal epithelium, whereas the epithelium was coated with drug delivered by MPP. We then demonstrate that when administered 30 min prior to inoculum, anti-HSV-2 MPP protected

Ensign-Hodges, Laura

135

Vaginal pH: Home-Use Tests  

MedlinePLUS

... provide a more thorough assessment of your vaginal status through your history, physical exam, and other laboratory tests than you can using a single pH test in your home. Useful Links MedlinePlus: ...

136

Trichomoniasis as Seen in a Chronic Vaginitis Clinic  

PubMed Central

Objective: We sought to determine the clinical and laboratory features of trichomonas vaginitis (TV) in a chronic vaginitis clinic. Methods: We studied 45 women with symptomatic TV attending a specialty chronic vaginitis clinic. These patients were older than the usual symptomatic patients with TV. They frequently described unusual chronicity of symptoms, half being referred because of clinical resistance and the other half referred because of chronic vaginitis of unknown etiology. Results: In spite of the chronicity of infection, the signs and symptoms of florid inflammation were still evident and high numbers of polymorphonuclear leukocytes and parasitic load were present. Conclusions: A longstanding infection, especially if previously untreated, invariably responded to conventional nitroimidazole therapy. In addition, the majority of patients seen with clinical resistance to the conventional doses of metronidazole responded to high-dose oral metronidazole therapy. Unsuspected TV should always be considered in low-risk patients with chronic vulvovaginal symptoms. PMID:18476071

Dan, Michael

1996-01-01

137

HPV-Associated Vaginal Cancer Rates by Race and Ethnicity  

MedlinePLUS

... Is Doing Related Links Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ... Cancer Home HPV-Associated Vaginal Cancer Rates by Race and Ethnicity Language: English Español (Spanish) Recommend on ...

138

Management of Vaginal Atrophy: Implications from the REVIVE Survey  

PubMed Central

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA. PMID:24987271

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

139

Diversity of the Vaginal Microbiome Correlates With Preterm Birth  

PubMed Central

Reproductive tract infection is a major initiator of preterm birth (PTB). The objective of this prospective cohort study of 88 participants was to determine whether PTB correlates with the vaginal microbiome during pregnancy. Total DNA was purified from posterior vaginal fornix swabs during gestation. The 16S ribosomal RNA gene was amplified using polymerase chain reaction primers, followed by chain-termination sequencing. Bacteria were identified by comparing contig consensus sequences with the Ribosomal Database Project. Dichotomous responses were summarized via proportions and continuous variables via means ± standard deviation. Mean Shannon Diversity index differed by Welch t test (P = .00016) between caucasians with PTB and term gestation. Species diversity was greatest among African Americans (P = .0045). Change in microbiome/Lactobacillus content and presence of putative novel/noxious bacteria did not correlate with PTB. We conclude that uncultured vaginal bacteria play an important role in PTB and race/ethnicity and sampling location are important determinants of the vaginal microbiome. PMID:23715799

Hyman, Richard W.; Fukushima, Marilyn; Jiang, Hui; Fung, Eula; Rand, Larry; Johnson, Brittni; Vo, Kim Chi; Caughey, Aaron B.; Hilton, Joan F.; Davis, Ronald W.; Giudice, Linda C.

2014-01-01

140

Massive Delayed Vaginal Hemorrhage after Laparoscopic Supracervical Hysterectomy  

PubMed Central

Background. A known complication of supracervical hysterectomy is cyclical bleeding from the retained cervix when functioning endometrial tissue is not totally removed. We present a rare case of delayed postoperative vaginal hemorrhage after supracervical hysterectomy. Case. A 44-year-old woman presented on postoperative day 15 after laparoscopic supracervical hysterectomy with massive vaginal hemorrhage requiring emergent re-operation. Her bleeding was controlled with vaginally placed sutures. Ultrasound confirmed no intraperitoneal free fluid. The etiology was thought to be induced by postoperative tissue necrosis from cautery applied to the endocervical canal during the original surgery. Conclusion. Delayed vaginal hemorrhage from a retained cervix is a rare complication of laparoscopic supracervical hysterectomy. Caution should be exercised when cauterizing the endocervical canal as induced tissue necrosis may increase the risk of postoperative bleeding. PMID:22919525

Holloran-Schwartz, M. Brigid; Potter, Shannon J.; Kao, Ming-Shian

2012-01-01

141

Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy  

PubMed Central

Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function. PMID:25379314

Pieh-Holder, Kelly L.; DeVente, James E.

2014-01-01

142

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

SciTech Connect

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions.

Supe, Sanjay S. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)], E-mail: sanjayssupe@gmail.com; Bijina, T.K.; Varatharaj, C.; Shwetha, B.; Arunkumar, T.; Sathiyan, S.; Ganesh, K.M.; Ravikumar, M. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)

2009-04-01

143

Rate of Vaginal Cuff Separation Following Laparoscopic or Robotic Hysterectomy  

PubMed Central

Objective Vaginal cuff separation is a rare but serious complication following hysterectomy. The goal of our study was to determine the rate of vaginal cuff separation and associated risk factors in patients undergoing laparoscopic or robotic hysterectomy. Methods We retrospectively identified patients who underwent a minimally invasive simple or radical hysterectomy at one institution between January 2000 and 2009. Fisher's exact test, Wilcoxon rank sum test and multiple logistic regression was used to determine associations between variables and increased risk of separation. Results A total of 417 patients underwent laparoscopic (n=285) or robotic (n=132) hysterectomy during the study period. Three hundred and sixty-two underwent simple hysterectomy (249 laparoscopic, 113 robotic) and 57 underwent radical hysterectomy (36 laparoscopic, 19 robotic). Seven (1.7%) patients developed a cuff complication and all had a diagnosis of malignancy. Three (1.1%) patients in the laparoscopy group suffered a vaginal cuff evisceration (n=2) or separation (n=1). Four patients in the robotic group (3.0%) had a vaginal evisceration (n=1) or separation (n=3). There was no difference based on surgical approach (p=0.22). Vaginal cuff complications were 9.46-fold higher among patients who had a radical hysterectomy (p<0.01). Median time to presentation of vaginal cuff complication was 128 days (58–175) in the laparoscopy group and 37 days (range: 32–44) in the robotic group. Conclusions The overall risk of vaginal cuff complication was 1.7%. There appears to be no difference in cuff complication rates based on surgical approach. Radical hysterectomy, however, was associated with a 9-fold increase in vaginal cuff complications. PMID:20869763

Nick, Alpa M.; Lange, Jimena; Frumovitz, Michael; Soliman, Pamela T.; Schmeler, Kathleen M.; Schlumbrecht, Matthew P.; dos Reis, Ricardo; Ramirez, Pedro T.

2015-01-01

144

Management of Vaginal Erosion of Polypropylene Mesh Slings  

Microsoft Academic Search

PurposeThe SPARC (American Medical Systems, Minneapolis, Minnesota) polypropylene sling has recently been introduced as an alternative delivery system to TVT (Ethicon, New Brunswick, New Jersey) tension-free vaginal tape for placement of a tension-free mid urethral sling. Erosion must always be considered a risk of synthetic materials. We present 4 cases of vaginal erosion of polypropylene mesh placed with this system

KATHLEEN C. KOBASHI; FRED E. GOVIER

2003-01-01

145

Robotic removal of eroded vaginal mesh into the bladder.  

PubMed

Vaginal mesh erosion into the bladder after midurethral sling procedure or cystocele repair is uncommon, with only a few cases having been reported in the literature. The ideal surgical management is still controversial. Current options for removal of eroded mesh include: endoscopic, transvaginal or abdominal (either open or laparoscopic) approaches. We, herein, present the first case of robotic removal of a large eroded vaginal mesh into the bladder and discuss potential benefits and limitations of the technique. PMID:23600850

Macedo, Francisco Igor B; O'Connor, Jeffrey; Mittal, Vijay K; Hurley, Patrick

2013-11-01

146

Ileal pouch vaginal fistulas: Incidence, etiology, and management  

Microsoft Academic Search

Some of the initial problems associated with the ileonal reservoir have been solved. In their place, other complications have\\u000a been recognized. Among these, the ileal pouch vaginal fistula stands out as a recently recognized difficult management problem.\\u000a This multicenter study was undertaken to gain insight into the causes for, and treatment of, pouch vaginal fistulas. Cases\\u000a were gathered from 11

Steven D. Wexner; David A. Rothenberger; Linda Jensen; Stanley M. Goldberg; Emmanuel G. Balcos; Paul Belliveau; Bradley H. Bennett; John G. Buls; Jeffrey M. Cohen; Harold L. Kennedy; Steven J. Medwell; Theodore M. Ross; David J. Schoetz; Lee E. Smith; Alan G. Thorson

1989-01-01

147

Urinary and vaginal criteria for detecting ovulation in the mare  

E-print Network

, anger, anxiety, etc. cause an inczeased secretion of epinephrine which leads to glycogen mobilization and resultant nervous glyco- suria. Cunningham and Friend (1965) demonstrated this nervous glycosuzia in pigs. Normal blood glucose levels of 94 mg... the secretory phase of the human menstrual cycle. Sexual stimulation also increases the quantity of vaginal fluid, according to PLasters (1959). In 1934 Cruickshsnk postulated that glycogenolysis occurs in living vaginal cells and stated that a glycogen...

Householder, D. Douglas

1973-01-01

148

Vaginal vault prolapse following cystectomy: transvaginal reconstruction by mesh interposition.  

PubMed

The present study aims to introduce a transvaginal interposition of polypropylene mesh as a reproducible procedure for women with vaginal vault prolapse following cystectomy due to bladder carcinoma. No recurrent prolapse occurred in two cases 16 and 4 months after the operation. With apical fixation of the mesh, vaginal length can be maintained. No perioperative complications appeared. Performing the technique in a reproducible way seems feasible irrespective of differing anatomical conditions. PMID:22955251

Graefe, Flora; Beilecke, Kathrin; Tunn, Ralf

2013-08-01

149

Sexual absorption of vaginal progesterone: a randomized control trial.  

PubMed

Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA) or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P = 0.0075). Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P = 0.0008). Conclusion(s). Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464. PMID:25713585

Merriam, Kathryn S; Leake, Kristina A; Elliot, Mollie; Matthews, Michelle L; Usadi, Rebecca S; Hurst, Bradley S

2015-01-01

150

Bioadhesive Mini-Tablets for Vaginal Drug Delivery  

PubMed Central

Different non-ionic cellulose ethers (methyl cellulose, MC; hydroxyethyl cellulose, HEC; hydroxypropyl cellulose, HPC; hydroxypropylmethyl cellulose, HPMC) and microcrystalline cellulose (MCC) were investigated as matrix formers for preparation of mini-tablets targeting vaginal drug delivery. Hexyl aminolevulinat hydrochloridum (HAL) was used as a model drug. The mini-tablets were characterized with respect to their mechanical strength, bioadhesion towards cow vaginal tissue in two independent tests (rotating cylinder test, detachment test using texture analyzer), and dissolution rate in two media mimicking the pH levels of fertile, healthy and post-menopausal women (vaginal fluid simulant pH 4.5, phosphate buffer pH 6.8). Mini-tablets with a matrix of either HPMC or HPC were found to possess adequate mechanical strength, superior bioadhesive behavior towards vaginal tissue, and pH independent controlled release of the model drug, suggesting that both systems would be suited for the treatment of women regardless of age, i.e., respective of their vaginal pH levels. Bioadhesive mini-tablets offer a potential for improved residence time in the vaginal cavity targeting contact with mucosal tissue and prolonged release of the drug. PMID:25166286

Hiorth, Marianne; Nilsen, Susanne; Tho, Ingunn

2014-01-01

151

Sexual Absorption of Vaginal Progesterone: A Randomized Control Trial  

PubMed Central

Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA) or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P = 0.0075). Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P = 0.0008). Conclusion(s). Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464. PMID:25713585

Merriam, Kathryn S.; Leake, Kristina A.; Elliot, Mollie; Matthews, Michelle L.; Usadi, Rebecca S.; Hurst, Bradley S.

2015-01-01

152

Barbed Suture for Vaginal Cuff Closure in Laparoscopic Hysterectomy  

PubMed Central

Background and Objectives: Our aim was to evaluate whether the use of barbed suture for vaginal cuff closure is associated with a decrease in postoperative vaginal bleeding compared with cuff closure with polyglactin 910 in patients who have undergone laparoscopic hysterectomy. Methods: We performed a cohort study of patients who underwent laparoscopic hysterectomy between January 2008 and July 2012 by the minimally invasive gynecologic surgery division of the Gynecology, Obstetrics and Human Reproduction Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Results: A total of 232 women were studied: 163 were in the polyglactin 910 group, and 69 were in the barbed suture group. The main outcome, postoperative vaginal bleeding, was documented in 53 cases (32.5%) in the polyglactin 910 group and in 13 cases (18.8%) in the barbed suture group (relative risk, 0.57; 95% confidence interval, 0.34–0.9; P = .03). No statistically significant differences were found in other postoperative outcomes, such as emergency department admission, vaginal cuff dehiscence, infectious complications, and the presence of granulation tissue. Conclusion: In this study an inverse association was observed between the use of barbed suture for vaginal cuff closure during laparoscopic hysterectomy and the presence of postoperative vaginal bleeding. PMID:24680149

Medina, Byron Cardoso; Riaño, Giovanni; Hoyos, Luis R.; Otalora, Camila

2014-01-01

153

Homogeneity of the vaginal microbiome at the cervix, posterior fornix, and vaginal canal in pregnant Chinese women.  

PubMed

The vaginal microbiome is an emerging concern in prenatal health. Because the sampling process of vaginal microbiota may pose potential risks for pregnant women, the choice of sampling site should be carefully considered. However, whether the microbial diversity is different across various sampling sites has been controversial. In the present study, three repeated swabs were collected at the cervix (C), posterior fornix (P), and vaginal canal (V) from 34 Chinese women during different pregnancy stages, and vaginal species were determined using the Illumina sequencing of 16S rRNA tag sequences. The identified microbiomes were classified into four community state types (CSTs): CST I (dominated by L. crispatus), CST II (dominated by L. gasseri), CST III (dominated by L. iners), and CST IV-A (characterized by a low abundance of Lactobacillus, but with proportions of various species previously shown to be associated with bacterial vaginosis). All individuals had consistent CST at the three sampling sites regardless of pregnancy stage and CST group. In addition, there was little heterogeneity across community structures within each individual, as determined by LEfSe, indicating high vaginal microbiome homogeneity at the three sampling sites. The present study also revealed different beta diversity during pregnancy stages. The vaginal microbiome variation among women during trimester T1 (9?±?2.6 weeks) is larger than that of non-pregnant women and women from other trimesters, as demonstrated by the UniFrac distance (P?vaginal microbiome of postpartum women compare to women in gestation. These results will be useful for future studies of the vaginal microbiota during pregnancy. PMID:25230887

Huang, Yi-E; Wang, Yan; He, Yan; Ji, Yong; Wang, Li-Ping; Sheng, Hua-Fang; Zhang, Min; Huang, Qi-Tao; Zhang, Dong-Jing; Wu, Jing-Jing; Zhong, Mei; Zhou, Hong-Wei

2015-02-01

154

Vaginal ultrasonography in patients with postmenopausal bleeding.  

PubMed

Our objective was to define a subset of women with postmenopausal bleeding in whom the accepted practice of endometrial sampling could be safely omitted. Vaginal endosonographic measurements were compared to the histological findings of curettings following diagnostic dilatation and curettage in 129 women with post-menopausal bleeding who were not receiving hormonal therapy. Atrophy was diagnosed in 49%, slight proliferation in 10%, endometrial polyps in 11%, hypoplasia in 12%, and adenocarcinoma in 12%. Endometrial atrophy was associated with a mean sonographic thickness of 2.6 mm of the double layer (range 0-6.5 mm). Of the women with a final histological diagnosis of atrophy, 92% had an endometrial thickness of 3 mm or less. Furthermore, all women with a sonographic endometrial thickness of 3 mm or less had atrophic endometrium (p < 0.0001). An endometrial thickness of 3 mm or less would have reduced the number of dilation and curettage procedures by 45% and no cases of endometrial pathologies would have been missed. In women presenting with postmenstrual bleeding, meticulous scanning of the endometrium can select a group where endometrial sampling can be omitted from the protocol. PMID:12797245

Auslender, R; Bornstein, J; Dirnfeld, M; Kogan, O; Atad, J; Abramovici, H

1993-11-01

155

Vaginal intraepithelial neoplasia: a therapeutical dilemma.  

PubMed

Vaginal intraepithelial neoplasia (VaIN) represents a rare and asymptomatic pre-neoplastic lesion. Its natural history and potential evolution into invasive cancer are uncertain. VaIN can occur alone or as a synchronous or metachronous lesion with cervical and vulvar HPV-related intra epithelial or invasive neoplasia. Its association with cervical intraepithelial neoplasia is found in 65% of cases, with vulvar intraepithelial neoplasia in 10% of cases, while for others, the association with concomitant cervical or vulvar intraepithelial neoplasias is found in 30-80% of cases. VaIN is often asymptomatic and its diagnosis is suspected in cases of abnormal cytology, followed by colposcopy and colposcopically-guided biopsy of suspicious areas. In the past, high-grade VaIN and multifocal VaIN have been treated by radical surgery, such as total or partial upper vaginectomy associated with hysterectomy and radiotherapy. The need to maintain the integrity of reproductive capacity has determined the transition from radical therapies to conservative ones, according to the different patients' characteristics. PMID:23267125

Frega, Antonio; Sopracordevole, Francesco; Assorgi, Chiara; Lombardi, Danila; DE Sanctis, Vitaliana; Catalano, Angelica; Matteucci, Eleonora; Milazzo, Giusi Natalia; Ricciardi, Enzo; Moscarini, Massimo

2013-01-01

156

Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction  

SciTech Connect

Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery.

Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

1983-06-01

157

Converting Potential Abdominal Hysterectomy to Vaginal One: Laparoscopic Assisted Vaginal Hysterectomy  

PubMed Central

Background. The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy. Material and methods. A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise. Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06 + 31.97?min versus 135.25 + 31.72 min; P < 0.05). However, the mean blood loss in LAVH was 100?mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79?mL versus 340.00 + 119.86?mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups. PMID:24729873

Shetty, Jyothi; Shanbhag, Asha

2014-01-01

158

Some characteristics of vaginal prolapse in Nepali buffaloes.  

PubMed

Prolapse of vagina is one of the important maternal abnormalities during pregnancy in cattle and buffaloes. A field investigation was carried out on 26 Murrah graded buffaloes to study clinical characteristics of vaginal prolapse in buffaloes in Nepal. Fifty-seven percent of the 26 buffaloes with vaginal prolapse were either heifers or in first lactation. Sixty-five percent of the cases were in seventh month of pregnancy or later. About three quarters of the cases occurred between June and October. Twelve cases (63%) of the 19 animals excluding 7 heifers had a history of vaginal prolapse in previous gestations. A half of the buffaloes were showing prolapse of the vagina even when they were in standing position and showing moderate or vigorous straining. After the conventional treatments, twenty-three buffaloes retained the replaced vagina and calved normally. One animal aborted although the vagina was retained. Two buffaloes had severest degree of vaginal prolapse complicated with edema, injury and cyanosis, and they did not respond to the treatment. The two buffaloes had frequently recurrent prolapse and subsequently died. Early detection and prompt treatment may be imperative to control the vaginal prolapse in buffaloes. PMID:14665751

Sah, Shyam Kishore; Nakao, Toshihiko

2003-11-01

159

77 FR 8900 - Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal...  

Federal Register 2010, 2011, 2012, 2013, 2014

...COMMISSION [Investigation No. 337-TA-768] Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on...within the United States after importation of certain vaginal birth control devices by reason of infringement of certain...

2012-02-15

160

BLT Humanized Mice as Model to Study HIV Vaginal Transmission  

PubMed Central

The majority of human immunodeficiency virus type 1 (HIV-1) infections occur by sexual exposure, and vaginal transmission accounts for more than half of all newly acquired infections. Studies of vaginal transmission of simian immunodeficiency virus to nonhuman primates (NHPs) have suggested an important role for immune cell trafficking in the establishment of infection as well is in the process of viral dissemination. However, NHP models do not permit the study of HIV transmission and dissemination. The improvement of humanized mouse models with robust human immune cell reconstitution of the female genital tract renders these mice susceptible to intravaginal HIV infection. Thus humanized mouse models of HIV vaginal infection will allow the study of the mechanisms involved in HIV transmission and dissemination in vivo. PMID:24151319

Deruaz, Maud; Luster, Andrew D.

2013-01-01

161

Sustained release of proteins from a modified vaginal ring device  

PubMed Central

A new vaginal ring technology, the insert vaginal ring (InVR), is presented. The InVR overcomes the current shortfall of conventional vaginal rings (VRs) that are generally ineffectual for the delivery of hydrophilic and/or macromolecular actives, including peptides, proteins and antibodies, due to their poor permeation characteristics in the hydrophobic polymeric elastomers from which VRs are usually fabricated. Release of the model protein BSA from a variety of insert matrices for the InVR is demonstrated, including modified silicone rods, directly compressed tablets and lyophilised gels, which collectively provided controlled release profiles from several hours to beyond 4 weeks. Furthermore, the InVR was shown to deliver over 1 mg of the monoclonal antibody 2F5 from a single device, offering a potential means of protecting women against the transmission of HIV. PMID:21055465

Morrow, Ryan J.; Woolfson, A. David; Donnelly, Louise; Curran, Rhonda; Andrews, Gavin; Katinger, Dietmar; Malcolm, R. Karl

2013-01-01

162

Vaginal antisepsis for hysterectomy: a review of the literature.  

PubMed

Infectious complications of hysterectomy remain common despite the use of prophylactic antibiotics. Most are caused by contamination of the surgical site by vaginal bacteria which are not controlled by current methods of pre-operative antisepsis. The medical literature concerning antiseptic preparation of the vagina for surgery was reviewed to discover the evidence on which practice may be based. A search using Medline, Current Contents, the Cochrane Library and the reference lists of articles on the subject and of major gynaecology textbooks produced 13 comparative studies. No conclusive randomized controlled trials were found and most of the studies had severe methodological problems limiting interpretation of their results. The scant available data suggest that use of vaginal antiseptics before the patient arrives in the operating room is probably not useful, and that application of povidone-iodine vaginal gel at the beginning of abdominal hysterectomy is sufficiently promising to justify further investigation. PMID:9403256

Eason, E L

1997-01-01

163

Magnetic resonance imaging in the evaluation of vaginal foreign bodies in a young girl.  

PubMed

A 7-year-old girl with foul-smelling, bloody vaginal discharge for more than 2 years was initially suspected of suffering from vaginal foreign bodies. Although plain radiography revealed no abnormal findings in the pelvis, magnetic resonance imaging (MRI) showed multiple low intensity objects and an intact vaginal wall. Four plastic toys were removed with forceps under general anesthesia. MRI is supposed to be the best technique for evaluating vaginal foreign bodies in young girls. PMID:11789752

Kihara, M; Sato, N; Kimura, H; Kamiyama, M; Sekiya, S; Takano, H

2001-11-01

164

Depomedroxyprogesterone-induced hypoestrogenism and changes in vaginal flora and epithelium  

Microsoft Academic Search

Objective: To identify the effects of depomedroxyprogesterone acetate (DMPA) on vaginal microbial flora and epithelium.Methods: Women who desired DMPA for contraception were evaluated before and at 3 and 6 months after initiation of 150-mg DMPA injections every 3 months. At each visit, we assessed genital symptoms, vaginal signs, vaginal microflora, and histopathology by vaginal biopsies.Results: Among 38 women observed for

Leslie Miller; Dorothy L Patton; Amalia Meier; Soe Soe Thwin; Thomas M Hooton; David A Eschenbach

2000-01-01

165

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance.  

PubMed

Bacterial communities colonizing the reproductive tracts of primates (including humans) impact the health, survival and fitness of the host, and thereby the evolution of the host species. Despite their importance, we currently have a poor understanding of primate microbiomes. The composition and structure of microbial communities vary considerably depending on the host and environmental factors. We conducted comparative analyses of the primate vaginal microbiome using pyrosequencing of the 16S rRNA genes of a phylogenetically broad range of primates to test for factors affecting the diversity of primate vaginal ecosystems. The nine primate species included: humans (Homo sapiens), yellow baboons (Papio cynocephalus), olive baboons (Papio anubis), lemurs (Propithecus diadema), howler monkeys (Alouatta pigra), red colobus (Piliocolobus rufomitratus), vervets (Chlorocebus aethiops), mangabeys (Cercocebus atys) and chimpanzees (Pan troglodytes). Our results indicated that all primates exhibited host-specific vaginal microbiota and that humans were distinct from other primates in both microbiome composition and diversity. In contrast to the gut microbiome, the vaginal microbiome showed limited congruence with host phylogeny, and neither captivity nor diet elicited substantial effects on the vaginal microbiomes of primates. Permutational multivariate analysis of variance and Wilcoxon tests revealed correlations among vaginal microbiota and host species-specific socioecological factors, particularly related to sexuality, including: female promiscuity, baculum length, gestation time, mating group size and neonatal birth weight. The proportion of unclassified taxa observed in nonhuman primate samples increased with phylogenetic distance from humans, indicative of the existence of previously unrecognized microbial taxa. These findings contribute to our understanding of host-microbe variation and coevolution, microbial biogeography, and disease risk, and have important implications for the use of animal models in studies of human sexual and reproductive diseases. PMID:25036926

Yildirim, Suleyman; Yeoman, Carl J; Janga, Sarath Chandra; Thomas, Susan M; Ho, Mengfei; Leigh, Steven R; Consortium, Primate Microbiome; White, Bryan A; Wilson, Brenda A; Stumpf, Rebecca M

2014-12-01

166

Vaginal dilator therapy for women receiving pelvic radiotherapy  

PubMed Central

Background Many vaginal dilator therapy guidelines advocate routine vaginal dilation during and after pelvic radiotherapy to prevent stenosis (abnormal narrowing of the vagina). The UK Gynaecological Oncology Nurse Forum recommend dilation “three times weekly for an indefinite time period”. The UK patient charity Cancer Backup advises using vaginal dilators from two to eight weeks after the end of radiotherapy treatment. Australian guidelines recommend dilation after brachytherapy “as soon as is comfortably possible” and “certainly within four weeks and to continue for three years or indefinitely if possible”. However, dilation is intrusive, uses health resources and can be psychologically distressing. It has also caused rare but very serious damage to the rectum. Objectives To review the benefits and harms of vaginal dilation therapy associated with pelvic radiotherapy for cancer. Search methods Searches included the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 4), MEDLINE (1950 to 2008), EMBASE (1980 to 2008) and CINAHL (1982 to 2008). Selection criteria Any comparative randomised controlled trials (RCT) or data of any type which compared dilation or penetration of the vagina after pelvic radiotherapy treatment for cancer. Data collection and analysis The review authors independently abstracted data and assessed risk of bias. We analysed the mean difference in sexual function scores and the risk ratio for non-compliance at six weeks and three months in single trial analyses. No trials met the inclusion criteria. Main results Dilation during or immediately after radiotherapy can, in rare cases, cause damage and there is no persuasive evidence from any study to demonstrate that it prevents stenosis. Data from one RCT showed no improvement in sexual scores in women who were encouraged to practice dilation. Two case series and one comparative study using historical controls suggest that dilation might be associated with a longer vaginal length but these data cannot reasonably be interpreted to show that dilation caused the change in the vagina. Authors’ conclusions Routine dilation during or soon after cancer treatment may be harmful. There is no reliable evidence to show that routine regular vaginal dilation during or after radiotherapy prevents the late effects of radiotherapy or improves quality of life. Gentle vaginal exploration might separate the vaginal walls before they can stick together and some women may benefit from dilation therapy once inflammation has settled but there are no good comparative supporting data. PMID:20824858

Miles, Tracie; Johnson, Nick

2014-01-01

167

Effect of dehydroepiandrosterone on vaginal and uterine histomorphology in the rat  

Microsoft Academic Search

Dehydroepiandrosterone (DHEA) applied on the dorsal skin of ovariectomized animals, at the twice daily dose of 30mg, resulted in a complete reversal of the vaginal atrophy seen 1, 3 and 6months after ovariectomy, and induced proliferation and mucification of the vaginal epithelium. A similar mucification of the vaginal epithelium related to androgenic action was observed in intact rats treated with

Antigone Sourla; Michel Flamand; Alain Bélanger; Fernand Labrie

1998-01-01

168

Successful pregnancy outcome in an untreated case of concomitant transverse complete vaginal septum with unicornuate uterus.  

PubMed

Transverse vaginal septum is a result of faulty canalization of embryonic vagina. Septum may be complete but usually has laterally placed tiny hole giving an impression of vaginal vault without cervix. We described a case of untreated transverse vaginal septum with small central aperture diagnosed during labor and unicornuate uterus diagnosed intraoperatively, with successful pregnancy outcome. PMID:25624665

Kumar, Naina; Tayade, Surekha

2014-01-01

169

76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation  

Federal Register 2010, 2011, 2012, 2013, 2014

...In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation...after importation of certain vaginal ring birth control devices by reason of infringement...after importation of certain vaginal ring birth control devices that infringe claim 1...

2011-03-29

170

Analysis of Bacterial Vaginosis-Related Amines in Vaginal Fluid by Gas Chromatography and Mass Spectrometry  

Microsoft Academic Search

The presence of various amines in vaginal fluid from women with malodorous vaginal discharge has been reported before. The investigations have used several techniques to identify the amines. However, an optimized quantification, together with a sensitive analysis method in connection with a diagnostic procedure for vaginal discharge, including the syndrome of bacterial vaginosis, as defined by the accepted \\

HELEN WOLRATH; URBAN FORSUM; P. G. LARSSON; HANS BOREN

2001-01-01

171

Free Glycogen in Vaginal Fluids Is Associated with Lactobacillus Colonization and Low Vaginal pH  

PubMed Central

Objective Lactobacillus dominates the lower genital tract microbiota of many women, producing a low vaginal pH, and is important for healthy pregnancy outcomes and protection against several sexually transmitted pathogens. Yet, factors that promote Lactobacillus remain poorly understood. We hypothesized that the amount of free glycogen in the lumen of the lower genital tract is an important determinant of Lactobacillus colonization and a low vaginal pH. Methods Free glycogen in lavage samples was quantified. Pyrosequencing of the 16S rRNA gene was used to identify microbiota from 21 African American women collected over 8–11 years. Results Free glycogen levels varied greatly between women and even in the same woman. Samples with the highest free glycogen had a corresponding median genital pH that was significantly lower (pH 4.4) than those with low glycogen (pH 5.8; p<0.001). The fraction of the microbiota consisting of Lactobacillus was highest in samples with high glycogen versus those with low glycogen (median?=?0.97 vs. 0.05, p<0.001). In multivariable analysis, having 1 vs. 0 male sexual partner in the past 6 months was negatively associated, while BMI ?30 was positively associated with glycogen. High concentrations of glycogen corresponded to higher levels of L. crispatus and L. jensenii, but not L. iners. Conclusion These findings show that free glycogen in genital fluid is associated with a genital microbiota dominated by Lactobacillus, suggesting glycogen is important for maintaining genital health. Treatments aimed at increasing genital free glycogen might impact Lactobacillus colonization. PMID:25033265

Mirmonsef, Paria; Hotton, Anna L.; Gilbert, Douglas; Burgad, Derick; Landay, Alan; Weber, Kathleen M.; Cohen, Mardge; Ravel, Jacques; Spear, Gregory T.

2014-01-01

172

The vaginal microbiome, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth.  

PubMed

Ascending bacterial infection is implicated in about 40-50% of preterm births. The human vaginal microbiota in most women is dominated by lactobacilli. In women whose vaginal microbiota is not lactobacilli-dominated anti-bacterial defence mechanisms are reduced. The enhanced proliferation of pathogenic bacteria plus degradation of the cervical barrier increase bacterial passage into the endometrium and amniotic cavity and trigger preterm myometrial contractions. Evaluation of protocols to detect the absence of lactobaciili dominance in pregnant women by self-measuring vaginal pH, coupled with measures to promote growth of lactobacilli are novel prevention strategies that may reduce the occurrence of preterm birth in low-resource areas. PMID:25316066

Witkin, S S

2015-01-01

173

Evaluation of the Effects of a New Intravaginal Gel, Containing Purified Bovine Colostrum, on Vaginal Blood Flow and Vaginal Atrophy in Ovariectomized Rat  

PubMed Central

Introduction Vaginal dryness due to vaginal atrophy is a common complaint of postmenopausal women, interfering with sexual function and quality of life. Hormone replacement therapy is the only effective therapy but with known risks that leave unmet medical needs. A new product, ZP-025 vaginal gel, containing purified (dialyzed lyophilized) bovine colostrum, has been developed for the treatment of vaginal dryness secondary to vaginal atrophy. Aim The study aims to investigate the effects of intravaginal application of ZP-025 on vaginal atrophy using an animal model. Methods Ovariectomized female Sprague-Dawley rats were used. Three weeks after surgery, rats were divided into four groups and treated for 4 weeks (twice a day) with placebo or ZP-025 at low (0.5%) or high (2.3%) concentrations of colostrum; in the control group, rats did not receive any treatment. Changes in vaginal blood flow due to pelvic nerve stimulation were assessed by laser Doppler flowmetry and vaginal tissue was collected for histological assay. Main Outcome Measures The main outcome measures were vaginal blood flow before and after pelvic nerve stimulation and histology of vaginal epithelium. Results Treatment with ZP-025 to ovariectomized rats induced an increase of vaginal blood flow parameters (vascular capacitance, amplitude and area under the curve of the response) in response to pelvic nerve stimulation compared with control group, statistically significant at 2.3%. Vaginal epithelium showed a physiological estrous cycle aspect in treated animals, with at least five cell layers vs. one or two cell layers in control rats. As expected from a topical formulation, systemic effects on body weights and uterine wet weights were not observed with application of ZP-025. Conclusions In this study, the new product ZP-025, containing purified colostrum, was shown to have beneficial effects on vaginal atrophy in ovariectomized rats, improving vaginal hemodynamics and thickness of vaginal epithelium. Vailati S, Melloni E, Riscassi E, Behr Roussel D, and Sardina M. Evaluation of the effects of a new intravaginal gel, containing purified bovine colostrum, on vaginal blood flow and vaginal atrophy in ovariectomized rat. Sex Med 2013;1:35–43. PMID:25356286

Vailati, Silvia; Melloni, Elsa; Riscassi, Ermanno; Behr Roussel, Delphine; Sardina, Marco

2013-01-01

174

A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child  

PubMed Central

Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic. PMID:25738041

Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish

2015-01-01

175

Labial Adhesion with Acute Urinary Retention Secondary to Vaginitis  

PubMed Central

Labial adhesion occurs most often in infants and girls and is usually associated with low estrogen levels. Labial adhesion in the reproductive age group is extremely rare due to abundance of estrogen. Herein we present a case of almost complete labial adhesion with acute urinary retention in a 21-year-old virgin woman secondary to a probable untreated severe vaginitis. PMID:25105038

?entürk, ?enol; Üstüner, Pelin; Bal?k, Gül?ah; Ka??tc?, Mehmet; Ural, Ülkü Mete; ?ahin, Figen K?r

2014-01-01

176

Penile – vaginal intercourse is better: evidence trumps ideology  

Microsoft Academic Search

It has often been asserted that all sexual behaviours are equal. However, empirical research demonstrates that different sexual behaviours differ in many physiological and psychological domains. These differences are remarkably consistent in revealing an association between specifically penile-vaginal intercourse and indices of better physiological and psychological function. Other sexual behaviours (masturbation, partner masturbation, oral sex, anal sex, or any other

2006-01-01

177

Adaptive Plasticity of Vaginal Innervation in Term Pregnant Rats  

PubMed Central

Changes in reproductive status place varied functional demands on the vagina. These include receptivity to male intromission and sperm transport in estrus, barrier functions during early pregnancy, and providing a conduit for fetal passage at parturition. Peripheral innervation regulates vaginal function, which in turn may be influenced by circulating reproductive hormones. We assessed vaginal innervation in diestrus and estrus (before and after the estrous cycle surge in estrogen), and in the early (low estrogen) and late (high estrogen) stages in pregnancy. In vaginal sections from cycling rats, axons immunoreactive for the pan-neuronal marker protein gene product 9.5 (PGP 9.5) showed a small reduction at estrus relative to diestrus, but this difference did not persist after correcting for changes in target size. No changes were detected in axons immunoreactive for tyrosine hydroxylase (sympathetic), vesicular acetylcholine transporter (parasympathetic), or calcitonin gene-related peptide and transient receptor potential vanilloid type 1 (TRPV-1; sensory nociceptors). In rats at 10 days of pregnancy, innervation was similar to that observed in cycling rats. However, at 21 days of pregnancy, axons immunoreactive for PGP 9.5 and each of the subpopulation-selective markers were significantly reduced both when expressed as percentage of sectional area or after correcting for changes in target size. Because peripheral nerves regulate vaginal smooth muscle tone, blood flow, and pain sensitivity, reductions in innervation may represent important adaptive mechanisms facilitating parturition. PMID:21666101

Liao, Zhaohui; Smith, Peter G.

2011-01-01

178

Benefits of Laser Therapy in Postmenopausal Vaginal Atrophy  

NASA Astrophysics Data System (ADS)

Maybe the worst aspect of menopause is the decline of the quality of the sexual life. The aim of the study is to demonstrate the beneficial effects of laser therapy in comparison with topical application of estrogen preparations, for the treatment of vaginal atrophy and sexual dysfunctions induced by menopause. A total of 50 menopausal patients were examined during a one year period. The methods used for objectifying vaginal atrophy and sexual dysfunctions were history taking, local clinical exam and PAP smear. From this group, 40 patients had vaginal atrophy with sexual dysfunctions. They have been treated differently, being included in four groups: patients treated with local estrogens, patients treated with intravaginal laser therapy, patients treated with both laser therapy and estrogens, patients treated with estrogens and placebo laser therapy. Therapeutic benefit, improvement of vaginal atrophy and quality of sexual life, were objectified by anamnesis (questionnaire), local and general clinical examination and PAP smear. The best results have been obtained, by far, in the 3rd group, followed by the women treated only with laser. In conclusion, we can say that laser therapy is the best way for solving the sexual inconveniences of menopause.

Brînzan, Daniela; P?iu?an, Lucian; Da?c?u, Voicu; Fur?u, Gheorghe

2011-08-01

179

Conservative Management of Placenta Accreta/Increta after Vaginal Birth  

PubMed Central

Aim: Aim of the study was to show that conservative management with preservation of the uterus and of fertility is possible in patients with placenta accreta/increta after vaginal delivery. Method: A retrospective analysis of patients with placental attachment disorders after vaginal delivery was done in a perinatal centre between November 2009 and April 2011. The patient collective was identified using the ICD-10 codes for placenta accreta/increta/percreta, and patient records were analysed for risk factors, maternal morbidity, preservation of the uterus and of fertility, and neonatal outcome. Results: Three cases of placenta increta were identified in the last 1.5 years out of a total of 1457 vaginal deliveries, and all 3 cases were treated conservatively. Mean maternal age was 35.3 years; gestational age ranged from 39 to 41 weeks, and mean duration between delivery of the child and delivery of the placenta was 44.67 days (range: 14–100 days). Two patients developed symptoms of endomyometritis, including fever, leukocytosis and increased CRP levels. All 3 women were successfully managed with preservation of the uterus. Conclusion: In selected cases with placenta accreta/increta after vaginal delivery, it is possible to avoid surgical procedures, particularly hysterectomy procedures, and successfully manage these patients conservatively with preservation of the uterus. PMID:25308979

Peiffer, S.; Reinhard, J.; Reitter, A.; Louwen, F.

2012-01-01

180

Vaginal Practices of HIV-Negative Zimbabwean Women  

PubMed Central

Background. Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84%) reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ?15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR): 1.17, 95% CI: 1.04–1.32). Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86). Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored. PMID:20871844

Turner, Abigail Norris; Morrison, Charles S.; Munjoma, Marshall W.; Moyo, Precious; Chipato, Tsungai; van de Wijgert, Janneke H.

2010-01-01

181

Vaginal Douching among University Women in the Southeastern United States  

ERIC Educational Resources Information Center

Objective: The authors assessed the knowledge, beliefs about, and practices of vaginal douching among women attending 2 universities in the southeastern United States. Participants: There were 416 participants in this study; 46.9% were black and 44.5% were white. Methods: The authors administered a 30-item questionnaire to women enrolled in…

Cottrell, Barbara Hansen; Close, Fran T.

2008-01-01

182

First trimester abortion with mifepristone and vaginal misoprostol  

Microsoft Academic Search

This study assessed the efficacy and side effects of first trimester medical abortion using mifepristone and vaginally administered misoprostol. Medical abortion was first introduced in Denmark in December 1997, and the acceptability of this new approach in a Danish population was evaluated. The study included the first 100 women seeking medical abortion. The gestational age was from 33 to 56

Ulla Breth Knudsen

2001-01-01

183

When is bacterial vaginosis not bacterial vaginosis?--a case of cervical carcinoma presenting as recurrent vaginal anaerobic infection  

Microsoft Academic Search

Vaginal anaerobic infection is the most common cause of vaginal discharge in women. We present a case of recurrent vaginal anaerobic infection and cervical carcinoma and discuss the association of the two conditions. More frequent cytology\\/colposcopy may be indicated in women who give a history of recurrent or persistent vaginal anaerobic infection.

M M Hudson; J A Tidy; T A McCulloch; K E Rogstad

1997-01-01

184

The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis  

Microsoft Academic Search

Antibacterial therapy may enhance the risk of symptomatic vulvo-vaginal candidosis in susceptible women. We addressed the\\u000a question whether oral antifungal treatment for vulvo-vaginal candidosis also influences the bacterial vaginal microflora.\\u000a One hundred and forty-two patients with a culture-proven acute episode of recurrent vulvo-vaginal candidosis (RVC) were treated\\u000a with fuconazole according to the ReCiDiF regimen (induction dose of 600 mg orally per

G. Donders; G. Bellen; J. Ausma; L. Verguts; J. Vaneldere; P. Hinoul; M. Borgers; D. Janssens

2011-01-01

185

Analysis of risk factors associated with vaginal erosion after synthetic sling procedures for stress urinary incontinence.  

PubMed

The goal of this study was to analyze the risk factors associated with vaginal erosion after synthetic sling procedure for stress urinary incontinence. Follow-up evaluations were at 1 week, 1 to 3 months, 6 months, and annually after the operation. The evaluations included detailed history taking, vaginal examinations, and perineal ultrasonographic urethrocystography. The vaginal erosion rate (6/239) after the synthetic sling procedure was 2.5%. We assessed the relationship between clinical features and vaginal erosion. Of these, only diabetes mellitus (DM) was a significant risk factor for vaginal erosion. Women with DM were 8.3 times more at risk than women without DM for developing vaginal erosion after synthetic sling procedure (p < 0.05). The vaginal erosion-free rate during the 24-month follow-up decreased significantly in women with DM. The rate of vaginal erosion associated with type III multifilamentous polypropylene sling (intravaginal slingplasty) is 10.7% more than that with type I monofilament polypropylene sling (such as tension-free vaginal tape and inside out transobturator vaginal tape) (p = 0.054). Women with DM should be informed that vaginal erosion is a possible complication after synthetic sling procedure. PMID:17594046

Chen, Huey-Yi; Ho, Ming; Hung, Yao-Ching; Huang, Li-Chia

2008-01-01

186

Forensic interlaboratory evaluation of the ForFLUID kit for vaginal fluids identification.  

PubMed

Identification of vaginal fluids is an important step in the process of sexual assaults confirmation. Advances in both microbiology and molecular biology defined technical approaches allowing the discrimination of body fluids. These protocols are based on the identification of specific bacterial communities by microfloraDNA (mfDNA) amplification. A multiplex real time-PCR assay (ForFLUID kit) has been developed for identifying biological fluids and for discrimination among vaginal, oral and fecal samples. In order to test its efficacy and reliability of the assay in the identification of vaginal fluids, an interlaboratory evaluation has been performed on homogeneous vaginal swabs. All the involved laboratories were able to correctly recognize all the vaginal swabs, and no false positives were identified when the assay was applied on non-vaginal samples. The assay represents an useful molecular tool that can be easily adopted by forensic geneticists involved in vaginal fluid identification. PMID:24365693

Giampaoli, Saverio; Alessandrini, Federica; Berti, Andrea; Ripani, Luigi; Choi, Ajin; Crab, Roselien; De Vittori, Elisabetta; Egyed, Balazs; Haas, Cordula; Lee, Hwan Young; Korabecná, Marie; Noel, Fabrice; Podini, Daniele; Tagliabracci, Adriano; Valentini, Alessio; Romano Spica, Vincenzo

2014-01-01

187

Nanoparticle incorporation of melittin reduces sperm and vaginal epithelium cytotoxicity.  

PubMed

Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001). However, melittin nanoparticles were not cytotoxic to sperm (p?=?0.42) or vaginal epithelium (p?=?0.48) at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ?20 µM (p<0.001) and were toxic to sperm at equivalent melittin concentrations ?40 µM (p<0.001). Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy. PMID:24748389

Jallouk, Andrew P; Moley, Kelle H; Omurtag, Kenan; Hu, Grace; Lanza, Gregory M; Wickline, Samuel A; Hood, Joshua L

2014-01-01

188

Nanoparticle Incorporation of Melittin Reduces Sperm and Vaginal Epithelium Cytotoxicity  

PubMed Central

Melittin is a cytolytic peptide component of bee venom which rapidly integrates into lipid bilayers and forms pores resulting in osmotic lysis. While the therapeutic utility of free melittin is limited by its cytotoxicity, incorporation of melittin into the lipid shell of a perfluorocarbon nanoparticle has been shown to reduce its toxicity in vivo. Our group has previously demonstrated that perfluorocarbon nanoparticles containing melittin at concentrations <10 µM inhibit HIV infectivity in vitro. In the current study, we assessed the impact of blank and melittin-containing perfluorocarbon nanoparticles on sperm motility and the viability of both sperm and vaginal epithelial cells. We found that free melittin was toxic to sperm and vaginal epithelium at concentrations greater than 2 µM (p<0.001). However, melittin nanoparticles were not cytotoxic to sperm (p?=?0.42) or vaginal epithelium (p?=?0.48) at an equivalent melittin concentration of 10 µM. Thus, nanoparticle formulation of melittin reduced melittin cytotoxicity fivefold and prevented melittin toxicity at concentrations previously shown to inhibit HIV infectivity. Melittin nanoparticles were toxic to vaginal epithelium at equivalent melittin concentrations ?20 µM (p<0.001) and were toxic to sperm at equivalent melittin concentrations ?40 µM (p<0.001). Sperm cytotoxicity was enhanced by targeting of the nanoparticles to the sperm surface antigen sperm adhesion molecule 1. While further testing is needed to determine the extent of cytotoxicity in a more physiologically relevant model system, these results suggest that melittin-containing nanoparticles could form the basis of a virucide that is not toxic to sperm and vaginal epithelium. This virucide would be beneficial for HIV serodiscordant couples seeking to achieve natural pregnancy. PMID:24748389

Jallouk, Andrew P.; Moley, Kelle H.; Omurtag, Kenan; Hu, Grace; Lanza, Gregory M.; Wickline, Samuel A.; Hood, Joshua L.

2014-01-01

189

Identification and genotyping of bacteria from paired vaginal and rectal samples from pregnant women indicates similarity between vaginal and rectal microflora  

PubMed Central

Background The vaginal microflora is important for maintaining vaginal health and preventing infections of the reproductive tract. The rectum has been suggested as the major source for the colonisation of the vaginal econiche. Methods To establish whether the rectum can serve as a possible bacterial reservoir for colonisation of the vaginal econiche, we cultured vaginal and rectal specimens from pregnant women at 35-37 weeks of gestation, identified the isolates to the species level with tRNA intergenic length polymorphism analysis (tDNA-PCR) and genotyped the isolates for those subjects from which the same species was isolated simultaneously vaginally and rectally, by RAPD-analysis. One vaginal and one rectal swab were collected from a total of each of 132 pregnant women at 35-37 weeks of gestation. Swabs were cultured on Columbia CNA agar and MRS agar. For each subject 4 colonies were selected for each of both sites, i.e. 8 colonies in total. Results Among the 844 isolates that could be identified by tDNA-PCR, a total of 63 bacterial species were present, 9 (14%) only vaginally, 26 (41%) only rectally, and 28 (44%) in both vagina and rectum. A total of 121 (91.6%) of 132 vaginal samples and 51 (38.6%) of 132 rectal samples were positive for lactobacilli. L. crispatus was the most frequently isolated Lactobacillus species from the vagina (40% of the subjects were positive), followed by L. jensenii (32%), L. gasseri (30%) and L. iners (11%). L. gasseri was the most frequently isolated Lactobacillus species from the rectum (15%), followed by L. jensenii (12%), L. crispatus (11%) and L. iners (2%). A total of 47 pregnant women carried the same species vaginally and rectally. This resulted in 50 vaginal/rectal pairs of the same species, for a total of eight different species. For 34 of the 50 species pairs (68%), isolates with the same genotype were present vaginally and rectally and a high level of genotypic diversity within species per subject was also established. Conclusion It can be concluded that there is a certain degree of correspondence between the vaginal and rectal microflora, not only with regard to species composition but also with regard to strain identity between vaginal and rectal isolates. These results support the hypothesis that the rectal microflora serves as a reservoir for colonisation of the vaginal econiche. PMID:19828036

2009-01-01

190

MTN-001: Randomized Pharmacokinetic Cross-Over Study Comparing Tenofovir Vaginal Gel and Oral Tablets in Vaginal Tissue and Other Compartments  

PubMed Central

Background Oral and vaginal preparations of tenofovir as pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection have demonstrated variable efficacy in men and women prompting assessment of variation in drug concentration as an explanation. Knowledge of tenofovir concentration and its active form, tenofovir diphosphate, at the putative vaginal and rectal site of action and its relationship to concentrations at multiple other anatomic locations may provide key information for both interpreting PrEP study outcomes and planning future PrEP drug development. Objective MTN-001 was designed to directly compare oral to vaginal steady-state tenofovir pharmacokinetics in blood, vaginal tissue, and vaginal and rectal fluid in a paired cross-over design. Methods and Findings We enrolled 144 HIV-uninfected women at 4 US and 3 African clinical research sites in an open label, 3-period crossover study of three different daily tenofovir regimens, each for 6 weeks (oral 300 mg tenofovir disoproxil fumarate, vaginal 1% tenofovir gel [40 mg], or both). Serum concentrations after vaginal dosing were 56-fold lower than after oral dosing (p<0.001). Vaginal tissue tenofovir diphosphate was quantifiable in ?90% of women with vaginal dosing and only 19% of women with oral dosing. Vaginal tissue tenofovir diphosphate was ?130-fold higher with vaginal compared to oral dosing (p<0.001). Rectal fluid tenofovir concentrations in vaginal dosing periods were higher than concentrations measured in the oral only dosing period (p<0.03). Conclusions Compared to oral dosing, vaginal dosing achieved much lower serum concentrations and much higher vaginal tissue concentrations. Even allowing for 100-fold concentration differences due to poor adherence or less frequent prescribed dosing, vaginal dosing of tenofovir should provide higher active site concentrations and theoretically greater PrEP efficacy than oral dosing; randomized topical dosing PrEP trials to the contrary indicates that factors beyond tenofovir’s antiviral effect substantially influence PrEP efficacy. Trial Registration ClinicalTrials.gov NCT00592124 PMID:23383037

Hendrix, Craig W.; Chen, Beatrice A.; Guddera, Vijayanand; Hoesley, Craig; Justman, Jessica; Nakabiito, Clemensia; Salata, Robert; Soto-Torres, Lydia; Patterson, Karen; Minnis, Alexandra M.; Gandham, Sharavi; Gomez, Kailazarid; Richardson, Barbra A.; Bumpus, Namandje N.

2013-01-01

191

Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: an open, non-controlled clinical trial.  

PubMed

Menopause, due to the physiological decrease in the estrogens levels, is often associated with many symptoms related to vaginal atrophy such vaginal dryness, dyspareunia, burning, itching, decreasing in libido and therefore a worsening of the quality of life and in particular of the sexual activity. There are many pharmacological remedies to solve these events, first of all hormone replacement therapy (HRT) that up to the 90s was the therapy of choice for the care of the menopause symptoms. This hormonal therapy, however, has been re-considered due to its side effects. As alternative, a clinical trial has been performed to investigate the efficacy and safety, in postmenopausal women with urogenital atrophy, of the use of suppositories for vaginal use, containing hyaluronic acid, vitamin E and vitamin A. The trial, according to a open, non-controlled design, was performed on 150 postmenopausal women, 1 vaginal suppository per day, for the first 14 days and then a vaginal suppository, day in and day out, for other 14 days. The primary endpoint was the evaluation of vaginal dryness assessed by a Visual Analogue Scale (VAS) both by the investigator and the patient. The secondary endpoints were the evaluation of all the other symptoms and signs associated with the vaginal atrophy (itching, burning, dyspareunia, vaginal inflammation or swelling, irritation, assessed by a 4-point scale, presence of vaginal abrasions and irritation), and the recording of the adverse events occurring during the trial. The patients have not reported adverse effects during the treatment, and the results in terms of effectiveness on the vaginal atrophy symptoms were markedly positive. A high level of compliance was registered. The product tested can therefore be considered a safe and effective alternative for the treatment of vaginal atrophy symptoms in postmenopausal women, especially when HRT is not recommended. PMID:19146203

Costantino, D; Guaraldi, C

2008-01-01

192

Bioadhesive vaginal tablets containing spray dried microspheres loaded with clotrimazole for treatment of vaginal candidiasis.  

PubMed

The aim of the present investigation was to prepare and evaluate novel bioadhesive vaginal tablets containing clotrimazole loaded microspheres in order to provide long-term therapeutic activity at the site of infection. Tablets were prepared by incorporating drug loaded microspheres and using bioadhesive polymers hydroxypropylmethylcellulose, sodium carboxymethylcellulose and Carbopol. Microspheres were prepared by the spray drying technique using Eudragit RS-100 and Eudragit RL-100. Microspheres were characterized by SEM, DSC, FTIR, particle size analysis and evaluated for percentage yield, drug loading, encapsulation efficiency and in vitro drug release. To achieve bioadhesion to the mucosal tissue, optimized microspheres were incorporated into bioadhesive tablets and were evaluated for in vitro drug release, in vitro and in vivo mucoadhesion. FTIR and DSC studies showed that no chemical interaction occurred between the drug and polymers. The sphericity factor indicated that the prepared microspheres were spherical. Formulation Mt6 indicated a controlled in vitro drug release and good bioadhesive strength. The in vivo images confirmed the bioadhesion and retention property of tablets up to 24 h. The results indicated that this drug delivery system can be explored for controlled intravaginal drug release. PMID:24152896

Gupta, Naresh Vishal; Natasha, Shirodker; Getyala, Anil; Bhat, Ramnath Sudeendra

2013-09-01

193

Selecting anti-microbial treatment of aerobic vaginitis.  

PubMed

Aerobic vaginitis (AV) is a vaginal infectious condition which is often confused with bacterial vaginosis (BV) or with the intermediate microflora as diagnosed by Nugent's method to detect BV on Gram-stained specimens. However, although both conditions reflect a state of lactobacillary disruption in the vagina, leading to an increase in pH, BV and AV differ profoundly. While BV is a noninflammatory condition composed of a multiplex array of different anaerobic bacteria in high quantities, AV is rather sparely populated by one or two enteric commensal flora bacteria, like Streptococcus agalactiae, Staphylocuccus aureus, or Escherichia coli. AV is typically marked by either an increased inflammatory response or by prominent signs of epithelial atrophy or both. The latter condition, if severe, is also called desquamative inflammatory vaginitis. As AV is per exclusionem diagnosed by wet mount microscopy, it is a mistake to treat just vaginal culture results. Vaginal cultures only serve as follow-up data in clinical research projects and are at most used in clinical practice to confirm the diagnosis or exclude Candida infection. AV requires treatment based on microscopy findings and a combined local treatment with any of the following which may yield the best results: antibiotic (infectious component), steroids (inflammatory component), and/or estrogen (atrophy component). In cases with Candida present on microscopy or culture, antifungals must be tried first in order to see if other treatment is still needed. Vaginal rinsing with povidone iodine can provide rapid relief of symptoms but does not provide long-term reduction of bacterial loads. Local antibiotics most suitable are preferably non-absorbed and broad spectrum, especially those covering enteric gram-positive and gram-negative aerobes, like kanamycin. To achieve rapid and short-term improvement of severe symptoms, oral therapy with amoxyclav or moxifloxacin can be used, especially in deep dermal vulvitis and colpitis infections with group B streptococci or (methicillin resistant) Staphylococcus aureus. Since the latter colonizations are frequent, but seldom inflammatory infections, we in general discourage the use of oral antibiotics in women with AV. In cases with a severe atrophy component (more than 10 % of epithelial cells are of the parabasal type), local estrogens can be used; and in postmenopausal or breast cancer patients with a contraindication for estrogens, even a combination of probiotics with an ultra-low dose of local estriol may be considered. PMID:25896749

Donders, Gilbert G G; Ruban, Katerina; Bellen, Gert

2015-05-01

194

Development of generic models for ambulatory vaginal surgery--a preliminary report.  

PubMed

Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from width to length or into a partial double-layered repair; the creation of artificial neoligaments; the prevention of urinary retention by avoiding tightness in the bladder neck area; local anesthetic infiltration; and buttressing vaginal tissue during wound healing. A total of 108 patients underwent vaginal surgery on an ambulatory or overnight stay basis, 72 under local anesthesia/midazolam. Minimal postoperative pain and the absence of catheterization reduced hospital stay from a statewide mean of 8 days to 1 day, and return to normal activities from 6 weeks to 7-10 days. Cure rates (18 months) were: uterovaginal prolapse 22/22, infracoccygeal sacropexy 21/23, rectocele 36/38, cystocele/anterior vaginal wall prolapse 21/25. Applied as prototypes to reconstructive vaginal surgery, the operations appear to be as effective as traditional techniques but far less invasive. They have the potential to assist working mothers, the old and infirm, and save the community up to $5,500 per patient. It is hoped that the generic models presented may act as a basis for the future development of ambulatory vaginal surgical techniques. PMID:9657174

Papa Petros, P E

1998-01-01

195

Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer  

ClinicalTrials.gov

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Squamous Cell Carcinoma

2015-03-18

196

Gemeprost vaginal pessaries for inducing third-trimester intrauterine deaths.  

PubMed

In 3rd trimester fetal death, when the cervix requires softening, labor may be induced by the administration of intravenous, intra-or extraamniotic, or vaginal prostaglandin E2 or intramuscular injections of synthetic prostaglandins, such as 15(S)-methyl prostaglandin F2 alpha. These methods all have various disadvantages. In 10 women with 3rd trimester intrauterine death, labor was induced by vaginal insertion of a 1 mg gemeprost (16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester) pessary. The mean number of pessaries s required was 1.9, and the mean duration of labor was 11.7 hours. The women remained mobile during most of the procedure. No patient required additional oxytocin, and the only side effects were mild fever and diarrhea. PMID:2804000

Shafi, M I; Constantine, G; Byrne, P; Luesley, D M; Pogmore, J R

1989-06-01

197

Chitosan/alginate complexes for vaginal delivery of chlorhexidine digluconate.  

PubMed

Chitosan/alginate complexes were prepared at different polycation/polyanion molar ratios and freeze-dried vaginal inserts were obtained for chlorhexidine digluconate local delivery in genital infections. Complex yield, FT-IR spectra, and TGA thermograms were studied to confirm the interaction between the two polyions. The influence of different complexes on physical handling, morphology, and drug distribution in the samples were evaluated by friability test, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS), respectively. In vitro water-uptake, mucoadhesion and release tests were performed as well as microbiological tests toward pathogenic vaginal microorganisms. The results showed that the selection of suitable chitosan/alginate molar ratio and drug loading allowed modulate insert ability to hydrate, adhere to the mucosa, and release chlorhexidine digluconate. The insert containing an excess of alginate was found to be the best performing formulation and showed good antimicrobial activity toward the pathogens Candida albicans and Escherichia coli. PMID:23121960

Abruzzo, A; Bigucci, F; Cerchiara, T; Saladini, B; Gallucci, M C; Cruciani, F; Vitali, B; Luppi, B

2013-01-16

198

Defining patient knowledge and perceptions of vaginal mesh surgery  

PubMed Central

Objective Given recent government investigations and media coverage of the controversy regarding mesh surgery, we sought to define patient knowledge and perceptions of vaginal mesh surgery. Study Design An anonymous survey was distributed to a convenience sample of new patients at Urogynecology and Female Urology clinics at a single medical center during April–June 2012. The survey assessed patient demographics, information sources, beliefs and concerns regarding mesh surgery. Fisher’s exact test was used to identify predictors of patients’ beliefs regarding mesh. Logistic and linear regressions were used to identify predictors of aversion to surgery and higher concern regarding future surgery. Results 164 women completed the survey; 62.2% (102/164) indicated knowledge of mesh surgery for prolapse and/or incontinence and were included in subsequent analyses. Mean age was 58.0±12.5 years and 24.5% reported prior mesh surgery. The most common information source was TV commercials (57.8%); only 23.5% of women reported receiving information from a medical professional. Participants indicated the following regarding vaginal mesh: class-action lawsuit in progress (55/102, 54.0%), causes pain (47/102, 47.1%), possibility of rejection (35/102, 34.3%), can cause bleeding and become exposed vaginally (30/102, 29.4%), and should be removed due to recall (28/102, 27.5%). Of these women, 22.1% (19/86) indicated they would not consider mesh surgery. On multivariable logistic regression, level of concern, information from friends/family, and knowledge of class-action lawsuit predicted aversion to mesh surgery. Conclusion Nearly two-thirds of new patients had knowledge of vaginal mesh surgery. We identified considerable misinformation and aversion to future mesh surgery among these women. PMID:23982577

Brown, Lindsay K.; Fenner, Dee E.; Berger, Mitchell B.; Delancey, John O.L.; Morgan, Daniel M.; Patel, Divya A.; Schimpf, Megan O.

2014-01-01

199

Urinary Incontinence after Vaginal Delivery or Cesarean Section  

Microsoft Academic Search

background It is uncertain whether women who deliver by cesarean section have an increased risk of urinary incontinence as compared with nulliparous women and whether women who deliver vaginally have an even higher risk. methods We studied 15,307 women enrolled in the Epidemiology of Incontinence in the County of Nord-Trøndelag (EPINCONT) study, which involved a community-based cohort. The data base

Guri Rortveit; Anne Kjersti Daltveit; Yngvild S. Hannestad; Steinar Hunskaar

2003-01-01

200

Clitoral blood flow increases following vaginal pressure stimulation  

Microsoft Academic Search

The vascular responses of clitoral arteries to vaginal pressure stimulation in 10 volunteer women were evaluated by Doppler ultrasonography. Pressure stimulations (20–160 mm Hg) along the lower third of the vagina increased blood velocity and flow into clitoral arteries in 9 of the 10 women. The latency and duration of the Doppler responses ranged from 0.1 to 1.6 sec and

Pierre Lavoisier; Rachild Aloui; Markus H. Schmidt; Antoine Watrelot

1995-01-01

201

Vaginal intraepithelial neoplasia: clinical-therapeutic analysis of 33 cases  

Microsoft Academic Search

Vaginal intraepithelial neoplasia (VAIN) represents 1% of all intraepithelial neoplasia of the lower genital tract. Our aim\\u000a was to study the clinical-therapeutic characteristics of patients with VAIN. A retrospective study was made of all cases of\\u000a patients, who attended within the outpatient service between 1993 and 2003, with a diagnosis of VAIN. During this period,\\u000a 84,293 Papanicolaou smears (triple collection)

Eddie F. C. Murta; Milton A. Neves Junior; Luciano R. F. Sempionato; Marcos C. Costa; Paulo J. Maluf

2005-01-01

202

Management of benign adnexal masses by vaginal route.  

PubMed

Until recently, surgical treatment of a benign adnexal mass implied a laparotomy. In recent years, the development of laparoscopic surgery, as well as ultrasound-guided aspiration techniques, have significantly modified the treatment options for these patients. These procedures have shown considerable advantages. They have reduced surgical trauma and have shortened the hospital stay. We present the results of our experience on the feasibility of a trans-vaginal surgical approach for the removal of benign adnexal masses. This technique, using traditional and cheap surgical instruments, allows the surgeon to excise benign adnexal masses, by entering the peritoneum through the posterior vaginal fornix and thus avoids the trauma of laparotomy. Fifty-four patients were operated on by this technique at our Department. The mean age was 39 years (range 21-66). In all cases, the operation was completed by the trans-vaginal approach. The median operative time was 30 minutes (range 20-45), and no blood transfusion was needed. The pathological diagnoses were as follows: functional ovarian cyst; 19, endometriotic cyst; 18, dermoid cyst; 11, parovarian cyst; 4 and peduncolated fibroid of the uterine fundus; 2 cases. The diameter of the adnexal masses ranged from 3 to 10 cm (median of 6 cm). In 30 cases, a conservative surgery was done (including 2 myomectomies), whereas in 24 cases, the adnexectomy was needed. Median post-operative stay in hospital was 4 days (range 1-14). This study shows the feasibility of trans-vaginal surgical approach for benign adnexal masses. The advantages and limitations of this technique, as well as of the traditional and laparoscopic surgery are considered and discussed. We believe that the transvaginal approach could be useful and cost-effective for the treatment of selected cases of adnexal masses. PMID:9159258

Massi, G B; Savino, L; Lena, A; Susini, T

1996-01-01

203

MR Imaging of Levator Ani Muscle Recovery Following Vaginal Delivery  

Microsoft Academic Search

:   Our aim was to quantify the changes that occur in the levator ani muscles (LA) after vaginal delivery using magnetic resonance\\u000a imaging. Fourteen women underwent MRI 1 day postpartum. Six of them were also scanned 1, 2, 6 weeks and 6 months after delivery.\\u000a LA signal intensities and thickness, in areas of the urogenital and the levator hiatus were

R. Tunn; J. O. L. DeLancey; D. Howard; J. M. Thorp; J. A. Ashton-Miller; L. E. Quint

1999-01-01

204

Effects of vaginal lactobacilli in Chlamydia trachomatis infection.  

PubMed

Increasing evidence indicates that abnormal vaginal flora lacking lactobacilli facilitates the acquisition of several sexually transmitted diseases including Chlamydia trachomatis. C. trachomatis, the most common bacterial agent of genital infections worldwide, can progress from the lower to upper reproductive tract and induce severe sequelae. The ability of C. trachomatis to develop into a persistent form has been suggested as key pathogenetic mechanism underlying chronic infections and sequelae. The aim of our study was to investigate the C. trachomatis interaction with vaginal microbiota analyzing the effects of Lactobacillus strains (L. brevis and L. salivarius) on the different phases of C. trachomatis developmental cycle. In addition, the effect of lactobacilli on persistent chlamydial forms induced by HSV-2 coinfection has also been evaluated. Our results demonstrated significant inhibition of C. trachomatis multiplication by vaginal lactobacilli. L. brevis was significantly more effective than L. salivarius (p<0.05) on all the steps of chlamydial infection cycle suggesting that the ability of lactobacilli to protect from infection is strain-dependent. Lactobacilli had an adverse effect on elementary chlamydial bodies (p<0.05), on chlamydial adsorption to epithelial cells (p<0.001) and on intracellular phases of chlamydial replication (p<0.0001). Our study also demonstrated a protective effect of lactobacilli toward persistent C. trachomatis forms induced by HSV-2 coinfection. A significant increase in the production of C. trachomatis infectious progeny was observed in C. trachomatis/HSV-2 coinfection in the presence of L. brevis (p=0.01) despite a significant inhibition of C. trachomatis multiplication (p=0.028). Our data suggest that a healthy vaginal microbiota can reduce the risk of acquiring C. trachomatis infection and counteract the development of persistent chlamydial forms. PMID:24875405

Mastromarino, Paola; Di Pietro, Marisa; Schiavoni, Giovanna; Nardis, Chiara; Gentile, Massimo; Sessa, Rosa

2014-07-01

205

Vaginal hyperplasia in the bitch: Literature review and commentary  

PubMed Central

We reviewed the incidence, etiology, clinical presentations, diagnosis, treatments and prevention of canine vaginal hyperplasia, and describe a simple surgical technique for its correction as practiced at the Small Animal Clinic, State University of Utrecht, The Netherlands. Many different treatments have been used, and some are novel approaches. In many cases, prevention is accomplished if the bitch is ovariectomized; there is a high incidence of recurrence with medical treatment. PMID:17423719

Post, Klaas; Van Haaften, Bas; Okkens, Auke C.

1991-01-01

206

Alexithymia is inversely associated with women's frequency of vaginal intercourse.  

PubMed

The study examined the relation between frequency of penile-vaginal intercourse (FSI; contrasted with other sexual behavior) and alexithymia (difficulty recognizing, identifying, and communicating emotions, reduced fantasy capacity, and an externally oriented cognitive style). To minimize response bias, persons scoring above the 86th percentile on the Eysenck Personality Inventory Lie scale were excluded. Participants (54 female and 39 male healthy young adults) completed the German version of the Toronto Alexithymia Scale (TAS-20), and provided both recall and diary measures of FSI, partner sex without vaginal intercourse, and masturbation. For women, TAS-20 scores were inversely associated with both recall and diary measures of FSI but not other sexual behavior. For men, TAS-20 scores were unrelated to all sexual behavior measures. Thus, for normal women but not men, alexithymia was specifically associated with lower FSI. Results are discussed in terms of the unique nature of penile-vaginal intercourse, emotional integration and sexuality, and both less alexithymia and greater FSI being associated with indices of better physical and psychological health. PMID:12597274

Brody, Stuart

2003-02-01

207

A disposable vaginal speculum for the chimpanzee (Pan troglodytes).  

PubMed

The unanticipated underutilization of chimpanzees (Pan troglodytes) by the National Institutes of Health (NIH) for current NIH-supported research has prompted the application of a variety of contraceptive forms. Among the many methods attempted, the intrauterine device (IUD) has been described as having an efficacy similar to that described for humans. In addition, the device is both a financially sound and practical solution to prevention of overpopulation, while minimizing disruption of normal cyclic hormonal fluctuations. However, variations in the size and shape of the sexual skin of the female chimpanzee and the depth of the vaginal vault have posed physical constraints on the use of instrumentation developed for humans for assisting with insertion of the device. In addition the literature is lacking in specific methodology for pelvic examination in chimpanzees. Previously, the University of Louisiana at Lafayette New Iberia Research Center used a 3-ml plastic syringe case as a vaginal speculum to accommodate requirements of an approved research protocol in African green monkeys (Chlorocebus aethiops). Similarly, a simple and effective disposable vaginal speculum was developed for the chimpanzee. The closed tip of a plastic syringe case of appropriate size (20 to 60 ml) was removed to provide an open tube; momentary heating smoothed the cut edge. This simple speculum allowed for sufficient visualization of the cervix for assessment and assistance in the insertion of the IUD. Variously sized speculums were prepared to accommodate differences in animal size. This simple and effective speculum was clean, disposable, and inexpensive. PMID:15934725

Hasselschwert, Dana L; Fontenot, M Babette

2005-05-01

208

Pelvic floor disorders following vaginal or cesarean delivery  

PubMed Central

Purpose of review Pelvic floor disorders affect women of all ages and are associated with significant economic burden and poor quality of life. Current literature suggests an association between childbirth and these disorders. In this review, we summarize recent advancements in our understanding of this association. Recent findings Vaginal childbirth appears to be strongly associated with stress urinary incontinence and pelvic organ prolapse. There is less evidence to suggest an association between vaginal delivery and overactive bladder symptoms. History of more than one perineal laceration increases the likelihood of developing prolapse. Similar association has not been established for episiotomy. Disruption or denervation of structural components of pelvic floor support system, particularly levator ani muscle complex, is associated with later development of pelvic floor disorders. Imbalance in homeostasis of connective tissue remodeling of the vaginal wall from overstretching during childbirth is another possible mechanism. Summary Pelvic floor disorders represent a significant health problem affecting women of all ages. Identification of potential modifiable risk factors and advancement in understanding of the underlying pathophysiology is crucial for primary and secondary prevention of these disorders and for improvement in treatment strategies. PMID:22907482

Memon, Hafsa; Handa, Victoria L.

2013-01-01

209

Characterization of Commercially Available Vaginal Lubricants: A Safety Perspective  

PubMed Central

Vaginal lubricants are widely used by women to help solve intercourse difficulties or as enhancers, but recent reports raise questions about their safety. Twelve commercially available gel products were tested for pH value, pH buffering capacity, osmolality and cytotoxicity relevant to vaginal delivery. Obtained data were analyzed in light of the recent Advisory Note by the World Health Organization (WHO) for personal lubricants to be concomitantly used with condoms. Results showed that most products do not comply with pH and osmolality recommended standards, thus posing a potential hazard. Four products presented values of osmolality around three-times higher than the maximum acceptable limit of 1200 mOsm/kg. In vitro cell testing further identified substantial cytotoxicity even at 1:100 dilutions for three products, contrasting with no significant effect of up to at least a 1:5 dilution of a Universal Placebo gel. However, no direct correlation between these last results and pH or osmolality was found, thus suggesting that the individual toxicity of specific formulation components plays an important role in the outcome of a particular product. Although further assessment is required, these results highlight potential safety issues related to the formulation of commercially available vaginal lubricants. PMID:25247884

Cunha, Ana Raquel; Machado, Rita M.; Palmeira-de-Oliveira, Ana; Martinez-de-Oliveira, José; das Neves, José; Palmeira-de-Oliveira, Rita

2014-01-01

210

Permeability of tritiated water through human cervical and vaginal tissue.  

PubMed

The increased incidence of human immunodeficiency virus infection in women has identified an urgent need to develop a female-controlled method to prevent acquisition of human immunodeficiency virus and other sexually transmitted diseases. Women would apply the product intravaginally before intercourse. Development of such a product requires a better understanding of the permeability characteristics of the tissues with which such products would come into contact. However, limited studies have been performed in this area. In the present study, water permeability of fresh human cervical and vaginal tissue was evaluated. The average apparent permeability coefficient was found to be 8 x 10(-5) cm/s for fresh human cervical tissue and 7 x 10(-5) cm/s for fresh human vaginal tissue. Considering the lack of regularity in obtaining cervical and vaginal tissue from surgical specimens, additional tests were performed to evaluate the effect of freezing on tritiated water permeability. No statistically significant differences were observed in the permeability values obtained when comparing fresh versus frozen tissues. PMID:15236450

Sassi, Alexandra B; McCullough, Kristy D; Cost, Marilyn R; Hillier, Sharon L; Rohan, Lisa Cencia

2004-08-01

211

A Novel Intra-body Sensor for Vaginal Temperature Monitoring  

PubMed Central

Over the years some medical studies have tried to better understand the internal behavior of human beings. Many researchers in this domain have been striving to find relationships between intra-vaginal temperature and certain female health conditions, such as ovulation and fertile period since woman’s intra-vaginal temperature is one of the body parameters most preferred in such studies. However, due to lack of a appropriate technology, medical research devoted to studying correlations of such body parameters with certain womans’ body phenomena could not obtain better results. This article presents the design and implementation of a novel intra-body sensor for acquisition and monitoring of intra-vaginal temperatures. This novel intra-body sensor provides data collection that is used for studying the relation between temperature variations and female health conditions, such as anticipation and monitoring of the ovulation period, detection of pregnancy contractions, preterm labor prevention, etc.. The motivation for this work focuses on the development of this new intra-body sensor that will represent a major step in medical technology. The novel sensor was tested and validated on hospitalized women as well as normal healthy women. Finally our medical team has attested to the accuracy, usability and performance of this novel intra-body sensor. PMID:22574046

Rodrigues, Joel J. P. C.; Caldeira, João; Vaidya, Binod

2009-01-01

212

Mucoadhesive liposomes as new formulation for vaginal delivery of curcumin.  

PubMed

Local delivery to the affected area represents the optimal means by which advantageous pharmacological properties of curcumin may be fully exploited as currently, due to the biopharmaceutical limitations associated with this polyphenol, its full beneficial effects remain limited. Curcumin-containing liposomes coated with bioadhesive polymers of natural and synthetic origin (chitosan and Carbopol) were evaluated in vitro. For these purposes, an in vitro model of vaginal mucus was developed allowing the monitoring of curcumin permeability in the conditions mimicking vaginal environment. The model was optimized by varying the amounts of glycoproteins, as compared to the permeabilities determined through isolated bovine mucus. The strength of bioadhesion was evaluated using the isolated bovine mucosa. Both curcumin solution and non-coated curcumin liposomes served as controls. Bioadhesive polymers enabled significantly higher (p<0.05) curcumin permeability through the artificial and isolated bovine mucus compared to the controls. Polymer coating of liposomes resulted in an increase in their bioadhesiveness. Mucoadhesive liposomes can be considered as potential novel drug delivery systems intended for vaginal administration of curcumin. PMID:24534774

Berginc, Katja; Suljakovi?, Sabina; Škalko-Basnet, Nataša; Kristl, Albin

2014-05-01

213

New thermal method for evaluating vaginal blood flow.  

PubMed

The goal of this study was the development noninvasive technique for measurement of vaginal blood flow. A vaginal probe (diameter 1.84 cm; length 7.0 cm) was constructed by winding 23 m of 34-gauge enameled copper wire around a hollow cylinder of epoxy-impregnated glass wool. Resistance of the wire was 20 omega at 40 degrees C. Surface area of coil was 40.5 cm2. The temperature of the wire midway along the coil was measured continuously with a thermcouple. Temperature difference (delta T) between coil and vagina was raised by delivery of 300 mA with a resultant production of 1.8 W. In ewes treated with 1 mg estrone im., delta T fell significantly (p less than 0.025) by 90 min and (p less than 0.005) by 120 min after injection. There was a significant correlation between delta T and vaginal blood flow as measured by the radiolabeled microsphere technique. PMID:7262635

Frisinger, J E; Abrams, R M; Graichen, H; Cassin, S

1981-01-01

214

Collagen scaffold: a treatment for large mesh exposure following vaginal prolapse repair.  

PubMed

Transvaginal repair with mesh of pelvic organ prolapse (POP) provides women with the durability of a synthetic graft using the less-invasive route of vaginal surgery. However, morbidities such as mesh exposures are common and challenging to manage. Small intestinal submucosa (SIS) is a naturally occurring collagen matrix derived from porcine intestine. It contains growth factors and cytokines that promote healing of damaged tissue. This case report describes a large vaginal mesh exposure due to necrosis of the full thickness of the anterior vaginal wall. A remarkable and rapid regeneration of vaginal tissue over the exposed mesh was achieved with SIS placement after failure of treatment with vaginal estrogen for >6 months. Collagen scaffold is an effective, rapid, and minimally invasive treatment for large vaginal mesh exposures. PMID:24832859

Alperin, Marianna

2014-11-01

215

Vaginal surgery for uterine descent; which options do we have? A review of the literature.  

PubMed

Several vaginal procedures are available for treating uterine descent. Vaginal hysterectomy is usually the surgeon's first choice. In this literature review, complications, anatomical and symptomatic outcomes, and quality of life after vaginal hysterectomy, sacrospinous hysteropexy, the Manchester procedure, and posterior intravaginal slingplasty are described. All procedures had low complication rates, except posterior intravaginal slingplasty, with a tape erosion rate of 0-21%. Minimal anatomical success rates regarding apical support ranged from 85% and 93% in favor of the Manchester procedure. Data on symptomatic cure and quality of life are scarce. In studies comparing vaginal hysterectomy with sacrospinous hysteropexy or the Manchester procedure, vaginal hysterectomy had higher morbidity. Because no randomized, controlled trials have been performed comparing these surgical techniques, we can not conclude that one of the procedures prevails. However, one can conclude from the literature that vaginal hysterectomy is not the logical first choice. PMID:19083135

Dietz, Viviane; Schraffordt Koops, Steven E; Koops, Steven E Schraffordt; van der Vaart, C Huub

2009-03-01

216

Microparticulated anti-HIV vaginal gel: in vitro-in vivo drug release and vaginal irritation study.  

PubMed

The aim of this study was to develop and evaluate a Zidovudine (AZT)-loaded microparticulated bioadhesive vaginal gel (MBVG) in order to obtain a controlled releasing, safe gel delivery system. AZT microparticles (ZMPs) were evaluated for encapsulation efficiency, drug loading, surface morphology and in vitro drug release profiles and drug release mechanism and optimized. The optimized ZMPs were then encompassed in bioadhesive gel using different bioadhesive polymers and evaluated for the drug encapsulation efficiency, drug loading, in vitro and in vivo drug release profiles, drug release mechanism and vaginal irritancy study. From the dissolution data of ZMP4 and MBVG4 showed a zero-order diffusion pattern and Fickian diffusion case I transport mechanism in 24 and 36?h, respectively. On the basis of a pharmacokinetic study of MBVG4 (containing ZMP: Carbopol 1:4), it was found to have better bioavailability, larger AUC and T(max) in comparison to an oral pure suspension of AZT. PMID:20497098

Chatterjee, Arkendu; Kumar, Lalit; Bhowmik, Benoy Brata; Gupta, Amlan

2011-10-01

217

Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency  

Microsoft Academic Search

Objective: Organic female sexual dysfunction may be related in part to vasculogenic impairment of the hypogastric-vaginal\\/clitoral arterial bed. The aim was to develop an animal model of vaginal engorgement insufficiency and clitoral erectile insufficiency. Methods: Pelvic nerve stimulated vaginal engorgement and clitoral erection were achieved in control (normal diet, n=8) and atherosclerotic (balloon injury of aorto-iliac arteries and 0.5% cholesterol

I Goldstein; C Andry; MB Siroky; RJ Krane; KM Azadzoi

1997-01-01

218

Human papillomavirus infection and vaginal tape exposure after midurethral sling: a case report.  

PubMed

Midurethral tape placement is the gold standard procedure for stress urinary incontinence (SUI). Among reported complications, tape erosion is uncommon. Several risk factors have been postulated as causes of vaginal erosion, but none have been demonstrated. Cases of vaginal erosion caused by tape infections have been described, but none has been associated with human papillomavirus (HPV) infection. We report the first case of vaginal exposure in a woman who underwent a midurethral sling procedure for SUI after HPV colonization. PMID:24052024

Balzarro, M; Rubilotta, E; Artibani, W

2013-01-01

219

Factors affecting vaginal pH levels among female adolescents attending genitourinary medicine clinics  

Microsoft Academic Search

Objectives: Vaginal pH is related to hormonal status, and adolescents experience disturbed hormonal patterns following menarche. We assessed hormonal factors and risk of abnormal vaginal pH and bacterial vaginosis (BV) among adolescents attending genitourinary medicine (GUM) clinics.Methods: In a cross sectional study adolescents within 5 years of menarche, ?17 years, or with oligo-amenorrhoea were recruited. Vaginal pH and BV were

L Brabin; S A Roberts; E Fairbrother; D Mandal; S P Higgins; S Chandiok; P Wood; G Barnard; H C Kitchener

2005-01-01

220

Vaginal Douches and Other Feminine Hygiene Products: Women's Practices and Perceptions of Product Safety  

Microsoft Academic Search

\\u000a Objective: Use of vaginal douche products has been linked with a variety of reproductive health problems; nonetheless, the practice\\u000a of douching persists. The goals of this study were to 1) determine the use of vaginal douches and other feminine hygiene products,\\u000a 2) ascertain how safe women think vaginal douche products are, and 3) evaluate women's readiness to stop douching. Methods:

Diane M. Grimley; Lucy Annang; Herman R. Foushee; F. Carol Bruce; Juliette S. Kendrick

2006-01-01

221

A simple identification method for vaginal secretions using relative quantification of Lactobacillus DNA.  

PubMed

In criminal investigations there are some cases in which identifying the presence of vaginal secretions provides crucial evidence in proving sexual assault. However, there are no methods for definitively identifying vaginal secretions. In the present study, we focused on Lactobacillus levels in vaginal secretions and developed a novel identification method for vaginal secretions by relative quantification based on real time PCR. We designed a Lactobacillus conserved region primer pair (LCP) by aligning 16S rRNA gene sequences from major vaginal Lactobacillus species (Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners and Lactobacillus jensenii), and selected the human specific primer pair (HSP) as an endogenous control for relative quantification. As a result, the ?Ct (?Ct=Ct[LCP]-Ct[HSP]) values of vaginal secretions (11 out of 12 samples) were significantly lower than those of saliva, semen and skin surface samples, and it was possible to discriminate between vaginal secretions and other body fluids. For the one remaining sample, it was confirmed that the predominant species in the microflora was not of the Lactobacillus genus. The ?Ct values in this study were calculated when the total DNA input used from the vaginal secretions was 10pg or more. Additionally, the ?Ct values of samples up to 6-months-old, which were kept at room temperature, remained unchanged. Thus, we concluded in this study that the simple ?Ct method by real time PCR is a useful tool for detecting the presence of vaginal secretions. PMID:24905338

Doi, Masanori; Gamo, Shinsuke; Okiura, Tatsuyuki; Nishimukai, Hiroaki; Asano, Migiwa

2014-09-01

222

Suburethral vaginal erosion and pyogenic granuloma formation: an unusual complication of intravaginal slingplasty (IVS).  

PubMed

We report an unusual case of suburethral vaginal erosion and pyogenic granuloma formation 14 months after intravaginal slingplasty (IVS). A 64-year-old woman underwent IVS for recurrent stress incontinence 12 years after Burch colposuspension. Following seemingly uncomplicated surgery and recovery, she developed a recurrent urinary tract infection which was treated with antibiotics. When she presented with vaginal pain and postmenopausal bleeding approximately 14 months postoperatively, she was found to have suburethral vaginal erosion of the tape and a pyogenic granuloma. The exposed tape was removed, the granuloma excised, and the overlying vaginal skin was then closed. She then made an uneventful recovery. PMID:14752602

Lim, Y N; Rane, A

2004-01-01

223

VAGINAL DEGENERATION FOLLOWING IMPLANTATION OF SYNTHETIC MESH WITH INCREASED STIFFNESS  

PubMed Central

Objective To compare the impact of the prototype prolapse mesh Gynemesh PS to that of two new generation lower stiffness meshes, UltraPro and SmartMesh, on vaginal morphology and structural composition. Design A mechanistic study employing a non-human primate (NHP) model. Setting Magee-Womens Research Institute at the University of Pittsburgh. Population Parous rhesus macaques, with similar age, weight, parity and POP-Q scores. Methods Following IACUC approval, 50 rhesus macaques were implanted with Gynemesh PS (n=12), UltraPro with its blue line perpendicular to the longitudinal axis of vagina (n=10), UltraPro with its blue line parallel to the longitudinal axis of vagina (n=8) and SmartMesh (n=8) via sacrocolpopexy following hysterectomy. Sham operated animals (n=12) served as controls. Main Outcome Measures The mesh-vagina complex (MVC) was removed after 12 weeks and analyzed for histomorphology, in situ cell apoptosis, total collagen, elastin, glycosaminoglycan content and total collagenase activity. Appropriate statistics and correlation analyses were performed accordingly. Results Relative to sham and the two lower stiffness meshes, Gynemesh PS had the greatest negative impact on vaginal histomorphology and composition. Compared to sham, implantation with Gynemesh PS caused substantial thinning of the smooth muscle layer (1557 ± 499?m vs 866 ± 210 ?m, P=0.02), increased apoptosis particularly in the area of the mesh fibers (P=0.01), decreased collagen and elastin content (20% (P=0.03) and 43% (P=0.02), respectively) and increased total collagenase activity (135% (P=0.01)). GAG (glycosaminoglycan), a marker of tissue injury, was the highest with Gynemesh PS compared to sham and other meshes (P=0.01). Conclusion Mesh implantation with the stiffer mesh Gynemesh PS induced a maladaptive remodeling response consistent with vaginal degeneration. PMID:23240802

Liang, Rui; Abramowitch, Steven; Knight, Katrina; Palcsey, Stacy; Nolfi, Alexis; Feola, Andrew; Stein, Susan; Moalli, Pamela A.

2012-01-01

224

Multicompartmental Pharmacokinetic Model of Tenofovir Delivery by a Vaginal Gel  

PubMed Central

Background Trials of a vaginal Tenofovir gel for pre-exposure prophylaxis (PrEP) for HIV have given conflicting results. Knowledge of concentrations of Tenofovir and its active form Tenofovir diphosphate, at putative sites of anti-HIV functioning, is central to understanding trial outcomes and design of products and dosage regimens. Topical Tenofovir delivery to the vaginal environment is complex, multivariate and non-linear; determinants relate to drug, vehicle, dosage regimen, and environment. Experimental PK methods cannot yield mechanistic understanding of this process, and have uncontrolled variability in drug sampling. Mechanistic modeling of the process could help delineate its determinants, and be a tool in design and interpretation of products and trials. Methods and Findings We created a four-compartment mass transport model for Tenofovir delivery by a gel: gel, epithelium, stroma, blood. Transport was diffusion-driven in vaginal compartments; blood concentration was time-varying but homogeneous. Parameters for the model derived from in vitro and in vivo PK data, to which model predictions gave good agreement. Steep concentration gradients occurred in stroma ?8 hours after gel release. Increasing epithelial thickness delayed initial TFV delivery to stroma and its decline: tmax increased but AUC at 24 hours was not significantly altered. At 24 and 48 hours, stromal concentrations were 6.3% and 0.2% of Cmax. Concentrations in simulated biopsies overestimated stromal concentrations, as much as ?5X, depending upon time of sampling, biopsy thickness and epithelial thickness. Conclusions There was reasonably good agreement of model predictions with clinical PK data. Conversion of TFV to TFV-DP was not included, but PK data suggest a linear relationship between them. Thus contrasts predicted by this model can inform design of gels and dosage regimens in clinical trials, and interpretation of PK data. This mass transport based approach can be extended to TFV conversion to TFV-DP, and to other drugs and dosage forms. PMID:24040241

Gao, Yajing; Katz, David F.

2013-01-01

225

Pathology Case Study: Post Coital Bleeding and Vaginal Discharge  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 33-year-old woman has a two-month history of post coital bleeding and vaginal discharge. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

Christakos, Peter

226

Acute mesenteric venous thrombosis with a vaginal contraceptive ring.  

PubMed

Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. PMID:25035742

Eilbert, Wesley; Hecht, Benjamin; Zuiderveld, Loren

2014-07-01

227

The psychosocial impact of vesico-vaginal fistula in Niger  

Microsoft Academic Search

Purpose  To explore the psycho-social impact of vesico-vaginal fistula (VVF) on women in Niger.\\u000a \\u000a \\u000a \\u000a Study design  We conducted a qualitative study on 21 women in convalescence at the DIMOL Reproductive Health Center in Niamey, Niger, in\\u000a 2008 and 2009. The women had undergone 1–3 fistula repair operations and all had stillborn infants.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Women reported many psychological consequences of VVF including depression, feelings

Amina P. Alio; Laura Merrell; Kimberlee Roxburgh; Heather B. Clayton; Phillip J. Marty; Linda Bomboka; Salamatou Traoré; Hamisu M. Salihu

2011-01-01

228

Epidemiology of vulvar and vaginal cancer in Germany  

Microsoft Academic Search

Objective  Vulvar and vaginal cancers are rare diseases with an incidence rate that increases with age. At present, epidemiological data\\u000a are rather scarce. This review article provides an epidemiologic overview of these diseases, focussing on recent German data.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This review article summarizes the information currently available in order to offer an epidemiologic overview.\\u000a \\u000a \\u000a \\u000a Results  The statistic incidence of vulvar carcinoma has been

C. Dittmer; A. Katalinic; C. Mundhenke; M. Thill; D. Fischer

2011-01-01

229

Enhanced vaginal drug delivery through the use of hypotonic formulations that induce fluid uptake  

PubMed Central

Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that administration of hypotonic solutions would induce fluid uptake that could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We found that hypotonic formulations markedly increased the rate at which small molecule drugs and muco-inert nanoparticles (mucus-penetrating particles, or MPP), but not conventional mucoadhesive nanparticles (CP), reached the vaginal epithelial surface in vivo in mice. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that drugs or MPP in isotonic formulations failed to reach efficiently. However, hypotonic formulations caused unencapsulated “free” drugs to be drawn through the epithelium, reducing vaginal retention. In contrast, hypotonic formulations caused MPP to accumulate rapidly and uniformly on vaginal surfaces, ideally positioned for localized sustained drug delivery. Using a mouse model of vaginal genital herpes (HSV-2) infection, we found that hypotonic delivery of free drug led to improved immediate protection, but diminished longer-term protection. In contrast, as we previously demonstrated, hypotonic delivery of drug via MPP led to better long-term retention and protection in the vagina. Importantly, we demonstrate that slightly hypotonic formulations provided rapid and uniform delivery of MPP to the entire vaginal surface, thus enabling formulations with minimal risk of epithelial toxicity. Hypotonic formulations for vaginal drug delivery via MPP may significantly improve prevention and treatment of reproductive tract diseases and disorders. PMID:23769419

Ensign, Laura M.; Hoen, Timothy; Maisel, Katharina; Cone, Richard; Hanes, Justin

2013-01-01

230

A Population-Based Study of Squamous Cell Vaginal Cancer: HPV and Cofactors  

Microsoft Academic Search

Background. Little is known about the etiology of in situ or invasive squamous cell cancer of the vagina. It is thought that some vaginal cancers may have the same etiology as cervical cancer. It is also not known whether in situ and invasive vaginal cancer share the same etiologic factors. We conducted a study to evaluate risk factors for in

Janet R. Daling; Margaret M. Madeleine; Stephen M. Schwartz; Katherine A. Shera; Joseph J. Carter; Barbara McKnight; Peggy L. Porter; Denise A. Galloway; James K. McDougall; Hisham Tamimi

2002-01-01

231

Management of Recurrent VulvoVaginal Candidosis as a Chronic Illness  

Microsoft Academic Search

For sporadic acute Candida vaginitis, any oral or local antifungal therapy can be used. For women with recurrent vulvo-vaginal candidosis (RVC), on the other hand, such simple approaches are insufficient, regardless of the product chosen. Instead, RVC should be managed as any other chronic disease and requires long-term, prophylactic, suppressive antifungal treatment. A regimen using individualized, decreasing doses of oral

Gilbert G. G. Donders; Gert Bellen; Werner Mendling

2010-01-01

232

Ureteral injury during vaginal mesh excision: role of prevention and treatment options.  

PubMed

Vaginal mesh kits are increasingly used in vaginal prolapse repair. Mesh erosion, infection, and pain may necessitate removal, which can lead to urinary tract injury. We describe 2 cases of ureteral injury at the time of mesh excision. Surgeons must recognize the possibility of ureteral injury and treatment modalities available. PMID:22999155

Heisler, Christine A; Casiano, Elizabeth R; Klingele, Christopher J; Gebhart, John B; Trabuco, Emanuel C

2012-12-01

233

Assessment of two methods for rapid intrapartum detection of vaginal group B streptococcal colonisation  

Microsoft Academic Search

AIMS--To compare two methods for the rapid detection of intrapartum vaginal carriage of group B streptococci (Streptococcus agalactiae) with standard culture techniques and to establish their suitability for routine use. METHODS--Vaginal swabs from 266 patients in labour were incubated in glucose broth in an anaerobic atmosphere for four to six hours. The Wellcogen Strep B latex particle agglutination test kit

A J Simpson; J A Mawn; S R Heard

1994-01-01

234

Systemic and Topical Hormone Therapies Reduce Vaginal Innervation Density in Post-Menopausal Women  

PubMed Central

Objective Menopause is often accompanied by vaginal discomfort including burning, itching, dryness and spontaneous or provoked pain. While direct effects of estrogen withdrawal on vaginal cells are implicated, surgical menopause in rodents causes autonomic and sensory nerves to proliferate, suggesting that indirect effects mediated by changes in vaginal innervation may contribute. We assessed whether post-menopausal women display hormone-dependent changes in vaginal innervation. Methods Vaginal biopsies from 20 postmenopausal women undergoing surgery for stress urinary incontinence and pelvic organ prolapse were fixed and immunostained for the pan-neuronal marker, PGP9.5, the sympathetic marker tyrosine hydroxylase, the parasympathetic marker vasoactive intestinal polypeptide, and the sensory nociceptor marker calcitonin gene-related peptide. Innervation density was measured as apparent percentage of section area occupied by immunofluorescent axons. Specimens were grouped according to whether participants received systemic hormone therapy (HT), topical (vaginal) HT, or no HT. Results Women not receiving HT showed relatively high levels of total innervation, with most axons expressing tyrosine hydroxylase or vasoactive intestinal polypeptide immunoreactivity. In patients receiving systemic HT, overall innervation was reduced, as were presumptive parasympathetic, sympathetic and sensory axon populations. Topical HT elicited more dramatic reductions in innervation than systemic HT. Conclusions Hormone therapy reduces autonomic and sensory vaginal innervation density, which may in part contribute to relief from vaginal discomfort. Moreover, topical therapy is more effective than systemic therapy, which may help explain the greater improvement reported with topical as compared to systemic HT. PMID:22205148

Griebling, Tomas L.; Liao, Zhaohui; Smith, Peter G.

2011-01-01

235

Do not have any sex (oral, vaginal, anal or using sex  

E-print Network

Do not have any sex (oral, vaginal, anal or using sex toys) with a partner until their treatment has also been completed Prevention Preventing Chlamydia · Use condoms every time you have sex sex (oral, vaginal, anal or using sex toys) with a partner until their treatment has also been

Talbot, James P.

236

Evaluation of immune system function in neonatal pigs born vaginally or by Cesarean section  

Technology Transfer Automated Retrieval System (TEKTRAN)

Eight full term crossbred sows were selected for study of the interaction of the immune system, hypothalamus-pituitary-adrenal axis, and growth in pigs born by Cesarean section (C-section) or vaginal-birth (n=4 each for vaginal-birth and C-section). Gestation length and birth weight did not differ b...

237

Effectiveness of a procedure for disinfecting the vaginal photoplethysmograph contaminated with herpes simplex virus type 2  

Microsoft Academic Search

To test the effectiveness of a disinfecting procedure involving 2% glutaraldehyde, a vaginal photoplethysmograph was contaminated with a known amount of herpes simplex type 2 (HSV-2). The vaginal photoplethysmograph was then put through the disinfection procedure. Two virus solutions were tested, one designed to approximate the concentration found in a naturally occurring infection (low inoculum), the other with 100 times

Patricia J. Morokoff; Lin S. Myers; John Hay; Michael N. Flora

1988-01-01

238

Commensal bacteria modulate innate immune responses of vaginal epithelial cell multilayer cultures.  

PubMed

The human vaginal microbiome plays a critical but poorly defined role in reproductive health. Vaginal microbiome alterations are associated with increased susceptibility to sexually-transmitted infections (STI) possibly due to related changes in innate defense responses from epithelial cells. Study of the impact of commensal bacteria on the vaginal mucosal surface has been hindered by current vaginal epithelial cell (VEC) culture systems that lack an appropriate interface between the apical surface of stratified squamous epithelium and the air-filled vaginal lumen. Therefore we developed a reproducible multilayer VEC culture system with an apical (luminal) air-interface that supported colonization with selected commensal bacteria. Multilayer VEC developed tight-junctions and other hallmarks of the vaginal mucosa including predictable proinflammatory cytokine secretion following TLR stimulation. Colonization of multilayers by common vaginal commensals including Lactobacillus crispatus, L. jensenii, and L. rhamnosus led to intimate associations with the VEC exclusively on the apical surface. Vaginal commensals did not trigger cytokine secretion but Staphylococcus epidermidis, a skin commensal, was inflammatory. Lactobacilli reduced cytokine secretion in an isolate-specific fashion following TLR stimulation. This tempering of inflammation offers a potential explanation for increased susceptibility to STI in the absence of common commensals and has implications for testing of potential STI preventatives. PMID:22412914

Rose, William A; McGowin, Chris L; Spagnuolo, Rae Ann; Eaves-Pyles, Tonyia D; Popov, Vsevolod L; Pyles, Richard B

2012-01-01

239

Plasma Catecholamines and Doppler-Derived Cardiac Time Intervals in Vaginally and Cesarean Delivered Neonates  

Microsoft Academic Search

Objective: Our purpose was to compare Doppler-derived cardiac time intervals and cord plasma levels of catecholamines in vaginally and cesarean delivered neonates. Methods: Doppler echocardiographic assessments of fetal and neonatal cardiac time intervals were made to determine differences in circulatory changes in 8 neonates delivered vaginally and 12 delivered by elective cesarean section. Aortic and pulmonary acceleration time (AT), ejection

Toshiyuki Hata; Atsushi Manabe; Ken Makihara; Kohkichi Hata; Kohji Miyazaki

1997-01-01

240

Effect of basal hormone profile on the formation of the vaginal bacterial cenosis in women.  

PubMed

Adhesion activity of L. acidophilus NK1, L. fermentum 90 TS4, and C. albicans 506 B on female vaginal epithelium was studied. Adhesion of various lactobacillus species was hormone-dependent. Adhesion of C. albicans 506 B was not associated with estrogen level. The effects of synthetic drugs and phytopreparations used for hormone replacement on adhesion of vaginal microbiocenosis members varied. PMID:22866310

Rybas, Ya A; Bustamante, R A; Kravtsov, E G; Tchernitchin, A N; Dalin, M V

2012-07-01

241

Clinical Features of Bacterial Vaginosis in a Murine Model of Vaginal Infection with Gardnerella vaginalis  

E-print Network

Clinical Features of Bacterial Vaginosis in a Murine Model of Vaginal Infection with Gardnerella: Gilbert NM, Lewis WG, Lewis AL (2013) Clinical Features of Bacterial Vaginosis in a Murine Model bacterial vaginosis (BV) [1], a microbial imbalance of the vaginal flora characterized by the absence

Lewis, Amanda L.

242

A Longitudinal Study of Vaginal Douching and Bacterial Vaginosis—A Marginal Structural Modeling Analysis  

Microsoft Academic Search

The etiology of bacterial vaginosis is unknown, and there are no long-term therapies for preventing this frequently recurring condition. Vaginal douching has been reported to be associated with bacterial vaginosis in observational studies. However, this association may be due to confounding by indication—that is, confounding by women douching in response to vaginal symptoms associated with bacterial vaginosis. The authors used

Rebecca M. Brotman; Mark A. Klebanoff; Tonja R. Nansel; William W. Andrews; Jane R. Schwebke; Jun Zhang; Kai F. Yu; Jonathan M. Zenilman; Daniel O. Scharfstein

2008-01-01

243

Evaluation of two clinical protocols for the management of women with vaginal discharge in southern Thailand  

Microsoft Academic Search

OBJECTIVES: (1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. DESIGN: Alternate allocation of

V. Chandeying; S. Skov; M. Kemapunmanus; M. Law; A. Geater; P. Rowe

1998-01-01

244

Impact of Parturition on Chemokine Homing Factor Expression in the Vaginal Distention Model of Stress Urinary Incontinence  

PubMed Central

Purpose Human childbirth simulated by vaginal distention is known to increase the expression of chemokines and receptors involved in stem cell homing and tissue repair. We hypothesized that pregnancy and parturition in rats contributes to the expression of chemokines and receptors after vaginal distention. Materials and Methods We used 72 age matched female Lewis rats, including virgin rats with and without vaginal distention, and delivered rats with and without vaginal distention. Each rat was sacrificed immediately, or 3 or 7 days after vaginal distention and/or parturition, and the urethra was harvested. Relative expression of chemokines and receptors was determined by real-time polymerase chain reaction. Mixed models were used with the Bonferroni correction for multiple comparisons. Results Vaginal distention up-regulated urethral expression of CCL7 immediately after injury in virgin and postpartum rats. Hypoxia inducible factor-1? and vascular endothelial growth factor were up-regulated only in virgin rats immediately after vaginal distention. CD191 expression was immediately up-regulated in postpartum rats without vaginal distention compared to virgin rats without vaginal distention. CD195 was up-regulated in virgin rats 3 days after vaginal distention compared to virgin rats without vaginal distention. CD193 and CXCR4 showed delayed up-regulation in virgin rats 7 days after vaginal distention. CXCL12 was up-regulated in virgin rats 3 days after vaginal distention compared to immediately after vaginal distention. Interleukin-8 and CD192 showed no differential expression. Conclusions Vaginal distention results in up-regulation of the chemokines and receptors expressed during tissue injury, which may facilitate the spontaneous functional recovery previously noted. Pregnancy and delivery up-regulated CD191 and attenuated the expression of hypoxia inducible factor-1? and vascular endothelial growth factor in the setting of vaginal distention, likely by decreasing hypoxia. PMID:23022009

Lenis, Andrew T.; Kuang, Mei; Woo, Lynn L.; Hijaz, Adonis; Penn, Marc S.; Butler, Robert S.; Rackley, Raymond; Damaser, Margot S.; Wood, Hadley M.

2015-01-01

245

Uterine prolapse complicated by vaginal cancer: a case report and literature review.  

PubMed

Primary vaginal cancer is not common, representing 1-2% of all female genital malignancies. We present a case of a third-degree uterine prolapse complicated by an isolated primary vaginal cancer and its surgical treatment. The cervix was clinically normal, but on the nearby prolapsed vaginal wall, a large exogenous hard lesion had developed. A biopsy of the lesion revealed a squamous carcinoma. The patient was asymptomatic and had no recurrence during the last 4 years of follow-up after surgical treatment with radiotherapy. The surgical treatment with or without radiotherapy is the optimum treatment for uterine prolapse with early-stage vaginal squamous cell carcinoma, although the majority of vaginal malignancies are treated with radiotherapy. We recommend always performing a biopsy prior to surgery in prolapse-induced ulceration. PMID:24481208

Wang, Yueling; Li, Qiling; Du, Huiping; Lv, Shulan; Liu, Huiting

2014-01-01

246

Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse  

Microsoft Academic Search

Objective: The anatomic and functional success of suspension of the vaginal cuff to the proximal uterosacral ligaments is described. Study Design: Forty-six women underwent vaginal site-specific repair of endopelvic fascia defects with suspension of the vaginal cuff to the proximal uterosacral ligaments for pelvic organ prolapse. Outcome measures included operative complications, pelvic organ prolapse quantitation, and assessment of pelvic floor

Matthew D. Barber; Anthony G. Visco; Alison C. Weidner; Cindy L. Amundsen; Richard C. Bump

2000-01-01

247

The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall  

Microsoft Academic Search

OBJECTIVE: The study assesses the efficacy and complications of Marlex mesh in repairing severe recurrent anterior vaginal wall prolapse. STUDY DESIGN: Twenty-four patients with two or more postsurgical recurrences of severe anterior vaginal wall prolapse were divided into control and treatment groups. Transvaginal repair was similar between groups except for reinforcement of the anterior vaginal wall with synthetic mesh. Two

Thomas M. Julian

1996-01-01

248

Vaginal Outflow Tract Obstruction Associated with Chronic Graft-versus-Host Disease Following Allogeneic Peripheral Blood Stem Cell Transplantation  

Microsoft Academic Search

Gynecological abnormalities following allogeneic hematopoietic stem cell transplantation include reduced vaginal elasticity and rugal folds, small vaginal, uterine, and cervical size, atrophic vulvovaginitis, introital stenosis, and loss of pubic hair, symptoms that are attributed to secondary ovarian failure [1]. We report the unusual complication of vaginal outflow tract obstruction occurring after allogeneic blood stem cell transplantation for lymphoblastic lymphoma. A

Makoto Hirokawa; Hirokazu Sato; Yoshinari Kawabata; Ken-ichi Sawada

2006-01-01

249

Assessment of air pockets in high-dose-rate vaginal cuff brachytherapy using cylindrical applicators  

PubMed Central

Purpose To retrospectively assess the incidence and magnitude of air pockets around vaginal cylinders and its impact on dose distribution in vaginal cuff image-guided high-dose-rate (HDR) brachytherapy. Material and methods Fifty endometrial carcinoma patients treated by postoperative HDR vaginal cuff brachytherapy were included in the study. The average age of patients was 58.3 ± 11.8 years (range: 31-87 years). Brachytherapy was performed using cylindrical applicators, and the dose prescribed to 0.5 cm from the applicator's surface, over a length of 5 cm from the applicator's tip. Computed tomography (CT) simulation was used for each brachytherapy fraction. The incidence, vaginal mucosa displacement, volume, and dosimetric effect of air pockets around the vaginal cylinder were evaluated. Results A total of 78 air pockets were found in 29/50 patients (58%) and 45/135 (33%) brachytherapy plans. They were located at the apex: 16/78 (20%) and lateral to the applicator: 62/78 (80%). The volume of air pockets ranged between 0.01 and 2.1 cm3 (mean: 0.15 cm3 ± 0.36 cm3), and the maximum displacement of vaginal mucosa from cylinder surface was between 0.1 and 1.09 cm (mean: 0.34 cm ± 0.2 cm). The dose reduction to the vaginal mucosa generated by the air pockets ranged from 0.5 to 66% (mean: 26.4% ± 13.9%). Conclusions The presence of air pockets around vaginal cylinder applicators is frequently noticed in post-operative vaginal cuff brachytherapy. The dose to the vaginal mucosa is reduced, as a result of displacement generated by air pockets. The effect on the clinical outcome of this dose reduction is yet to be determined. PMID:25337128

Hassouna, Ashraf; Constantinescu, Camelia

2014-01-01

250

[Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding'].  

PubMed

The revised Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding' provides recommendations for abnormal bleeding in women in the reproduction phase of life and for post-menopausal bleeding. This guideline is closely attuned to the guideline on 'Heavy menstrual bleeding' of the Dutch Society of Obstetrics and Gynaecology. Transvaginal sonography is not reliable for excluding endometrial carcinoma in women with abnormal vaginal bleeding treated with tamoxifen. The choice of medical treatment is determined in consultation with the patient. The following factors are assessed: severity and bother, long-term need for contraception, preference for cycle control, desire to have a child, pain during menstruation, comorbidity and use of medication. Treatment options are nonhormonal (NSAIDs, or tranexamic acid) or hormonal (a levonorgestrel-releasing intrauterine system, or combined oral contraceptive). In women of reproductive age, referral is indicated if medical treatment is not effective. Other indications are intracavitary abnormalities diagnosed by transvaginal sonography, tamoxifen use, persistent contact bleeding, and suspicion of coagulation disorders. Indications for referral for post-menopausal bleeding include: sonographic endometrial thickness > 4 mm, abnormal cervical cytology, tamoxifen use, irregular bleeding during use of hormone therapy for vasomotor symptoms and persistent or recurrent bleeding, regardless of endometrial thickness. PMID:25654687

de Vries, Corlien J H; Meijer, Loes J; Janssen, C A H Ineke; Burgers, Jako S; Opstelten, Wim

2015-01-01

251

Clinical challenges in the management of vaginal prolapse.  

PubMed

Pelvic organ prolapse is highly prevalent, and negatively affects a woman's quality of life. Women with bothersome prolapse may be offered pessary management or may choose to undergo corrective surgery. In choosing the most appropriate surgical procedure, there are many factors to consider. These may include the location(s) of anatomic defects, the severity of prolapse symptoms, the activity level of the woman, and concerns regarding the durability of the repair. In many instances, women and their surgeons are challenged to weigh the risks and benefits of native tissue versus mesh-augmented repairs. Though mesh-augmented repairs may offer better durability, they are also associated with unique complications, such as mesh erosion. Furthermore, newer surgical techniques of mesh placement via abdominal or vaginal routes may result in different outcomes compared to traditional techniques. Biologic grafts may also be considered to improve durability of a surgical repair, while avoiding potential complications of synthetic mesh. In this article, we review many of the clinical challenges that gynecologic surgeons face in the surgical management of vaginal prolapse. Furthermore, we review data that can help guide decision making when treating women with pelvic organ prolapse. PMID:24474848

Siddiqui, Nazema Y; Edenfield, Autumn L

2014-01-01

252

Clinical challenges in the management of vaginal prolapse  

PubMed Central

Pelvic organ prolapse is highly prevalent, and negatively affects a woman’s quality of life. Women with bothersome prolapse may be offered pessary management or may choose to undergo corrective surgery. In choosing the most appropriate surgical procedure, there are many factors to consider. These may include the location(s) of anatomic defects, the severity of prolapse symptoms, the activity level of the woman, and concerns regarding the durability of the repair. In many instances, women and their surgeons are challenged to weigh the risks and benefits of native tissue versus mesh-augmented repairs. Though mesh-augmented repairs may offer better durability, they are also associated with unique complications, such as mesh erosion. Furthermore, newer surgical techniques of mesh placement via abdominal or vaginal routes may result in different outcomes compared to traditional techniques. Biologic grafts may also be considered to improve durability of a surgical repair, while avoiding potential complications of synthetic mesh. In this article, we review many of the clinical challenges that gynecologic surgeons face in the surgical management of vaginal prolapse. Furthermore, we review data that can help guide decision making when treating women with pelvic organ prolapse. PMID:24474848

Siddiqui, Nazema Y; Edenfield, Autumn L

2014-01-01

253

An Emerging Mycoplasma Associated with Trichomoniasis, Vaginal Infection and Disease  

PubMed Central

Humans are colonized by thousands of bacterial species, but it is difficult to assess the metabolic and pathogenic potential of the majority of these because they have yet to be cultured. Here, we characterize an uncultivated vaginal mycoplasma tightly associated with trichomoniasis that was previously known by its 16S rRNA sequence as “Mnola.” In this study, the mycoplasma was found almost exclusively in women infected with the sexually transmitted pathogen Trichomonas vaginalis, but rarely observed in women with no diagnosed disease. The genomes of four strains of this species were reconstructed using metagenome sequencing and assembly of DNA from four discrete mid-vaginal samples, one of which was obtained from a pregnant woman with trichomoniasis who delivered prematurely. These bacteria harbor several putative virulence factors and display unique metabolic strategies. Genes encoding proteins with high similarity to potential virulence factors include two collagenases, a hemolysin, an O-sialoglycoprotein endopeptidase and a feoB-type ferrous iron transport system. We propose the name “Candidatus Mycoplasma girerdii” for this potential new pathogen. PMID:25337710

Fettweis, Jennifer M.; Serrano, Myrna G.; Huang, Bernice; Brooks, J. Paul; Glascock, Abigail L.; Sheth, Nihar U.; Strauss, Jerome F.; Jefferson, Kimberly K.; Buck, Gregory A.

2014-01-01

254

Chitosan in Mucoadhesive Drug Delivery: Focus on Local Vaginal Therapy  

PubMed Central

Mucoadhesive drug therapy destined for localized drug treatment is gaining increasing importance in today’s drug development. Chitosan, due to its known biodegradability, bioadhesiveness and excellent safety profile offers means to improve mucosal drug therapy. We have used chitosan as mucoadhesive polymer to develop liposomes able to ensure prolonged residence time at vaginal site. Two types of mucoadhesive liposomes, namely the chitosan-coated liposomes and chitosan-containing liposomes, where chitosan is both embedded and surface-available, were made of soy phosphatidylcholine with entrapped fluorescence markers of two molecular weights, FITC-dextran 4000 and 20,000, respectively. Both liposomal types were characterized for their size distribution, zeta potential, entrapment efficiency and the in vitro release profile, and compared to plain liposomes. The proof of chitosan being both surface-available as well as embedded into the liposomes in the chitosan-containing liposomes was found. The capability of the surface-available chitosan to interact with the model porcine mucin was confirmed for both chitosan-containing and chitosan-coated liposomes implying potential mucoadhesive behavior. Chitosan-containing liposomes were shown to be superior in respect to the simplicity of preparation, FITC-dextran load, mucoadhesiveness and in vitro release and are expected to ensure prolonged residence time on the vaginal mucosa providing localized sustained release of entrapped model substances. PMID:25574737

Andersen, Toril; Bleher, Stefan; Flaten, Gøril Eide; Tho, Ingunn; Mattsson, Sofia; Škalko-Basnet, Nataša

2015-01-01

255

Release of Tenofovir from Carrageenan-Based Vaginal Suppositories  

PubMed Central

Microbicides are an active area of research for HIV prevention, being developed as a woman-initiated method of prevention during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have produced microbicide prototypes in the form of semisoft vaginal suppositories prepared from carrageenan and conducted both qualitative and quantitative studies using these prototypes to determine the physical properties that drive acceptability and possibly adherence. In order to ensure that the suppositories function as effective drug delivery vehicles, we have conducted in vitro dissolution studies in water, vaginal simulant fluid (VSF) and semen simulant fluid (SSF) with suppositories loaded with the antiretroviral drug, tenofovir (TFV). TFV was released via diffusion and matrix erosion in water or by diffusion out of the matrix in VSF and SSF. Diffusion studies were conducted in two different volumes of VSF and SSF. The volume of VSF/SSF into which TFV diffused and the size of the suppositories determined the rate of diffusion from the suppositories. About 45%–50% of the encapsulated TFV diffused out of the suppositories within the first two hours, irrespective of suppository size, diffusion medium (VSF/SSF) and the volume of medium. Prior work indicates that a short waiting period between insertion and coitus is highly desired by women; present data suggest our microbicide prototypes have rapid initial release followed by a slow release curve over the first 24 h. PMID:24999606

Zaveri, Toral; Hayes, John E.; Ziegler, Gregory R.

2014-01-01

256

Vaginal ring delivery of selective progesterone receptor modulators for contraception.  

PubMed

Vaginal ring delivery of selective progesterone receptor modulators (SPRMs) is under development to address the limitations of current hormonal methods that affect use and effectiveness. This method would be appropriate for use in women with contraindications to, or preferences to avoid, estrogens. A contraceptive vaginal ring (CVR) also eliminates the need for daily dosing and therefore might improve the effectiveness of contraception. The principal contraceptive effect of SPRMs is the suppression of ovulation. One limiting factor of chronic SPRM administration is the development of benign endometrial thickening characterized as PRM-associated endometrial changes. Ulipristal acetate (UPA) is approved for use as an emergency contraceptive pill, but no SPRM is approved for regular contraception. The Population Council is developing an ulipristal acetate CVR for regular contraception. The CVR studied is of a matrix design composed of micronized UPA mixed in a silicone rubber matrix The target product is a ring designed for continuous use over 3 months delivering near steady-state drug levels that will suppress ovulation. Results from Phase 1 and 2 studies demonstrate that suppression of ovulation occurs with UPA levels above 6-7 ng/mL. PMID:23040126

Jensen, Jeffrey T

2013-03-01

257

Vaginal ring delivery of selective progesterone receptor modulators for contraception  

PubMed Central

Vaginal ring delivery of selective progesterone receptor modulators (SPRMs) are under development to address limitations of current hormonal methods that affect use and effectiveness. This method would be appropriate for use in women with contraindications to, or preferences to avoid, estrogens. A contraceptive vaginal ring (CVR) also eliminates the need for daily dosing, and therefore might improve the effectiveness of contraception. The principle contraceptive effect of SPRMs is the suppression of ovulation. One limiting factor of chronic SPRM administration is the development of benign endometrial thickening characterized as PRM-associated endometrial changes. Ulipristal acetate is approved for use as an emergency contraceptive pill, but no SPRM is approved for regular contraception. The Population Council is developing an ulipristal acetate CVR for regular contraception. The CVR studied is of a matrix design composed of micronized UPA mixed in a silicone rubber matrix The target product is a ring designed for continuous use over 3 months delivering near steady-state drug levels that will suppress ovulation. Results from Phase 1–2 studies demonstrate that suppression of ovulation occurs with UPA levels above 6–7 ng/mL. PMID:23040126

Jensen, Jeffrey T.

2013-01-01

258

Release of tenofovir from carrageenan-based vaginal suppositories.  

PubMed

Microbicides are an active area of research for HIV prevention, being developed as a woman-initiated method of prevention during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have produced microbicide prototypes in the form of semisoft vaginal suppositories prepared from carrageenan and conducted both qualitative and quantitative studies using these prototypes to determine the physical properties that drive acceptability and possibly adherence. In order to ensure that the suppositories function as effective drug delivery vehicles, we have conducted in vitro dissolution studies in water, vaginal simulant fluid (VSF) and semen simulant fluid (SSF) with suppositories loaded with the antiretroviral drug, tenofovir (TFV). TFV was released via diffusion and matrix erosion in water or by diffusion out of the matrix in VSF and SSF. Diffusion studies were conducted in two different volumes of VSF and SSF. The volume of VSF/SSF into which TFV diffused and the size of the suppositories determined the rate of diffusion from the suppositories. About 45%-50% of the encapsulated TFV diffused out of the suppositories within the first two hours, irrespective of suppository size, diffusion medium (VSF/SSF) and the volume of medium. Prior work indicates that a short waiting period between insertion and coitus is highly desired by women; present data suggest our microbicide prototypes have rapid initial release followed by a slow release curve over the first 24 h. PMID:24999606

Zaveri, Toral; Hayes, John E; Ziegler, Gregory R

2014-01-01

259

Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: A prospective randomized study with long-term outcome evaluation  

Microsoft Academic Search

OBJECTIVES: Our purpose was to determine whether a vaginal or abdominal approach is more effective in correcting uterovaginal prolapse. STUDY DESIGN: Eighty-eight women with cervical prolapse to or beyond the hymen or with vaginal vault inversion >50% of its length and anterior vaginal wall descent to or beyond the hymen were randomized to a vaginal versus abdominal surgical approach. Forty-eight

J. Thomas Benson; Vincent Lucente; Elizabeth McClellan

1996-01-01

260

Chlamydia caviae infection alters abundance but not composition of the guinea pig vaginal microbiota.  

PubMed

In humans, the vaginal microbiota is thought to be the first line of defense again pathogens including Chlamydia trachomatis. The guinea pig has been extensively used as a model to study chlamydial infection because it shares anatomical and physiological similarities with humans, such as a squamous vaginal epithelium as well as some of the long-term outcomes caused by chlamydial infection. In this study, we aimed to evaluate the guinea pig-C. caviae model of genital infection as a surrogate for studying the role of the vaginal microbiota in the early steps of C. trachomatis infection in humans. We used culture-independent molecular methods to characterize the relative and absolute abundance of bacterial phylotypes in the guinea pig vaginal microbiota in animals non-infected, mock-infected or infected by C. caviae. We showed that the guinea pig and human vaginal microbiotas are of different bacterial composition and abundance. Chlamydia caviae infection had a profound effect on the absolute abundance of bacterial phylotypes but not on the composition of the guinea pig vaginal microbiota. Our findings compromise the validity of the guinea pig-C. caviae model to study the role of the vaginal microbiota during the early steps of sexually transmitted infection. PMID:25761873

Neuendorf, Elizabeth; Gajer, Pawel; Bowlin, Anne K; Marques, Patricia X; Ma, Bing; Yang, Hongqiu; Fu, Li; Humphrys, Michael S; Forney, Larry J; Myers, Garry S A; Bavoil, Patrik M; Rank, Roger G; Ravel, Jacques

2015-06-01

261

An Audit of Singleton Breech Deliveries in a Hospital with a High Rate of Vaginal Delivery  

PubMed Central

The term breech trial (TBT) has brought about radical changes but it is debatable whether it provides unequivocal evidence regarding the practice of breech deliveries. There is a need to publish the data of a study that was performed before the era of the TBT in a hospital where there was a high rate of breech vaginal delivery. The objectives were to ascertain the incidence, mode of delivery and fetal outcome in singleton breech deliveries. The study design was a retrospective cohort study where 165 consecutive breech and 165 controls (cephalic) were included. Statistical analysis, used were Chi squared and Fischer’s exact test. P<0.05 is taken as the level of significance. The incidence of breech deliveries was found to be 3% and has remained fairly constant but the rate of breech vaginal delivery has fallen and the CS rates have increased. Even though more breech compared to controls were significantly sectioned, majority of the breeches {n=137 (83%)} were planned for vaginal delivery and in these patients two-thirds attained vaginal delivery. There was 1 fetal death in the CS group compared to 12 deaths in the vaginally delivered breech. However, most death in the breech delivered vaginally are unavoidable. In conclusion, there is a high rate of breech vaginal delivery in this series of patients and most perinatal deaths were not related to the mode of delivery. PMID:22593649

Nordin, Noraihan Mohd.

2007-01-01

262

Advanced topical drug delivery system for the management of vaginal candidiasis.  

PubMed

Abstract Vaginal candidiasis or vulvovaginal candidiasis (VC) is a common mucosal infection of vagina, mainly caused by Candida species. The major symptoms of VC are dyspareunia, pruritis, itching, soreness, vagina as well as vulvar erythema and edema. Most common risk factors that lead to the imbalance in the vaginal micro biota are the use of antibiotics, pregnancy, diabetes mellitus, immuno suppression as in AIDS or HIV patients, frequent sexual intercourse, spermicide and intra-uterine devices and vaginal douching. Various anti-fungal drugs are available for effective treatment of VC. Different conventional vaginal formulations (creams, gels, suppositories, powder, ointment, etc.) for VC are available today but have limited efficacy because of lesser residence time on vaginal epithelium due to self-cleansing action of vagina. So to overcome this problem, an extended and intimate contact with vaginal mucosa is desired; which can be accomplished by utilizing mucoadhesive polymers. Mucoadhesive polymers have an excellent binding capacity to mucosal tissues for considerable period of time. This unique property of these polymers significantly enhances retention time of different formulations on mucosal tissues. Currently, various novel formulations such as liposomes, nano- and microparticles, micro-emulsions, bio-adhesive gel and tablets are used to control and treat VC. In this review, we focused on current status of vaginal candidiasis, conventional and nanotechnology inspired formulation approaches. PMID:24959937

Johal, Himmat Singh; Garg, Tarun; Rath, Goutam; Goyal, Amit Kumar

2014-06-24

263

The Vaginal Bacterial Communities of Japanese Women Resemble Those of Women in Other Racial Groups  

PubMed Central

To determine if different racial groups shared common types of vaginal microbiota we characterized the composition and structure of vaginal bacterial communities in asymptomatic and apparently healthy Japanese women in Tokyo, Japan and compared them with those of White and Black women from North America. The composition of vaginal communities was compared based on community profiles of terminal restriction fragments of 16S rRNA genes and phylogenetic analysis of cloned 16S rRNA gene sequences of the numerically dominant bacterial populations. The types of vaginal communities found in Japanese women were similar to those of Black and White women. As with White and Black women, most vaginal communities were dominated by lactobacilli, and only four species of Lactobacillus (L. iners, L. crispatus, L. jensenii and L. gasseri) were commonly found. Communities dominated by multiple species of lactobacilli were common in Japanese and White women, but rare in Black women. The incidence in Japanese women of vaginal communities with several non-Lactobacillus species at moderately high frequencies was intermediate between Black women and White women. The limited number of community types found among women in different ethnic groups suggests that host genetic factors, including the innate and adaptive immune systems, may be more important in determining the species composition of vaginal bacterial communities than are cultural and behavioral differences. PMID:19912342

Zhou, Xia; Hansmann, Melanie A.; Davis, Catherine C.; Suzuki, Haruo; Brown, Celeste J.; Schutte, Ursel; Pierson, Jacob D.; Forney, Larry J.

2009-01-01

264

Foreign Body in Vagina: An Uncommon Cause of Vaginitis in Children  

PubMed Central

Vaginal discharge in children may result from a variety of causes. A long-standing intra-vaginal foreign body can pose both diagnostic and therapeutic challenges in children. Treatment failure may occur because of alteration of the normal vaginal flora. A 6-year-old girl, who lived with her parents, presented with a foul-smelling, blood-stained vaginal discharge as well as dysuria for 2 years. There was no history of sexual abuse. Initial evaluation that excluded gynecologic examination revealed lower abdominal tenderness. Vaginal swab and urine cultures yielded Staphylococcus aureus sensitive to ceftriaxone only. She was commenced on this antibiotic for 2 weeks, but the discharge persisted, necessitating referral to the gynecologist. Examination under anesthesia by the gynecologist revealed shreds of toilet tissue paper extracted from the vagina and slight excoriations on the wall of the vagina. Vaginal foreign body can present with diverse symptoms. It should be considered in any young female patient presenting with recurrent or persistent vaginal discharge. PMID:23634340

Chinawa, JM; Obu, HA; Uwaezuoke, SN

2013-01-01

265

Vaginal swab specimen processing methods influence performance of rapid semen detection tests: A cautionary tale  

PubMed Central

Background Detection of semen biomarkers in vaginal fluid can be used to assess women’s recent exposure to semen. Quantitative tests for detection of prostate-specific antigen (PSA) perform well, but are expensive and require specialized equipment. We assessed two rapid immunochromatographic strip tests for identification of semen in vaginal swabs. Study Design We tested 581 vaginal swabs collected from 492 women. Vaginal secretions were eluted into saline, and PSA was measured using the quantitative IMx (Abbott Laboratories) assay. Specimens were also tested using the ABAcard p30 test (Abacus Diagnostics) for detection of PSA and RSID-Semen test (Independent Forensics) for detection of semenogelin (Sg). Results Vaginal swab extraction using saline was compatible with direct assessment of vaginal swab eluates using ABAcard for PSA detection, but not for Sg detection using RSID. The rapid PSA test detected 91% of specimens containing semen compared to 74% by the rapid Sg test. Conclusion Investigators are urged to optimize vaginal swab specimen preparation methods for performance of RSID or other tests to detect semen components other than PSA. Previously described methods for PSA testing are not uniformly applicable to other tests. PMID:20705160

Hobbs, Marcia M.; Steiner, Markus J.; Rich, Kimberly D.; Gallo, Maria F.; Warner, Lee; Macaluso, Maurizio

2010-01-01

266

The vaginal microbiome during pregnancy and the postpartum period in a European population.  

PubMed

The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8-12, 20-22, 28-30 and 34-36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes. PMID:25758319

MacIntyre, David A; Chandiramani, Manju; Lee, Yun S; Kindinger, Lindsay; Smith, Ann; Angelopoulos, Nicos; Lehne, Benjamin; Arulkumaran, Shankari; Brown, Richard; Teoh, Tiong Ghee; Holmes, Elaine; Nicoholson, Jeremy K; Marchesi, Julian R; Bennett, Phillip R

2015-01-01

267

The vaginal microbiome during pregnancy and the postpartum period in a European population  

PubMed Central

The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes. PMID:25758319

MacIntyre, David A.; Chandiramani, Manju; Lee, Yun S.; Kindinger, Lindsay; Smith, Ann; Angelopoulos, Nicos; Lehne, Benjamin; Arulkumaran, Shankari; Brown, Richard; Teoh, Tiong Ghee; Holmes, Elaine; Nicoholson, Jeremy K.; Marchesi, Julian R.; Bennett, Phillip R.

2015-01-01

268

Successful External Cephalic Version: Factors Predicting Vaginal Birth  

PubMed Central

Purpose. To determine the maternal and fetal outcomes of successful external cephalic version (ECV) as well as factors predicting vaginal birth. Methods. The ECV data over a period of three years at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between 1 September 2008 and 30 September 2010 was reviewed. Sixty-seven patients who had successful ECV were studied and reviewed for maternal, fetal, and labour outcomes. The control group comprised patients with cephalic singletons of matching parity who delivered following the index cases. Results. The mean gestational age at ECV was 263 ± 6.52?days (37.5 weeks ± 6.52 days). Spontaneous labour and transient cardiotocographic (CTG) changes were the commonest early adverse effects following ECV. The reversion rate was 7.46%. The mean gestational age at delivery of the two groups was significantly different (P = 0.000) with 277.9 ± 8.91 days and 269.9 ± 9.68 days in the study group and control groups, respectively. The study group needed significantly more inductions of labour. They required more operative deliveries, had more blood loss at delivery, a higher incidence of meconium-stained liquor, and more cord around the neck. Previous flexed breeches had a threefold increase in caesarean section rate compared to previous extended breeches (44.1% versus 15.2%, P = 0.010). On the contrary, an amniotic fluid index (AFI) of 13 or more is significantly associated with a higher rate of vaginal birth (86.8% versus 48.3%, P = 0.001). Conclusions. Patients with successful ECV were at higher risk of carrying the pregnancy beyond 40 weeks and needing induction of labour, with a higher rate of caesarean section and higher rates of obstetrics complications. Extended breech and AFI 13 or more were significantly more likely to deliver vaginally postsuccessful ECV. This additional information may be useful to caution a patient with breech that ECV does not bring them to behave exactly like a normal cephalic, so that they have more realistic expectations. However, these predictive factors needed further confirmation and hopefully, in the future, they would be able to further enhance counselling prior to ECV. PMID:24587759

Lim, Pei Shan; Ng, Beng Kwang; Ali, Anizah; Shafiee, Mohamad Nasir; Kampan, Nirmala Chandralega; Mohamed Ismail, Nor Azlin; Omar, Mohd Hashim; Abdullah Mahdy, Zaleha

2014-01-01

269

Influence of Vaginal Bacteria and d- and l-Lactic Acid Isomers on Vaginal Extracellular Matrix Metalloproteinase Inducer: Implications for Protection against Upper Genital Tract Infections  

PubMed Central

ABSTRACT We evaluated levels of vaginal extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinase (MMP-8) in vaginal secretions in relation to the composition of vaginal bacterial communities and d- and l-lactic acid levels. The composition of vaginal bacterial communities in 46 women was determined by pyrosequencing the V1 to V3 region of 16S rRNA genes. Lactobacilli were dominant in 71.3% of the women, followed by Gardnerella (17.4%), Streptococcus (8.7%), and Enterococcus (2.2%). Of the lactobacillus-dominated communities, 51.5% were dominated by Lactobacillus crispatus, 36.4% by Lactobacillus iners, and 6.1% each by Lactobacillus gasseri and Lactobacillus jensenii. Concentrations of l-lactic acid were slightly higher in lactobacillus-dominated vaginal samples, but most differences were not statistically significant. d-Lactic acid levels were higher in samples containing L. crispatus than in those with L. iners (P < 0.0001) or Gardnerella (P = 0.0002). The relative proportion of d-lactic acid in vaginal communities dominated by species of lactobacilli was in concordance with the proportions found in axenic cultures of the various species grown in vitro. Levels of l-lactic acid (P < 0.0001) and the ratio of l-lactic acid to d-lactic acid (P = 0.0060), but not concentrations of d-lactic acid, were also correlated with EMMPRIN concentrations. Moreover, vaginal concentrations of EMMPRIN and MMP-8 levels were highly correlated (P < 0.0001). Taken together, the data suggest the relative proportion of l- to d-lactic acid isomers in the vagina may influence the extent of local EMMPRIN production and subsequent induction of MMP-8. The expression of these proteins may help determine the ability of bacteria to transverse the cervix and initiate upper genital tract infections. PMID:23919998

Witkin, Steven S.; Mendes-Soares, Helena; Linhares, Iara M.; Jayaram, Aswathi; Ledger, William J.; Forney, Larry J.

2013-01-01

270

Partial protection against multiple RT-SHIV162P3 vaginal challenge of rhesus macaques by a silicone elastomer vaginal ring releasing the NNRTI MC1220  

PubMed Central

Objectives The non-nucleoside reverse transcriptase inhibitor MC1220 has potent in vitro activity against HIV type 1 (HIV-1). A liposome gel formulation of MC1220 has previously been reported to partially protect rhesus macaques against vaginal challenge with a simian HIV (SHIV). Here, we describe the pre-clinical development of an MC1220-releasing silicone elastomer vaginal ring (SEVR), including pharmacokinetic (PK) and efficacy studies in macaques. Methods In vitro release studies were conducted on SEVRs loaded with 400 mg of MC1220, using simulated vaginal fluid (SVF, n?=?4) and 1?:?1 isopropanol/water (IPA/H2O, n?=?4) as release media. For PK evaluation, SEVRs were inserted into adult female macaques (n?=?6) for 30 days. Following a 1week washout period, fresh rings were placed in the same animals, which were then challenged vaginally with RT-SHIV162P3 once weekly for 4 weeks. Results SEVRs released 1.66 and 101 mg of MC1220 into SVF and IPA/H2O, respectively, over 30 days, the differential reflecting the low aqueous solubility of the drug. In macaque PK studies, MC1220 was consistently detected in vaginal fluid (peak 845 ng/mL) and plasma (peak 0.91 ng/mL). Kaplan–Meier analysis over 9weeks showed significantly lower infection rates for animals given MC1220-containing SEVRs than placebo rings (hazard ratio 0.20, P?=?0.0037). Conclusions An MC1220-releasing SEVR partially protected macaques from vaginal challenge. Such ring devices are a practical method for providing sustained, coitally independent protection against vaginal exposure to HIV-1. PMID:23109186

Fetherston, Susan M.; Geer, Leslie; Veazey, Ronald S.; Goldman, Laurie; Murphy, Diarmaid J.; Ketas, Thomas J.; Klasse, Per Johan; Blois, Sylvain; La Colla, Paolo; Moore, John P.; Malcolm, R. Karl

2013-01-01

271

Comparative Study of Oral and Vaginal Misoprostol for Induction of Labour, Maternal and Foetal Outcome  

PubMed Central

Background: Misoprostol is a new promising agent for cervical ripening and induction of labour .The ideal dose, route and frequency of administration of misoprostol are still under investigation. Although, vaginal application of misoprostol has been validated as a reasonable mean of induction, there is a patient resistance to digital examination and there is a risk of ascending infection. For this reason, oral administration of misoprostol for cervical ripening and labour induction has been tried. Aims and Objectives: To compare 50?g of oral misoprostol versus 25?g of intravaginal misoprostol for induction of labour at term and maternal, foetal outcomes. Methods: Two hundred women who were at term, with indication for induction of labour and Bishop scores of ?5 were randomly assigned to receive misoprostol 50?g or 25?g intravaginal, every 4-6 hours, for a maximum of 5 doses. In either group, pregnant females with inadequate uterine contractions despite being given maximum 5 doses of misoprostol, were augmented using oxytocin. The primary outcome measure was time-interval from induction to vaginal delivery and vaginal delivery rate within 24 hours. Results: The median induction to vaginal delivery time in oral group (12.92h) and vaginal group (14.04 h) was not significant. Oral misoprostol resulted in more number of vaginal deliveries as compared to vaginal misoprostol (94% as compared to 86%), which was not significant. There was a significantly higher incidence of uterine tachysystole in the vaginal group, as compared to oral group. There were no significant differences between the groups with respect to oxytocin augmentation, caesarean section rate, analgesic requirement and neonatal outcome. Conclusion: Oral misoprostol is as efficacious as vaginal misoprostol because of shorter induction delivery interval, lower caesarean section rates, and lower incidence of failed induction rates. Lower incidence of foetal distress and easy intake are observed if the drug is administered orally. PMID:24551660

Komala, Kambhampati; Reddy, Meherlatha; Quadri, Iqbal Jehan; B., Suneetha; V., Ramya

2013-01-01

272

Comparison of the Vaginal Microbial Communities in Women with Recurrent Genital HSV Receiving Acyclovir Intravaginal Rings  

PubMed Central

Vaginally administered antiviral agents may reduce the risk of HIV and HSV acquisition. Delivery of these drugs using intravaginal rings (IVRs) holds the potential benefits of improving adherence and decreasing systemic exposure, while maintaining steady-state drug levels in the vaginal tract. Elucidating how IVRs interact with the vaginal microbiome constitutes a critical step in evaluating the safety of these devices, as shifts the vaginal microbiome have been linked with several disease states. To date, clinical IVR trials have relied on culture-dependent methods that omit the high diversity of unculturable microbial population. Longitudinal, culture-independent characterization of the microbiota in vaginal samples from 6 women with recurrent genital HSV who used an acyclovir IVR was carried out and compared to the communities developing in biofilms on the IVR surface. The analysis utilized Illumina MiSeq sequence datasets generated from bar-coded amplicons of 16S rRNA gene fragments. Specific taxa in the vaginal communities of the study participants were found to be associated with the duration of recurrent genital HSV status and the number of HSV outbreaks. Taxonomic comparison of the vaginal and IVR biofilm communities did not reveal any significant differences, suggesting that the IVRs were not systematically enriched with members of the vaginal microbiome. Device usage did not alter the participants' vaginal microbial communities, within the confines of the current study design. Rigorous, molecular analysis of the effects of intravaginal devices on the corresponding microbial communities shows promise for integration with traditional approaches in the clinical evaluation of candidate products. PMID:24361269

Ursell, Luke K.; Gunawardana, Manjula; Chang, Simon; Mullen, Madeline; Moss, John A.; Herold, Betsy C.; Keller, Marla J.; McDonald, Daniel; González, Antonio; Knight, Rob; Baum, Marc M.

2014-01-01

273

Aggressive angiomyxoma of the vaginal wall at the initial stage: a case report.  

PubMed

Aggressive angiomyxoma (AA) is a rare mesenchimal tumor usually located in the pelvic and perineal region. Less than 30 cases of aggressive angiomyxoma with vaginal location have been reported in the literature up to this date. The authors report the case of a 50-year-old female patient diagnosed with vaginal AA whose characteristics at its initial stage were macroscopically indistinguishable from those of a polypoid lesion. Therefore this case suggests that this type of tumor should be considered as part of the differential diagnosis of vaginal polypoid lesions. PMID:23327070

Carta, G; Parisse, V; Accurti, V; Sollima, L; Di Stefano, L; D'Alfonso, A; Patacchiola, F

2012-01-01

274

Secondary Vaginal Atresia Treated with Vaginoplasty Using Amnion Graft: A Case Report  

PubMed Central

We report a case of 26-year-old primipara with last child birth 1.5 year back who presented with amenorrhoea, cyclical lower abdominal pain and dyspareunia for past six months. Examination revealed vaginal atresia secondary to previous traumatic/mismanaged vaginal delivery with haematocolpos. She was managed by vaginoplasty with amnion graft and regular dilation with soft vaginal mould for six weeks and was advised for regular intercourse after that. On follow up our patient was doing well with restoration of normal coital function. PMID:25584275

Samal, Sunil Kumar

2014-01-01

275

Complete Utero Vaginal Prolapse in a Woman with Prolapsed Submucous Fibroid  

PubMed Central

Background: Uterine fibroids are benign tumors of the uterus and those located beneath the uterine mucosa may present as prolapsed fibroid in the vagina. Prolapsed submucous fibroid associated with complete uterovaginal prolapse is however uncommon. Case: A case of irreducible complete utero-vaginal and infected sub-mucous fibroid prolapse, in a 45-year-old grandmultiparous woman, is reported. Bed rest and antibiotics failed to relief edema and infection of the vault. Vaginal myomectomy, followed by interval vaginal hysterectomy, and pelvic floor repair a week later resulted in a satisfactory outcome. PMID:25745583

Aniebue, UU; Nwankwo, TO

2015-01-01

276

Adenocarcinoma in an ano-vaginal fistula in Crohn's disease  

PubMed Central

INTRODUCTION Fistulas are a relatively common occurrence in Crohn's disease (CD), and often present early in the disease process. Additionally, patients suffering from either CD or ulcerative colitis are shown to have an increased risk of colorectal malignancies compared with the general population. PRESENTATION OF CASE We present a case of adenocarcinoma in an ano-vaginal fistula in a patient with longstanding CD. DISCUSSION Various pathogenic mechanisms for the development of carcinoma in fistulas have been suggested, but there is no consensus and indeed this risk may be cumulative. In this case report, we also discuss the pathogenesis of mucinous adenocarcinoma in fistulas secondary to CD. CONCLUSION Better detection of adenocarcinoma in patients presenting with persistent non-resolving fistulas in the presence of CD should be undertaken with regular biopsies following examinations under anaesthetic of the anorectum. PMID:23702362

Alfa-Wali, Maryam; Atinga, Angela; Mohsen, Yasser; Anthony, Andrew; Myers, Alistair

2013-01-01

277

A New Wireless Biosensor for Intra-Vaginal Temperature Monitoring  

PubMed Central

Wireless Body Sensors for medical purposes offer valuable contributions to improve patients’ healthcare, including diagnosis and/or therapeutics monitoring. Body temperature is a crucial parameter in healthcare diagnosis. In gynecology and obstetrics it is measured at the skin’s surface, which is very influenced by the environment. This paper proposes a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in a Wireless Sensor Network (WSN) for remote data access and monitoring. We present the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used in different medical applications, including preterm labor prevention and fertility and ovulation period detection. The features of the constructed testbed were validated in laboratory tests verifying its accuracy and performance. PMID:22163471

Caldeira, João M. L. P.; Rodrigues, Joel J. P. C.; Garcia, João F. R.; de la Torre, Isabel

2010-01-01

278

Vaginal laparoscopically assisted radical trachelectomy in cervical clear cell adenocarcinoma  

PubMed Central

Adenocarcinoma of the cervix is a rare condition that has shown an increase in incidence, especially in the 20- to 34-year-old group. Adenocarcinoma represents about 5–10% of all tumours in this area, and, among these, the clear cell type accounts for 4–9%. This type of tumour affects mainly postmenopausal women but also occurs in young women with a history of prenatal exposure to diethylstilbestrol (DES). The prognosis for adenocarcinoma of the cervix is poor overall and worse for the clear cell variety. This article discusses a case of clear cell adenocarcinoma of the cervix, unrelated to intrauterine exposure to DES, in a woman of childbearing age who wished to preserve her fertility and was therefore treated by radical vaginal trachelectomy and pelvic lymphadenectomy. PMID:24244219

Iacoponi, Sara; Diestro, Maria Dolores; Zapardiel, Ignacio; Serrano, María; Santiago, Javier De

2013-01-01

279

Vaginal lactobacilli as potential probiotics against Candida SPP.  

PubMed Central

Urogenital infections affect millions of people every year worldwide. The treatment of these diseases usually requires the use of antimicrobial agents, and more recently, the use of probiotic lactic acid bacteria (LAB) cultures for the management of vaginal infections has been extensively studied. In this work, 11 vaginal lactobacilli isolates, previously obtained from healthy patients, were studied to screen microorganisms with probiotic properties against Candida spp. The LAB were tested for their ability of auto-aggregation, co-aggregation with C. albicans, C. glabrata, C. krusei, and C. tropicalis, adhesion to Caco-2 epithelial cells and production of lactic acid and hydrogen peroxide (H2O2). All lactobacilli isolates tested were able to auto-aggregate (ranging from 25.3% to 75.4% assessed at 4 hours of incubation) and to co-aggregate with the four Candida species into different degrees; among them L. crispatus showed the highest scores of co-aggregation. The highest amount of lactic acid was produced by L. salivarius (13.9 g/l), followed by L. johnsonii (6.5 g/l), L. acidophilus (5.5 g/l), and L. jensenii (5.4 g/l). All isolates produced H2O2, but the highest levels (3 – 10 mg/l) were observed for L. acidophilus, L. crispatus, L. gasseri, L. johnsonii, and L. vaginalis. Only L. agilis, L. jensenii, L. johnsonii and L. ruminus were able to adhere to epithelial Caco-2 cells. Among the isolates evaluated, L agilis, L. jensenii, L. johnsonii, and L. ruminus exhibited simultaneously several desirable properties as potential probiotic strains justifying future studies to evaluate their technological properties in different pharmaceutical preparations for human use. PMID:24031455

Gil1, Natalia F.; Martinez, Rafael C.R.; Gomes, Bruna C.; Nomizo, Auro; De Martinis, Elaine C. P.

2010-01-01

280

77 FR 70167 - Draft Guidance for Industry on Vaginal Microbicides: Development for the Prevention of Human...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Microbicides: Development for the Prevention of Human Immunodeficiency Virus Infection; Availability AGENCY: Food and Drug Administration...vaginal microbicides for the prevention of human immunodeficiency virus (HIV) infection. The guidance outlines the types of...

2012-11-23

281

Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis  

PubMed Central

Background Bacterial vaginosis (BV) is a common gynecologic diagnosis characterized by dysbiosis of the vaginal microbiota. It is often accompanied by vaginal symptoms such as odor and discharge, but can be asymptomatic. Despite over 50 years of research, the etiology of BV is not well understood, which is a major impediment to treatment and prevention of BV. Results Here we report on the temporal dynamics of 25 vaginal communities over a 10 week period using samples collected daily from women who were diagnosed with symptomatic BV (15 women), asymptomatic BV (6 women), and women who did not have BV (4 women). Conclusion This unique resource of samples and data will contribute to a better understanding of the role that the vaginal microbes have in the natural history of BV and lead to improved diagnosis and treatment. PMID:24451163

2013-01-01

282

Delayed vaginal and urethral mesh exposure: 10 years after TVT surgery.  

PubMed

Delayed mesh exposure after tension-free vaginal tape (TVT) procedure is rare. We report a case of mesh exposure into the vagina and urethra that developed 10 years after TVT surgery. A 58-year-old postmenopausal woman presented with mixed urinary incontinence. She was investigated, and her stress urinary incontinence was cured with a TVT procedure 10 years ago. She was then scheduled follow-up annually. Two years postsurgery, a granulation tissue was observed and excised at the vaginal incision site. Vaginal examination 10 years postsurgery showed vaginal mesh erosion 0.5 cm from urethral meatus. Cystoscopy revealed concomitant urethral erosion at the posterior urethral wall. Mesh excision was performed, and urethra and vagina were repaired in layers. Postoperative recovery was uneventful. This finding shows that, although rare, complications can occur even after 10 years of TVT surgery. PMID:22736034

Khanuengkitkong, Siwatchaya; Lo, Tsia-Shu; Dass, Anil Krishna

2013-03-01

283

[Ambulatory vaginal tubal sterilization using a plastic clip with special reference to reversibility].  

PubMed

Report about 248 vaginal tubesterilizations with plastic clips. 94% were carried out in outpatients, no complications were observed. After removing plastic clips in animal experiments four rabbits became pregnancy. PMID:1015005

Koschnick, K F; Magnus, J

1976-01-01

284

Gluteo-vaginal fistula after posterior intravaginal slingplasty: a case report.  

PubMed

In patients with posthysterectomy prolapse of the vaginal vault, the posterior intravaginal slingplasty (posterior IVS, Tyco Healthcare, USA) has been suggested as an alternative to traditional vaginal vault suspensions. The goal of this technique is to recreate the uterosacral ligaments and to reinforce the rectovaginal fascia with the use of prosthetic material. We report the case of a 53-year-old woman with a history of 27 months of perineal suppurative discharge after she underwent a vaginal vault prolapse and rectocele repair using a posterior IVS (Tyco Healthcare, USA). The IVS tape was reinforced by interposing a rectovaginal monofilament polypropylene mesh (Parietex, Sofradim, France). Imaging studies and surgical exploration confirmed infection of the IVS mesh with the formation of a gluteo-vaginal fistula while the rectovaginal mesh was intact. PMID:19015799

Grynberg, Michael; Teyssedre, Jacques; Staerman, Frederic

2009-07-01

285

Formulation and evaluation of clindamycin HCL in situ gel for vaginal application  

PubMed Central

Objective: The vagina has been studied as a favorable site for the local and systemic delivery of drugs, for female associated conditions. Vaginal preparations, although generally perceived as safer most still associated with number of problems including multiple days of dosing, dripping, leakage and messiness, causing discomfort to users and expulsion due to the self-cleansing action of the vaginal tract. These limitations lead to poor patient compliance and failure of the desired therapeutic effects. For efficient vaginal delivery of drugs, the delivery system should reside at the site of infection for a prolonged period of time. In situ gel formulation which combines advantages of both gels and solution so that an accurate dose can be administered with ease. These formulations remain in solution state before administration and transforms to gel after administration in to vaginal cavity. Material and Methods: In these formulations we prepared clindamycin loaded hydroxypropyl methycellulose (0.1%) (bioadhesive) and gellan gum (ion activated gelling polymer) based in situ gel system for vaginal application. NaCl (0.9%) was added as an isotonic agent. The developed formulation was characterized for various in vitro parameters such as clarity, refractive index, pH, viscosity, drug release profile, statistical release kinetics, bioadhesive force, and microbial efficacy along with stability studies. To simulate vaginal conditions, synthetic membrane (cellophane hydrated with modified simulated vaginal fluid) was used as model membranes. Results and Discussion: The developed formulation was found to be nonirritant, bioadhesive with good retention properties. Formulations have satisfactory appearance, clarity and drug content in the range 98.1-101%. Refractive index of the gel is ranging from 1.335 to 1.337, proofing the transparency of gel. Furthermore, formulation displayed 33.3% cumulative drug release after 2 h. 67.4% after 6 h and 98.9% after 12 h. Conclusion: Developed formulation should be stable. Hence, formulation is thus a viable alternative to conventional vaginal dosage forms. PMID:25599033

Patel, Priya; Patel, Paresh

2015-01-01

286

Vaginal estriol-lactobacilli combination and quality of life in endocrine-treated breast cancer.  

PubMed

Objective We investigated the effect of a combination of vaginal ultra-low-dose estriol with lactobacilli on the sexual functioning domain of quality of life during the treatment of breast cancer survivors on an aromatase inhibitor with vaginal atrophy. Subjects and methods This was an open-label, bicentric, exploratory, clinical study in 16 postmenopausal breast cancer survivors on aromatase inhibitors suffering from vaginal atrophy-induced sexual disorders. Atrophy symptoms were assessed by scoring with an 11-point estimation scale (0 = not at all, 10 = worst imaginable feeling). Sexuality parameters of quality of life and medication adherence were recorded in a patient's diary and in the Female Somatic Sexual Experience Instrument (FSSEI) questionnaire. Patients underwent an initial treatment for 4 weeks (one vaginal tablet of Gynoflor(®) containing 0.03 mg estriol daily), followed by maintenance therapy (three vaginal Gynoflor(®) tablets weekly) for 8 weeks. Results Vaginal dryness continuously improved from a median score of 8 at entry to a score of 4 at the end of initial therapy, and a median score of 2 at the end of maintenance therapy. Normal sexual activity before breast cancer diagnosis was reported by 14 women (88%). At study entry, only three women (19%) were sexually active. At the end of the Gynoflor(®) regimen, ten women (63%) reported sexual activity, of which seven (44%) reported sexual intercourse. The FSSEI demonstrated a non-significant trend of improvement of parameters related to sexuality. Conclusions Local vaginal therapy with Gynoflor(®) in breast cancer survivors on aromatase inhibitors reporting atrophic vaginitis could be considered as a useful treatment for the quality of sexual life. PMID:25427450

Buchholz, S; Mögele, M; Lintermans, A; Bellen, G; Prasauskas, V; Ortmann, O; Grob, P; Neven, P; Donders, G

2015-04-01

287

A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse  

Microsoft Academic Search

The objective of this study was to evaluate anatomic, functional, short- and long-term outcome of vaginal surgery for pelvic\\u000a organ prolapse. This was a prospective observational study of 185 consecutive women planned for vaginal prolapse reconstructive\\u000a surgery. Stage of prolapse, urinary incontinence (UI), bowel and mechanical symptoms were assessed preoperatively and at 1,\\u000a 3 and 5 years postoperatively. The mean follow-up

Ann Miedel; Gunilla Tegerstedt; Birgitta Mörlin; Margareta Hammarström

2008-01-01

288

The effect of vitamin D on vaginal atrophy in postmenopausal women  

PubMed Central

Background: Most of the women suffer from vaginal atrophy and dryness, and therefore, efficient and safe treatment is needed to improve vaginal lubrication. Vitamin D has several important functions which may be effective in proliferation and repair of the epithelial tissue. This study aimed to evaluate the effect of vitamin D vaginal suppositories on maturation index, pH, and dryness in postmenopausal women. Materials and Methods: Women were enrolled in this double-blind clinical trial, in whom menopause occurred at least one year ago. Those women who had an abnormal Papanicolaou smear, had undergone hormonal treatment, or have had vaginal infection in the previous year were excluded. Forty-four women who found eligible were randomized into two equal groups, the treatment and control groups, which received vitamin D and placebo vaginal suppository daily for 8 weeks, respectively. Vaginal pH and maturation value were measured at the beginning and end of the study. Pain, dryness, and paleness were assessed before treatment and at the end of the 2, 4, and 8 weeks of treatment. Results: In the treatment group, the number (Mean ± SD) of superficial cells increased (69.76 ± 12.4) and vaginal pH decreased (1.42 ± 0.67) significantly compared to the control group after 56 days. The mean pain significantly reduced after 8 weeks in the treatment group (1.23 ± 0.53) compared to the control group 1.95 ± 0.74 (P < 0.001). The mean of dryness and paleness reduced significantly in the treatment group versus control at 56 days. Conclusions: Vitamin D is effective in improving the maturation index and decreased the pH and dryness of the vaginal atrophy due to menopause.

Rad, Parastou; Tadayon, Mitra; Abbaspour, Mohammadreza; Latifi, Seyed Mahmood; Rashidi, Iran; Delaviz, Hamdollah

2015-01-01

289

Inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair  

Microsoft Academic Search

Graft augmentation for repair of recurrent pelvic organ prolapse is commonly used in reconstructive pelvic surgery. The reported complications are mainly late onset. We report a case of early-onset inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair. A 49-year-old presented with a recurrent and symptomatic posterior vaginal wall defect. She underwent an uneventful site-specific repair

George Lazarou; Kenneth Powers; Carlos Pena; Lance Bruck; Magdy S. Mikhail

2005-01-01

290

Severe bleeding from internal obturator muscle following tension-free vaginal tape Secur hammock approach procedure  

Microsoft Academic Search

Various perioperative and postoperative complications have been reported after the use of pubo-vaginal tension-free vaginal\\u000a tapes. The transobturator approach was introduced to minimize the potential complications connected with entering the retropubic\\u000a space, but different types of complications have also been described. The next generation of recently introduced minitapes\\u000a such as TVT-Secur is intended to minimize the incidence of complications. This

Jaromir Masata; Alois Martan; Kamil Svabík

2008-01-01

291

Influence of age, reproductive cycling status, and menstruation on the vaginal microbiome in baboons (Papio anubis).  

PubMed

The vaginal microbiome is believed to influence host health by providing protection from pathogens and influencing reproductive outcomes such as fertility and gestational length. In humans, age-associated declines in diversity of the vaginal microbiome occur in puberty and persist into adulthood. Additionally, menstruation has been associated with decreased microbial community stability. Adult female baboons, like other non-human primates (NHPs), have a different and highly diverse vaginal microbiome compared to that of humans, which is most commonly dominated by Lactobacillus spp. We evaluated the influence of age, reproductive cycling status (cycling vs. non-cycling) and menstruation on the vaginal microbiome of 38 wild-caught, captive female olive baboons (Papio anubis) by culture-independent sequencing of the V3-V5 region of the bacterial 16S rRNA gene. All baboons had highly diverse vaginal microbial communities. Adult baboons had significantly lower microbial diversity in comparison to subadult baboons, which was attributable to decreased relative abundance of minor taxa. No significant differences were detected based on cycling state or menstruation. Predictive metagenomic analysis showed uniformity in relative abundance of metabolic pathways regardless of age, cycle stage, or menstruation, indicating conservation of microbial community functions. This study suggests that selection of an optimal vaginal microbial community occurs at puberty. Since decreased diversity occurs in both baboons and humans at puberty, this may reflect a general strategy for selection of adult vaginal microbial communities. Comparative evaluation of vaginal microbial community development and composition may elucidate mechanisms of community formation and function that are conserved across host species or across microbial community types. These findings have implications for host health, evolutionary biology, and microbe-host ecosystems. Am. J. Primatol. 77:563-578, 2015. © 2015 Wiley Periodicals, Inc. PMID:25676781

Uchihashi, M; Bergin, I L; Bassis, C M; Hashway, S A; Chai, D; Bell, J D

2015-05-01

292

Fungal Morphogenetic Pathways Are Required for the Hallmark Inflammatory Response during Candida albicans Vaginitis  

PubMed Central

Vulvovaginal candidiasis, caused primarily by Candida albicans, presents significant health issues for women of childbearing age. As a polymorphic fungus, the ability of C. albicans to switch between yeast and hyphal morphologies is considered its central virulence attribute. Armed with new criteria for defining vaginitis immunopathology, the purpose of this study was to determine whether the yeast-to-hypha transition is required for the hallmark inflammatory responses previously characterized during murine vaginitis. Kinetic analyses of vaginal infection with C. albicans in C57BL/6 mice demonstrated that fungal burdens remained constant throughout the observation period, while polymorphonuclear leukocyte (PMN), S100A8, and interleukin-1? levels obtained from vaginal lavage fluid increased by day 3 onward. Lactate dehydrogenase activity was also positively correlated with increased effectors of innate immunity. Additionally, immunodepletion of neutrophils in infected mice confirmed a nonprotective role for PMNs during vaginitis. Determination of the importance of fungal morphogenesis during vaginitis was addressed with a two-pronged approach. Intravaginal inoculation of mice with C. albicans strains deleted for key transcriptional regulators (bcr1?/?, efg1?/?, cph1?/?, and efg1?/? cph1?/?) controlling the yeast-to-hypha switch revealed a crucial role for morphogenetic signaling through the Efg1 and, to a lesser extent, the Bcr1 pathways in contributing to vaginitis immunopathology. Furthermore, overexpression of transcription factors NRG1 and UME6, to maintain yeast and hyphal morphologies, respectively, confirmed the importance of morphogenesis in generating innate immune responses in vivo. These results highlight the yeast-to-hypha switch and the associated morphogenetic response as important virulence components for the immunopathogenesis of Candida vaginitis, with implications for transition from benign colonization to symptomatic infection. PMID:24478069

Palmer, Glen E.; Nash, Andrea K.; Lilly, Elizabeth A.; Fidel, Paul L.; Noverr, Mairi C.

2014-01-01

293

Spontaneous Caecal Perforation Associated with Ogilvie's Syndrome Following Vaginal Delivery - A Case Report.  

PubMed

Acute pseudo-obstruction of the large bowel, Ogilvie's syndrome, can occur in the postpartum period following caesarean section which can result in caecal dilatation and may progress to perforation. This is quiet rare following normal vaginal delivery. Only two previous reports have been found in the English literature. We report a case of Ogilvie's syndrome with caecal perforation following normal vaginal delivery. PMID:25121027

E, Harish; Vk, Sundeep; Kola, Sivasai Krishnaprasad; Kg, Dharma Kumar

2014-06-01

294

Spontaneous Caecal Perforation Associated with Ogilvie’s Syndrome Following Vaginal Delivery – A Case Report  

PubMed Central

Acute pseudo-obstruction of the large bowel, Ogilvie’s syndrome, can occur in the postpartum period following caesarean section which can result in caecal dilatation and may progress to perforation. This is quiet rare following normal vaginal delivery. Only two previous reports have been found in the English literature. We report a case of Ogilvie’s syndrome with caecal perforation following normal vaginal delivery. PMID:25121027

VK, Sundeep; Kola, Sivasai Krishnaprasad; KG, Dharma Kumar

2014-01-01

295

Intrapartum ultrasound: A useful method for evaluating labor progress and predicting operative vaginal delivery  

PubMed Central

The last step of a successful pregnancy is the safe delivery of the fetus. An important question is if the delivery should vaginal or operative. In addition to the use of conventional antenatal ultrasound, the use of intrapartum ultrasound to evaluate fetal head station, position, cervical ripening, and placental separation is promising. This review evaluates and summarizes the usefulness of intrapartum ultrasound for the evaluation of labor progress and predicting successful operative vaginal delivery. PMID:25469329

Ahn, Ki Hoon

2014-01-01

296

Attitudes and approaches to vaginal atrophy in postmenopausal women: a focus group qualitative study  

PubMed Central

Objective The impact of postmenopausal vaginal atrophy and women's coping strategies were evaluated through international focus groups. Methods Three-hour focus groups of three to five postmenopausal women who had symptoms of vaginal atrophy but had not sought treatment were conducted in Canada, Sweden, the United States, and the United Kingdom. Participants were asked about their experience with menopause and vaginal atrophy, including use of non-prescription treatments and their interactions with health-care providers. Women were classified as one of five personality types, based on their interaction with the world (individualism or belonging) and strategies for coping with stress (control or liberation). Results Vaginal atrophy was not recognized as a medical condition by focus group participants, and women had not used treatments for vaginal atrophy apart from non-prescription lubricants. Women who had discussed vaginal atrophy symptoms with their doctor felt their concerns were dismissed as a normal part of aging, and they did not receive counseling about treatment options such as low-dose estrogen therapy. Those whose coping strategy involved dominance, combatting, or individualism were more likely to seek treatment than those whose strategy involved submission, acceptance, or belonging. Women who used control to cope with menopausal changes were more likely to respond to information validated by perceived experts than were those who used a strategy of release. Conclusions Women's reactions to their vaginal atrophy varied according to personality. Use of a personality-based approach to patient counseling may encourage patients to discuss vaginal atrophy with their health-care provider and seek treatment. PMID:24083795

2014-01-01

297

Formulation development and evaluation of innovative two-polymer (SR-2P) bioadhesive vaginal gel.  

PubMed

The main objective of this investigation was to study the feasibility of developing a vaginal bioadhesive microbicide using a SRI's proprietary two-polymer gel platform (SR-2P). Several formulations were prepared with different combinations of temperature-sensitive polymer (Pluronic® F-127) and mucoadhesive polymer (Noveon® AA-1), producing gels of different characteristics. Prototype polymeric gels were evaluated for pH, osmolality, buffering capacity, and viscosity under simulated vaginal semen dilutions, and bioadhesivity using ex vivo mini pig vaginal tissues and texture analyzer. The pH of the polymeric gel formulations ranged from 5.1 to 6.4; the osmolality varied from 13 to 173 mOsm. Absolute viscosity ranged from 513 to 3,780 cPs, and was significantly reduced (1.5- to 3-fold) upon incubation with simulated vaginal and semen fluid mixture. Among the tested gels (indicated in the middle row as a molar ratio of a mixture of Noveon vs. Pluronic), only SR-2P retained gel structure upon dilution with simulated fluids and mild simulated coital stress. The pH of the SR-2P gel was maintained at about 4.6 in simulated vaginal fluid and also showed high peak force of adhesion in mini pig vaginal tissue. Furthermore, SR-2P gel caused no or only minimal irritation in a mouse vaginal irritation model. The results of this preliminary study demonstrated the potential application of SR-2P gel as a vaginal microbicide vehicle for delivery of anti-HIV agents. PMID:24781671

Podaralla, Satheesh; Alt, Carsten; Shankar, Gita N

2014-08-01

298

Primary Malignant Vaginal Melanoma – Case Report and Review of the Literature  

PubMed Central

With fewer than 250 cases published worldwide, primary vaginal melanoma is an extremely rare malignant entity which is mostly diagnosed in advanced stages. The estimated incidence of vaginal melanoma is 0.026/100?000 women per year. The poor prognosis for advanced tumour stages and different therapies used in very limited numbers of patients require precise preoperative staging and a planned interdisciplinary therapeutic approach. PMID:25258467

Kühn, F.; Dieterich, M.; Klar, E.; Gerber, B.; Prinz, C.

2012-01-01

299

Development of an in vitro alternative assay method for vaginal irritation  

PubMed Central

The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus-2. Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed using the rabbit vaginal irritation (RVI) assay. In the current study, we investigated whether the organotypic, highly differentiated EpiVaginal™ tissue could be used as a non-animal alternative to the RVI test. The EpiVaginal tissue was exposed to a single application of ingredients commonly found in feminine hygiene products and the effects on tissue viability (MTT assay), barrier disruption (measured by transepithelial electrical resistance, TEER and sodium fluorescein (NaFl) leakage), and inflammatory cytokine release (interleukin (IL)-1?, IL-1?, IL-6, and IL-8) patterns were examined. When compared to untreated controls, two irritating ingredients, nonoxynol 9 and benzalkonium chloride, reduced tissue viability to <40% and TEER to <60% while increasing NaFl leakage by 11–24% and IL-1? and IL-1? release by >100%. Four other non-irritating materials had minimal effects on these parameters. Assay reproducibility was confirmed by testing the chemicals using three different tissue production lots and by using tissues reconstructed from cells obtained from three different donors. Coefficients of variation between tissue lots reconstructed with cells obtained from the same donor or lots reconstructed with cells obtained from different donors were less than 10% and 12%, respectively. In conclusion, decreases in tissue viability and barrier function and increases in IL-1? and IL-1? release appear to be useful endpoints for preclinical screening of topically applied chemicals and formulations for their vaginal irritation potential. PMID:20937349

Ayehunie, Seyoum; Cannon, Chris; LaRosa, Karen; Pudney, Jeffrey; Anderson, Deborah J.; Klausner, Mitchell

2010-01-01

300

Chronical cervical infections and dysplasia (CIN I, CIN II): Vaginal vitamin D (high dose) treatment  

PubMed Central

In a small praxis/ambulance study we evaluated data of 200 women with chronical recurrent cervical infections and with a cervix dysplasia (CIN 1, CIN 2). who got after the primary therapy a treatment with vitamin D vaginal suppositories (12.500 IU, 3 nights a week, for 6 weeks). We found that - when compared with the lactobacillus vaginal suppositories - the high dose vitamin D vaginal treatment might be more effective. Vitamin D showed very good anti-inflammatory effects. In the survey after six weeks therapy 79% of the women had “less vaginal problems,” “less discharge” and “less problems with the sexual intercourse.” Objectively after six weeks therapy only 7% of the patients still had bacterial and/or fungal vaginal infections that required a treatment. We found that vitamin D is reabsorbed by the vaginal mucosa, but the reabsorption may be individually very different. In the CIN 1 group we found six weeks after treatment good antidysplastic effects, in the CIN 2 group we often found no or only temporary antidysplastic effects. So this vaginal vitamin D treatment method might be an option for the therapy and prevention of chronical cervical infections and maybe of a cervic dysplasia CIN 1 (good antiinflammatory effects, antidysplastic effects). This small study is not representative. We need much bigger studies with much more dates and with a longer follow up. Caution: At the moment we do not know, if the vaginal vitamin D treatment with 12500 IE is possible in pregnancy. We have no experience. Therefore we recommend an effective contraception during the application. PMID:24605180

Schulte-Uebbing, C; Schlett, S; Craiut, ID; Antal, L; Olah, H

2014-01-01

301

MIV-150-Containing Intravaginal Rings Protect Macaque Vaginal Explants against SHIV-RT Infection  

PubMed Central

Recent studies demonstrated that intravaginal rings (IVRs) containing 100 mg of the nonnucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 significantly protect macaques against a chimeric simian-human immunodeficiency virus that expresses the HIV-1 HxB2 reverse transcriptase (SHIV-RT) when present before and after vaginal challenge. The objectives of this study were to (i) evaluate the pharmacodynamics (PD) of MIV-150 in vaginal fluids (VF) and in ectocervical and vaginal tissues following 100-mg MIV-150 IVR exposure and to (ii) gain more insight whether pharmacokinetics (PK) of MIV-150 can predict PD. MIV-150 in VF collected at 1 day and 14 days post-MIV-150 IVR insertion inhibited ex vivo SHIV-RT infection in vaginal biopsy specimens from untreated animals (not carrying IVRs) in a dose-dependent manner. Previous PK studies demonstrated a significant increase of ectocervical and vaginal tissue MIV-150 concentrations 14 days versus 1 day post-IVR insertion, with the highest increase in vaginal tissue. Therefore, we tested PD of MIV-150 in tissues 14 days post-MIV-150 IVR insertion. Ex vivo SHIV-RT infection of vaginal, but not ectocervical, tissues collected 14 days post-MIV-150 IVR insertion was significantly inhibited compared to infection at the baseline (prior to MIV-150 IVR exposure). No changes in vaginal and ectocervical tissue infection were observed after placebo IVR exposure. Overall, these data underscore the use of the ex vivo macaque explant challenge models to evaluate tissue and VF PK/PD of candidate microbicides before in vivo animal efficacy studies. The data support further development of MIV-150-containing IVRs. PMID:24614384

Ouattara, Louise A.; Barnable, Patrick; Mawson, Paul; Seidor, Samantha; Zydowsky, Thomas M.; Kizima, Larisa; Rodriguez, Aixa; Fernández-Romero, José A.; Cooney, Michael L.; Roberts, Kevin D.; Gettie, Agegnehu; Blanchard, James; Robbiani, Melissa

2014-01-01

302

An effective group psychoeducational intervention for improving compliance with vaginal dilation: A randomized controlled trial  

SciTech Connect

Purpose: Although vaginal dilation is often recommended to minimize or prevent vaginal scarring after pelvic radiotherapy, compliance with this recommendation has historically been very low. Therefore, effective intervention strategies are needed to enhance compliance with vaginal dilation after radiotherapy for gynecologic cancer. Methods and Materials: This study was a randomized controlled clinical trial of a psychoeducational intervention specifically designed to increase compliance with vaginal dilation. The information-motivation-behavioral skills model of enhancing compliance with behavioral change was the basis for the intervention design. Forty-two sexually active women, 21 to 65 years of age, diagnosed with Stages Ic-III cervical or endometrial cancer, who received pelvic radiotherapy, were randomized to either the experimental psychoeducational group or the information-only control group. Assessment via questionnaire occurred before treatment and at 6-week, 6-month, 12-month, 18-month, and 24-month follow-up. Assessment via interview also occurred at 6-month, 12-month, 18-month, and 24-month follow-up. Results: The psychoeducational intervention was successful in increasing compliance with vaginal dilation. Conclusions: This study is the first randomized controlled study to demonstrate the effectiveness of an intervention in increasing compliance with the use of vaginal dilators.

Jeffries, Sherryl A. [Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta (Canada); Calgary Health Region Chronic Pain Centre, Calgary, Alberta (Canada); Robinson, John W. [Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta (Canada) and Program in Clinical Psychology, University of Calgary, Calgary, Alberta (Canada) and Faculty of Medicine, Department of Oncology, University of Calgary, Calgary, Alberta (Canada)]. E-mail: johnrobi@cancerboard.ab.ca; Craighead, Peter S. [Faculty of Medicine, Department of Oncology, University of Calgary, Calgary, Alberta (Canada); Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta (Canada); Keats, Melanie R. [Faculty of Kinesiology, University of Calgary, Calgary, Alberta (Canada)

2006-06-01

303

Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment.  

PubMed

Vaginal atrophy occurring during menopause is closely related to the dramatic decrease in ovarian estrogens due to the loss of follicular activity. Particularly, significant changes occur in the structure of the vaginal mucosa, with consequent impairment of many physiological functions. In this study, carried out on bioptic vaginal mucosa samples from postmenopausal, nonestrogenized women, we present microscopic and ultrastructural modifications of vaginal mucosa following fractional carbon dioxide (CO2) laser treatment. We observed the restoration of the vaginal thick squamous stratified epithelium with a significant storage of glycogen in the epithelial cells and a high degree of glycogen-rich shedding cells at the epithelial surface. Moreover, in the connective tissue constituting the lamina propria, active fibroblasts synthesized new components of the extracellular matrix including collagen and ground substance (extrafibrillar matrix) molecules. Differently from atrophic mucosa, newly-formed papillae of connective tissue indented in the epithelium and typical blood capillaries penetrating inside the papillae, were also observed. Our morphological findings support the effectiveness of fractional CO2 laser application for the restoration of vaginal mucosa structure and related physiological trophism. These findings clearly coupled with striking clinical relief from symptoms suffered by the patients before treatment. PMID:25410301

Zerbinati, Nicola; Serati, Maurizio; Origoni, Massimo; Candiani, Massimo; Iannitti, Tommaso; Salvatore, Stefano; Marotta, Francesco; Calligaro, Alberto

2015-01-01

304

Functional vaginal rejuvenation with elastic silicone threads: a 4-year experience with 180 patients.  

PubMed

Recently, there has been growing interest in female genital plastic surgery. To the authors' knowledge, no studies have adopted elastic silicone thread for vaginal rejuvenation. This study introduces clinical experience over 4 years with vaginal rejuvenation using elastic silicone thread to specifically assess the overall patient satisfaction (sexual function and correction of the vaginal width). It is hypothesised that this novel surgical method can improve sexual function. Between 2007-2011, 180 patients underwent vaginal rejuvenation using elastic silicone thread performed by the authors at a single institution. Patients with persistent feeling of a wide vagina and/or a decreased ability to reach orgasm were included. Patients were excluded from the study if they were unavailable for follow-up, or if they had been diagnosed with any gynecologic diseases. To measure the 15 degree of improvement with regard to sexual function, this study adopted the validated system; Female Sexual Function Index (FSFI). 92.8% (167/180) of the patients were satisfied with outcome with regard to feelings of correction of vaginal width. Vaginal rejuvenation using elastic silicone thread significantly improved postoperative outcomes, resulting in improved sexual function, with a focus on improving the FSFI score. This is especially prominent in FSFI orgasm subscore. However, a prospective multicentre study would be beneficial to provide patients with the best possible management. PMID:25141944

Park, Tae Hwan; Park, Hye June; Whang, Kwi Whan

2015-02-01

305

Osmotic pump tablets for delivery of antiretrovirals to the vaginal mucosa  

PubMed Central

Vaginal pre-exposure prophylaxis has focused heavily on gel formulations. Low adherence linked with frequent dosing and short therapeutic duration has emerged as the major reason for inconsistent efficacy outcomes with gels in clinical trials. Osmotic pumps can achieve versatile drug release profiles however, have not been explored for vaginal delivery. In this report, we describe an osmotic pump tablet (OPT) that can deliver antiretrovirals for several days. We also describe configuring the OPT for pH sensitive delivery where the drug delivery system consistently delivers a antiretroviral at vaginal pH and then gives a burst release triggered by a coitally associated pH increase. We have investigated the vaginal OPT for multiple day delivery of a potent antiretroviral, IQP-0528 in a sheep model. To effectively register spatial drug distribution we also engineered a tool to precisely collect multiple vaginal fluid samples. In a 10-day duration post single application, high micromolar mucosal levels were obtained with peak concentration more than 6 logs higher than IQP-0528 EC50. Overall, our results show successful implementation of the osmotic pump technology for vaginal antiretroviral delivery. PMID:23973812

Rastogi, Rachna; Teller, Ryan S.; Mesquita, Pedro M. M.; Herold, Betsy C.; Kiser, Patrick F.

2013-01-01

306

Prevalence of vaginal infections and associated lifestyles of students in the university of Cape Coast, Ghana  

PubMed Central

Objective To determine the prevalence of vaginal infections and associated lifestyles of students visiting the University of Cape Coast Hospital. Methods Fifty female students presenting with clinical symptoms of vaginitis were sampled. One hundred samples made up of 50 urine and 50 higher vaginal swabs (HVS) were obtained from patients and questionnaire administered. Samples were wet prepared, examined microscopically, and cultured on blood and chocolate agars for 24 h at (35±2) °C. Colonial morphology, Gram reactions and biochemical tests were used for the identification of isolates. Results There were high percentages of pus cells (64%), epithelial cells (62%) and yeast cells (56%) in all urine samples. Bacterial isolates included Staphylococcus aureus (28%) and (22%), Klebsiella spp. (6%) and (4%) in urine and HVS samples respectively; Escherichia coli in urine (18%) and Candida in HVS (16%). The overall prevalence of vaginitis was 66%, including bacterial vaginosis 28%, Candida infection 22% and co-infection of bacterial and Candida 16%. Lifestyle data showed all sampled students were sexually active, 48% used contraceptives, 54% used antimicrobial agents, and 92% prefered wearing of trousers and shorts. Conclusions The present study indicates prevalence of vaginal infection among female students, which strongly correlates with student lifestyle. Education on lifestyle modifications will go a long way in reducing the prevalence of vaginitis.

Aubyn, Gloria Baaba; Tagoe, Daniel Nii Aryee

2013-01-01

307

Osmotic pump tablets for delivery of antiretrovirals to the vaginal mucosa.  

PubMed

Vaginal pre-exposure prophylaxis has focused heavily on gel formulations. Low adherence linked with frequent dosing and short therapeutic duration has emerged as the major reason for inconsistent efficacy outcomes with gels in clinical trials. Osmotic pumps can achieve versatile drug release profiles however, have not been explored for vaginal delivery. In this report, we describe an osmotic pump tablet (OPT) that can deliver antiretrovirals for several days. We also describe configuring the OPT for pH sensitive delivery where the drug delivery system consistently delivers an antiretroviral at vaginal pH and then gives a burst release triggered by a coitally associated pH increase. We have investigated the vaginal OPT for multiple day delivery of a potent antiretroviral, IQP-0528 in a sheep model. To effectively register spatial drug distribution we also engineered a tool to precisely collect multiple vaginal fluid samples. In a 10-day duration post single application, high micromolar mucosal levels were obtained with peak concentration more than 6 logs higher than the EC50 of IQP-0528. Overall, our results show successful implementation of the osmotic pump technology for vaginal antiretroviral delivery. PMID:23973812

Rastogi, Rachna; Teller, Ryan S; Mesquita, Pedro M M; Herold, Betsy C; Kiser, Patrick F

2013-10-01

308

A potential role for tissue kallikrein-related peptidases in human cervico-vaginal physiology.  

PubMed

Human tissue kallikrein-related peptidases (KLK) are a family of 15 genes located on chromosome 19q13.4 that encode secreted serine proteases with trypsin- and/or chymotrypsin-like activity. Relatively large levels of many KLKs are present in human cervico-vaginal fluid (CVF) and in the supernatant of cultured human vaginal epithelial cells. Many KLKs are also hormonally regulated in vaginal epithelial cells, particularly by glucocorticoids and estrogens. The physiological role of KLK in the vagina is currently unknown; however, analysis of the CVF proteome has revealed clues for potential KLK functions in this environment. Here, we detail potential roles for KLKs in cervico-vaginal physiology. First, we suggest that KLKs play a role in the vagina similar to their role in skin physiology: (1) in the desquamation of vaginal epithelial cells, similar to their activity in the desquamation of skin corneocytes; and (2) in their ability to activate antimicrobial proteins in CVF as they do in sweat. Consequently, we hypothesize that dysregulated KLK expression in the vagina could lead to the development of pathological conditions such as desquamative inflammatory vaginitis. Second, we propose that KLKs may play a role in premature rupture of membranes and pre-term birth through their cleavage of fetal membrane extracellular matrix proteins. PMID:18627298

Shaw, Julie L V; Diamandis, Eleftherios P

2008-06-01

309

3D ultrasound Nakagami imaging for radiation-induced vaginal fibrosis  

NASA Astrophysics Data System (ADS)

Radiation-induced vaginal fibrosis is a debilitating side-effect affecting up to 80% of women receiving radiotherapy for their gynecological (GYN) malignancies. Despite the significant incidence and severity, little research has been conducted to identify the pathophysiologic changes of vaginal toxicity. In a previous study, we have demonstrated that ultrasound Nakagami shape and PDF parameters can be used to quantify radiation-induced vaginal toxicity. These Nakagami parameters are derived from the statistics of ultrasound backscattered signals to capture the physical properties (e.g., arrangement and distribution) of the biological tissues. In this paper, we propose to expand this Nakagami imaging concept from 2D to 3D to fully characterize radiation-induced changes to the vaginal wall within the radiation treatment field. A pilot study with 5 post-radiotherapy GYN patients was conducted using a clinical ultrasound scanner (6 MHz) with a mechanical stepper. A serial of 2D ultrasound images, with radio-frequency (RF) signals, were acquired at 1 mm step size. The 2D Nakagami shape and PDF parameters were calculated from the RF signal envelope with a sliding window, and then 3D Nakagami parameter images were generated from the parallel 2D images. This imaging method may be useful as we try to monitor radiation-induced vaginal injury, and address vaginal toxicities and sexual dysfunction in women after radiotherapy for GYN malignancies.

Yang, Xiaofeng; Rossi, Peter; Shelton, Joseph; Bruner, Debrorah; Tridandapani, Srini; Liu, Tian

2014-03-01

310

Multiplex quantitative polymerase chain reaction assay for the identification and quantitation of major vaginal lactobacilli.  

PubMed

Lactobacilli play a key role in promoting vaginal health. Depletion of these bacteria is associated with bacterial vaginosis (BV), the most common vaginal disorder. Here we describe the development and laboratory validation of a novel single-tube multiplex TaqMan quantitative polymerase chain reaction (qPCR) assay for the identification and quantitative assessment of the four major vaginal Lactobacillus species: L. crispatus, L. jensenii, L. gasseri, and L. iners. The assay utility was evaluated by the analysis of lactobacilli in non-cultured clinical vaginal swab specimens collected from BV patients and healthy individuals. As confirmed by the assay, L. crispatus, L. jensenii, and to a lesser extent L. gasseri, are common in the vagina of healthy women, whereas L. iners dominance is associated with BV. The major assay limitation was preferential detection of dominant Lactobacillus species in samples with mixed lactobacilli resulting in lower sensitivity for minor species. The multiplex qPCR assay described here is an advance in the detection and quantitation of the major vaginal lactobacilli, potentially facilitating the molecular diagnosis of BV and post-therapy restoration of the vaginal microflora. PMID:24445159

Balashov, Sergey V; Mordechai, Eli; Adelson, Martin E; Sobel, Jack D; Gygax, Scott E

2014-04-01

311

Robust Vaginal Colonization of Macaques with a Novel Vaginally Disintegrating Tablet Containing a Live Biotherapeutic Product to Prevent HIV Infection in Women  

PubMed Central

MucoCept is a biotherapeutic for prevention of HIV-1 infection in women and contains a human, vaginal Lactobacillus jensenii that has been genetically enhanced to express the HIV-1 entry inhibitor, modified cyanovirin-N (mCV-N). The objective of this study was to develop a solid vaginal dosage form that supports sustained vaginal colonization of the MucoCept Lactobacillus at levels previously shown, with freshly prepared cultures, to protect macaques from SHIV infection and to test this formulation in a macaque vaginal colonization model. Vaginally disintegrating tablets were prepared by lyophilizing the formulated bacteria in tablet-shaped molds, then packaging in foil pouches with desiccant. Disintegration time, potency and stability of the tablets were assessed. For colonization, non-synchronized macaques were dosed vaginally with either one tablet or five tablets delivered over five days. Vaginal samples were obtained at three, 14, and 21 days post-dosing and cultured to determine Lactobacillus colonization levels. To confirm identity of the MucoCept Lactobacillus strain, genomic DNA was extracted from samples on days 14 and 21 and a strain-specific PCR was performed. Supernatants from bacteria were tested for the presence of the mCV-N protein by Western blot. The tablets were easy to handle, disintegrated within two minutes, potent (5.7x1011 CFU/g), and stable at 4°C and 25°C. Vaginal administration of the tablets to macaques resulted in colonization of the MucoCept Lactobacillus in 66% of macaques at 14 days post-dosing and 83% after 21 days. There was no significant difference in colonization levels for the one or five tablet dosing regimens (p=0.88 Day 14, p=0.99 Day 21). Strain-specific PCR confirmed the presence of the bacteria even in culture-negative macaques. Finally, the presence of mCV-N protein was confirmed by Western blot analysis using a specific anti-mCV-N antibody. PMID:25875100

Lagenaur, Laurel A.; Swedek, Iwona; Lee, Peter P.; Parks, Thomas P.

2015-01-01

312

Inflammation biomarkers in vaginal fluid and preterm delivery  

PubMed Central

STUDY QUESTION Which inflammation biomarkers detected in the vaginal fluid are most informative for identifying preterm delivery (PTD) risk? SUMMARY ANSWER Elevated interleukin (IL)-6 at mid-trimester was associated with increased odds of spontaneous PTD at <35 weeks and with PTD plus histologic chorioamnionitis (HCA), and had the greatest sensitivity for detecting these two PTD subtypes. WHAT IS KNOWN ALREADY Maternal and/or fetal inflammation play a role in some preterm deliveries, therefore inflammation biomarkers might help to identify women at greater risk. STUDY DESIGN, SIZE, DURATION We examined 1115 women from the Pregnancy Outcomes and Community Health Study, a cohort study conducted from September 1998 through June 2004, for whom data were available on mid-pregnancy inflammatory biomarkers. PARTICIPANTS/MATERIALS, SETTING, METHODS At enrollment at 16–27 weeks gestation, vaginal fluid samples were collected from a swab and 15 eluted biomarkers were measured using the Meso Scale Discovery multiplex electrochemiluminescence platform. Associations of biomarkers with PTD were examined, according to clinical circumstance, week at delivery and presence/absence of HCA. Weighted logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) adjusted for race. Sensitivity and specificity were compared between individual and multiple biomarkers, identified by a bootstrapping method. MAIN RESULTS AND THE ROLE OF CHANCE Elevated IL-6 (>75th percentile) displayed the strongest association with spontaneous PTD <35 weeks (OR 2.3; CI 1.3–4.0) and PTD with HCA (OR 2.8; CI 1.4–6.0). The sensitivity of IL-6 to detect spontaneous PTD <35 weeks or PTD with HCA was 0.43 and 0.51, respectively, while specificity was 0.74 and 0.75, respectively. IL-6 plus IL1?, IL-6r, tumor necrosis factor-alpha or granulocyte-macrophage colony-stimulating factor increased specificity (range 0.84–0.88), but decreased sensitivity (range 0.28–0.34) to detect both PTD subtypes. Results were similar when a combination of IL-6 and bacterial vaginosis (BV) was explored. Thus, the use of multiple biomarkers did not detect PTD subtypes with a greater sensitivity than IL-6 alone, and IL-6 is a specific but non-sensitive marker for the detection of spontaneous PTD. LIMITATIONS, REASONS FOR CAUTION Our ability to find small effect size associations between PTD and inflammation biomarkers (OR <2.0) might have been limited by the modest number of less common PTD subtypes in our population (e.g. spontaneous delivery <35 weeks, PTD accompanied by HCA) and by relatively higher variability for some cytokines, for example tumor necrosis factor-?, IL-12p70, IL-10 and granulocyte-macrophage colony-stimulating factor, that are less stable and commonly undetectable or detectable at low levels in human vaginal secretions. WIDER IMPLICATIONS OF THE FINDINGS Larger studies are needed to further explore a role of inflammation biomarkers in combination with other risk factors, including specific BV-associated organisms, for the prediction of PTD subtypes. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Child Health and Human Development, National Institute of Nursing, March of Dimes Foundation, Thrasher Research Foundation and Centers for Disease Control and Prevention. The authors have no conflicts of interest. PMID:23416276

Taylor, Brandie D.; Holzman, Claudia B.; Fichorova, Raina N.; Tian, Yan; Jones, Nicole M.; Fu, Wenjiang; Senagore, Patricia K.

2013-01-01

313

Firmness Perception Influences Women’s Preferences for Vaginal Suppositories  

PubMed Central

Microbicides are being actively researched and developed as woman-initiated means to prevent HIV transmission during unprotected coitus. Along with safety and efficacy, assessing and improving compliance is a major area of research in microbicide development. We have developed carrageenan-based semisoft vaginal suppositories and have previously evaluated how physical properties such as firmness, size and shape influence women’s willingness to try them. Firmness has previously been quantified in terms of small-strain storage modulus, G’, however large-strain properties of the gels may also play a role in the firmness perception. In the current study we prepared two sets of suppositories with the same G’ but different elongation properties at four different G’ values (250, 2500, 12,500, 25,000 Pa): For convenience we refer to these as “brittle” and “elastic”, although these terms were never provided to study participants. In the first of two tests conducted to assess preference, women compared pairs of brittle and elastic suppositories and indicated their preference. We observed an interaction, as women preferred brittle suppositories at lower G’ (250, 2500 Pa) and elastic ones at a higher G’ (25,000 Pa). In the second test, women evaluated samples across different G’, rated the ease-of-insertion and willingness-to-try and ranked the samples in order of preference. Brittle suppositories at G’ of 12,500 Pa were most preferred. In vitro studies were also conducted to measure the softening of the suppositories in contact with vaginal simulant fluid (VSF). Release of antiretroviral drug tenofovir in VSF was quantified for the brittle and elastic suppositories at G’ of 12,500 Pa to determine the effect of suppository type on release. The initial rate of release was 20% slower with elastic suppositories as compared to brittle suppositories. Understanding how different physical properties simultaneously affect women’s preferences and pharmacological efficacy in terms of drug release is required for the optimization of highly acceptable and efficacious microbicides. PMID:25211123

Zaveri, Toral; Primrose, Rachel J.; Surapaneni, Lahari; Ziegler, Gregory R.; Hayes, John E.

2014-01-01

314

Large Vaginal and Bladder Calculi in a Woman With Previous Operation of Bladder Exstrophy: A Case Report  

PubMed Central

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones. PMID:24719809

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2013-01-01

315

Changes in Vaginal Bacterial Concentrations with Intravaginal Metronidazole Therapy for Bacterial Vaginosis as Assessed by Quantitative PCR  

Microsoft Academic Search

Several fastidious bacteria have been associated with bacterial vaginosis (BV) using broad-range bacterial PCR methods such as consensus sequence 16S rRNA gene PCR, but their role in BV remains poorly defined. We describe changes in vaginal bacterial concentrations following metronidazole therapy for BV. Vaginal swabs were collected from women with BV diagnosed using Amsel clinical criteria, and vaginal fluid was

David N. Fredricks; Tina L. Fiedler; Katherine K. Thomas; Caroline M. Mitchell; Jeanne M. Marrazzo

316

Understanding vaginal microbiome complexity from an ecological perspective  

PubMed Central

The various microbiota normally associated with the human body have an important influence on human development, physiology, immunity, and nutrition. This is certainly true for the vagina wherein communities of mutualistic bacteria constitute the first line of defense for the host by excluding invasive, nonindigenous organisms that may cause disease. In recent years much has been learned about the bacterial species composition of these communities and how they differ between individuals of different ages and ethnicities. A deeper understanding of their origins and the interrelationships of constituent species is needed to understand how and why they change over time or in response to changes in the host environment. Moreover, there are few unifying theories to explain the ecological dynamics of vaginal ecosystems as they respond to disturbances caused by menses and human activities such as intercourse, douching, and other habits and practices. This fundamental knowledge is needed to diagnose and assess risk to disease. Here we summarize what is known about the species composition, structure, and function of bacterial communities in the human vagina and the applicability of ecological models of community structure and function to understanding the dynamics of this and other ecosystems that comprise the human microbiome. PMID:22683415

Hickey, Roxana J.; Zhou, Xia; Pierson, Jacob D.; Ravel, Jacques; Forney, Larry J.

2012-01-01

317

Vaginal Cuff Dehiscence: Risk Factors and Associated Morbidities  

PubMed Central

Background and Objectives: To evaluate whether the route and surgical technique by which hysterectomy is performed influence the incidence of vaginal cuff dehiscence. Methods: We performed a retrospective analysis of total hysterectomy cases performed at Brigham and Woman's Hospital or Faulkner Hospital during 2009 through 2011. Results: During the study period, 2382 total hysterectomies were performed; 23 of these (0.96%) were diagnosed with cuff dehiscence, and 4 women had recurrent dehiscence. Both laparoscopic (odds ratio, 23.4; P = .007) and robotic (odds ratio, 73; P = .0006) hysterectomies were associated with increased odds of cuff dehiscence in a multivariate regression analysis. The type of energy used during colpotomy, mode of closure (hand sewn, laparoscopic suturing, or suturing assisted by a device), and suture material did not differ significantly between groups; however, continuous suturing of the cuff was a protective factor (odds ratio, 0.24; P = .03). Women with dehiscence had more extensive procedures, as well as an increased incidence of additional major postoperative complications (17.4% vs 3%, P = .004). Conclusion: The rate of cuff dehiscence in our cohort correlates with the current literature. This study suggests that the risk of dehiscence is influenced mainly by the scope and complexity of the surgical procedure. It seems that different colpotomy techniques do not influence the rate of cuff dehiscence; however, continuous suturing of the cuff may be superior to interrupted suturing.

Fuchs Weizman, Noga; Einarsson, Jon I.; Wang, Karen C.; Vitonis, Allison F.

2015-01-01

318

Elective repeat cesarean sections: how many could be vaginal births?  

PubMed Central

OBJECTIVE: To determine (a) the proportion of women undergoing elective repeat cesarean section without a trial of labour who were eligible for such a trial by the 1986 guidelines of the panel of the National Consensus Conference on Aspects of Cesarean Birth, (b) whether vaginal birth after cesarean section (VBAC) was discussed with these women and (c) the reasons cited for not having a trial of labour. DESIGN: Chart audit. SETTING: Level 2 perinatal care centre in a general teaching hospital. PATIENTS: All 313 women with a history of previous cesarean section who gave birth at the centre during 1989. RESULTS: Only 93 (30%) of the 313 women underwent a trial of labour. According to the 1986 guidelines 71% were eligible. A further 13% would have been eligible according to the revised 1991 guidelines. Of the 220 women who underwent elective repeat cesarean section, only 24 (11%) had a discussion of VBAC noted in their hospital charts. However, of all 117 patients whose charts indicated discussion of VBAC 93 (79%) chose to try it. Most of the women had either questionable indications or no indication noted for undergoing repeat cesarean section. CONCLUSION: Most of the women who underwent repeat cesarean section were eligible for a trial of labour. However, few charts noted a discussion of VBAC. Further physician and patient education is necessary to promote the appropriate use of VBAC and repeat cesarean section. PMID:8348425

Norman, P; Kostovcik, S; Lanning, A

1993-01-01

319

Total Laparoscopic Hysterectomy and Laparoscopy-Assisted Vaginal Hysterectomy  

PubMed Central

Background and Objectives: To compare the feasibility of total laparoscopic hysterectomy (TLH) and laparoscopy-assisted vaginal hysterectomy (LAVH) in the treatment of benign gynecologic diseases and to determine the selection criteria for each technique. Methods: This was a retrospective medical records review of 168 patients who underwent TLH or LAVH performed by one surgeon. A chi-square test was used to compare the difference between the TLH and LAVH groups. Pearson's correlation coefficient was calculated for the relationship between the clinico-demographic factors of the patients. Results: There were no differences between the 2 groups with respect to age, parity, history of abdominal delivery, body mass index, and indication for hysterectomy. The operative time was similar between the 2 groups (P>.99). The uterine weight was greater in the LAVH group compared to the TLH group (P<.01). Ten patients were converted from TLH to LAVH, because of a large uterus and/or a lower segmental mass on the uterus, making it difficult to expose the Koh cup rim contour. Conclusions: TLH and LAVH are safe, feasible methods by which to perform a hysterectomy. LAVH is preferred in patients with a mass involving the lower segment or a relatively large uterus. PMID:21902979

Lee, Ho Hyung; Lee, Soon Pyo; Park, Chan Yong

2011-01-01

320

Adherence of Tritrichomonas foetus to bovine vaginal epithelial cells.  

PubMed Central

Adherence of Tritrichomonas foetus to bovine vaginal epithelial cells (VECs) in vitro was investigated with fresh washed bovine VECs and log-phase cultures of T. foetus. Observation under phase-contrast microscopy showed that T. foetus usually adhered first by the posterior flagellum and later by the body. Significantly more keratinized squamous epithelial cells were detected with attached parasites than nonkeratinized round epithelial cells. The optimal pH range for attachment was 6.0 to 7.5, with peak attachment at pH 6.5 for squamous VECs. Surface-reactive bovine antiserum to T. foetus prevented adherence to bovine squamous VECs. Inhibition of adherence occurred at nonagglutinating, nonimmobilizing serum dilutions. Antiserum fractions enriched for immunoglobulin G1 inhibited adherence, but fractions enriched for immunoglobulin G2 did not. The inhibitory antiserum was specific for several medium- to high-molecular-weight membrane antigens as detected in Western blots (immunoblots). The ability of surface-reactive antibodies to prevent adherence and to agglutinate and immobilize T. foetus indicates that they may be protective. Images PMID:2471692

Corbeil, L B; Hodgson, J L; Jones, D W; Corbeil, R R; Widders, P R; Stephens, L R

1989-01-01

321

Murine Vaginal Colonization Model for Investigating Asymptomatic Mucosal Carriage of Streptococcus pyogenes  

PubMed Central

While many virulence factors promoting Streptococcus pyogenes invasive disease have been described, specific streptococcal factors and host properties influencing asymptomatic mucosal carriage remain uncertain. To address the need for a refined model of prolonged S. pyogenes asymptomatic mucosal colonization, we have adapted a preestrogenized murine vaginal colonization model for S. pyogenes. In this model, derivatives of strains HSC5, SF370, JRS4, NZ131, and MEW123 established a reproducible, asymptomatic colonization of the vaginal mucosa over a period of typically 3 to 4 weeks' duration at a relatively high colonization efficiency. Prior treatment with estradiol prolonged streptococcal colonization and was associated with reduced inflammation in the colonized vaginal epithelium as well as a decreased leukocyte presence in vaginal fluid compared to the levels of inflammation and leukocyte presence in non-estradiol-treated control mice. The utility of our model for investigating S. pyogenes factors contributing to mucosal carriage was verified, as a mutant with a mutation in the transcriptional regulator catabolite control protein A (CcpA) demonstrated significant impairment in vaginal colonization. An assessment of in vivo transcriptional activity in the CcpA? strain for several known CcpA-regulated genes identified significantly elevated transcription of lactate oxidase (lctO) correlating with excessive generation of hydrogen peroxide to self-lethal levels. Deletion of lctO did not impair colonization, but deletion of lctO in a CcpA? strain prolonged carriage, exceeding even that of the wild-type strain. Thus, while LctO is not essential for vaginal colonization, its dysregulation is deleterious, highlighting the critical role of CcpA in promoting mucosal colonization. The vaginal colonization model should prove effective for future analyses of S. pyogenes mucosal colonization. PMID:23460515

Watson, Michael E.; Nielsen, Hailyn V.; Hultgren, Scott J.

2013-01-01

322

Clinical Features of Bacterial Vaginosis in a Murine Model of Vaginal Infection with Gardnerella vaginalis  

PubMed Central

Bacterial vaginosis (BV) is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and Gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells). G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and associated complications. PMID:23527214

Gilbert, Nicole M.; Lewis, Warren G.; Lewis, Amanda L.

2013-01-01

323

Laparoscopic Reconstructive Surgery is Superior to Vaginal Reconstruction in the Pelvic Organ Prolapse  

PubMed Central

Background: Our purpose was to provide the clinical advantages of the laparoscopic approach compare to the vaginal approach in correcting uterine and vaginal vault prolapse. Methods: Between June 2007 and June 2011, 174 women were admitted to HUMC (Hallym University Medical Center) and underwent pelvic reconstructive surgery for prolapsed vaginal vault and uterus. Upon retrospective review of the medical records, 174 of the patients who had symptoms of pelvic organ prolapsed and Baden-Walker prolapse grade ? 2 were selected and divided into two groups as follows: vaginal approach group (n=120) and laparoscopic approach group (n=54). We compared the results of clinical outcome by analyzing Student's t-test and ?2-test or the Fisher exact test as appropriate. Results: There were significant difference in success rates without reoperation for recurrence as 91.7% (vaginal approach group, n=110) vs 100% (laparoscopic approach group, n=54), p=0.032. Mean follow-up duration was 31.3 ± 7.6 months for vaginal approach group and 29.7 ± 9.7 months for laparoscopic approach group. The Foley catheter indwelling duration (4.7± 1.9 vs 3.4±2.1 days, p< 0.001) and the length of postoperative hospitalization (6.4 ± 2.1 vs 5.0 ± 1.9 days, p <0.001) were significantly longer in vaginal approach group, whereas the operative time was significantly longer (108.2 ± 38.6 vs 168.3 ± 69.7 minutes, p <0.001) in laparoscopic approach group. Conclusions: Our result suggest there is significantly lower recurrence rate requiring reoperation and less catheterization time but increased operative time for laparascopic sacrocolpopexy. PMID:25170290

Park, Young-Han; Yang, Seong Cheon; Park, Sung Taek; Park, Sung Ho; Kim, Hong Bae

2014-01-01

324

Diverse Vaginal Microbiomes in Reproductive-Age Women with Vulvovaginal Candidiasis  

PubMed Central

Vulvovaginal candidiasis (VVC) is one of the most prevalent vaginal infectious diseases, and there are controversial reports regarding the diversity of the associated vaginal microbiota. We determined the vaginal microbial community in patients with VVC, bacterial vaginosis (BV), and mixed infection of VVC and BV using Illumina sequencing of 16S rRNA tags. Our results revealed for the first time the highly variable patterns of the vaginal microbiome from VVC patients. In general, the alpha-diversity results of species richness and evenness showed the following order: normal control < VVC only < mixed BV and VVC infection < BV only. The beta-diversity comparison of community structures also showed an intermediate composition of VVC between the control and BV samples. A detailed comparison showed that, although the control and BV communities had typical patterns, the vaginal microbiota of VVC is complex. The mixed BV and VVC infection group showed a unique pattern, with a relatively higher abundance of Lactobacillus than the BV group and higher abundance of Prevotella, Gardnerella, and Atopobium than the normal control. In contrast, the VVC-only group could not be described by any single profile, ranging from a community structure similar to the normal control (predominated with Lactobacillus) to BV-like community structures (abundant with Gardnerella and Atopobium). Treatment of VVC resulted in inconsistent changes of the vaginal microbiota, with four BV/VVC samples recovering to a higher Lactobacillus level, whereas many VVC-only patients did not. These results will be useful for future studies on the role of vaginal microbiota in VVC and related infectious diseases. PMID:24265786

Liu, Mu-Biao; Xu, Su-Rong; He, Yan; Deng, Guan-Hua; Sheng, Hua-Fang; Huang, Xue-Mei; Ouyang, Cai-Yan; Zhou, Hong-Wei

2013-01-01

325

Evaluation of Rapidly Disintegrating Vaginal Tablets of Tenofovir, Emtricitabine and Their Combination for HIV-1 Prevention  

PubMed Central

Vaginal tablets are being developed as an alternative to gels as an inexpensive, discreet dosage form for the administration of microbicides. This work describes the pharmacokinetic (PK) evaluation of rapidly disintegrating vaginal tablets containing tenofovir (TFV, 10 mg), emtricitabine (FTC, 10 mg), and the combination of TFV and FTC (10 mg each) under in vitro and in vivo conditions, and in direct comparison to the clinical TFV 1% gel, a microbicide product in Phase III clinical testing. The PK of TFV and FTC from tablets were also evaluated in female rabbits following intravaginal administration. Direct comparison of a single dose of TFV tablets (intact or predissolved at 10 mg/mL) and TFV 1% gel showed no differences in the vaginal PK of TFV between groups; however systemic bioavailability of TFV was significantly higher from the gel. When rabbits were dosed either once or daily for seven days with intact tablets of TFV, FTC, or the combination of TFV/FTC, vaginal and systemic concentrations of TFV and FTC were unaffected by co-formulation. Moreover, plasma PK parameters were similar following a single dose or seven once-daily doses. Tissue concentrations of TFV and FTC in the cranial vagina 4 h after administration ranged between 104 and 105 ng/g. Concentrations of TFV-diphospate (TFV-DP, the active metabolite) were also high (over 103 ng/g or about 3000 to 6000 fmol/mg) in the cranial vagina 4 h after administration and similar to those measured following administration of TFV 1% gel. These data demonstrate that rapidly disintegrating vaginal tablets may be a suitable topical microbicide dosage form providing similar vaginal TFV PK to that of TFV 1% gel. The data also support co-administration of FTC with TFV in a single vaginal tablet to create a combination microbicide in a simple and inexpensive dosage form. PMID:25494201

Clark, Meredith R.; Peet, M. Melissa; Davis, Sarah; Doncel, Gustavo F.; Friend, David R.

2014-01-01

326

Vaginal bacterial flora and cytology in proestrous bitches: role on fertility.  

PubMed

The study of canine vaginal cytology underwent limited evolution over the years. Presence and significance of inflammatory cells in vaginal smears are little considered aspects in the bitch. Moreover, occurrence of vaginal bacteria in breeding bitches during follicular phase of the reproductive cycle, in absence of clinical signs of infection, involves the difficult question of antibiotics administration. The aim of this study was to relate findings in vaginal cytology (presence of neutrophils, lymphocytes, eosinophils, erytrocytes and bacteria) and microbial environment during proestrus with fertility outcomes (development of pregnancy, uterine infection, resorption, abortion and neonatal mortality). Bacteria sensitivity to antibiotics normally used in small animal practice was also evaluated. Bacteria isolated from vagina, in order of frequency, were Enterococcus faecalis, Streptococcus ?-haemolyticus, Pasteurella multocida, E. coli, Klebsiella pneumoniae, Proteus mirabilis, E. coli haemolyticus, Arcanobacterium pyogenes, Streptococcus spp., Staphylococcus spp. and Acinetobacter spp. No mycoplasmas were observed. The present study showed that proestrous cytological aspects do not affect fertility. Eosinophils were never detected, while erythrocytes were always detected. During diestrus, E. coli was found in all pregnant bitches that developed clinical symptoms of uterine disorders (n = 3), resulting in uterine infection, resorption or abortion, but without statistical significance. Vaginal presence of Streptococcus spp. in proestrus was instead negatively associated with development of uterine infections (P = 0.005). Therefore, Streptococcus spp. could have a protective competitive role against more dangerous pathogens affecting fertility of the bitch. Among the 12 antibiotics tested, Gram-negative bacteria showed a significant sensitivity towards the amoxicillin and clavulanic acid association (P = 0.038). However, antibiotic treatment before mating, on the basis of positive culture, yet in the absence of clinical signs, seems to be unnecessary besides harmful leading to imbalance in vaginal commensal flora with adverse effects on fertility. In conclusion, vaginal bacteria, neutrophils, lymphocytes and erytrocytes should be considered as physiological aspect in the bitch during proestrus that does not require antibiotic therapy when asymptomatic. PMID:22289216

Groppetti, D; Pecile, A; Barbero, C; Martino, P A

2012-05-01

327

Pelvic Floor Disorders 5-10 Years After Vaginal or Cesarean Childbirth  

PubMed Central

Objective To estimate differences in pelvic floor disorders by mode of delivery. Methods We recruited 1,011 women for a longitudinal cohort study, 5-10 years after first delivery. Using hospital records, we classified each birth as: cesarean without labor, cesarean during active labor, cesarean after complete cervical dilation, spontaneous vaginal birth, or operative vaginal birth. At enrollment, stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Logistic regression analysis was used to estimate the relative odds of each pelvic floor disorder by obstetric history, adjusting for relevant confounders. Results Compared to cesarean without labor, spontaneous vaginal birth was associated with a significantly greater odds of stress incontinence (odds ratio (OR) 2.9; 95% confidence interval (CI) 1.5, 5.5) and prolapse to or beyond the hymen (OR 5.6; 95% CI 2.2, 14.7). Operative vaginal birth significantly increased the odds for all pelvic floor disorders, especially prolapse (OR 7.5; 95% CI 2.7, 20.9). These results suggest that 6.8 additional operative births or 8.9 spontaneous vaginal births, relative to cesarean births, would lead to one additional case of prolapse. Among women delivering exclusively by cesarean, neither active labor nor complete cervical dilation increased the odds for any pelvic floor disorder considered, although the study had less than 80% power to detect a doubling of the odds with these exposures. Conclusion Although spontaneous vaginal delivery was significantly associated with stress incontinence and prolapse, the most dramatic risk was associated with operative vaginal birth. PMID:21897313

Handa, Victoria L.; Blomquist, Joan L.; Knoepp, Leise R.; Hoskey, Kay A.; McDermott, Kelly C.; Muñoz, Alvaro

2011-01-01

328

Feline immunodeficiency virus Gag- and Env-specific immune responses after vaginal versus intravenous infection.  

PubMed

To better understand the correlation of mucosal and systemic immune responses with lentiviral containment, we contrasted the early mucosal and systemic immune responses induced by vaginal versus intravenous exposure of cats to feline immunodeficiency virus (FIV) isolates of differing pathogenicity and clade (i.e., FIV-B-2542 and FIV-A-PPR). We found that despite divergence in viral genotype, the mucosal and systemic immune responses induced differed more with route of exposure than virus isolate. In intravenously exposed cats, Gag-specific antibody (both IgG and IgA isotype) predominated in the serum, saliva, and vaginal wash fluid irrespective of infecting virus isolate. While Env-specific responses were more variable, they were more often detected in vaginally infected cats. Both IgG and IgA directed against Gag and Env were consistently present in vaginal wash fluids independent of route of infection or virus isolate. FIV Gag- and Env-specific cytotoxic lymphocytes (CTLs) were detected in blood and tissue lymphocytes of cats infected with either virus strain but were greatest in intravenously infected animals. Likewise, FIV-specific CTLs were detected in CD8(+) vaginal lymphocytes of animals infected by either route but were also more frequent in intravenously inoculated animals. In summary, we found qualitative differences in the immune responses following vaginal infection but no evidence (1) that mucosal immune responses were enhanced in vaginally exposed cats, (2) that local mucosal infection led to measurably greater immune responses in either compartment; or (3) that more prominent immune responses correlated with lower viral burden. PMID:11788028

Burkhard, M J; Mathiason, C K; Bowdre, T; Hoover, E A

2001-12-10

329

Use of porcine vaginal tissue ex-vivo to model environmental effects on vaginal mucosa to toxic shock syndrome toxin-1  

SciTech Connect

Menstrual toxic shock syndrome (mTSS) is a rare, recognizable, and treatable disease that has been associated with tampon use epidemiologically. It involves a confluence of microbial risk factors (Staphylococcus aureus strains that produce the superantigen—TSST-1), as well as environmental characteristics of the vaginal ecosystem during menstruation and host susceptibility factors. This paper describes a series of experiments using the well-characterized model of porcine vaginal mucosa ex-vivo to assess the effect of these factors associated with tampon use on the permeability of the mucosa. The flux of radiolabeled TSST-1 and tritiated water ({sup 3}H{sub 2}O) through porcine vaginal mucosa was determined at various temperatures, after mechanical disruption of the epithelial surface by tape stripping, after treatment with surfactants or other compounds, and in the presence of microbial virulence factors. Elevated temperatures (42, 47 and 52 °C) did not significantly increase flux of {sup 3}H{sub 2}O. Stripping of the epithelial layers significantly increased the flux of labeled toxin in a dose-dependent manner. Addition of benzalkonium chloride (0.1 and 0.5%) and glycerol (4%) significantly increased the flux of {sup 3}H{sub 2}O but sodium lauryl sulfate at any concentration tested did not. The flux of the labeled toxin was significantly increased in the presence of benzalkonium chloride but not Pluronic® L92 and Tween 20 and significantly increased with addition of ?-hemolysin but not endotoxin. These results show that the permeability of porcine vagina ex-vivo to labeled toxin or water can be used to evaluate changes to the vaginal environment and modifications in tampon materials, and thus aid in risk assessment. - Highlights: • Model assessed local effects of tampon use on vaginal mucosa. • Risks were evaluated using two tracers to assess permeability in an ex vivo model. • Mechanical damage to the epithelial surface increased tracer penetration. • Surfactants increased penetration of tracers across vaginal mucosa. • Alpha-hemolysin increased the penetration of bacterial toxin across vaginal mucosa.

Davis, Catherine C.; Baccam, Mekhine [Feminine Care Global Product Stewardship, 6110 Center Hill Road, The Procter and Gamble Company, Cincinnati, OH 45224 (United States); Mantz, Mary J. [Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242 (United States); Osborn, Thomas W.; Hill, Donna R. [Feminine Care Product Development, 6110 Center Hill Road, The Procter and Gamble Company, Cincinnati, OH 45224 (United States); Squier, Christopher A. [Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242 (United States)

2014-01-15

330

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes  

PubMed Central

Background: The aim of this study is to evaluate the outcome of an innovative, minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse (AVWP). Materials and Methods: Fifty-six women with stress urinary incontinence (SUI) or mixed urinary incontinence and AVWP were randomly assigned into two groups: In Group A (26 patients), anterior colporrhaphy (Kelly placation) and sling placement using a strip of anterior vaginal wall were performed, and in Group B (30 patients), transvaginal mesh correction of AVWP and tension-free vaginal tape (TVT) insertion (retropubic – craniocaudal route) using polypropylene mesh were carried out. The patients were followed-up for over 18 months and were assessed objectively using a 48 h frequency-volume chart, a 48 h pad test and a standardized stress test. Related surgical complications and outcomes were recorded and compared. Results: Surgical cure rates for Group A and Group B at the first (3 days) and last (18 months) post-operative visits were 62% and 84%; and 54%, and 72%, respectively (P = 0.09 and 0.31). Complications occurred in 9 patients (44%) of Group B, but only 3 patients (12%) in Group A. Conclusion: Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates. Although, the surgical success rate of this technique is lower than T-Sling, larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery. PMID:24516492

Zargham, Mahtab; Alizadeh, Farshid; Tadayyon, Farhad; Khorrami, Mohammad-Hatef; Nouri-Mahdavi, Kia; Gharaati, Mohammad Reza; Izadpanahi, Mohammad Hossein; Yazdani, Mohammad; Mazdak, Hamid

2013-01-01

331

Selected Vaginal Bacteria and Risk of Preterm Birth: An Ecological Perspective  

PubMed Central

We examined the community ecology of vaginal microbial samples taken from pregnant women with previous preterm birth experience to investigate whether targeted pathogenic and commensal bacteria are related to risk of preterm birth in the current pregnancy. We found a significant correlation between the community structure of selected bacteria and birth outcome, but the correlation differed among self-reported racial/ethnic groups. Using a community ordination analysis, we observed infrequent co-occurrence of Mycoplasma and bacteria vaginosis associated bacteria 3 (BVAB3) among black and Hispanic participants. In addition, we found that the vaginal bacteria responded differently in different racial/ethnic groups to modifications of maternal behavioral (ie, douching and smoking) and biological traits (ie, body mass index [BMI]). Even after accounting for these maternal behaviors and traits, the selected vaginal bacteria was significantly associated with preterm birth among black and Hispanic participants. By contrast, white participants did not exhibit significant correlation between microbial community and birth outcome. Findings from this study affirm the necessity of considering women's race/ethnicity when evaluating the correlation between vaginal bacteria and preterm birth. The study also illustrates the importance of studying the vaginal microbiota from an ecological perspective, and demonstrates the power of ecological community analysis to improve understanding of infectious disease. PMID:24273044

Wen, Ai; Srinivasan, Usha; Goldberg, Deborah; Owen, John; Marrs, Carl F.; Misra, Dawn; Wing, Deborah A.; Ponnaluri, Sreelatha; Miles-Jay, Arianna; Bucholz, Brigette; Abbas, Khadija; Foxman, Betsy

2014-01-01

332

High-dose-rate vaginal brachytherapy with chemotherapy for surgically staged localized uterine serous carcinoma  

PubMed Central

Purpose To evaluate our institutional experience combining carboplatin-paclitaxel (C/T) chemotherapy with high-dose-rate (HDR) intra-vaginal brachytherapy (IVB) following comprehensive surgical staging in localized uterine serous carcinoma (USC). Material and methods Institutional chart review identified 56 patients with FIGO 2009 stage I-II USC treated between 2000-2010. Patients underwent total hysterectomy, bilateral salpingo-oopherectomy, and comprehensive surgical staging including pelvic and para-aortic lymph node dissection, omentectomy, and peritoneal cytology. Chemotherapy was 6 cycles of C/T, and the IVB dose was 14 Gy in 2 fractions, prescribed to 0.5 cm from the cylinder surface. Kaplan-Meier methods were used to estimate recurrence-free survival (RFS) and overall survival (OS). Results The median follow-up time was 49 months (range: 9-145). The 5-yr RFS and OS were 85% and 93%, respectively. In all cases of recurrence (n = 8), the first site of failure was extra-pelvic. There were no isolated vaginal recurrences, however, there was one vaginal apex recurrence recorded at 19 months in a patient with simultaneous lung metastases. Thus, the 2-year vaginal RFS was 98%. Conclusions Excellent vaginal/pelvic control rates were observed. Further study of HDR brachytherapy dose and fractionation in combination with chemotherapy is worthwhile. PMID:25829935

Higgins, Susan A.; Ratner, Elena; De Leon, Maria C.; Mani, Sheida; Silasi, Dan-Arin; Azodi, Masoud; Santin, Alessandro; Rutherford, Thomas; Schwartz, Peter E.

2015-01-01

333

Postpartum urinary retention after vaginal delivery: Assessment of risk factors in a case-control study  

PubMed Central

Objective To assess the obstetrics risk factors for postpartum urinary retention after vaginal delivery. Material and Methods Of 234 women with a vaginal delivery, 19 (8.1%) women who had postpartum urinary retention were cases, and 215 (91.9%) women who did not were controls. Postpartum urinary retention was defined as the presence of postvoid residual bladder volume ?150 mL or the inability to void within 6 hours after vaginal delivery. Logistic regression analysis identified risk factors for urinary retention. Results Prolonged duration of the second stage of labor (OR=0.46, 95% CI for OR=0.06–3.67, p<0.001), presence of episiotomy (OR=0.07, 95% CI for OR=0.01–0.68, p=0.022) and perineal laceration (OR=97.09, 95% CI for OR=7.93–1188.93, p<0.001), and birth weight of >4000 g for the newborn (OR=0.04, 95% CI for OR=0.01–0.20, p<0.001) were found as independent risk factors for postpartum urinary retention after vaginal delivery. Conclusion Postpartum urinary retention after vaginal delivery is a relatively common condition. Awareness of risk factors, including prolonged second stage of labor, episiotomy, perineal lacerations, and macrosomic birth, may allow us to take the necessary precautions against this complication. PMID:25317040

Cavkaytar, Sabri; Kokanal?, Mahmut Kuntay; Baylas, Ay?egül; Topçu, Hasan Onur; Laleli, Bergen; Ta?ç?, Yasemin

2014-01-01

334

A comparison of upper airway parameters in postpartum patients: vaginal delivery vs. caesarean section  

PubMed Central

Mallampati class has been shown to increase during labour. The influence of delivery mode on this change is not known yet. The aim of our study is to investigate the changes of upper airway parameters in parturients after caesarean section and vaginal delivery. Ninety parturients undergoing elective caesarean section and ninety parturients with vaginal delivery were enrolled. The parameters of Modified Mallampati test (MMT), inter-incisor distance, thyromental distance, sternomental distance, neck circumference were measured before labour (T0) and 1 h (T1), 6 h (T6) and 24 h (T24) after delivery. Overall, 39 parturients (45.3%) with increases in MMT class in the vaginal delivery group within 24 h After childbirth, were more than that in the caesarean section group [24 parturients (26.7%), P=0.01]. In the vaginal delivery group, the incidence of the increases in MMT class at T1 and T6 were similar, which were higher than that at T24 (P=0.015). In the caesarean section group, the incidence of MMT class increases at T6 was significantly higher than that at T1 (P=0.015) and T24 (P=0.015). Our findings indicate that increase in Mallamapti class may be more significant and may take place earlier in parturients undergoing vaginal delivery than in those undergoing elective caesarean section. PMID:25664060

Hu, Jianying; Huang, Shaoqiang; Tian, Fubo; Sun, Shen; Li, Ning; Xie, Yi

2014-01-01

335

Role of Oxidative Stress on Vaginal Bleeding during The First Trimester of Pregnant Women  

PubMed Central

Background: Reactive oxygen species (ROS) are produced in many metabolic and physiologic processes. Antioxidative mechanisms remove these harmful species. Our aim was to assess whether serum total antioxidant capacity and total oxidant status altered during first trimester pregnancies with vaginal bleeding. Materials and Methods: In this cross-sectional study, A group of pregnant women at less than 10 weeks of gestation with vaginal bleeding (n=25) and a control group of healthy pregnancies with similar characteristics (n=25) were included. All of the patients in the two groups were matched for age, gestational age and body mass index. Serum total antioxidant capacity and total oxidant status levels were determined using a Hitachi 912 analyzer and compared between the two groups. Results: Characteristics, including maternal age, parity, and gestational age were similar between the two groups. Serum total antioxidant capacity levels were significantly lower in the women with vaginal bleeding than in control women (1.16 ± 0.20 vs. 1.77 ± 0.08 mmol Trolox Equiv./L; p=0.001), whereas higher total oxidant status measurements were found in women with vaginal bleeding compared to the control group (4.01 ± 0.20 vs. 2.57 ± 0.65 µmol H2O2 Equiv./L; p=0.001). Conclusion: Increased total oxidant status might be involved in the pathophysiology of vaginal bleeding during early first trimester pregnancies. PMID:24520496

Deveer, Rüya; Deveer, Mehmet; Engin-Üstün, Yaprak; Akbaba, Eren; Uysal, Sema; Sarikaya, Esma; Gülerman, Cavidan; Mollamahmutoglu, Leyla

2014-01-01

336

The relationship between vaginal bleeding in the first and second trimester of pregnancy and preterm labor  

PubMed Central

Background: Vaginal bleeding is a common complication during pregnancy, which is observed in about 1/4 of pregnancies and in half of cases can lead to abortion. If vaginal bleeding happens during pregnancy some adverse pregnancy outcomes, including perinatal mortality and morbidity, low birth weight and preterm delivery will be increased. Objective: The aim of this study was to determine the relationship between vaginal bleeding and its characteristics in the first and second trimester of pregnancy and preterm labor. Materials and Methods: This is a case-control study conducted on 440 pregnant women referred to Al-Zahra Hospital in Rasht, Iran. Data were collected by a form. The form included demographic characteristics and confounding factors, the occurrence of bleeding during pregnancy and its features. Data were analyzed by T test, chi square and logistic regression in SPSS 16. Results: Findings showed that vaginal bleeding was associated with 3 times increased risk of preterm delivery (OR: 3, 1.84-4.89). Also, findings showed that bleeding characteristics including bleeding time, frequency, severity and intensity was significantly associated with preterm labor. Conclusion: According to significant association between vaginal bleeding and preterm delivery, it seems that performing some interventions to prevent preterm labor could be appropriate. PMID:24639770

Sharami, Seyedeh Hajar; Faraji Darkhaneh, Roya; Zahiri, Ziba; Milani, Forozan; Asgharnia, Maryam; Shakiba, Maryam; Didar, Zirak

2013-01-01

337

Monilial and Trichomonal Vaginitis—Topical Treatment with Povidone-Iodine Preparations  

PubMed Central

A regimen of treatment for vaginitis combining the use of a povidone-iodine solution for swabbing, a povidone-iodine vaginal gel for application at night and a povidone-iodine douche for use in the morning, was evaluated in 93 courses of treatment in 87 patients with monilial or trichomonal vaginitis or a combination of both. In monilial vaginitis, symptoms were cleared and negative laboratory results obtained in one to three weeks in all 74 courses of treatment. These results were obtained within one week in 52 cases and within two weeks in another 17. In four of five patients with trichomonal vaginitis, symptoms were cleared within three weeks. In the fifth, negative laboratory results were obtained but a mild discharge persisted at the end of the fourth week. In 14 courses for combined infections, symptoms were cleared within three weeks in 13, and the pathogens were absent in those patients within four weeks. In one patient the disease did not respond. PMID:5762464

Ratzan, Jerome J.

1969-01-01

338

Vaginal Anomalies: Vaginal Agenesis  

MedlinePLUS

... Enlarged Prostate) C Cancer of the Ureter and Renal Pelvis Circumcision Cloacal Exstrophy Complete Blood Count (CBC) Conn's Syndrome Continent Urinary Diversion Contrast and Radionuclide Cystography Cryptorchidism CT Scan Cushing's Syndrome Cystocele/Fallen Bladder Cystometry Cystoscopy ...

339

Indication and method of frozen section in vaginal radical trachelectomy.  

PubMed

Vaginal radical trachelectomy (VRT) is a fertility-sparing surgical technique used as an alternative to radical hysterectomy in early stage cervical carcinoma. With the advent of VRT, preoperative evaluation of the surgical margin has become imperative, because if the tumor is found within 5 mm of the endocervical margin, additional surgical resection is required. In a study published earlier from our center, we came to the conclusion that a frozen section should be conducted only when a cancerous lesion is grossly visible, and that it could be omitted in normal-looking specimens or VRT with nonspecific lesions. Since then, 53 VRT have been performed in our center, and frozen sections were conducted according to these recommendations. Fifteen VRT were grossly normal, 24 had a nonspecific lesion and 14 showed a grossly visible lesion. Final margins were satisfactory on all 15 grossly normal specimens. Of the 24 VRT with nonspecific lesions, 2 cases for which no frozen section was performed had unsatisfactory final margins (<5 mm). Of the 14 VRT with grossly visible lesions, 3 cases were inadequately evaluated by frozen section due to sampling errors, which led to unsatisfactory final margin assessment. These results confirm that a frozen section can be omitted on normal looking VRT specimens, but contrary to results published earlier, we recommend that a frozen section be performed on all VRT with nonspecific lesions. As for VRT with a grossly visible lesion, frozen section evaluation is still warranted, and we recommend increasing the sampling to improve the adequacy of frozen sections. PMID:19696621

Chênevert, Jacinthe; Têtu, Bernard; Plante, Marie; Roy, Michel; Renaud, Marie-Claude; Grégoire, Jean; Grondin, Katherine; Dubé, Valérie

2009-09-01

340

Vaginal Revision of a Haematoma after Placement of Retropubic Tapes in Two Cases  

PubMed Central

Formation of a haematoma after placement of retropubic tapes for stress incontinence is a rare but typical complication potentially requiring a subsequent operation. Under certain circumstances, haematoma removal by a vaginal approach represents a milder alternative to the subperitoneal laparotomy approach under general anaesthesia. We present two cases of vaginal haematoma revision after placement of retropubic tapes. By means of this gentle alternative to the standard laparotomy approach we could avoid general anaesthesia in one case and perform the operation under analgosedative local anaesthesia. In the second case, use of the vaginal approach enabled us to avoid a laparotomy in this obese patient with a superinfected haematoma that could have led to a possible secondary wound healing problem.

Harf, S.; Marschke, J.; Lippkowski, A.; Beilecke, K.; Tunn, R.

2015-01-01

341

Automated segmentation algorithm for detection of changes in vaginal epithelial morphology using optical coherence tomography  

PubMed Central

Abstract. We have explored the use of optical coherence tomography (OCT) as a noninvasive tool for assessing the toxicity of topical microbicides, products used to prevent HIV, by monitoring the integrity of the vaginal epithelium. A novel feature-based segmentation algorithm using a nearest-neighbor classifier was developed to monitor changes in the morphology of vaginal epithelium. The two-step automated algorithm yielded OCT images with a clearly defined epithelial layer, enabling differentiation of normal and damaged tissue. The algorithm was robust in that it was able to discriminate the epithelial layer from underlying stroma as well as residual microbicide product on the surface. This segmentation technique for OCT images has the potential to be readily adaptable to the clinical setting for noninvasively defining the boundaries of the epithelium, enabling quantifiable assessment of microbicide-induced damage in vaginal tissue. PMID:23117799

Vincent, Kathleen L.; Vargas, Gracie; Motamedi, Massoud

2012-01-01

342

Gluteo-vaginal fistula: a long-term complication of posterior intravaginal slingplasty  

PubMed Central

A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on. PMID:22675111

Sivarajah, Vernon; Bello, Sean OZ; Yiu, Chu Yiu; Oke, Olatokunbo

2011-01-01

343

Inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair.  

PubMed

Graft augmentation for repair of recurrent pelvic organ prolapse is commonly used in reconstructive pelvic surgery. The reported complications are mainly late onset. We report a case of early-onset inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair. A 49-year-old presented with a recurrent and symptomatic posterior vaginal wall defect. She underwent an uneventful site-specific repair and bovine graft augmentation. Her early postoperative course was complicated by inflammatory response to the graft presenting as intense pelvic floor spasm and urinary retention. The condition was managed conservatively and resolved subsequently. One year later, the patient continues to be asymptomatic. Transient intense pelvic floor spasm and urinary retention can be the result of inflammatory reaction following graft augmentation with bovine pericardium for posterior vaginal wall defect repair. PMID:15378236

Lazarou, George; Powers, Kenneth; Pena, Carlos; Bruck, Lance; Mikhail, Magdy S

2005-01-01

344

Abdominal sacral colpoperineopexy: A new approach for correction of posterior compartment defects and perineal descent associated with vaginal vault prolapse  

Microsoft Academic Search

OBJECTIVE: Our purpose was to assess a modification of abdominal sacral colpopexy in 19 patients. STUDY DESIGN: The rectovaginal space was dissected to the superior aspect of the posterior vaginal fascia still contiguous with the perineal body. Mersilene (Ethicon, Somerville, N.J.) mesh was sutured to this fascia and along the entire posterior vaginal wall. Patients with vault prolapse, perineal descent,

Geoffrey W. Cundiff; Robert L. Harris; Kimberly Coates; Vincent H. S. Low; Richard C. Bump; W. Allen Addison

1997-01-01

345

'You don't really feel you can function normally': Women's perceptions and personal management of vaginal thrush  

Microsoft Academic Search

Vaginal symptoms caused by thrush are extremely common. However, there have been few qualitative studies reporting women's perceptions and self - management of this condition. This paper reports the results of 30 telephone interviews that were conducted with women who had previously presented at community pharmacies with a self - diagnosis of vaginal thrush. Some women reported that thrush made

A. Chapple; K. Hassell; M. Nicolson; J. Cantrill

2000-01-01

346

Ectopic vaginal insertion of an obstructed duplicated ureter in an adult female: demonstration by magnetic resonance imaging  

Microsoft Academic Search

The usual presentation of an ectopically inserted vaginal ureter is continuous dribbling of urine in an otherwise healthy girl. This case did not present with the usual symptomatology, as there was severe stenosis of the ectopically located ureteric orifice. Conventional imaging failed to show the vaginal insertion of an ectopic ureter. However, a magnetic resonance urogram readily depicted the collecting

Kiran A. Jain

2007-01-01

347

Poor Reliability of Vaginal and Endocervical Cultures for Evaluating Microbiology of Endometrial Cavity in Women with Chronic Endometritis  

Microsoft Academic Search

Background: Chronic endometritis (CE) is a subtle pathology causing infertility and abnormal uterine bleeding. We evaluated the reliability of vaginal and cervical cultures for detecting infectious agents at the endometrial level. Methods: In a prospective diagnostic study, 181 women diagnosed with CE and 100 controls underwent vaginal, endocervical and endometrial sampling. Cultures for common bacteria, Neisseria gonorrhoeae, yeast and Ureaplasma

Ettore Cicinelli; Dominique De Ziegler; Roberto Nicoletti; Raffaele Tinelli; Nicola Saliani; Leonardo Resta; Marina Bellavia; Danila De Vito

2009-01-01

348

Development of long-acting bioadhesive vaginal gels of oxybutynin: formulation, in vitro and in vivo evaluations.  

PubMed

Overactive bladder (OAB) and vaginal dryness are common problems after menopause. Oxybutynin (OXY) is an antimuscarinic agent that has been available for more than 30 years in the treatment of OAB patients. The aim of the work reported in this paper was to develop long acting mucoadhesive gel formulations of OXY and to investigate their effects on blood levels compared to those of oral OXY immediate release tablets, in rabbits. Mucoadhesive gels were prepared with chitosan, hydroxypropyl methylcellulose (HPMC K100M) and Poloxamer 407 (Pluronic F 127). The physicopharmaceutical properties of gels were evaluated. The gel formulation which was prepared with HPMC K100M, exhibited the highest viscosity, the greatest adhesiveness, cohesiveness and mucoadhesion values. The formulation which was prepared from HPMC K100M showed suitable permeation characteristics across the vaginal mucosa. Comparative bioavailability studies were carried out on rabbits with vaginal HPMC gel, vaginal chitosan gel, vaginal OXY solution and commercially available oral Üropan tablets. It was concluded that the highest AUC and relative bioavailability values were obtained for the bioadhesive vaginal gel formulation prepared with HPMC K100M. Therefore, the mucoadhesive vaginal gels of OXY can be a promising and innovative alternative therapeutic system for the treatment of OAB. It can be safely used in cases of overactive bladder and as well as vaginal dryness after menopause. PMID:24036011

Tu?cu-Demiröz, Fatmanur; Acartürk, Füsun; Erdo?an, Deniz

2013-11-30

349

Comparative Functional Genomics of Lactobacillus spp. Reveals Possible Mechanisms for Specialization of Vaginal Lactobacilli to Their Environment  

PubMed Central

Lactobacilli are found in a wide variety of habitats. Four species, Lactobacillus crispatus, L. gasseri, L. iners, and L. jensenii, are common and abundant in the human vagina and absent from other habitats. These may be adapted to the vagina and possess characteristics enabling them to thrive in that environment. Furthermore, stable codominance of multiple Lactobacillus species in a single community is infrequently observed. Thus, it is possible that individual vaginal Lactobacillus species possess unique characteristics that confer to them host-specific competitive advantages. We performed comparative functional genomic analyses of representatives of 25 species of Lactobacillus, searching for habitat-specific traits in the genomes of the vaginal lactobacilli. We found that the genomes of the vaginal species were significantly smaller and had significantly lower GC content than those of the nonvaginal species. No protein families were found to be specific to the vaginal species analyzed, but some were either over- or underrepresented relative to nonvaginal species. We also found that within the vaginal species, each genome coded for species-specific protein families. Our results suggest that even though the vaginal species show no general signatures of adaptation to the vaginal environment, each species has specific and perhaps unique ways of interacting with its environment, be it the host or other microbes in the community. These findings will serve as a foundation for further exploring the role of lactobacilli in the ecological dynamics of vaginal microbial communities and their ultimate impact on host health. PMID:24488312

Suzuki, Haruo; Hickey, Roxana J.; Forney, Larry J.

2014-01-01

350

Perineal and posterior vaginal wall reconstruction with a superior gluteal artery dual perforator-pedicled propeller flap.  

PubMed

Gluteal artery perforator flaps are a good option to reconstruct perineal and posterior vaginal wall defects after abdominoperineal resection. The bulkiness of the folded flap may compromise the results by obliterating the introitus and vaginal cavity. In this report, we present a case of the use of a superior gluteal artery dual perforator-pedicled propeller flap to reconstruct the posterior vaginal wall and perineum in a 60-year-old female who had an abdominoperineal resection of a locally progressive anal squamous cell carcinoma. Two perforators were completely skeletonized through gluteus maximus muscle fibers. The vascularization of the skin flap was based on the first perforator, whereas the aponeurotic flap was vascularized by the second perforator. The vaginal defect was reconstructed with a gluteus maximus aponeurotic flap, and the perineal reconstruction was based on a superior gluteal artery perforator skin flap. No postoperative infection or necrosis occurred. Skin healing was completed in 3 weeks. Vaginal opening was controlled using lubricant and graduated vaginal dilators during 6 weeks. The patient began sexual intercourse 2 months postoperatively. No revision was needed. Perineal and posterior vaginal wall defects may be reconstructed with a gluteal artery perforator flap. The thickness of the flap allows a complete filling of the full perineal cavity. The gluteus maximus aponeurosis may be suitable for the reconstruction of the posterior vaginal wall. PMID:24848991

Ayestaray, Benoit; Proske, Yann Martin

2015-01-01

351

Vaginal polymorphonuclear leukocytes and bacterial vaginosis as markers for histologic endometritis among women without symptoms of pelvic inflammatory disease  

Microsoft Academic Search

Objective: The study was performed to determine whether vaginal polymorphonuclear leukocytes can be used as predictors of histologic endometritis among women at risk for, but without symptoms of, acute pelvic inflammatory disease. Study design: Five hundred thirty-seven women with, or at risk for, pelvic infection underwent pelvic examinations, including endometrial biopsies. These women were assessed for the presence of vaginal

Mark H. Yudin; Sharon L. Hillier; Harold C. Wiesenfeld; Marijane A. Krohn; Antonio A. Amortegui; Richard L. Sweet

2003-01-01

352

Improving Appropriate Use of Antifungal Medications: The Role of an Over-the-Counter Vaginal pH Self-Test Device  

PubMed Central

Objectives: To determine whether patients can understand and use the vaginal pH device in the diagnosis of vaginitis. To compare whether vaginal pH readings determined by patients and healthcare providers are similar. To determine whether vaginalpHcan reduce inappropriate over-the-counter (OTC) antifungal medication use and improve the correct diagnosis of vaginitis. Methods: One hundred and fifty-one women indicated their belief about the cause of their vaginal infection, read the instructions of the vaginal pH device package insert, used the device and interpreted the findings. The patient interpretations were compared with results obtained by healthcare providers, blinded to patient findings. Results: Over 96% of patients stated that they could easily read the instructions, use the vaginal pH device and interpret the readings. They obtained the same readings as healthcare professionals (Kappa = 0.9). Restricting the use of OTC antifungal medications to those individuals with vaginitis symptoms and vaginal pH ? 4.5 significantly reduced inappropriate use by approximately 50%, Fisher's exact test,p-value = 0.018. Conversely, seeking healthcare provider assessment with vaginal pH > 4.5, leads to correct diagnosis of vaginitis. Conclusions: The vaginal pH device can be used as an OTC diagnostic tool by consumers when a vaginal infection is suspected. Vaginal pH readings would direct patients whether to purchase an antifungal medication or seek professional diagnosis from a healthcare provider. Understanding and use of this vaginal pH device could reduce inappropriate use of OTC antifungal medications by approximately 50% and improve the correct diagnosis of vaginitis. PMID:15108867

Caillouette, James C.; Faden, Joel S.; Roy, Tapon; Ramos, Diana E.

2003-01-01

353

Lactobacillus acidophilus Contributes to a Healthy Environment for Vaginal Epithelial Cells  

PubMed Central

Lactobacillus species in the female genital tract are thought to act as a barrier to infection. Several studies have demonstrated that lactobacilli can adhere to vaginal epithelial cells. However, little is known about how the adherence of lactobacilli to vaginal epithelial cells affects the acidity, cell viability, or proliferation of the lactobacilli themselves or those of vaginal epithelial cells. Lactobacillus acidophilus was co-cultured with immortalized human vaginal epithelial cells (MS74 cell line), and the growth of L. acidophilus and the acidity of the culture medium were measured. MS74 cell density and viability were also assessed by counting cell numbers and observing the cell attachment state. L. acidophilus showed exponential growth for the first 6 hr until 9 hr, and the pH was maintained close to 4.0-5.0 at 24 hr after culture, consistent with previous studies. The growth curve of L. acidophilus or the pH values were relatively unaffected by co-culture with MS74 cells, confirming that L. acidophilus maintains a low pH in the presence of MS74 cells. This co-culture model could therefore potentially be used to mimic vaginal conditions for future in vitro studies. On the other hand, MS74 cells co-cultured with L. acidophilus more firmly attached to the culture plate, and a higher number of cells were present compared to cells cultured in the absence of L. acidophilus. These results indicate that L. acidophilus increases MS74 cell proliferation and viability, suggesting that lactobacilli may contribute to the healthy environment for vaginal epithelial cells. PMID:22072832

Pi, Woojin; Ryu, Jae-Sook

2011-01-01

354

High-Dose-Rate Brachytherapy for the Treatment of Vaginal Intraepithelial Neoplasia  

PubMed Central

Purpose Vaginal intraepithelial neoplasia (VAIN), a rare premalignant condition, is difficult to eradicate. We assess the effectiveness of high-dose rate intracavitary brachytherapy (HDR-ICR) in patients with VAIN or carcinoma in situ (CIS) of the vagina after hysterectomy. Materials and Methods We reviewed 34 patients treated for posthysterectomy VAIN or CIS of the vagina by brachytherapy as the sole treatment. All patients underwent a coloposcopic-directed punch biopsy or had abnormal cytology, at least 3 consecutive times. All patients were treated with a vaginal cylinder applicator. The total radiation dose was mainly 40 Gy in 8 fractions during the periods of 4 weeks at a prescription point of the median 0.2 cm (range, 0 to 0.5 cm) depth from the surface of the vaginal mucosa. Results Acute toxicity was minimal. Seven patients had grade 1/2 acute urinary and rectal complications. There were 15 cases of late toxicity, predominantly vaginal mucosal reaction in 12 patients. Of these patients, two patients suffered from grade 3 vaginal stricture and dyspareunia continuously. After a median follow-up time of 48 months (range, 4 to 122 months), there were 2 recurrences and 2 persistent diseases, in which a second-line therapy was needed. The success rate was 88.2%. The average prescription point in failure patients was 1.1 mm from the surface of the vagina compared to an average of 2.6 mm in non-recurrent patients (p=0.097). Conclusion HDR-ICR is an effective treatment method in VAIN patients. In spite of high cure rates, we should consider issues regarding vaginal toxicity and radiation techniques to reduce the occurrence of failure and toxicity. PMID:24520226

Song, Jin Ho; Lee, Joo Hwan; Lee, Jong Hoon; Park, Jong Sup; Hong, Sook Hee; Jang, Hong Seok; Kim, Yeon Sil; Choi, Byung Ock

2014-01-01

355

Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health  

PubMed Central

The human body is colonized by a vast number of microorganisms collectively referred to as the human microbiota. One of the main microbiota body sites is the female genital tract, commonly dominated by Lactobacillus spp., in approximately 70% of women. Each individual species can constitute approximately 99% of the ribotypes observed in any individual woman. The most frequently isolated species are Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii and Lactobacillus iners. Residing at the port of entry of bacterial and viral pathogens, the vaginal Lactobacillus species can create a barrier against pathogen invasion since mainly products of their metabolism secreted in the cervicovaginal fluid can play an important role in the inhibition of bacterial and viral infections. Therefore, a Lactobacillus-dominated microbiota appears to be a good biomarker for a healthy vaginal ecosystem. This balance can be rapidly altered during processes such as menstruation, sexual activity, pregnancy and various infections. An abnormal vaginal microbiota is characterized by an increased diversity of microbial species, leading to a condition known as bacterial vaginosis. Information on the vaginal microbiota can be gathered from the analysis of cervicovaginal fluid, by using the Nugent scoring or the Amsel's criteria, or at the molecular level by investigating the number and type of Lactobacillus species. However, when translating this to the clinical setting, it should be noted that the absence of a Lactobacillus-dominated microbiota does not appear to directly imply a diseased condition or dysbiosis. Nevertheless, the widely documented beneficial role of vaginal Lactobacillus species demonstrates the potential of data on the composition and activity of lactobacilli as biomarkers for vaginal health. The substantiation and further validation of such biomarkers will allow the design of better targeted probiotic strategies.

Petrova, Mariya I.; Lievens, Elke; Malik, Shweta; Imholz, Nicole; Lebeer, Sarah

2015-01-01

356

The clinical relevance of the effect of ospemifene on symptoms of vulvar and vaginal atrophy.  

PubMed

Objectives To explore clinically relevant differences in severity of vulvar and vaginal atrophy (VVA) in postmenopausal women treated with ospemifene compared with placebo. Methods Analysis of two multicenter, randomized, double-blind, 12-week phase-III studies in postmenopausal women (40-80 years, with VVA, treated with ospemifene 60 mg/day or placebo (Study 310 and Study 821)). Severity of vaginal dryness and dyspareunia were evaluated using a four-point scoring system and clinically relevant differences between ospemifene and placebo were analyzed and are presented as improvement (reduction in ? 1 unit on four-point scoring system), substantial improvement (reduction in 2-3 units on four-point scoring system) and relief (severity score of mild/none after 12 weeks). Results In Study 310, significantly more women with a most bothersome symptom of dyspareunia had improvement (68.3% vs. 54.1%; p = 0.0255) or relief (57.5% vs. 41.8%; p = 0.0205) in the severity of dyspareunia from baseline to week 12 with ospemifene compared with placebo. For those with a most bothersome symptom of vaginal dryness, significantly more experienced improvement (74.6% vs. 57.7%; p = 0.0101), substantial improvement (42.4% vs. 26.9%; p = 0.0172) and relief (66.1% vs. 49.0%; p = 0.0140) of vaginal dryness from baseline to week 12 with ospemifene compared with placebo. Proportions of women with improvement/substantial improvement/relief of symptoms of vaginal dryness or dyspareunia were similar in Study 821. Clinically relevant differences were noticeable by week 4. Conclusions Treatment with ospemifene was consistently associated with greater improvement, substantial improvement or relief in the severity of the most bothersome symptoms of vaginal dryness or dyspareunia compared with placebo. PMID:25335119

Nappi, R E; Panay, N; Bruyniks, N; Castelo-Branco, C; De Villiers, T J; Simon, J A

2015-04-01

357

Single versus multichannel applicator in high-dose-rate vaginal brachytherapy optimized by inverse treatment planning  

PubMed Central

Purpose To retrospectively compare the potential dosimetric advantages of a multichannel vaginal applicator vs. a single channel one in intracavitary vaginal high-dose-rate (HDR) brachytherapy after hysterectomy, and evaluate the dosimetric advantage of fractional re-planning. Material and methods We randomly selected 12 patients with endometrial carcinoma, who received adjuvant vaginal cuff HDR brachytherapy using a multichannel applicator. For each brachytherapy fraction, two inverse treatment plans (for central channel and multichannel loadings) were performed and compared. The advantage of fractional re-planning was also investigated. Results Dose-volume-histogram (DVH) analysis showed limited, but statistically significant difference (p = 0.007) regarding clinical-target-volume dose coverage between single and multichannel approaches. For the organs-at-risk rectum and bladder, the use of multichannel applicator demonstrated a noticeable dose reduction, when compared to single channel, but statistically significant for rectum only (p = 0.0001). For D2cc of rectum, an average fractional dose of 6.1 ± 0.7 Gy resulted for single channel vs. 5.1 ± 0.6 Gy for multichannel. For D2cc of bladder, an average fractional dose of 5 ± 0.9 Gy occurred for single channel vs. 4.9 ± 0.8 Gy for multichannel. The dosimetric benefit of fractional re-planning was demonstrated: DVH analysis showed large, but not statistically significant differences between first fraction plan and fractional re-planning, due to large inter-fraction variations for rectum and bladder positioning and filling. Conclusions Vaginal HDR brachytherapy using a multichannel vaginal applicator and inverse planning provides dosimetric advantages over single channel cylinder, by reducing the dose to organs at risk without compromising the target volume coverage, but at the expense of an increased vaginal mucosa dose. Due to large inter-fraction dose variations, we recommend individual fraction treatment plan optimization.

Constantinescu, Camelia; Hassouna, Ashraf H.; Eltaher, Maha M.; Ghassal, Noor M.; Awad, Nesreen A.

2014-01-01

358

Characterization of the vaginal micro- and mycobiome in asymptomatic reproductive-age Estonian women.  

PubMed

The application of high-throughput sequencing methods has raised doubt in the concept of the uniform healthy vaginal microbiota consisting predominantly of lactobacilli by revealing the existence of more variable bacterial community composition. As this needs to be analyzed more extensively and there is little straightforward data regarding the vaginal mycobiome of asymptomatic women we aimed to define bacterial and fungal communities in vaginal samples from 494 asymptomatic, reproductive-age Estonian women. The composition of the vaginal microbiota was determined by amplifying bacterial 16S rRNA and fungal internal transcribed spacer-1 (ITS-1) regions and subsequently sequencing them using 454 Life Sciences pyrosequencing. We delineated five major bacterial community groups with distinctive diversity and species composition. Lactobacilli were among the most abundant bacteria in all groups, but also members of genus Gardnerella had high relative abundance in some of the groups. Microbial diversity increased with higher vaginal pH values, and was also higher when a malodorous discharge was present, indicating that some of the women who consider themselves healthy may potentially have asymptomatic bacterial vaginosis (BV). Our study is the first of its kind to analyze the mycobiome that colonizes the healthy vaginal environment using barcoded pyrosequencing technology. We observed 196 fungal operational taxonomic units (OTUs), including 16 OTUs of Candida spp., which is more diverse than previously recognized. However, assessing true fungal diversity was complicated because of the problems regarding the possible air-borne contamination and bioinformatics used for identification of fungal taxons as significant proportion of fungal sequences were assigned to unspecified OTUs. PMID:23372716

Drell, Tiina; Lillsaar, Triin; Tummeleht, Lea; Simm, Jaak; Aaspõllu, Anu; Väin, Edda; Saarma, Ivo; Salumets, Andres; Donders, Gilbert G G; Metsis, Madis

2013-01-01

359

Vaginal administration of estradiol: effects of dose, preparation and timing on plasma estradiol levels.  

PubMed

Context The use of systemic estrogens for the treatment of menopausal symptoms has declined by approximately 80% following the initial publication of the Women's Health Initiative in 2002. Current attention focuses on vaginal estrogen as a local therapeutic means to achieve control of symptoms due to vulvovaginal atrophy without increasing plasma estradiol levels. A key issue is whether or not vaginally administered estrogens are absorbed and produce systemic effects. Evidence acquisition Medline and PubMed were searched for relevant English-language articles using pertinent key words. The bibliographies of the pertinent articles were then read to identify further relevant articles. Evidence synthesis Several confounding factors influenced the data analysis including: (1) estradiol assay sensitivity and specificity; (2) acute versus chronic absorption; (3) delivery systems, doses, timing, and formulation; and (4) effect of atrophic versus mature vaginal mucosa on absorption. Each preparation was associated with acute estradiol absorption with peaks at approximately 8 h and return to baseline at 12 h. Low-dose vaginal estrogen, arbitrarily defined as the 7.5-?g vaginal ring and 10-?g tablet, increased plasma estradiol levels during chronic administration but not above the normal range of ? 20 pg/ml. Surprisingly, these increments were associated with systemic effects to lower plasma levels of low density lipoprotein cholesterol and bone resorption rates. Intermediate doses (i.e. 25 ?g estradiol or 0.3 mg conjugated equine estrogen) resulted in plasma estradiol levels approaching or exceeding 20 pg/ml. The higher doses (50-2000 ?g estradiol or 0.625-2.5 mg conjugated equine estrogen) resulted in premenopausal levels of estrogen. Conclusions Low-dose vaginal estrogen appears to be an effective strategy for managing women whose symptoms result from vulvovaginal atrophy. These regimens limit but do not completely eliminate systemic absorption. Low-doses regimens should be preferred clinically to intermediate- or high-dose methods. PMID:25327484

Santen, R J

2015-04-01

360

Development and characterization of a three-dimensional organotypic human vaginal epithelial cell model.  

PubMed

We have developed an in vitro human vaginal epithelial cell (EC) model using the innovative rotating wall vessel (RWV) bioreactor technology that recapitulates in vivo structural and functional properties, including a stratified squamous epithelium with microvilli, tight junctions, microfolds, and mucus. This three-dimensional (3-D) vaginal model provides a platform for high-throughput toxicity testing of candidate microbicides targeted to combat sexually transmitted infections, effectively complementing and extending existing testing systems such as surgical explants or animal models. Vaginal ECs were grown on porous, collagen-coated microcarrier beads in a rotating, low fluid-shear environment; use of RWV bioreactor technology generated 3-D vaginal EC aggregates. Immunofluorescence and scanning and transmission electron microscopy confirmed differentiation and polarization of the 3-D EC aggregates among multiple cell layers and identified ultrastructural features important for nutrient absorption, cell-cell interactions, and pathogen defense. After treatment with a variety of toll-like receptor (TLR) agonists, cytokine production was quantified by cytometric bead array, confirming that TLRs 2, 3, 5, and 6 were expressed and functional. The 3-D vaginal aggregates were more resistant to nonoxynol-9 (N-9), a contraceptive and previous microbicide candidate, when compared to two-dimensional monolayers of the same cell line. A dose-dependent production of tumor necrosis factor-related apoptosis-inducing ligand and interleukin-1 receptor antagonist, biomarkers of cervicovaginal inflammation, correlated to microbicide toxicity in the 3-D model following N-9 treatment. These results indicate that this 3-D vaginal model could be used as a complementary tool for screening microbicide compounds for safety and efficacy, thus improving success in clinical trials. PMID:20007410

Hjelm, Brooke E; Berta, Alice N; Nickerson, Cheryl A; Arntzen, Charles J; Herbst-Kralovetz, Melissa M

2010-03-01

361

Vaginal microbiome in women from Greenland assessed by microscopy and quantitative PCR  

PubMed Central

Background Bacterial vaginosis (BV) is a common condition, although its aetiology remains unexplained. The aim of this study was to analyse the composition of vaginal microbiota in women from Greenland to provide a quantitative description and improve the understanding of BV. Methods Self-collected vaginal smears and swabs were obtained from 177 women. The vaginal smears were graded for BV according to Nugent’s criteria. The vaginal swab samples were analysed by 19 quantitative PCRs (qPCRs) for selected vaginal bacteria and by PCR for four sexually transmitted infections (STIs). Results STIs were common: Mycoplasma genitalium 12%, Chlamydia trachomatis 7%, Neisseria gonorrhoeae 1%, and Trichomonas vaginalis 0.5%. BV was found in 45% of women, but was not associated with individual STIs. Seven of the 19 vaginal bacteria (Atopobium vaginae, Prevotella spp., Gardnerella vaginalis, BVAB2, Eggerthella-like bacterium, Leptotrichia amnionii, and Megasphaera type 1) had areas under the receiver operating characteristic (ROC) curve?>?85%, suggesting they are good predictors of BV according to Nugent. Prevotella spp. had the highest odds ratio for BV (OR 437; 95% CI 82–2779) in univariate analysis considering only specimens with a bacterial load above the threshold determined by ROC curve analysis as positive, as well as the highest adjusted odds ratio in multivariate logistic regression analysis (OR 4.4; 95% CI 1.4-13.5). BV could be subdivided into clusters dominated by a single or a few species together. Conclusions BV by Nugent score was highly prevalent. Two of seven key species (Prevotella spp. and A. vaginae) remained significantly associated with BV in a multivariate model after adjusting for other bacterial species. G. vaginalis and Prevotella spp. defined the majority of BV clusters. PMID:24131550

2013-01-01

362

Association of the Vaginal Microbiota with Human Papillomavirus Infection in a Korean Twin Cohort  

PubMed Central

Human papillomavirus (HPV) is the most important causative agent of cervical cancers worldwide. However, our understanding of how the vaginal microbiota might be associated with HPV infection is limited. In addition, the influence of human genetic and physiological factors on the vaginal microbiota is unclear. Studies on twins and their families provide the ideal settings to investigate the complicated nature of human microbiota. This study investigated the vaginal microbiota of 68 HPV-infected or uninfected female twins and their families using 454-pyrosequencing analysis targeting the variable region (V2–V3) of the bacterial 16S rRNA gene. Analysis of the vaginal microbiota from both premenopausal women and HPV-discordant twins indicated that HPV-positive women had significantly higher microbial diversity with a lower proportion of Lactobacillus spp. than HPV-negative women. Fusobacteria, including Sneathia spp., were identified as a possible microbiological marker associated with HPV infection. The vaginal microbiotas of twin pairs were significantly more similar to each other than to those from unrelated individuals. In addition, there were marked significant differences from those of their mother, possibly due to differences in menopausal status. Postmenopausal women had a lower proportion of Lactobacillus spp. and a significantly higher microbiota diversity. This study indicated that HPV infection was associated with the composition of the vaginal microbiota, which is influenced by multiple host factors such as genetics and menopause. The potential biological markers identified in this study could provide insight into HPV pathogenesis and may represent biological targets for diagnostics. PMID:23717441

Lee, Jung Eun; Lee, Sunghee; Lee, Heetae; Song, Yun-Mi; Lee, Kayoung; Han, Min Ji; Sung, Joohon; Ko, GwangPyo

2013-01-01

363

Identification, quantification and subtyping of Gardnerella vaginalis in noncultured clinical vaginal samples by quantitative PCR.  

PubMed

Gardnerella vaginalis is an important component of the human vaginal microflora. It is proposed to play a key role in the pathogenesis of bacterial vaginosis (BV), the most common vaginal condition. Here we describe the development, validation and comparative analysis of a novel molecular approach capable of G. vaginalis identification, quantification and subtyping in noncultured vaginal specimens. Using two quantitative PCR (qPCR) assays, we analysed G. vaginalis bacterial loads and clade distribution in 60 clinical vaginal-swab samples. A very high pathogen prevalence was revealed by species-specific qPCR not only among BV patients (100?%), but also in healthy women (97?%), although the G. vaginalis concentration was significantly lower in non-BV samples. G. vaginalis clades identified in vaginal specimens by subtyping multiplex qPCR, which targets four clade-specific genetic markers, had frequencies of 53?% for clade 1, 25?% for clade 2, 32?% for clade 3 and 83?% for clade 4. Multiple clades were found in 70?% of samples. Single G. vaginalis clades were represented by clade 1 and clade 4 in 28?% of specimens. A positive association with BV was shown for clade 1 and clade 3, while clade 2 was positively associated with intermediate vaginal microflora, but not with BV. Clade 4 demonstrated no correlation with the disorder. The presence of multiple clades had a high positive association with BV, whereas G. vaginalis identified as a single clade was negatively linked with the condition. Polyclonal G. vaginalis infection may be a risk factor for BV. PMID:24200640

Balashov, Sergey V; Mordechai, Eli; Adelson, Martin E; Gygax, Scott E

2014-02-01

364

Characterization of the Vaginal Micro- and Mycobiome in Asymptomatic Reproductive-Age Estonian Women  

PubMed Central

The application of high-throughput sequencing methods has raised doubt in the concept of the uniform healthy vaginal microbiota consisting predominantly of lactobacilli by revealing the existence of more variable bacterial community composition. As this needs to be analyzed more extensively and there is little straightforward data regarding the vaginal mycobiome of asymptomatic women we aimed to define bacterial and fungal communities in vaginal samples from 494 asymptomatic, reproductive-age Estonian women. The composition of the vaginal microbiota was determined by amplifying bacterial 16S rRNA and fungal internal transcribed spacer-1 (ITS-1) regions and subsequently sequencing them using 454 Life Sciences pyrosequencing. We delineated five major bacterial community groups with distinctive diversity and species composition. Lactobacilli were among the most abundant bacteria in all groups, but also members of genus Gardnerella had high relative abundance in some of the groups. Microbial diversity increased with higher vaginal pH values, and was also higher when a malodorous discharge was present, indicating that some of the women who consider themselves healthy may potentially have asymptomatic bacterial vaginosis (BV). Our study is the first of its kind to analyze the mycobiome that colonizes the healthy vaginal environment using barcoded pyrosequencing technology. We observed 196 fungal operational taxonomic units (OTUs), including 16 OTUs of Candida spp., which is more diverse than previously recognized. However, assessing true fungal diversity was complicated because of the problems regarding the possible air-borne contamination and bioinformatics used for identification of fungal taxons as significant proportion of fungal sequences were assigned to unspecified OTUs. PMID:23372716

Drell, Tiina; Lillsaar, Triin; Tummeleht, Lea; Simm, Jaak; Aaspõllu, Anu; Väin, Edda; Saarma, Ivo; Salumets, Andres; Donders, Gilbert G. G.; Metsis, Madis

2013-01-01

365

Endometriosis-induced vaginal hyperalgesia in the rat: effect of estropause, ovariectomy, and estradiol replacement  

PubMed Central

Endometriosis (ENDO) is a painful disorder defined by extrauteral endometrial growths. It is created in rats by autotransplanting pieces of uterus (which form cysts), or, for shamENDO, fat (no cysts). ENDO induces vaginal hyperalgesia, likely via central sensitization. The severity of this hyperalgesia correlates with estradiol levels during the estrous cycle, suggesting the hyperalgesia is estradiol-modulated. If so, then hyperalgesic severity should track estradiol changes during reproductive senescence (estropause) when estradiol levels initially decrease, then increase. Using psychophysical methods to assess vaginal nociception, we found that the severity of ENDO-induced hyperalgesia paralleled estradiol changes during estropause: hyperalgesia first decreased, then returned. Furthermore, the return occurred regardless of the presence of the cysts (excised in some rats). This finding provides further support for ENDO’s likely centrally-mediated effects. Additionally, the results suggest that elimination of estradiol via ovariectomy (OVX) should alleviate ENDO-induced hyperalgesia and estradiol replacement should restore it. However, in healthy and shamENDO rats, OVX produces a vaginal hyperalgesia that is alleviated by estradiol, likely via estradiol’s peripheral influences on the vagina. Hence, we tested the hypothesis that OVX in ENDO rats would trigger a different type of vaginal hyperalgesia dependent on the loss of estradiol. We predicted that the opposing influences of estradiol on ENDO- and OVX-induced hyperalgesia would cancel each other. As predicted, OVX had no effect on ENDO-induced hyperalgesia and estradiol replacement alleviated it. These results suggest that, in intact rats, ENDO-induced vaginal hyperalgesia is exacerbated by estradiol, and that different mechanisms underlie ENDO-induced versus OVX-induced vaginal hyperalgesia. PMID:17959309

Berkley, Karen J.; McAllister, Stacy L.; Accius, Briane E.; Winnard, Kenneth P.

2007-01-01

366

Congenital malformation of the vaginal orifice, imperforate vagina, in the common marmoset (Callithrix jacchus)  

PubMed Central

The following is a report on a congenital vaginal malformation, imperforate vagina, in the common marmoset (Callithrix jacchus). This anomaly was observed for the first time in an adult female in our research colony. There was no uterine and vaginal aplasia or atresia in her grossly normal genital tract. The plasma progesterone concentration suggested that the ovarian cycle had ceased. However, this may not be related to a functional anomaly, but rather to suppressed ovulation resulting from subordination to cagemates considering the various stages of follicular development observed. PMID:25391536

NIIMI, Kimie; OGUCHI, Ayaka; NISHIO, Kenji; OKANO, Yasushi; TAKAHASHI, Eiki

2014-01-01

367

Congenital malformation of the vaginal orifice, imperforate vagina, in the common marmoset (Callithrix jacchus).  

PubMed

The following is a report on a congenital vaginal malformation, imperforate vagina, in the common marmoset (Callithrix jacchus). This anomaly was observed for the first time in an adult female in our research colony. There was no uterine and vaginal aplasia or atresia in her grossly normal genital tract. The plasma progesterone concentration suggested that the ovarian cycle had ceased. However, this may not be related to a functional anomaly, but rather to suppressed ovulation resulting from subordination to cagemates considering the various stages of follicular development observed. PMID:25391536

Niimi, Kimie; Oguchi, Ayaka; Nishio, Kenji; Okano, Yasushi; Takahashi, Eiki

2014-11-13

368

Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing®)  

PubMed Central

The contraceptive vaginal ring is a novel contraceptive method that offers unique advantages. Intravaginal delivery of both estrogen and progesterone allows continuous release of medication, resulting in lower systemic levels. The use of long-term combined hormonal contraception enables improved cycle control compared with progesterone-only methods. The indications and usage of the NuvaRing® are described along with the efficacy, tolerability, and safety. Overall, the contraceptive vaginal ring appears to be very effective, with a favorable side-effect profile, and is highly acceptable to most patients. PMID:21151688

Wieder, Devorah R; Pattimakiel, Lynn

2010-01-01

369

Vaginal lactobacilli inhibiting growth of Gardnerella vaginalis, Mobiluncus and other bacterial species cultured from vaginal content of women with bacterial vaginosis.  

PubMed

On a solid agar medium the growth-inhibitory effect of 9 Lactobacillus strains cultured from vaginal content was tested on bacteria cultured from vaginal content of women with bacterial vaginosis: Mobiluncus, Gardnerella vaginalis, Bacteroides and anaerobic cocci. Inhibition zones were observed in the growth of all of the strains isolated from women with bacterial vaginosis around all lactobacilli. The inhibitory effect of the lactobacilli was further tested on various anaerobic and facultatively anaerobic species, both type strains and fresh extragenitally cultured strains. Four Bacteroides fragilis strains as well as 2 out of 4 Staphylococcus aureus strains were clearly inhibited by the lactobacilli. The inhibition zones were generally wider at pH 5.5 than at 6.0. For all inhibited strains, (the S. aureus excepted) a low pH on the agar around the lactobacilli correlated to wider growth-inhibition zones. PMID:3494379

Skarin, A; Sylwan, J

1986-12-01

370

Silver sucrose octasulfate (IASOS™) as a valid active ingredient into a novel vaginal gel against human vaginal pathogens: in vitro antimicrobial activity assessment.  

PubMed

This in vitro study assessed the antimicrobial properties of a novel octasilver salt of Sucrose Octasulfate (IASOS) as well as of an innovative vaginal gel containing IASOS (SilSOS Femme), against bacterial and yeast pathogens isolated from human clinical cases of symptomatic vaginal infections. In BHI and LAPT culture media, different ionic silver concentrations and different pHs were tested. IASOS exerted a strong antimicrobial activity towards all the pathogens tested in both culture media. The results demonstrated that salts and organic compounds present in the culture media influenced IASOS efficacy only to a moderate extent. Whereas comparable MBCs (Minimal Bactericidal Concentrations) were observed for G. vaginalis (10 mg/L Ag+), E. coli and E. aerogenes (25 mg/L Ag+) in both media, higher MBCs were found for S. aureus and S. agalactiae in LAPT cultures (50 mg/L Ag+ versus 25 mg/L Ag+). No minimal concentration totally inhibiting the growth of C. albicans was found. Nevertheless, in both media at the highest ionic silver concentrations (50-200 mg/L Ag+), a significant 34-52% drop in Candida growth was observed. pH differently affected the antimicrobial properties of IASOS against bacteria or yeasts; however, a stronger antimicrobial activity at pH higher than the physiological pH was generally observed. It can be therefore concluded that IASOS exerts a bactericidal action against all the tested bacteria and a clear fungistatic action against C. albicans. The antimicrobial activity of the whole vaginal gel SilSOS Femme further confirmed the antimicrobial activity of IASOS. Overall, our findings support IASOS as a valid active ingredient into a vaginal gel. PMID:24897299

Marianelli, Cinzia; Petrucci, Paola; Comelli, Maria Cristina; Calderini, Gabriella

2014-01-01

371

[Evaluation of vaginal dysfunction in symptomatic and asymptomatic pregnant women by using the analysis of basic vaginal states (BVS) and its comparison with the conventional microbiological study].  

PubMed

Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control. PMID:25444125

Touzon, María S; Losada, Mirta; Eliseht, Martha Cora; Menghi, Claudia; Gatta, Claudia; Santa Cruz, Gabriela; Malamud de Ruda Vega, Hilda; Vay, Carlos; Tatti, Silvio; Famiglietti, Angela; Perazzi, Beatriz

2014-01-01

372

Silver Sucrose Octasulfate (IASOS™) as a Valid Active Ingredient into a Novel Vaginal Gel against Human Vaginal Pathogens: In Vitro Antimicrobial Activity Assessment  

PubMed Central

This in vitro study assessed the antimicrobial properties of a novel octasilver salt of Sucrose Octasulfate (IASOS) as well as of an innovative vaginal gel containing IASOS (SilSOS Femme), against bacterial and yeast pathogens isolated from human clinical cases of symptomatic vaginal infections. In BHI and LAPT culture media, different ionic silver concentrations and different pHs were tested. IASOS exerted a strong antimicrobial activity towards all the pathogens tested in both culture media. The results demonstrated that salts and organic compounds present in the culture media influenced IASOS efficacy only to a moderate extent. Whereas comparable MBCs (Minimal Bactericidal Concentrations) were observed for G. vaginalis (10 mg/L Ag+), E. coli and E. aerogenes (25 mg/L Ag+) in both media, higher MBCs were found for S. aureus and S. agalactiae in LAPT cultures (50 mg/L Ag+ versus 25 mg/L Ag+). No minimal concentration totally inhibiting the growth of C. albicans was found. Nevertheless, in both media at the highest ionic silver concentrations (50–200 mg/L Ag+), a significant 34–52% drop in Candida growth was observed. pH differently affected the antimicrobial properties of IASOS against bacteria or yeasts; however, a stronger antimicrobial activity at pH higher than the physiological pH was generally observed. It can be therefore concluded that IASOS exerts a bactericidal action against all the tested bacteria and a clear fungistatic action against C. albicans. The antimicrobial activity of the whole vaginal gel SilSOS Femme further confirmed the antimicrobial activity of IASOS. Overall, our findings support IASOS as a valid active ingredient into a vaginal gel. PMID:24897299

Marianelli, Cinzia; Petrucci, Paola; Comelli, Maria Cristina; Calderini, Gabriella

2014-01-01

373

Utilization and perioperative outcomes of robotic vaginal vault suspension compared to abdominal or vaginal approaches for pelvic organ prolapse  

PubMed Central

Objectives: Robot-assisted vaginal vault suspension (RAVVS) for pelvic organ prolapse (POP) represents a minimally-invasive alternative to abdominal sacrocolpopexy. We measured perioperative outcomes and utilization rates of RAVVS. Methods: RAVVS (n = 2381) and open VVS (OVVS, n = 11080) data were extracted from the 2009–2010 Nationwide Inpatient Sample. Propensity score-matched analysis compared patients undergoing RAVVS or OVVS for complications, mortality, prolonged length-of-stay, and elevated hospital charges. Results: Use of RAVVS for POP increased from 2009 to 2010 (16.3% to 19.2%). Patients undergoing RAVVS were more likely to be white (77.2% vs. 69.6%), to carry private insurance (52.8% vs. 46.0%) and to have fewer comorbidities (Charlson Comorbidity Index [CCI] ?1 = 17.5% vs. 26.6%). They were more likely to undergo surgery at urban (98.2% vs. 93.7%) and academic centres (75.7% vs. 56.7%). Patients undergoing RAVVS were less likely to receive a blood-transfusion (0.7% vs. 1.8%, p < 0.001) or experience prolonged length-of-stay (9.3% vs. 25.1%, p < 0.001). They had more intraoperative complications (6.0% vs. 4.2%, p < 0.001), and higher median hospital charges ($32 402 vs. $24 136, p < 0.001). Overall postoperative complications were equivalent (17.9%, p = 1.0), though there were differences in wound (0.4% vs. 1.3%, p < 0.001), genitourinary (4.9% vs. 6.5%, p = 0.009), and surgical (6.6% vs. 4.9%, p = 0.007) complications. Conclusions: The increasing use of RAVVS from 2009 to 2010 suggests a growth in the adoption of robotics to manage POP. We show that RAVVS is associated with decreased length of stay, fewer blood transfusions, as well as lower postoperative wound, genitourinary and vascular complications. The benefits of RAVVS are mitigated by higher hospital charges and higher rates of intra-operative complications. PMID:24839477

Li, Hanhan; Sammon, Jesse; Roghmann, Florian; Sood, Akshay; Ehlert, Michael; Sun, Maxine; Menon, Mani; Atiemo, Humphrey; Trinh, Quoc-Dien

2014-01-01

374

Maturitas 41 (2002) 157165 Estrogen replacement reverses ovariectomy-induced vaginal  

E-print Network

in the rat Heather B. Bradshaw, Karen J. Berkley * Program in Neuroscience, Department of Psychology, Florida). Pressures exerted by the eight volumes on the vaginal wall were also measured, thereby permitting assessment. * Corresponding author. Tel.: +1-850-644-5741; fax: +1- 850-644-9874. E-mail address: kberkley@psy.fsu.edu (K

Berkley, Karen J.

375

Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion  

Microsoft Academic Search

Two doses, 200 and 400 ?g, of misoprostol, administered vaginally every 12 hours, up to four times, were tested in 101 and 133 healthy women, respectively, for interruption of pregnancies with 35 through 77 days of amenorrhea. The proportion of women who aborted increased with longer duration of treatment and was significantly higher with 400 than with 200 ?g (66

A. Bugalho; A. Faúndes; L. Jamisse; M. Usfá; E. Maria; C. Bique

1996-01-01

376

Optimisation of polyherbal gels for vaginal drug delivery by Box-Behnken statistical design  

Microsoft Academic Search

The present research work aimed at development and optimisation of mucoadhesive polyherbal gels (MPG) for vaginal drug delivery. As the rheological and mucoadhesive properties of the gels correlate well to each other the prepared MPGs were optimised for maximum mucoadhesion using a relationship between the storage modulus (G?) and Gel Index (GI), by employing a 3-factor, 3-level Box-Behnken statistical design.

Shruti Chopra; Sanjay K. Motwani; Zeenat Iqbal; Sushma Talegaonkar; Farhan J. Ahmad; Roop K. Khar

2007-01-01

377

Rheological properties of the anterior vaginal fluid from superovulated dairy heifers at estrus.  

PubMed

Anterior vaginal fluid samples were collected from 25 dairy heifers induced to superovulation at 12 to 20 hours after estrus detection. Thixotropy and flow behavior were evaluated. In samples from 19 heifers, structural variation was registered and the fluids were considered to be thixotropic; in the remaining samples (6 heifers), structural variation was not registered and the fluids were considered to be nonthixotropic. The mean estradiol concentration of the thixotropic fluids (20.8 pg/ml) was lower (P=0.0002) than of the nonthixotropic samples (56.7 pg/ml). All the nonthixotropic samples of anterior vaginal fluid exhibited Newtonian behavior. Of the 25 thixotropic anterior vaginal fluid samples, 10 exhibited Newtonian behavior while 9 exhibited non-Newtonian behavior. Heifers in which samples exhibited Newtonian behavior had a higher mean estradiol concentration (38.8 pg/ml; P=0.003) than heifers in which samples exhibited non-Newtonian behavior (12.8 pg/ml). Estradiol concentrations were correlated negatively (P=0.02) with the index of consistency (r = -0.46) and were not related to structural variation (P=0.08), although a certain tendency was shown. These results have shown that thixotropic and flow behavior measurements in the anterior vaginal fluid of superovulated estrous heifers vary over a wide range and even qualitatively. This variation is related to estrogen levels: Fluidity increases with increased plasma estrogen values, and the integrity of the gel structure tends toward elimination. PMID:16727303

López-Gatius, F; Miró, J; Sebastián, I; Ibarz, A; Labèrnia, J

1993-07-01

378

Vaginal microbicides: detecting toxicities in vivo that paradoxically increase pathogen transmission  

Microsoft Academic Search

BACKGROUND: Microbicides must protect against STD pathogens without causing unacceptable toxic effects. Microbicides based on nonoxynol-9 (N9) and other detergents disrupt sperm, HSV and HIV membranes, and these agents are effective contraceptives. But paradoxically N9 fails to protect women against HIV and other STD pathogens, most likely because it causes toxic effects that increase susceptibility. The mouse HSV-2 vaginal transmission

Richard A Cone; Timothy Hoen; XiXi Wong; Raed Abusuwwa; Deborah J Anderson; Thomas R Moench

2006-01-01

379

Vaginal Spasm, Pain, and Behavior: An Empirical Investigation of the Diagnosis of Vaginismus  

Microsoft Academic Search

This study investigated the roles of vaginal spasm, pain, and behavior in vaginismus and the ability of psychologists, gynecologists, and physical therapists to agree on a diagnosis of vaginismus. Eighty-seven women, matched on age, relationship status, and parity, were assigned to one of three groups: vaginismus, dyspareunia resulting from vulvar vestibulitis syndrome (VVS), and no pain with intercourse. Diagnostic agreement

Elke D. Reissing; Yitzchak M. Binik; Samir Khalifé; Deborah Cohen; Rhonda Amsel

2004-01-01

380

PULSED FIELD FINGERPRINTING OF VAGINAL GROUP B STREPTOCOCCUS IN PREGNANCY: CORRELATION OF RESTRICTION PROFILES WITH SEROTYPE.  

Technology Transfer Automated Retrieval System (TEKTRAN)

Management protocols for vaginal group B beta-hemolytic streptococci (GBS; Streptococcus agalactiae) infection during pregnancy focus on treatment after an infection is identified. However, there is more to be learned about the epidemiology of GBS infections during pregnancy. In this study, we compa...

381

Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer  

SciTech Connect

Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.

Friedman, Lois C., E-mail: Lois.Friedman@UHhospitals.org [Department of Psychiatry, CASE Comprehensive Cancer Center and University Hospitals of Cleveland, Cleveland, OH (United States); Abdallah, Rita [Ireland Cancer Center, CASE Comprehensive Cancer Center and University Hospitals of Cleveland, Cleveland, OH (Ireland); Schluchter, Mark; Panneerselvam, Ashok [Department of Epidemiology and Biostatistics, CASE Comprehensive Cancer Center and University Hospitals of Cleveland, Cleveland, OH (United States); Kunos, Charles A. [Department of Radiation Oncology, CASE Comprehensive Cancer Center and University Hospitals of Cleveland, Cleveland, OH (United States)

2011-07-01

382

Vaginal histological changes after using intravaginal sponges for oestrous synchronization in anoestrous ewes.  

PubMed

To characterize the histological and cytological vaginal changes generated by the use of intravaginal sponge (IS) applied in oestrous synchronization treatments in ewes during mid-non-breeding season. Thirty-five multiparous ewes were allocated to three experimental groups according to the moment in which the samples were taken: (i) ewes treated with IS containing 60 mg of medroxyprogesterone acetate for 14 days, sampled the day of IS removal (group ISR; n = 10), (ii) or after sponge removal at time of oestrus or 72 h after removal (group AR; n = 14) and (iii) ewes without sponge treatment that were sampled at the day of IS removal of the other groups (group CG; n = 11). Vaginal biopsies and cytological samples were taken from the anterior vaginal fornix area. The vagina of the CG group had a stratified squamous epithelium with a moderate degree of cellular infiltration with lymphocytes and plasma cells in the lamina propia. Treated ewes (ISR and AR) had epithelial hyperplasia and hypertrophy. ISR ewes had haemorrhage and perivascular infiltrate and an increased number of epithelial cells, neutrophils, macrophages and erythrocytes at IS removal. The use of IS generated histological and cytological alterations in the vaginal wall when used for oestrous synchronization in anoestrous ewes. PMID:25604995

Manes, J; Campero, C; Hozbor, F; Alberio, R; Ungerfeld, R

2015-04-01

383

Lactobacilli isolated from vaginal vault of dairy and meat cows during progesteronic stage of estrous cycle  

Microsoft Academic Search

Lactobacilli have been barely studied in cows. We proposed isolate and characterize lactic acid bacteria from dairy cows as compared to those raised for meat production and elucidate the presence of strains with evident probiotic employment’s potential. For this, isolation and quantification of LAB mainly lactobacilli were realized from vaginal cattle samples in MRS medium. Each selected microorganism was then

C. Rodríguez; J. V. Cofré; M. Sánchez; P. Fernández; G. Boggiano; E. Castro

2011-01-01

384

Vaginal intraepithelial neoplasia: treatment by carbon dioxide laser and risk factors for failure  

Microsoft Academic Search

Objective: To evaluate the effectiveness of CO2 laser ablation of vaginal intraepithelial neoplasia (VAIN) and to define prognostic factors. Study Design: Medical records of 24 patients with VAIN II or III, treated by CO2 laser ablation from 1990 to 1998 were reviewed. The grade, location, and focality of the lesions, the age, follow-up period and menopausal status of the patients,

Omer T Yalcin; Thomas J Rutherford; Setsuko K Chambers; Joseph T Chambers; Peter E Schwartz

2003-01-01

385

Treatment of Vaginal Intraepithelial Neoplasia with Laser Ablation and Upper Vaginectomy  

Microsoft Academic Search

To assess the effectiveness of laser ablation and upper vaginectomy in the treatment of vaginal intraepithelial neoplasia (VAIN), we have reviewed the charts of 52 patients managed with laser ablation (28 patients) and upper colpectomy (24 patients). On the basis of our results, patient selection and operator skill have a significant influence on the outcome. In posthysterectomy patients with VAIN3

Emmanuel Diakomanolis; Alexandros Rodolakis; Zanis Boulgaris; Georgios Blachos; Stylianos Michalas

2002-01-01

386

Clinical Features and Risk of Recurrence among Patients with Vaginal Intraepithelial Neoplasia  

Microsoft Academic Search

Objective. The best treatment modality and factors affecting recurrence among women with vaginal intraepithelial neoplasia (VAIN) are yet to be determined. The aims of the current study were to describe the clinical features, results of treatment, and factors affecting recurrence among patients with VAIN.Methods. We conducted a retrospective review of 121 women with VAIN after confirming the histologic diagnosis. Patient

Jeffrey A. Dodge; Gamal H. Eltabbakh; Sharon L. Mount; R. Paige Walker; Ann Morgan

2001-01-01

387

Cavitational Ultrasonic Surgical Aspiration for the Treatment of Vaginal Intraepithelial Neoplasia  

Microsoft Academic Search

Objective. The aim of this study is to determine whether cavitational ultrasonic surgical aspiration (CUSA) is effective and safe for treating vaginal intraepithelial neoplasia (VAIN).Methods. We conducted a retrospective chart review of 46 patients who were treated with CUSA for VAIN in a single gynecologic oncology practice between 1981 and 1999.Results. At initial presentation, 39% of treated patients had grade

Jubilee B. Robinson; Charlotte C. Sun; Diane Bodurka-Bevers; Dwight D. Im; Neil B. Rosenshein

2000-01-01

388

Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence  

Microsoft Academic Search

Objectives. To assess the objective and subjective cure rates after the tension-free vaginal tape (TVT) procedure in women with urinary incontinence.Methods. We performed a retrospective analysis of 112 consecutive women with genuine stress (n = 88) and mixed (n = 24) incontinence. The objective cure rate was evaluated by clinical and urodynamic examinations and the subjective cure rate using the

Louis Jeffry; Bruno Deval; Anca Birsan; David Soriano; Emile Daraï

2001-01-01

389

Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial  

Microsoft Academic Search

Summary Background For 3-4% of pregnancies, the fetus will be in the breech presentation at term. For most of these women, the approach to delivery is controversial. We did a randomised trial to compare a policy of planned caesarean section with a policy of planned vaginal birth for selected breech-presentation pregnancies. Methods At 121 centres in 26 countries, 2088 women

Mary E Hannah; Walter J Hannah; Sheila A Hewson; Ellen D Hodnett; Saroj Saigal; Andrew R Willan

2000-01-01

390

Reproductive biology of the coyote (Canis latrans): integration of mating behavior, reproductive hormones, and vaginal cytology  

Microsoft Academic Search

The reproductive biology of wild Canis species is often described as unique among mammals because an unusual combination of behavioral and physiological characteristics including a seasonally monestrous cycle, copulatory lock or tie, obligatory pseudopregnancy, social monogamy, and biparental care of the young. We investigated social behavior, endocrine profiles, and vaginal cytology of female coyotes (Canis latrans) during 4 breeding seasons,

Debra A. Carlson; Eric M. Gese

2008-01-01

391

Uncomplicated vaginal delivery 6 years after stent graft repair of an acute traumatic aortic transection.  

PubMed

Acute traumatic transection of the aorta (ATAT) is a devastating event. Transluminal endovascular aortic repair (TEVAR) has meanwhile become an excellent alternative for such lesions. A 27-year old woman sustained a multiple trauma in a car accident including ATAT which was treated by aortic stent graft placement. Six years after the endovascular repair, our patient had only noticed, just shortly after an annual computed tomography (CT) check-up, that she was pregnant and in the 9th week of gestation. The CT was considered as unproblematic for the foetus since direct radiation of the uterus had been avoided. Our patient clearly preferred a vaginal delivery over a caesarean section. The pregnancy was uneventful with uncomplicated vaginal delivery at term. This case shows that vaginal delivery is possible if the stent graft is in regular position without signs of endoleaks and the rest of the aorta is free from dissection or aneurysm formation. It indicates that TEVAR is a sound and durable treatment modality in ATATs and that aortic stent grafts can resist increased intravascular volume and elevated aortic pressure levels as encountered in pregnancy and during vaginal delivery. This particular case also shows that it is possible to respect a patient's right of self-determination. PMID:22108919

Schlechta, Bernhard; Wiedemann, Dominik; Eppel, Wolfgang; Kocher, Alfred

2012-01-01

392

Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods  

Microsoft Academic Search

The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understanding the aetiology of these diseases. Common wisdom is that lactobacilli dominate the normal vaginal microflora of post-pubertal women. However, this conclusion is based on

Xia Zhou; Stephen J. Bent; Maria G. Schneider; Catherine C. Davis; Mohammed R. Islam; Larry J. Forney

2004-01-01

393

Assessing outcome after a modified vaginal wall sling for stress incontinence with intrinsic sphincter deficiency  

Microsoft Academic Search

Forty women with stress incontinence, intrinsic sphincter deficiency (ISD), associated or not with urethral hypermobility, a Valsalva leak point pressure (VLLP) 20 and a maximum urethral closure pressure 20 underwent in situ vaginal wall sling. The main modification to the technique was the use of two small Marlex meshes placed at the lateral edges of the sling. Outcome was assessed

Elisabetta Costantini; Luigi Mearini; Ettore Mearini; Cinzia Pajoncini; Federico Guercini; Vittorio Bini; Massimo Porena

2005-01-01

394

Effect of vaginal misoprostol on pregnancy rate after intrauterine insemination: a randomized controlled trial  

PubMed Central

Background: Intrauterine insemination (IUI) is one of the most appropriate and cost-effective methods in infertility treatment. Objective: We aimed to investigate effect of vaginal misoprostol on pregnancy rate after IUI. Materials and Methods: Two hundred and ten infertile women who were referred to Infertility Clinic of Alzahra Hospital by an indication of IUI during 2012-2013 were randomly assigned to receive 200 µg vaginal misoprostol (n=105) or vaginal placebo (n=105) after IUI. For detecting pregnancy, past 2 weeks, beta human chorionic gonadotropin evaluation was made and if positive, transvaginal sonography was done for evaluation of pregnancy 2-3 weeks later and clinical pregnancy was recorded. Results: Pregnancy had been noted in 24 patients in misoprotol (22.9%) and 27 patients in placebo (25.7%) groups that this difference was not significant (p=0.748). In misoprostol group, 3 case of nausea and vomiting (2.9%) had been observed. Conclusion: According to the results, administering 200 µg vaginal misoprostol after IUI doesn’t have significant effect on the success rate of IUI. PMID:25653670

Zahiri sorouri, Ziba; Asgharnia, Maryan; Gholampoor, Ameneh

2015-01-01

395

Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury  

PubMed Central

The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case. PMID:25722727

Simó González, Marta; Porta Roda, Oriol; Perelló Capó, Josep; Gich Saladich, Ignasi; Calaf Alsina, Joaquim

2015-01-01

396

Evaluation of chitosan based vaginal bioadhesive gel formulations for antifungal drugs.  

PubMed

The aim of the present study was to evaluate chitosan as a vaginal mucoadhesive gel base for econazole nitrate and miconazole nitrate. To this aim, different types of chitosan with different molecular masses and viscosity properties [low molecular mass chitosan (viscosity: 20,000 mPa s), medium molecular mass chitosan (viscosity: 200,000 mPa s), high molecular mass chitosan (viscosity: 800,000 mPa s)] have been used. First, rheological studies were conducted on chitosan gels. Mechanical, syringeability and mucoadhesive properties of chitosan gels were determined. Release profiles of econazole nitrate and miconazole nitrate from chitosan gels were obtained and evaluated kinetically. In addition, anticandidal activities of formulations were determined. Finally, vaginal retention of chitosan gels in rats was evaluated by in vivo distribution studies. Based on the results, it can be concluded that gels prepared with medium molecular mass chitosan might be effectively used for different antifungal agents in the treatment of vaginal candidiosis, since it has high mucoadhesiveness, suitable mechanical and release properties with good vaginal retention. PMID:24914716

Senyi?it, Zeynep Ay; Karavana, Sinem Yaprak; Eraç, Bayri; Gürsel, Ozge; Limoncu, Mine Ho?gör; Balo?lu, Esra

2014-06-01

397

Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population  

ERIC Educational Resources Information Center

Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

2009-01-01

398

Effect of semen and seminal amyloid on vaginal transmission of simian immunodeficiency virus  

PubMed Central

Background Semen and semen-derived amyloid fibrils boost HIV infection in vitro but their impact on sexual virus transmission in vivo is unknown. Here, we examined the effect of seminal plasma (SP) and semen-derived enhancer of virus infection (SEVI) on vaginal virus transmission in the SIV/rhesus macaque (Macacca mulatta) model. Results A total of 18 non-synchronized female rhesus macaques (six per group) were exposed intra-vaginally to increasing doses of the pathogenic SIVmac239 molecular clone in the presence or absence of SEVI and SP. Establishment of productive virus infection was assessed by measuring plasma viral RNA loads at weekly intervals. We found that the first infections occurred at lower viral doses in the presence of SP and SEVI compared to the control group. Furthermore, the average peak viral loads during acute infection were about 6-fold higher after exposure to SP- and SEVI-treated virus. Overall infection rates after a total of 27 intra-vaginal exposures to increasing doses of SIV, however, were similar in the absence (4 of 6 animals) and presence of SP (5 of 6), or SEVI (4 of 6). Furthermore, the infectious viral doses required for infection varied considerably and did not differ significantly between these three groups. Conclusions Semen and SEVI did not have drastic effects on vaginal SIV transmission in the present experimental setting but may facilitate spreading of virus infection after exposure to low viral doses that most closely approximate the in vivo situation. PMID:24308721

2013-01-01

399

Cervical Ripening with Low-Dose Prostaglandins in Planned Vaginal Birth after Cesarean  

PubMed Central

Objectives To compare uterine rupture, maternal and perinatal morbidity rates in women with one single previous cesarean after spontaneous onset of labor or low-dose prostaglandin-induced cervical ripening for unfavourable cervix. Study Design This was a retrospective cohort study of 4,137 women with one single previous cesarean over a 22-year period. Inpatient prostaglandin administration consisted in single daily local applications. Results Vaginal delivery was planned for 3,544 (85.7%) patients, 2,704 (76.3%) of whom delivered vaginally (vaginal birth after Cesarean (VBAC) rate = 65.4%). Among women receiving prostaglandins (n=515), 323 (62.7%) delivered vaginally. Uterine rupture (0.7% compared with 0.8%, OR 1.1, 95% CI 0.4-3.4, p=0.88), maternal (0.9% compared with 1.2%, OR 1.3, 95% CI 0.5-3.2, p=0.63) and perinatal (0.3% compared with 0.8%, OR 2.4, 95% CI 0.7-8.5, p=0.18) morbidity rates did not differ significantly between patients with spontaneous onset of labor and those receiving prostaglandins, nor did these rates differ according to the planned mode of delivery. Conclusion In comparison with patients with spontaneous labor, inducing cervical ripening with low-dose prostaglandins in case of unfavourable cervix is not associated with appreciable increase in uterine rupture, maternal or perinatal morbidity. PMID:24260505

Schmitz, Thomas; Pourcelot, Anne-Gaelle; Moutafoff, Constance; Biran, Valérie; Sibony, Olivier; Oury, Jean-François

2013-01-01

400

An Odor of Racism: Vaginal Deodorants in African-American Beauty Culture and Advertising  

Microsoft Academic Search

The use of vaginal deodorants such as douches and feminine sprays is a troubling phenomenon due to its association with many adverse health consequences. Complicating this issue is the fact that African-American women are four times as likely to use these products as Caucasian women. This essay seeks to explain this practice as an element of African-American beauty culture. By

Michelle Ferranti

2011-01-01

401

An Odor of Racism: Vaginal Deodorants in African-American Beauty Culture and Advertising  

Microsoft Academic Search

: The use of vaginal deodorants such as douches and feminine sprays is a troubling phenomenon due to its association with many adverse health consequences. Complicating this issue is the fact that African-American women are four times as likely to use these products as Caucasian women. This essay seeks to explain this practice as an element of African-American beauty culture.

Michelle Ferranti

2011-01-01

402

The use of vaginal ultrasound to identify copper T IUDs at high risk of expulsion  

Microsoft Academic Search

A total of 235 women who had a TCu 380A IUD inserted had a vaginal ultrasound scan performed to identify if the IUDs were correctly placed in the uterine fundus. Women identified as having a misplaced IUD had it removed. The remaining women were compared to 201 women who had an IUD inserted and had no ultrasound evaluation, matched by

Carlos Alberto Petta; Daniel Faúndes; Eliane Pimentel; Juan Diaz; Luis Bahamondes

1996-01-01

403

Mucoadhesive Vaginal Tablets as Veterinary Delivery System for the Controlled Release of an Antimicrobial Drug, Acriflavine  

Microsoft Academic Search

The aim of the study was the development of mucoadhesive vaginal tablets designed for the local controlled release of acriflavine, an antimicrobial drug used as a model. The tablets were prepared using drug-loaded chitosan microspheres and additional excipients (methylcellulose, sodium alginate, sodium carboxymethylcellulose, or Carbopol 974). The microspheres were prepared by a spray-drying method, using the drug to polymer weight

Elisabetta Gavini; Vanna Sanna; Claudia Juliano; Maria Cristina Bonferoni; Paolo Giunchedi

2002-01-01

404

Characterization of Vaginal Flora and Bacterial Vaginosis in Women Who Have Sex with Women  

Microsoft Academic Search

Bacterial vaginosis (BV) may be common among women who report having sex with women (WSW) and frequently occurs in both members of monogamous couples. The results of Gram staining of a vaginal smear were consistent with BV in 81 (25%) and intermediate in 37 (11%) of 326 WSW included in this study. Lactobacilli were detected in 64% of subjects, and

Kathy Agnew; Kathleen Stine

2002-01-01

405

Vaginal fetal fibronectin measurements from 8 to 22 weeks’ gestation and subsequent spontaneous preterm birth  

Microsoft Academic Search

Objective: We sought to determine the range of fetal fibronectin values in the vagina from 8 to 22 weeks’ gestation, the factors associated with both low and high values, and whether high values are associated with gestational age at birth. Study Design: Vaginal fetal fibronectin was quantitatively determined in a prospective cohort study of 13,360 women being evaluated for participation

Robert L. Goldenberg; Mark Klebanoff; J. Christopher Carey; Cora MacPherson; Kenneth J. Leveno; Atef H. Moawad; Baha Sibai; R. P. Heine; J. M. Ernest; Mitchell P. Dombrowski; Menachem Miodovnik; Ronald J. Wapner; Jay D. Iams; Oded Langer; Mary J. O’Sullivan; James M. Roberts

2000-01-01

406

The bacterial microbiome in paired vaginal and vestibular samples from women with vulvar vestibulitis syndrome.  

PubMed

Composition of the bacterial microbiome in the vagina and vestibule from 30 women with vulvar vestibulitis syndrome (VVS) and 15 healthy controls were compared by pyrosequencing 16S rRNA gene amplicons. Vaginal concentrations of interleukin (IL)-1? were determined by ELISA. Questionnaires elicited clinical and symptom data. Eighteen genera were detected in vaginal samples, and 23 genera were identified in vestibule samples, from women with VVS. The genera at both sites and the mean number of genera in subjects with VVS were largely similar to those in control subjects. However, differences were noted including higher proportions of Streptococcus and Enterococcus in women with VVS. Furthermore, Lactobacillus iners was more frequently identified in women with VVS while L. crispatus was more frequent in the control women. The dominant bacterial genera in the vagina closely paralleled the dominant genera present in the corresponding vestibular sample in both groups, leading us to postulate that vaginal secretions are an important source of bacteria present on the vestibule. Vaginal IL-1? levels were similar and varied depending on the dominant bacteria. We conclude in this pilot study that no major differences are apparent in the vagina and vestibule between women with or without VVS, except for an increased prevalence of Streptococcus and L. iners in some women with VVS. PMID:24961922

Jayaram, Aswathi; Witkin, Steven S; Zhou, Xia; Brown, Celeste J; Rey, Gustavo E; Linhares, Iara M; Ledger, William J; Forney, Larry J

2014-12-01

407

Development of sponge-like dressings for mucosal/transmucosal drug delivery into vaginal cavity.  

PubMed

The aim of the present work was the development of vaginal sponge-like dressings based on chitosan ascorbate (CS) and on hyaluronic acid sodium salt/lysine acetate (HAS) combination. Sponge-like dressings were prepared by freeze-drying and characterized for mechanical resistance and mucoadhesion. CS dressings show higher mechanical and mucoadhesion properties in comparison with HAS dressing. The enzymatic inhibition properties of the dressings were evaluated in vitro against carboxipeptidase A in view of their employment for vaginal delivery of peptidic drugs. All the dressings were able to inhibit carboxipeptidase activity; CS dressings, independently of polymer MW, completely inhibited enzyme activity. Release and penetration enhancement properties of the dressings loaded with a high molecular weight hydrophilic molecule, fluorescein isothiocyanate dextran (FD4), were assessed. CS dressings were able to prolong FD4 release. All the dressings showed penetration enhancement properties into pig vaginal mucosa although to a different extent: greater for dressings based on CS than for that containing HAS. Moreover, CS dressings demonstrated intrinsic antimicrobial properties. The suitability of sponge-like systems for the treatment of vaginal infections was assessed by loading the CS dressing characterized by the best mechanical and antimicrobial properties with an antibiotic drug (clyndamicin-2-phosphate) and by checking drug release. PMID:21077750

Rossi, Silvia; Marciello, Marzia; Ferrari, Franca; Puccio, Antonella; Bonferoni, Cristina; Sandri, Giuseppina; Caramella, Carla

2012-01-01

408

Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult.  

PubMed

Ventriculo-peritoneal shunts (VPS) are commonly used in the treatment of various neurosurgical conditions, including hydrocephalus and pseudotumor cerebri. We report only the second case of vaginal extrusion of a VPS catheter in an adult, and the first case with a modern VPS silastic peritoneal catheter. A 45-year-old female with a history of VPS for pseudotumor cerebri, Behcet's syndrome, and hysterectomy presented to our institution with the chief complaint of tubing protruding from her vagina after urination. On gynecologic examination, the patient was found to have approximately 15 cm of VPS catheter protruding from her vaginal apex. A computed tomography scan of the abdomen and shunt X-ray series demonstrated no breaks in the tubing, but also confirmed the finding of the VPS catheter extruding through the vaginal cuff into the vagina. The patient had the VPS removed and an external ventricular drain was placed for temporary cerebrospinal fluid diversion. Ventricular catheter cultures were positive for diphtheroids. After an appropriate course of antibiotics, a contralateral ventriculo-pleural shunt was placed one week later. Although vary rare, vaginal extrusion can occur in adults, even with modern VPS catheters. PMID:25552862

Bonfield, Christopher M; Weiner, Gregory M; Bradley, Megan S; Engh, Johnathan A

2015-01-01

409

Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult  

PubMed Central

Ventriculo-peritoneal shunts (VPS) are commonly used in the treatment of various neurosurgical conditions, including hydrocephalus and pseudotumor cerebri. We report only the second case of vaginal extrusion of a VPS catheter in an adult, and the first case with a modern VPS silastic peritoneal catheter. A 45-year-old female with a history of VPS for pseudotumor cerebri, Behcet's syndrome, and hysterectomy presented to our institution with the chief complaint of tubing protruding from her vagina after urination. On gynecologic examination, the patient was found to have approximately 15 cm of VPS catheter protruding from her vaginal apex. A computed tomography scan of the abdomen and shunt X-ray series demonstrated no breaks in the tubing, but also confirmed the finding of the VPS catheter extruding through the vaginal cuff into the vagina. The patient had the VPS removed and an external ventricular drain was placed for temporary cerebrospinal fluid diversion. Ventricular catheter cultures were positive for diphtheroids. After an appropriate course of antibiotics, a contralateral ventriculo-pleural shunt was placed one week later. Although vary rare, vaginal extrusion can occur in adults, even with modern VPS catheters. PMID:25552862

Bonfield, Christopher M.; Weiner, Gregory M.; Bradley, Megan S.; Engh, Johnathan A.

2015-01-01

410

Mifepristone followed on the same day by vaginal misoprostol for early abortion  

Microsoft Academic Search

We performed a pilot study to examine the clinical efficacy of mifepristone 200 mg followed on the same day by misoprostol 800 ?g vaginally in women with pregnancies up to 49 days gestation. Forty women received mifepristone 200 mg after which they self-inserted misoprostol intravaginally 6 to 8 h later at home. Participants returned for an evaluation, including transvaginal ultrasonography,

Helen C. Pymar; Mitchell D. Creinin; Jill L. Schwartz

2001-01-01

411

Randomized trial of oral versus vaginal misoprostol at one day after mifepristone for early medical abortion  

Microsoft Academic Search

Mifepristone was recently approved in the United States. Regimens with shorter intervals may be more acceptable. The objective of this study was to determine whether the oral route of misoprostol was as effective as the vaginal route of misoprostol 1 day after mifepristone. A prospective, open-labeled, randomized trial of healthy adult women up to 63 days pregnant and wanting a

Eric A. Schaff; Stephen L. Fielding; Carolyn Westhoff

2001-01-01

412

A Randomized Trial of Planned Cesarean or Vaginal Delivery for Twin Pregnancy  

PubMed Central

BACKGROUND Twin birth is associated with a higher risk of adverse perinatal outcomes than singleton birth. It is unclear whether planned cesarean section results in a lower risk of adverse outcomes than planned vaginal delivery in twin pregnancy. METHODS We randomly assigned women between 32 weeks 0 days and 38 weeks 6 days of gestation with twin pregnancy and with the first twin in the cephalic presentation to planned cesarean section or planned vaginal delivery with cesarean only if indicated. Elective delivery was planned between 37 weeks 5 days and 38 weeks 6 days of gestation. The primary outcome was a composite of fetal or neonatal death or serious neonatal morbidity, with the fetus or infant as the unit of analysis for the statistical comparison. RESULTS A total of 1398 women (2795 fetuses) were randomly assigned to planned cesarean delivery and 1406 women (2812 fetuses) to planned vaginal delivery. The rate of cesarean delivery was 90.7% in the planned-cesarean-delivery group and 43.8% in the planned-vaginal-delivery group. Women in the planned-cesarean-delivery group delivered earlier than did those in the planned-vaginal-delivery group (mean number of days from randomization to delivery, 12.4 vs. 13.3; P = 0.04). There was no significant difference in the composite primary outcome between the planned-cesarean-delivery group and the planned-vaginal-delivery group (2.2% and 1.9%, respectively; odds ratio with planned cesarean delivery, 1.16; 95% confidence interval, 0.77 to 1.74; P = 0.49). CONCLUSIONS In twin pregnancy between 32 weeks 0 days and 38 weeks 6 days of gestation, with the first twin in the cephalic presentation, planned cesarean delivery did not significantly decrease or increase the risk of fetal or neonatal death or serious neonatal morbidity, as compared with planned vaginal delivery. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00187369; Current Controlled Trials number, ISRCTN74420086.) PMID:24088091

Barrett, Jon F.R.; Hannah, Mary E.; Hutton, Eileen K.; Willan, Andrew R.; Allen, Alexander C.; Armson, B. Anthony; Gafni, Amiram; Joseph, K.S.; Mason, Dalah; Ohlsson, Arne; Ross, Susan; Sanchez, J. Johanna; Asztalos, Elizabeth V.

2014-01-01

413

[The first case of persistent vaginitis due to Aspergillus protuberus in an immunocompetent patient].  

PubMed

The vast majority of vaginal fungal infections are caused by Candida species. However, vaginitis cases caused by molds are extremely rare. Aspergillus protuberus is previously known as a member of Aspergillus section Versicolores which can cause opportunistic infections in immunocompromised patients, however it has recently been described as a seperate species. Although the members of Aspergillus section Versicolores have been isolated rarely in cases of pulmonary infections, eye infections, otomycosis, osteomyelitis and onycomycoses, to the best of our knowledge, there is no published case of human infection caused by A.protuberus. In this report, the first case of persistent vaginitis due to A.protuberus in an immunocompetent patient was presented. A 42-year-old female patient was admitted to our hospital with the complaints of pelvic pain, vaginal itching and discharge during one month. Her symptoms had been persistant despite of the miconazole nitrate and clotrimazole therapies for probable candidal vaginitis. Fungal structures such as branched, septate hyphae together with the conidial forms were seen in microscopic examination as in the cervical smear. Thereafter, a vaginal discharge sample was taken for microbiological evaluation and similar characteristics of fungal structures were observed in the microscopic examination as of cervical smear. Then, preliminary result was reported as Aspergillus spp. At the same time, the sample was plated on Sabouraud dextrose agar (SDA) in duplicate and incubated at room temperature and at 37oC. After 5 days, white, powdery and pure-looking fungal colonies were observed in SDA which was incubated at room temperature, while the other medium remained sterile. The culture was submitted to the CBS-KNAW Fungal Biodiversity Center for further characterization. Phenotypic identification showed that the isolated strain belonged to the Aspergillus section Versicolores. The strain was grown for 7 days on malt extract agar and then ITS regions were amplified and sequenced from isolated DNA for genomic characterization. The obtained sequences were compared with the NCBI database and internal databases of the CBS-KNAW Fungal Biodiversity Centre and confirmed as Aspergillus section Versicolores. As a result of recent changes in classification of fungi, analysis of partial ?-tubulin and calmodulin sequences have also been used to obtain a detailed and precise characterization. Eventually, the strain has been identified as A.protuberus which is a recently accepted species distinct from Aspergillus section Versicolores. As the patient could not be contacted after the preliminary report, detailed demographical information, probable origin and route of transmission of the agent and prognosis of infection remained obscure. In conclusion, the first case of vaginitis caused by A.protuberus was described in this report with the support of clinical, pathological, microbiological and molecular data. PMID:25706739

Borsa, Bar?? Ata; Özgün, Gonca; Houbraken, Jos; Ökmen, F?rat

2015-01-01

414

Vaginal douching and sexually transmitted infections among female sex workers: a cross-sectional study in three provinces in China.  

PubMed

Though vaginal douching is a common practice among female sex workers that could increase the risk of HIV and adverse reproductive health outcomes, it has drawn limited attention. From November 2010 to January 2011, a convenience sample of female sex workers was recruited in three cities in China. Face-to-face interviews were conducted to gather socio-demographic and behavioural information. Blood samples were collected for syphilis serological tests. Endo-cervical swabs were collected and tested for Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction. A logistic regression model was used to determine factors associated with vaginal douching and the association between vaginal douching and sexually transmitted infection. A total of 1032 eligible female sex workers were enrolled. The overall prevalence of any sexually transmitted infection (syphilis, Chlamydia trachomatis or Neisseria gonorrhoeae) and vaginal douching with disinfectant were 23.4% and 23.1%, respectively. Factors independently associated with douching practice included study sites, venue types, ethnicity, having regular partner and sexually transmitted infection history. No significant association was found between vaginal douching and current sexually transmitted infection. Vaginal douching with disinfectant after sex with clients seemed to be a prevalent practice among female sex workers in China. Prevention programmes targeting female sex workers should incorporate components about the adverse health outcomes associated with vaginal douching. PMID:25015933

Li, Jing; Jiang, Ning; Yue, Xiaoli; Gong, Xiangdong

2015-05-01

415

Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan  

PubMed Central

Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery) admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees) and from the patient's perspective was 79 US$ (5278 rupees). The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees) and 204 US$ (13678 rupees) from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74%) of households had a monthly income of less than 149 US$ (10000 rupees). Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare. PMID:20085662

2010-01-01

416

Vaginal Immunization to Elicit Primary T-Cell Activation and Dissemination  

PubMed Central

Primary T-cell activation at mucosal sites is of utmost importance for the development of vaccination strategies. T-cell priming after vaginal immunization, with ovalbumin and CpG oligodeoxynucleotide adjuvant as model vaccine formulation, was studied in vivo in hormone-synchronized mice and compared to the one induced by the nasal route. Twenty-four hours after both vaginal or nasal immunization, antigen-loaded dendritic cells were detected within the respective draining lymph nodes. Vaginal immunization elicited a strong recruitment of antigen-specific CD4+ T cells into draining lymph nodes that was more rapid than the one observed following nasal immunization. T-cell clonal expansion was first detected in iliac lymph nodes, draining the genital tract, and proliferated T cells disseminated towards distal lymph nodes and spleen similarly to what observed following nasal immunization. T cells were indeed activated by the antigen encounter and acquired homing molecules essential to disseminate towards distal lymphoid organs as confirmed by the modulation of CD45RB, CD69, CD44 and CD62L marker expression. A multi-type Galton Watson branching process, previously used for in vitro analysis of T-cell proliferation, was applied to model in vivo CFSE proliferation data in draining lymph nodes 57 hours following immunization, in order to calculate the probabilistic decision of a cell to enter in division, rest in quiescence or migrate/die. The modelling analysis indicated that the probability of a cell to proliferate was higher following vaginal than nasal immunization. All together these data show that vaginal immunization, despite the absence of an organized mucosal associated inductive site in the genital tract, is very efficient in priming antigen-specific CD4+ T cells and inducing their dissemination from draining lymph nodes towards distal lymphoid organs. PMID:24349003

Pettini, Elena; Prota, Gennaro; Ciabattini, Annalisa; Boianelli, Alessandro; Fiorino, Fabio; Pozzi, Gianni; Vicino, Antonio; Medaglini, Donata

2013-01-01

417

Impact of chemoradiotherapy on vaginal and sexual function of patients with FIGO IIb cervical cancer  

PubMed Central

The opinion regarding sexual and vaginal function of patients with advanced cervical cancer treated primarily by chemoradiotherapy has still not been formed, mainly due to inappropriate methodology as the control group was comprised of healthy women. The aim of this study is to, by means of interview, evaluate vaginal and sexual function of patients with advanced cervical cancer before and after chemoradiotherapy and compare the results. A number of 35 patients were irradiated by teleradiotherapy dose of 45 Gy in 25 fractions over 5 weeks to the pelvis and additional 20-24 Gy in 4-6 fractions were given by intracavitary HDR brachytherapy. Patients received 40 mg/m2 of cisplatin once a week, which is a total of 4-6 cycles of cisplatin. Patients answered the questions in a form of a questionnaire specifically created for cervical cancer (EORTC-QLQ-Cx 24), for the period immediately before diagnosed cervical cancer (thus being a control group). They also answered the same questions for the period starting 12 months after the completion of concomitant chemoradiotherapy, and were an experimental group at the time. For the testing of statistical significance of differences among the examined groups parameter and non-parameter tests were used (the Wilcoxon signed ranks test and Student’s t-test). The difference p<0.05 was considered statistically significant. Vaginal problems of patients after chemoradiotherapy were statistically reduced (44 versus 0; p<0.0001). There is no statistical significance in the vaginal function among the analyzed groups but weaker pain during intercourse was registered after chemoradiotherapy (p=0.009). After chemoradiotherapy, patients’ vaginal function is extremely improved whereas there is no difference in the sexual function. Pain during intercourse is statistically reduced after chemoradiotherapy. PMID:21342145

Ljuca, Dženita; Maroševi?, Goran

2011-01-01

418

Global Expression of Molecular Transporters in the Human Vaginal Tract: Implications for HIV Chemoprophylaxis  

PubMed Central

Background Pre-exposure chemoprophylaxis (PrECP) using antiretroviral agents is a promising strategy for the prevention of sexual HIV transmission in women. Molecular transporters in the human vaginal tract (VT) may play a pivotal role in determining drug disposition and, consequently, pharmacodynamic outcomes in these efforts. Little is known, however, on the expression of these transporters in vaginal tissues, representing a critical knowledge gap. Methodology/Principal Findings Our study analyzed the genome-wide transcriptome in 44 vaginal tissue samples from 6 reproductive-age women undergoing gynecologic surgeries. The analysis revealed that, unexpectedly, a large number (43%) of gene isoforms corresponding to membrane transporters were over-expressed (above the median expression level) in all samples. A subset of 12 highly expressed membrane transporters was identified and contained 10 members (83%) of the solute carrier superfamily. The largest difference in membrane transporter gene expression was observed across subjects, but more subtle differential expression also was found along the anterior-posterior axis of the VT. Cross-validation of the microarray analyses with measurements RT-qPCR demonstrated high concordance between these data sets. Immunofluorescence labeling of membrane transporter proteins in vaginal tissues was highly dependent on tissue/cell types. Conclusions/Significance Antiretroviral PrECP drugs currently under evaluation are substrates for molecular transporters that were commonly expressed, but fell into both over- or under-expressed categories in all samples, suggesting a complex role for carrier-mediated processes in determining the disposition of these xenobiotics in vaginal tissues. These findings hold important implications for the successful development of products, either oral or intravaginal, for female-controlled HIV PrECP. PMID:24143220

Gunawardana, Manjula; Mullen, Madeline; Moss, John A.; Pyles, Richard B.; Nusbaum, Rebecca J.; Patel, Jignesh; Vincent, Kathleen L.; Wang, Charles; Guo, Chao; Yuan, Yate-Ching; Warden, Charles D.; Baum, Marc M.

2013-01-01

419

Vaginal practices diary: development of a pictorial data collection tool for sensitive behavioural data  

PubMed Central

Background Intravaginal practices (IVP) are highly prevalent behaviours among women at increased risk for HIV in sub-Saharan Africa. IVP data collected by face-to-face interviews (FTFI) may be subject to recall or social desirability bias. Daily self-administered diaries may help to decrease bias associated with FTFI. IVP data from a diary and FTFI were compared during a multi-site microbicide feasibility study in Tanzania and Uganda. Methods Two hundred women were recruited and given diaries to complete daily for six weeks. Data obtained in the diary were compared to data from the FTFI during clinical visits to assess the consistency of reporting of IVP between the data collection methods. Results In Tanzania, proportions of overall vaginal cleansing and insertion were similar for the FTFI and the diary, but the diary indicated higher frequency of cleansing and use of a cloth or other applicator. In Uganda, proportions of overall vaginal cleansing were similar for FTFI and the diary, but the diary indicated higher frequency of cleansing, use of soaps and cloths for cleansing, and insertion. Most of the inconsistencies between the two data collection methods were from reported frequency of IVP or IVP related to sexual intercourse. Conclusions The comparison of FTFI and the vaginal practice diary suggests that recall of IVP may be improved by a daily self-administered diary, especially for frequency of cleansing and cleansing in proximity to sexual intercourse. The vaginal practices diary can provide a more detailed understanding of IVP and aid in the interpretation of findings from FTFI. Vaginal practices diary: development of a pictorial data collection tool for sensitive behavioural data. PMID:22801344

Francis, Suzanna C.; Lees, Shelley S.; Andrew, Bahati; Zalwango, Flavia; Vandepitte, Judith; Ao, Trong; Baisley, Kathy; Kapiga, Saidi; Grosskurth, Heiner; Hayes, Richard

2013-01-01

420

Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft.  

PubMed

The aim of this study was to evaluate quality of life, sexual function, and anatomical outcome after posterior vaginal wall prolapse repair using a collagen xenograft. Thirty-three patients were evaluated preoperatively and at 6 and 12 months follow-up (FU). Quality of life and sexual function were assessed using a self-reported questionnaire. Prolapse staging was performed using the pelvic organ prolapse quantification system (POPQ). Preoperatively 3 patients had stage I, 26 patients stage II, and 4 patients stage III prolapse of the posterior vaginal wall. Prolapse of the posterior vaginal wall > or = stage II was observed in 7 patients (21%) at the 6-month FU and in 13 patients (39%) at the 12-month FU. Mean point Bp was reduced from -1.1 preoperatively to -2.5 at 6 months FU (p < 0.01) and -1.8 at 12 months FU (p < 0.01). Previous abdominal surgery was associated with a less favorable anatomical outcome (odds ratio: 2.0, 95% confidence interval: 1.5-3.8). There were no significant changes in sexual function or dyspareunia during the 1-year FU. Preoperatively 76% of the patients reported a negative impact on quality of life as a result of genital prolapse. There was a significant improvement in several variables associated with quality of life at 6 and 12 months FU. Posterior vaginal wall prolapse repair using a collagen xenograft was associated with an unsatisfying anatomical outcome at 1-year FU although several quality of life-associated variables affecting psychosocial function were improved. Improvement was not restricted to postoperative restoration of vaginal topography, and previous surgery had a negative effect on anatomical outcome. PMID:15809772

Altman, Daniel; López, Annika; Gustafsson, Catharina; Falconer, Christian; Nordenstam, Johan; Zetterström, Jan

2005-01-01

421

Efficacy of the combination of 2 g oral tinidazole and acidic buffering vaginal gel in comparison with vaginal clindamycin alone in bacterial vaginosis: a randomized, investigator-blinded, controlled trial  

Microsoft Academic Search

Objective: To evaluate the efficacy of tinidazole (T) (Trimonase®, Mipharm, Italy) and an acidic vaginal gel (Miphil®) (M) in comparison with vaginal clindamycin (CL) (Cleocin® Pharmacia Upjohn) in BV. Design: A multicentre, randomised, investigator-blinded, controlled trial. Population and methods: 64 women with BV were enrolled. Thirty-two were allocated to receive oral T 2g, single dose, and 32 were assigned to

Massimo Milani; Eliana Barcellona; Antonella Agnello

2003-01-01

422

External Pelvic and Vaginal Irradiation Versus Vaginal Irradiation Alone as Postoperative Therapy in Medium-Risk Endometrial Carcinoma-A Prospective Randomized Study  

SciTech Connect

Purpose: To evaluate the value of adjuvant external beam pelvic radiotherapy as adjunct to vaginal brachytherapy (VBT) in medium-risk endometrial carcinoma, with regard to locoregional tumor control, recurrences, survival, and toxicity. Methods and Materials: Consecutive series of 527 evaluable patients were included in this randomized trial. Median follow-up for patients alive was 62 months. The primary study endpoints were locoregional recurrences and overall survival. Secondary endpoints were recurrence-free survival, recurrence-free interval, cancer-specific survival, and toxicity. Results: Five-year locoregional relapse rates were 1.5% after external beam radiotherapy (EBRT) plus VBT and 5% after vaginal irradiation alone (p = 0.013), and 5-year overall survival rates were 89% and 90%, respectively (p = 0.548). Endometrial cancer-related death rates were 3.8% after EBRT plus VBT and 6.8% after VBT (p = 0.118). Pelvic recurrences (exclusively vaginal recurrence) were reduced by 93% by the addition of EBRT to VBT. Deep myometrial infiltration was a significant prognostic factor in this medium-risk group of endometrioid carcinomas but not International Federation of Gynecology and Obstetrics grade or DNA ploidy. Combined radiotherapy was well tolerated, with serious (Grade 3) late side effects of less than 2%. However, there was a significant difference in favor of VBT alone. Conclusions: Despite a significant locoregional control benefit with combined radiotherapy, no survival improvement was recorded, but increased late toxicity was noted in the intestine, bladder, and vagina. Combined RT should probably be reserved for high-risk cases with two or more high-risk factors. VBT alone should be the adjuvant treatment option for purely medium-risk cases.

Sorbe, Bengt, E-mail: bengt.sorbe@orebroll.se [Department of Gynecological Oncology, Oerebro University Hospital, Oerebro (Sweden); Horvath, Gyoergy; Andersson, Hakan [Department of Gynecological Oncology, Sahlgrenska University Hospital, Gothenburg (Sweden); Boman, Karin [Department of Gynecological Oncology, Umea University Hospital, Umea (Sweden); Lundgren, Caroline [Department of Gynecological Oncology, Radiumhemmet, Karolinska University Hospital, Stockholm (Sweden); Pettersson, Birgitta [Medical Products Agency, Uppsala (Sweden)

2012-03-01

423

Rheological and ultrastructural properties of bovine vaginal fluid obtained at oestrus  

PubMed Central

The properties of cervical–vaginal fluid are under strict hormonal control: and in mammals in which semen is deposited in the anterior vagina, changes produced in these properties can result in a lower or higher resistance to sperm motion. The aim of this study was to determine whether the structural organization of bovine vaginal fluid is related to its rheological properties. Vaginal fluid samples were collected from 41 cows at oestrus: 20 at the middle of oestrus (between 8 and 12 h after starting) and 21 at the end of oestrus (between 18 and 22 h). Flow behaviour was determined using a viscosimeter, and the ultrastructural analysis was performed by scanning electron microscopy. Six samples showed newtonian behaviour: three collected at the middle and three collected at the end of oestrus. Newtonian samples had dense and compact matrices arranged as membranes with rough, irregular surfaces, and sparse, thin filaments (< 150 nm). Non-newtonian samples collected at the end of oestrus (n = 18) had a higher (P = 0.016) consistency index (K = 944 ± 229 mPa.sn) than those collected at the middle of oestrus (n = 17; K = 237 ± 84 mPa.sn). Thick filaments (> 700 nm) that were either randomly arranged with thinner filaments forming a mesh or heavily cross-linked by thin filaments (50–150 nm) were observed in all non-newtonian samples collected at the end of oestrus, while medium-diameter filaments (between 200 and 500 nm) forming loose networks were observed in non-newtonian samples collected at the middle of oestrus. These findings indicate a close relationship between the molecular organization of the structural elements of bovine vaginal fluid and its rheological behaviour. Vaginal fluid dramatically reduces its mechanical barrier effect during the course of oestrus but always appears to maintain its three-dimensional filamentous structure. The images of vaginal fluid showing newtonian behaviour would appear to support previous results, suggesting that this property may be related to bovine infertility. PMID:12171476

Rutllant, J; López-Béjar, M; Santolaria, P; Yániz, J; López-Gatius, F

2002-01-01

424

Short communication: Evaluation of vaginal discharge following treatment with a progesterone insert.  

PubMed

Yellowish discharge after application of intravaginal progesterone releasing inserts is frequently observed in cows. The objective of this study was to compare the bacteriological contamination of the vagina and uterus before and after a treatment with a progesterone insert in heifers. Forty-two Holstein heifers received a progesterone releasing insert [Eazi-Breed controlled internal drug release (CIDR) insert; Pfizer Animal Health, Berlin, Germany] for 7d. The protruding tail had been removed from half of the inserts (no tail group: n=21; tail group: n=21). Nine heifers from the tail group lost the insert within the 7-d treatment interval and were excluded. Heifers identified in estrus were artificially inseminated on d 9 or 10. Vaginal discharge was scored on a 4-point scale [vaginal discharge score (VDS) 0 to 3] and vaginal swabs were taken for bacteriological examination on d 0 and 7 and the day of artificial insemination (AI). Furthermore, cytological and bacteriological samples were obtained from the uterus on d 7 and the day of AI. On d 0, coliforms and Streptococcus spp. were found in vaginal swabs of 21 heif