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1

Vaginitis  

MedlinePLUS

... diagnosed? • How is vaginitis treated? • What is a yeast infection? • What causes yeast infections? • What factors increase the risk of getting a yeast infection? • What are the symptoms of a yeast ...

2

Vaginal itching  

MedlinePLUS

... and make you more susceptible to infections. Vaginal yeast infection Vaginitis . Vaginitis in girls before puberty is ... If you are sure that you have a yeast infection, try over-the-counter creams or vaginal ...

3

Vaginal discharge  

MedlinePLUS

... infections and sexually transmitted infections (STIs) Trichomoniasis Vaginal yeast infection ... is never recommended. Use an over-the-counter yeast infection treatment cream or vaginal suppository, if you ...

4

Vaginal Yeast Infections  

MedlinePLUS

... HIV/AIDS Sexually transmitted infections fact sheet Vaginal yeast infections fact sheet What is a vaginal yeast ... on vaginal yeast infections What is a vaginal yeast infection? A vaginal yeast infection is irritation of ...

5

Vaginal Discharge  

MedlinePLUS

... also be on the lookout for symptoms of yeast infections, bacterial vaginosis and trichomoniasis, 3 infections that ... cause changes in your vaginal discharge. Signs of yeast infections White, cottage cheese-like discharge Swelling and ...

6

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 ...

7

Vaginal Cancer  

MedlinePLUS

... Vaginal cancer treatments are likely to cause side effects that make sexual intimacy more difficult for you and your partner. If treatment makes sex painful or temporarily impossible, try to find new ways of maintaining intimacy. Spending quality time together and having ...

8

Vaginal Cancer  

MedlinePLUS

... body). There are four types of vaginal cancer: Squamous cell carcinoma. Squamous cell carcinoma is a type of skin cancer that begins in the cells lining the vagina, most often in the area closest to the cervix. Squamous cell cancer makes up 85% to 90% of ...

9

Vaginal agenesis.  

PubMed

Vaginal agenesis is not rare. Many ingenious procedures have been devised for its correction; some are simple, and some are complicated. Not enough emphasis has been placed on the emotional aspects when patients with this problem are treated. Proper timing of the operation and selection of the best procedure are discussed. We feel that procedure of choice is the simplest, least dangerous one which will give good results in the individual patient. Rather than using the same routine procedure in each patient, we fitted the treatment to each patient. Our experience, particularly with the simple vulvovaginoplasty technique, is given. Postoperative support and encouragement are needed to have a successful outcome. PMID:1244753

Capraro, V J; Gallego, M B

1976-01-01

10

[Bacterial vaginitis: general overview].  

PubMed

Bacteria are the most frequently detected agents in women, clinically complaining of vaginal discharge. The studies have shown that the vaginal microflora of women with bacterial vaginitis have altered from Lactobacillus spp. to various anaerobic bacteria. Gardnerella vaginalis is found in vaginal flora of women with bacterial vaginitis as well as in healthy women, while anaerobic bacteria such as Mobiluncus and Prevotella are the causative agents for bacterial vaginosis. For the laboratory diagnosis of bacterial vaginitis, direct microscopy is one of the most commonly used methods, and for this purpose cervicovaginal smears are examined by staining Papanicolaou and Gram stains. Because of the demonstration of bacterial vaginitis in association with the obstetric diseases such as preterm labor and postpartum endometritis, is a risk factor, its importance has increased recently. In this review article, the microorganisms that cause bacterial vaginitis, their biological characteristics, and the diagnostic laboratory methods of infection, have been discussed. PMID:12838684

Demirezen, Sayeste

2003-01-01

11

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 ...

12

Vaginal mechanical contraceptive devices.  

PubMed Central

The alleged adverse effects of oral contraceptives and intrauterine devices have led to increased consumer and physician demand for vaginal contraceptive devices. The efficacy and the advantages and disadvantages of vaginal sponges, cervical caps and diaphragms are discussed and compared in this article.

Smith, M.; Barwin, B. N.

1983-01-01

13

[Vaginitis and vaginosis].  

PubMed

Recently, within the wide subject on vaginal phlogosis a new pathology has been included. Owing to its peculiar characteristics, as it is not to be regarded as a vaginitis in the strict sense of the word, it has been identified as anaerobic bacterial vaginosis. The latter proves to be different from most common vaginitis related pathologies as a result of a series of microbiological and clinical patterns that are widely dealt with in this research. Moreover, the author place special emphasis on the diagnostic and therapeutic aspects of vaginosis. PMID:2284037

Cerza, S; Cerza, G; Custo, G M

1990-09-01

14

Review of Vaginitis  

PubMed Central

Adisruption of the dynamic equilibrium of the healthy vagina may have significant sequelae, leading to chronic or serious conditions. Therefore, all cases of vaginitis should be accurately diagnosed and appropriately treated.

1993-01-01

15

Yeast Infection (Vaginal)  

MedlinePLUS

... may be reprinted for personal, noncommercial use only. Yeast infection (vaginal) By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/yeast-infection/DS01182 Definition Symptoms Causes Risk factors Preparing ...

16

Vaginitis - self-care  

MedlinePLUS

... of all ages. It can be caused by: Yeast, bacteria, viruses, and parasites Bubble baths, soaps, vaginal ... Creams or suppositories are used to treat yeast infections in the ... some grocery stores, and other stores. Treating yourself ...

17

Comparative Assessment of Pelvic Floor Function Using Vaginal Cones, Vaginal Digital Palpation and Vaginal Pressure Measurements  

Microsoft Academic Search

A group-comparative study to assess pelvic floor muscle function using vaginal cones, vaginal digital palpation, and vaginal pressure measurements in 30 women suffering from genuine stress urinary incontinence and in an age-matched group of continent women was undertaken. Vaginal digital palpation score and vaginal pressure during active contraction were greater (p < 0.001) in continent women (1.9 ± 0.1 and

Inger Hahn; Ian Milsom; Bo L. Ohlssor; Peter Ekelund; Christer Uhlemann; Magnus Fall

1996-01-01

18

Value of vaginal culture in management of acute vaginitis  

Microsoft Academic Search

Objective: To evaluate the relative contribution of clinical assessment and vaginal discharge cultures in the treatment of acute vaginitis.\\u000a Methods: A prospective observational study of 75 consecutive sexually active women with acute vaginal symptoms was undertaken. Each\\u000a patient underwent an evaluation that included a standardized history, interview a thorough pelvic examination and vaginal\\u000a culture. The treatment was administered based upon

S. Lurie; I. Woliovitch; S. Rotmensch; O. Sadan; M. Glezerman

2001-01-01

19

Management of vaginal agenesis.  

PubMed

Rokitansky syndrome and complete androgen insensitivity syndrome are the most common causes of vaginal agenesis. Treatment should be deferred until adolescence to allow informed consent and compliance. The best treatment for vaginal agenesis remains controversial although vaginal dilation therapy is still widely considered the first line treatment because success rates are high and associated risks are low. A variety of surgical options are also available, each with enthusiastic proponents. Long-term outcome studies on most surgical techniques, however, are still lacking and until recently most studies have reported on success rate in terms of anatomical success only, without including sexual function. Moreover, the medical literature lacks prospective comparative outcome studies, meaning that current choice of surgical procedure relies greatly on the surgeon's preference and experience. PMID:21872517

Nakhal, Rola S; Creighton, Sarah M

2011-08-27

20

Vaginal polyp in a newborn.  

PubMed

Vaginal fibroepithelial polyp is a rare lesion, and although benign, it can be confused with malignant connective tissue lesions. Treatment is simple excision, and recurrence is extremely uncommon. We report a case of a newborn with vaginal fibroepithelial polyp. The authors suggest that vaginal polyp must be considered in the evaluation of interlabial masses in prepubertal girls. PMID:17619202

Jallouli, Mohamed; Trigui, Lilia; Gargouri, Abdellatif; Mhiri, Riadh

2007-07-07

21

Vulvar and vaginal HPV disease.  

PubMed

Human papilloma virus is associated with a multitude of lower genital tract diseases in women in addition to cervical cancer, including genital warts, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, and some vulvar, vaginal, and anal cancers that are associated with oncogenic subtypes. The degree to which HPV manifests pathology depends on viral type, host immune response, and local environmental factors. This article reviews the evaluation and management of the following vulvar and vaginal human papilloma virus diseases: condyloma, vulvar intraepithelial neoplasia, and vaginal intraepithelial neoplasia. Included is a brief discussion of the association with vulvar and vaginal cancer. PMID:23732036

Nelson, Erin L; Stockdale, Colleen K

2013-06-01

22

Failed Operative Vaginal Delivery  

PubMed Central

Objective To compare maternal and neonatal outcomes in women undergoing a second stage cesarean after a trial of operative vaginal delivery with women undergoing a second stage cesarean without such an attempt. Methods This study is a secondary analysis of the women who underwent second stage cesarean. .The maternal outcomes examined included blood transfusion, endometritis, wound complication, anesthesia use, and maternal death. Infant outcomes examined included umbilical artery pH < 7.0, Apgar of 3 or less at 5 minutes, seizures within 24 hours of birth, hypoxic ischemic encephalopathy (HIE), stillbirth, skull fracture, and neonatal death. Results Of 3189 women who underwent second stage cesarean, operative vaginal delivery was attempted in 640. Labor characteristics were similar in the two groups with the exception of the admission to delivery time and cesarean indication. Those with an attempted operative vaginal delivery were more likely to undergo cesarean delivery for a non-reassuring fetal heart rate tracing (18.0% vs 13.9%, p=.01), have a wound complication (2.7% vs 1.0%; OR 2.65 95% CI 1.43–4.91), and require general anesthesia (8.0% vs 4.1%, OR 2.05 95% CI 1.44–2.91). Neonatal outcomes including umbilical artery pH less than 7.0, Apgar at or below 3 at 5 minutes, and hypoxic ischemic encephalopathy were more common for those with an attempted operative vaginal delivery. This was not significant when cases with a non-reassuring fetal heart rate tracing were removed. Conclusion Cesarean delivery after an attempt at operative vaginal delivery was not associated with adverse neonatal outcomes in the absence of a non-reassuring fetal heart rate tracing.

Alexander, James M.; Leveno, Kenneth J.; Hauth, John C.; Landon, Mark B.; Gilbert, Sharon; Spong, Catherine Y.; Varner, Michael W.; Caritis, Steve N.; Meis, Paul; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; O'Sullivan, Mary J.; Sibai, Baha M.; Langer, Oded; Gabbe, Steven G.

2010-01-01

23

Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.  

PubMed

Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour. PMID:23223657

Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

2012-12-01

24

Abnormal vaginal bleeding in the nonpregnant patient  

Microsoft Academic Search

Abnormal vaginal bleeding is a common presenting complaint to most emergency departments. This article focuses on vaginal bleeding in the nonpregnant patient; pregnancy-related vaginal bleeding is reviewed elsewhere in this issue. Vaginal bleeding can be the cause of significant morbidity and mortality in nonpregnant patients. Vaginal bleeding can also herald serious underlying problems related to malignancy, chronic illness, and sexual

Richard V. Daniels; Charles McCuskey

25

Vaginal Mucormycosis: A Case Report  

PubMed Central

Although Zygomycetes cause life-threatening, opportunistic infections in immunocompromised hosts, the first case of vaginitis caused by Mucor species in a healthy woman is reported. Mucor vaginitis, which caused mild symptoms only, was refractory to conventional azole therapy and resistant to flucytosine. Cure was achieved with topical amphotericin B.

2001-01-01

26

Heterogeneity of Vaginal Microbial Communities within Individuals? #  

PubMed Central

Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal microbial populations have not been investigated using molecular methods. Here, we evaluated site-specific microbial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S rRNA gene clone libraries were prepared from samples obtained from different locations (cervix, fornix, outer vaginal canal) and by different methods (swabbing, scraping, lavaging) from the vaginal tracts of eight clinically healthy, asymptomatic women. The data reveal that the vaginal microbiota is not homogenous throughout the vaginal tract but differs significantly within an individual with regard to anatomical site and sampling method used. Thus, this study illuminates the complex structure of the vaginal ecosystem and calls for the consideration of microenvironments when sampling vaginal microbiota as a clinical predictor of vaginal health.

Kim, Tae Kyung; Thomas, Susan M.; Ho, Mengfei; Sharma, Shobha; Reich, Claudia I.; Frank, Jeremy A.; Yeater, Kathleen M.; Biggs, Diana R.; Nakamura, Noriko; Stumpf, Rebecca; Leigh, Steven R.; Tapping, Richard I.; Blanke, Steven R.; Slauch, James M.; Gaskins, H. Rex; Weisbaum, Jon S.; Olsen, Gary J.; Hoyer, Lois L.; Wilson, Brenda A.

2009-01-01

27

Vaginal oxytetracycline concentrations.  

PubMed

Although tetracycline preparations are widely used in departments of genitourinary medicine, or sexually transmitted diseases clinics, little is known of the concentrations of these preparations in genital secretions. For this reason a microbiological method was used for estimating oxytetracycline concentrations in vaginal secretions. These concentrations varied from 0.6 to 6.5 microgram/ml in 19 women who had had sexual contact with a man with non-specific urethritis and who were taking oxytetracycline dihydrate 250 mg four times daily. They were well in excess of the minimum inhibitory concentration of oxytetracycline (0.2 microgram/ml) for the strains of Chlamydia trachomatis isolated from the patients with positive culture results. Thus, oxytetracycline 250 mg four times daily appears to be a satisfactory regimen for the treatment of chlamydial genital infection in women. PMID:509190

Thin, R N; Al Rawi, Z H; Simmons, P D; Treharne, J; Tabaqchali, S

1979-10-01

28

Vaginal Yeast Infections (For Parents)  

MedlinePLUS

... infection is simple and painless. What Is a Yeast Infection? A yeast infection, also known as candidiasis ( ... you can be treated appropriately. Do Guys Get Yeast Infections? Guys don't get vaginal yeast infections, ...

29

Desquamative inflammatory vaginitis. A review.  

PubMed Central

Desquamative inflammatory vaginitis is an uncommon cause of an intractable vaginitis often accompanied by serious dyspareunia, which can occur at any stage of reproductive life and after the menopause. The cytological changes are identical with those seen in atrophic vaginitis yet the disorder often occurs in the presence of apparently normal ovarian function. Vaginal synechiae and stenosis develop in an appreciable number of patients. Treatment is unsatisfactory though there is some response to either local or systemic steroid therapy. The literature is reviewed and the association of some cases with lichen planus of the mouth and genitals discussed. Its causation and natural history remain largely unknown and there is as yet, insufficient evidence to regard it as a single entity. It is likely that the incidence of the disorder is underestimated.

Oates, J K; Rowen, D

1990-01-01

30

Impact of vaginal ascorbic acid on abnormal vaginal microflora.  

PubMed

PURPOSE: To evaluate the impact of vaginal ascorbic acid (vitamin C) as a treatment/maintenance regimen on increased vaginal pH and abnormal microflora on wet mounts in premenopausal women. METHODS: A randomized study of 140 asymptomatic, low-risk pregnant and non-pregnant premenopausal women with vaginal pH ? 4.5 and a variety of partly/completely disrupted Lactobacillus microflora patterns on wet mounts in five outpatient clinics was carried out. Participants were randomized to the intervention group [250 mg vitamin C tablets vaginally at bedtime once a day for 6 days (treatment phase), followed by a one tablet per week, for 12 weeks (maintenance phase)] or the control group (no treatment). Outcomes were evaluated 4 months after randomizing, i.e., 2-3 weeks after the last vitamin C tablet insertion. RESULTS: Normalization to normal flora was observed in 51.4 % of all ascorbic acid and in 24.3 % of control group patients (difference 27.1 %, 95 % CI 11.7-42.6, p < 0.05, ITT population). In the per protocol population, normalization was confirmed in 53.5 % of the intervention and 22.4 % of the control group (difference 31 %, 95 % CI 14.3-47.8, p < 0.05). Results of pregnant subgroup analysis showed better outcomes for the subgroup: difference of normalization rate between ascorbic acid and control group was 41.2 % (95 % CI 21.8-60.1, p < 0.05). Itching occurred in 19 %; 23 % of women reported irritation and 10 % stopped the treatment because of side effects. CONCLUSIONS: Vaginal ascorbic acid improves abnormal vaginal pH and microflora, especially in pregnant women, but is not well tolerated by all women. PMID:23677418

Zodzika, Jana; Rezeberga, Dace; Donders, Gilbert; Vedmedovska, Natalija; Vasina, Olga; Pundure, Inara; Bite, Ruta; Silberga, Ingrida; Socenova, Julija; Melngaile, Olita

2013-05-16

31

[Multipurpose treatment of vaginal infections].  

PubMed

Untreated bacterial vaginosis is related with many complications for non-pregnant women in reproductive age, most common from them are vaginal discharge and postoperative infections. The aim of our investigation was to compare the effectiveness of two therapeutic regimes which consist in Macmiror/Macmiror Complex alone and in combination with Feminella Vagi C for treatment of bacterial vaginosis (BV) and/or mycotic infection. 117 non-pregnant women with symptoms of vaginal infection were prospectively enrolled into two groups according their treatment. First group consist 66 women treated with Macmiror tablets and vaginal capsules followed with local application of Feminella Vagi C, the second group consist 54 women treated with Macmiror tablets and vaginal capsules only. The impact of treatment on clinical symptoms was observed at the end of medication and 20 days after it. Microbiological testing was repeated 20 days after treatment. Over than 80% (78.6 divided by 86.7%) of the cases with vaginal infection (BV and mycotic one) were successfully treated with Macmiror/Macmiror Complex. Supplement treatment with Feminella Vagi C lead to higher percentage of clinically recovery (86.7% vs 84.6%), better microbiological cleaning (86.7% vs 82.1%) and longer effect of treatment. Used medication showed higher efficacy against BV than to fungal infection. According obtained results we may conclude that bacterial vaginosis was better treated with multipurpose treatment (Nifuratel, Nistatin and vit. C) than with Macmiror alone. PMID:23234030

Nikolov, A; Masseva, A; Shopova, E; Georgiev, S

2012-01-01

32

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...3900 Vaginal stent. (a) 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...

2010-04-01

33

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2013 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...

2013-04-01

34

Do We Know What Causes Vaginal Cancer?  

MedlinePLUS

... section " What are the risk factors for vaginal cancer? " Research is now being done to learn more about ... Your Doctor After Treatment What`s New in Vaginal Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

35

Evaluation and management of vaginitis  

Microsoft Academic Search

OBJECTIVE: To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections,\\u000a and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting.\\u000a \\u000a \\u000a DATA SOURCES: Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997\\u000a were reviewed.\\u000a \\u000a \\u000a \\u000a \\u000a DATA

Phyllis L. Carr; Donna Felsenstein; Robert H. Friedman

1998-01-01

36

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and...Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina...

2009-04-01

37

Vaginal douching practices and beliefs in Turkey  

Microsoft Academic Search

The aim of this study was to identify women's motivations for vaginal douching, vaginal douching practices, and women's reactions to situations that discourage vaginal douching. Research took place in the outskirts of Antalya, a city located on the Mediterranean coast of Turkey. A total of 776 women participated in the study. Age, religious affiliation, place of residence, and poverty were

Kamile Kukulu

2006-01-01

38

Current Concepts of Treating Vaginitis  

PubMed Central

Vaginitis can be a frustrating entity to treat, since the incidence of recurrence is high. This paper examines evidence from the literature concerning diagnosis and treatment of Candida albicans, Trichomonas vaginalis, Corynebacterium vaginale, herpes simplex type 2 and gonorrhea. A protocol based on these readings is outlined.

Robinson, Theresa

1977-01-01

39

Operative vaginal delivery - Year 2000  

Microsoft Academic Search

Literature review was performed to analyze and define the current state of operative vaginal delivery. On the basis of published data, it is concluded that outlet and low forceps deliveries with ?45 degrees of rotation are effective and safe for both mother and baby. The greatest risk to mother or fetus occurs with operations performed at the 0 or +1

Gary D. V. Hankins; Thomas F. Rowe

1996-01-01

40

Vaginal birth after cesarean section  

Microsoft Academic Search

Vaginal birth after cesarean section (VBAC) is safe, cost effective, and the preferred obstetrical option for most parturients in health care settings which are equipped to manage intrapartum emergencies. Since 1981, cesarean sections have been the most frequently performed major surgical procedure in the United States. Approximately 1,000,000 cesarean deliveries are performed in the United States per year. The rate

Jordan Pritzker

1996-01-01

41

Vaginal Redox Potential in Bacterial Vaginosis (Nonspecific Vaginitis)  

Microsoft Academic Search

To explore of the association of bacterial vaginosis with anaerobic bacterial growth in the vagina, we measured the redox potential ($E_{h}$) at the vaginal epithelial surface of women with this syndrome. Among normal women, the value for $E_{h}$ in the vagina ranged from +322 mV to +137 mV (mean, +170 mV); whereas among women with bacterial vaginosis, the $E_{h}$ ranged

King K. Holmes; Kirk C. S. Chen; Carolyn M. Lipinski; David A. Eschenbach

1985-01-01

42

Antigonococcal effects of vaginal tampons.  

PubMed Central

Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae. Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections. Strains from patients with pelvic inflammatory disease were moderately sensitive. Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice. Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice. These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes.

Arko, R J; Wong, K H; Smith, S J; Finley-Price, K G

1983-01-01

43

Vacuum-Assisted Vaginal Delivery  

PubMed Central

Approximately 5% (1 in 20) of all deliveries in the United States are operative vaginal deliveries. The past 20 years have seen a progressive shift away from the use of forceps in favor of the vacuum extractor as the instrument of choice. This article reviews in detail the indications, contraindications, patient selection criteria, choice of instrument, and technique for vacuum-assisted vaginal delivery. The use of vacuum extraction at the time of cesarean delivery will also be discussed. With vacuum extraction becoming increasingly popular, it is important that obstetric care providers are aware of the maternal and neonatal risks associated with such deliveries and of the options available to effect a safe and expedient delivery.

Ali, Unzila A; Norwitz, Errol R

2009-01-01

44

Uterine and Vaginal Vault Prolapse  

Microsoft Academic Search

The surgical management of pelvic organ prolapse is more challenging than that for stressurinary incontinence, and detection\\u000a and correction of apical repairs can be the most difficult of all pelvic floor defects. One-third of procedures performed\\u000a for pelvic organ prolapse are secondary procedures (1). The number of procedures performed in the United States to treat posthysterectomy vaginal vault prolapse increased

Peggy A. Norton

45

Vaginal cuff dehiscence after vaginal cuff brachytherapy for uterine cancer. A case report  

PubMed Central

Vaginal cuff dehiscence is a rare, but potentially serious complication after total hysterectomy. We report a case of vaginal cuff dehiscence after vaginal cuff brachytherapy. A 62 year old female underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy, and was found to have International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB endometrioid adenocarcinoma of the uterus. The patient was referred for adjuvant vaginal cuff brachytherapy. During the radiation treatment simulation, a computerized tomography (CT) of the pelvis showed abnormal position of the vaginal cylinder. She was found to have vaginal cuff dehiscence that required immediate surgical repair. Vaginal cuff dehiscence triggered by vaginal cuff brachytherapy is very rare with only one case report in the literature.

Cattaneo, Richard; Bellon, Maria

2013-01-01

46

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.

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

2013-01-01

47

What's New in Vaginal Cancer Research and Treatment?  

MedlinePLUS

... resources for vaginal cancer What`s new in vaginal cancer research and treatment? Research is under way to find ... Your Doctor After Treatment What`s New in Vaginal Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

48

Outcomes of term vaginal breech delivery.  

PubMed

In December 2001, the American College of Obstetricians and Gynecologists revised their recommendations for breech delivery. These recommendations acknowledge that although a planned vaginal delivery may no longer be appropriate, there are instances in which vaginal breech delivery is inevitable. Moreover, there continues to be patients who for any number of reasons will choose vaginal over cesarean delivery when faced with a fetus in the breech presentation. We sought to review maternal and fetal outcomes in such circumstances when vaginal breech delivery occurs, and compare these outcomes to elective cesarean deliveries for breech presentation. We performed a retrospective review of all singleton breech deliveries at our county hospital from January 2002 through June 2003. We reviewed maternal age, ethnicity, gestational age, gravity, parity, birthweight, mode of delivery, Apgar scores, umbilical arterial blood gases, and maternal and infant complications of both cesarean deliveries and vaginal breech deliveries. Univariate and logistic regression statistical analyses were performed with NCSS software. We had a total of 150 term breech deliveries with gestational ages between 37 and 42 weeks. Of these, 41 were vaginal breech and 109 were cesarean deliveries. Greater than 95% of patients are of Hispanic origin. There were no statistically significant differences in maternal age, ethnicity, gravity, or gestational age. Mean birthweight was significantly lower and parity was significantly higher in the vaginal delivery group. There was also a higher proportion of patients who underwent labor induction/augmentation in the vaginal group. We found no differences in the outcomes of 5-minute Apgar scores, umbilical arterial blood gas values, neonatal intensive care unit admissions, deaths or maternal/fetal complications reported between the two groups. Mean umbilical arterial blood gas values were greater than 7.18 in both groups. Vaginal breech delivery cannot always be avoided. Moreover, at our county hospital several patients continue to choose vaginal breech delivery. Our data would suggest that vaginal breech delivery remains a viable option in selected patients. PMID:16118722

Doyle, Nora M; Riggs, John W; Ramin, Susan M; Sosa, Manuel A; Gilstrap, Larry C

2005-08-01

49

Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa  

Microsoft Academic Search

BACKGROUND: Bacterial vaginosis (BV) – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge

Edward Demba; Linda Morison; Maarten Schim van der Loeff; Akum A Awasana; Euphemia Gooding; Robin Bailey; Philippe Mayaud; Beryl West

2005-01-01

50

Vaginitis: Its Diagnosis and Treatment  

PubMed Central

Ninety-nine patients with a variety of specific and non-specific vaginitis were treated initially with a broad spectrum anti-microbial agent (AVC cream) in an effort to alleviate the acute symptoms of these problems even before specific organisms could be isolated. Diagnostic methods are discussed for Candida albicans and trichomonas vaginalis which could be employed in routine office practice. This agents advantage in being effective against almost all known pathogens, is offset by its some-what limited effectiveness against trichomoniasis. It has been shown in this study to be well tolerated, and it offers an overall cure rate of 66 percent against the more common pathogens.

O'Brien, John R.; Hayden, Peter D.

1970-01-01

51

Vaginitis  

MedlinePLUS

... Date: 04/03/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) All related topics NICHD News and Spotlights Division of Epidemiology, Statistics, and Prevention Research 2012 Annual Report Harnessing Research ...

52

Protection against rat vaginal candidiasis by adoptive transfer of vaginal B lymphocytes.  

PubMed

Vulvovaginal candidiasis is a mucosal infection affecting many women, but the immune mechanisms operating against Candida albicans at the mucosal level remain unknown. A rat model was employed to further characterize the contribution of B and T cells to anti-Candida vaginal protection. Particularly, the protective role of vaginal B cells was studied by means of adoptive transfer of vaginal CD3(-) CD5(+) IgM(+) cells from Candida-immunized rats to naïve animals. This passive transfer of B cells resulted into a number of vaginal C. albicans CFU approximately 50% lower than their controls. Sorted CD3(-) CD5(+) IgM(+) vaginal B lymphocytes from Candida-infected rats proliferated in response to stimulation with an immunodominant mannoprotein (MP) antigen of the fungus. Importantly, anti-MP antibodies and antibody-secreting B cells were detected in the supernatant and cell cultures, respectively, of vaginal B lymphocytes from infected rats incubated in vitro with vaginal T cells and stimulated with MP. No such specific antibodies were found when using vaginal B cells from uninfected rats. Furthermore, inflammatory and anti-inflammatory cytokines, such as interleukin-2 (IL-2), IL-6 and IL-10, were found in the supernatant of vaginal B cells from infected rats. These data are evidence of a partial anti-Candida protective role of CD3(-) CD5(+) IgM(+) vaginal B lymphocytes in our experimental model. PMID:20402794

De Bernardis, Flavia; Santoni, Giorgio; Boccanera, Maria; Lucciarini, Roberta; Arancia, Silvia; Sandini, Silvia; Amantini, Consuelo; Cassone, Antonio

2010-03-08

53

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

Microsoft Academic Search

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

Sanjay S. Supe; T. K. Bijina; C. Varatharaj; B. Shwetha; T. Arunkumar; S. Sathiyan; K. M. Ganesh; M. Ravikumar

2009-01-01

54

Mullerian agenesis with vaginal vault prolapse following mechanically created neovagina.  

PubMed

A 21-year-old with mullerian agenesis, presented with vaginal mass. Previously, she developed a neovagina by the use of vaginal dilators. Examination revealed vaginal vault prolapse. She was surgically treated with vaginal vault suspension using a mesh. PMID:22578488

Burns, Eve; Naim, Masood; Badawy, Shawky Z A

2012-06-01

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.

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

2012-01-01

56

[Local combined therapy of vaginal infections by nifuratel-nistatin].  

PubMed

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too. PMID:20387731

Jahi?, Mahira; Bali?, Adem; Nurki?, Mahmud; Dragovi?, Jasmina; Adzajli?, Amela; Habibovi?, Amra; Mesali?, Lejla; Zigi?, Aza

2010-02-01

57

Efficacy and safety of Vitamin C vaginal tablets in the treatment of non-specific vaginitis  

Microsoft Academic Search

Methods: This was a randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of Vitamin C vaginal tablets (250mg) given once a day in patients suffering from non-specific vaginitis. The total length of the study was 20 days, including a treatment phase of 6 days. The primary end-point was the presence in the two groups of non-specific vaginitis 1

E. Eiko Petersen; Paola Magnani

2004-01-01

58

Effects of Electrosurgery and Vaginal Closure Technique on Postoperative Vaginal Cuff Dehiscence  

PubMed Central

Background and Objectives: The aim of our study is to evaluate the role of electrosurgery and vaginal closure technique in the development of postoperative vaginal cuff dehiscence. Methods: From prospective surgical databases, we identified 463 patients who underwent total laparoscopic hysterectomy (TLH) for benign disease and 147 patients who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) for cancer. All TLHs and LAVHs were performed entirely by use of electrosurgery, including colpotomy. Colpotomy in the TLH group was performed with Harmonic Ace Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH, USA), and in the LAVH group, it was performed with a monopolar electrosurgical pencil. The main surgical difference was vaginal cuff closure—laparoscopically in the TLH group and vaginally in the LAVH group. Results: Although patients in the LAVH group were at increased risk for poor healing (significantly older, higher body mass index, more medical comorbidities, higher blood loss, and longer operative time), there were no vaginal cuff dehiscences in the LAVH group compared with 17 vaginal cuff dehiscences (4%) in the TLH group (P = .02). Conclusion: It does not appear that the increased vaginal cuff dehiscence rate associated with TLH is due to electrosurgery; rather, it is due to the vaginal closure technique.

Kesterson, Joshua; Davies, Matthew; Green, Janis; Penezic, Lindsey; Vargas, Roberto; Harkins, Gerald

2013-01-01

59

Nursing considerations in patients with vaginitis.  

PubMed

Vaginitis is defined as an inflammation of the vagina. It can result in symptoms of any or all of the following: discharge, itching and pain, and often irritation or infection of the vulva. There is no specific cause for vaginitis, and many other conditions can cause the symptoms. Vaginitis is a distressing condition that affects many women of reproductive age and beyond, and encompasses candidiasis (also known as thrush), bacterial vaginosis, and trichomoniasis. It can occur in a single episode, or recur throughout a woman's lifetime. Some women will seek medical help, but many more self-treat with over-the-counter medications, suspecting the recurrence of Candida in particular. This article aims to explore the causes, signs and symptoms, and treatments of vaginitis to provide nurses with the necessary background information to feel more confident in dealing with women's health issues. PMID:20852467

Holloway, Debra

60

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

MedlinePLUS

... period Vaginal infections, such as bacterial vaginosis, candidiasis (yeast infection), and trichomoniasis are common causes of abnormal ... having sex, such as bacterial vaginosis or a yeast infection. If you notice any changes in your ...

61

Rulemaking History for OTC Vaginal Drug Products  

Center for Drug Evaluation (CDER)

... Correction [PDF], 3/21/1994, 59FR13284. Notice: Guidance on vaginal yeast infection topical drug product labeling [PDF], 7/16/1998, 63FR38412. ... More results from www.fda.gov/drugs/developmentapprovalprocess/developmentresources

62

Vaginitis: Questions to Discuss with Your Doctor  

MedlinePLUS

? Harvard Health Publications ? Order the Book ? Contact Us Sign up for our free e-mail newsletter, HEALTHbeat . ... the vaginal discharge ©2000–2006 President & Fellows of Harvard College Sign Up Now For HEALTH beat Our ...

63

Vaginal childbirth and pelvic floor disorders.  

PubMed

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

2013-05-01

64

Emerging therapies for postmenopausal vaginal atrophy.  

PubMed

Symptoms related to vaginal atrophy are a significant problem for postmenopausal women and estrogen has been the gold standard for its treatment. A number of recent reviews of vaginal estrogen products are available. This review will, therefore, focus on other products and potential products for this indication, including the tissue selective estrogen complex and selective estrogen receptor modulators. Additionally, lesser-studied approaches will be discussed. PMID:23434231

Pickar, James H

2013-02-22

65

Vaginal cysts causing tenesmus in a bitch.  

PubMed

An eight-year-old female border collie was referred with a two-month history of faecal tenesmus. Ultrasonography and radiology identified fluid-filled masses in the cranial vagina. The fluid was drained from the vaginal cysts via an episiotomy and the clinical signs resolved. Histological examination confirmed that the cysts were of urogenital origin. This is believed to be the first report of vaginal cysts causing faecal tenesmus in the dog. PMID:7474963

Cauvin, A; Sullivan, M; Harvey, M J; Thompson, H

1995-07-01

66

Effects of miphil, a new polycarbophil vaginal gel, in suspected bacterial vaginosis: a randomized study versus vaginal douche  

Microsoft Academic Search

Background: Vaginal pH is an important factor in maintaining a normal vaginal flora. Miphil (Mi) (Mipharm, Italy) is a new polycarbophil-based vaginal gel with high bioadhesivity and a long-lasting (>72 h) pH-lowering effect.Objective: To evaluate the effects on vaginal pH and odor of Mi in comparison with a vaginal douche (Lactacid) (L) in suspected bacterial vaginosis.Patients and methods: Thirty women

Massimo Milani; Bruno Molteni

2000-01-01

67

Desflurane analgesia for vaginal delivery.  

PubMed

The use of subanaesthetic concentration of inhalational anaesthetic for vaginal delivery offers many advantages to the mother and newborn. Desflurane, with the characteristics of rapid onset and minimal metabolism, may provide better analgesia and safety for labour pain control. Eighty healthy parturients were randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or nitrous oxide 30-60% in oxygen (n = 40). Analgesia was assessed using a score from 0 (no relief) to 4+ (excellent analgesia), amnesia for the delivery, blood loss were recorded. Neonates were evaluated by Apgar scores and neurologic and adaptive capacity scores (NACS). Data were analyzed for statistical significance using Student's t-test or Chi-square when appropriate. Analgesia scores were similar for both groups with more amnesia in desflurane group (23% vs 0% P < 0.05). Blood loss did not differ significantly, 364 ml for the desflurane group and 335 ml for the nitrous oxide group. There were no significant differences for neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between the two groups. We conclude that desflurane in subanaesthetic doses is safe and effective inhalation agent for normal delivery but might be associated with amnesia. PMID:7793195

Abboud, T K; Swart, F; Zhu, J; Donovan, M M; Peres Da Silva, E; Yakal, K

1995-02-01

68

Protection of macaques from vaginal SHIV challenge by vaginally delivered inhibitors of virus-cell fusion  

Microsoft Academic Search

Human immunodeficiency virus type 1 (HIV-1) continues to spread, principally by heterosexual sex, but no vaccine is available. Hence, alternative prevention methods are needed to supplement educational and behavioural-modification programmes. One such approach is a vaginal microbicide: the application of inhibitory compounds before intercourse. Here, we have evaluated the microbicide concept using the rhesus macaque `high dose' vaginal transmission model

Ronald S. Veazey; Per Johan Klasse; Susan M. Schader; Qinxue Hu; Thomas J. Ketas; Min Lu; Preston A. Marx; Jason Dufour; Richard J. Colonno; Robin J. Shattock; Martin S. Springer; John P. Moore

2005-01-01

69

[Vulvo-vaginitis in pediatric age].  

PubMed

In pediatric gynecology, inflammatory vulvo-vaginitis are very common. Their diagnosis cannot be based either on the symptoms (itching or pain) or on the signs (leucoxanthorrhea) for these classifications are "non-specific". At the Consulting Room of pediatric gynecology of the Vittore Buzzi Hospital, 215 "non-specific" vulvo-vaginitis cases have been analyzed through bacteriological and microscopical examinations of vaginal secretions. The vaginal tampon resulted negative in 53% of the cases and positive in the remaining 47%. Comparing these results with microscopical examinations we obtain: 81.8% of sensibility, 77.4% of specificity, 87.8% of negative predictive value and 62.2% of positive predictive value. In particular, this last figure is influenced by the high number of false positives of the vaginal tampons, due to the growth "in vitro" of opportunist germs momentarily quiescent "in vivo". Thus it is useful to associated the microscopical examination (that will indicate all the cases in need of treatment) and the bacteriological examination (that will indicate the right cure). PMID:8133837

Beolchi, S; Brambilla, C; Roberti, P; Fadin, M; Facchini, M; Pansini, L; Maestri, L; Morandi, C

1993-11-01

70

Breech vaginal delivery at or near term.  

PubMed

Three percent to 4% of term fetuses will be breech at delivery. Evidence from randomized controlled trials has found a policy of planned cesarean section to be significantly better for the singleton fetus in breech presentation at term compared to a policy of planned vaginal birth. However, some women may wish to avoid cesarean section and for others, cesarean section may not be possible. We undertook this review to identify factors associated with higher and lower risk of adverse fetal or neonatal outcome at term during vaginal breech delivery. We searched MEDLINE from 1966 to 2002 using the search terms vaginal breech delivery and breech presentation and retrieved all relevant articles. We also reviewed personal references and reference lists of articles retrieved. Women who are older or who have a fetus that is either in footling presentation, has a hyperextended head or is estimated to weigh <2500 g or >4000 g may be at higher risk of adverse fetal outcome. Prolonged labor or not having an experienced clinician at vaginal breech birth may also increase the risk. Women with a fetus in breech presentation at term should be offered the option of delivery by planned cesarean section and should be informed that this will reduce their risk of adverse fetal or neonatal outcome. Practitioners should develop and maintain skills at vaginal breech delivery for those women not wishing or not able to be delivered by cesarean section. PMID:12641301

Tunde-Byass, Modupe O; Hannah, Mary E

2003-02-01

71

Effect of Vaginal Lubricants on Natural Fertility  

PubMed Central

Objective Over-the-counter vaginal lubricants have been shown to negatively affect in vitro sperm motility. The objective of this study was to estimate the effect of vaginal lubricant use during procreative intercourse on natural fertility. Methods Women aged 30–44 years with no history of infertility who had been trying to conceive for less than 3 months completed a baseline questionnaire on vaginal lubricant use. Subsequently, women kept a diary to record menstrual bleeding, intercourse, and vaginal lubricant use and conducted standardized pregnancy testing for up to 6 months. Diary data were used to determine the fertile window and delineate lubricant use during the fertile window. A proportional hazards model was used to estimate fecundability ratios with any lubricant use in the fertile window considered as a time-varying exposure. Results Of the 296 participants, 75 (25%) stated in their baseline questionnaire that they use vaginal lubricants while attempting to conceive. Based on daily diary data, 57% of women never used a lubricant, 29% occasionally used a lubricant, and 14% used a lubricant frequently. Women who used lubricants during the fertile window had similar fecundability to those women who did not use lubricants (fecundability ratio 1.05, 95% CI: 0.59, 1.85) after adjusting for age, partner race, and intercourse frequency in the fertile window. Conclusion Lubricants are commonly used by couples during procreative intercourse. Lubricant use during procreative intercourse does not appear to reduce the probability of conceiving.

Steiner, Anne Z.; Long, D. Leann; Tanner, Catherine; Herring, Amy H.

2012-01-01

72

[Clinical characteristics of aerobic vaginitis and its mixed infections.  

PubMed

OBJECTIVE: To investigate clinical characteristics of aerobic vaginitis (AV) and its mixed infections for diagnosis efficiently. METHODS: From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonal vaginitis (TV), and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. RESULTS: Among 516 cases, AV cases were found in 14.7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30%, 13/44), and mixed with TV (25%, 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4.5 (84%, 27/32). Vaginal cleanliness mainly was grade III - IV (88%, 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. CONCLUSIONS: Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV. PMID:21211421

Fan, Ai-Ping; Xue, Feng-Xia

2010-12-01

73

Vaginal T lymphocyte population kinetics during experimental vaginal candidosis: evidence for a possible role of CD8+ T cells in protection against vaginal candidosis  

PubMed Central

Vaginal candidosis represents a significant health problem to women of childbearing age worldwide. It has been postulated that localized T cells play a role in protection against vaginal candidosis. In an attempt to evaluate the role of vaginal T cells in protection against vaginal candidosis, T cell population kinetics was evaluated using an oestrogen-dependent vaginal candidosis murine model. Vaginal T lymphocytes were isolated at different time points post C. albicans inoculation, viable cells were enumerated, phenotypically analysed for the expression of CD3, CD4 and CD8 T cell markers and absolute numbers of T cell subsets were calculated. Oestrogen-induced persistence of vaginal candidosis resulted in a significant increase in the total number of vaginal lymphocytes within 24–48 h post infection; increased vaginal lymphocyte numbers persisted throughout the infection period. The number of CD3+ T cells dramatically increased following C. albicans administration and was maintained at high levels throughout the infection period. The majority of CD3+ T cells were of the CD8+ type; however, considerable numbers of both CD4+ T cells and CD4+CD8+ T cells were also observed throughout the infection period. The considerable and persistent increase in vaginal T cell numbers in general and that of CD8+ T cells in particular are evidence of the possible role played by localized T cells in protection against vaginal candidosis.

GHALEB, M; HAMAD, M; ABU-ELTEEN, K H

2003-01-01

74

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.

Kose, Osman; Saglam, Hasan S.; Kumsar, Sukru; Budak, Salih; Adsan, Oztug

2013-01-01

75

Vaginal delivery through annular placenta -- case report.  

PubMed

Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery. PMID:23630149

Živkovi?, Nikica; Krezo, Stipe; Matijevi?, Ratko; Živkovi?, Kresimir

2013-04-01

76

Vaginal delivery through annular placenta - case report  

PubMed Central

Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery.

Zivkovic, Nikica; Krezo, Stipe; Matijevic, Ratko; Zivkovic, Kresimir

2013-01-01

77

Peritonitis due to a peritoneal vaginal fistula.  

PubMed

Development of a peritoneal vaginal fistula is rare and presents a unique clinical scenario, since the fistula wall is less likely to spontaneously heal because of the increased intra-abdominal pressure in the abdomen from the peritoneal fluid. Catheter removal and surgical repair of the fistula are required. Early catheter removal contributes to peritoneal membrane preservation. In the case of M.T., the most likely explanation was that the peritoneal fluid was leaking through the vaginal cuff created during the surgical procedure in 2004. Early identification of this problem may have prevented the numerous complications and lengthy hospitalization. Suspicion should be raised in any patient who complains of vaginal leakage or if the passage of "urine" in a previously anuric patient is noted. Early assessment and evaluation along with prompt catheter removal can help reduce complications and preserve the peritoneal membrane. This case also emphasizes that prompt catheter removal is very important in cases of fungal peritonitis. PMID:20462078

Neumann, Joanna Lee; Moran, John

78

Operative vaginal delivery: current trends in obstetrics.  

PubMed

After centuries of use in obstetrics, have forceps and vacuum deliveries become a dying art? Contemporary trends in operative vaginal delivery show increasing numbers of vacuum deliveries and decreasing numbers of forceps deliveries worldwide. Primary drivers of such trends include concerns over neonatal and maternal safety as well as fewer clinicians skilled in forcep use. Current literature reports a comparable efficacy rate for the two instruments, as well as a decrease in maternal morbidity compared with cesarean section. It has also been suggested that the neonatal morbidity once associated with operative vaginal delivery may actually be a function of an abnormal labor process itself, rather than a consequence of an operative vaginal intervention. Both the American College and the Royal College of Obstetricians and Gynecologists continue to support the use of both vacuum and forceps and strongly encourage residency programs to incorporate the teaching of these skills into their curricula. PMID:19072477

Goetzinger, Katherine R; Macones, George A

2008-05-01

79

Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?  

MedlinePLUS

... may be reprinted for personal, noncommercial use only. Hormone replacement therapy: Cause of vaginal bleeding? By Mayo Clinic staff ... share your e-mail address Sign up Question Hormone replacement therapy: Cause of vaginal bleeding? I'm taking hormone ...

80

Efficacy and Tolerability of Fitostimoline (Vaginal Cream, Ovules, and Vaginal Washing) and of Benzydamine Hydrochloride (Tantum Rosa Vaginal Cream and Vaginal Washing) in the Topical Treatment of Symptoms of Bacterial Vaginosis  

PubMed Central

Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0–3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV.

Boselli, F.; Petrella, E.; Campedelli, A.; Muzi, M.; Rullo, V.; Ascione, L.; Papa, R.; Saponati, G.

2012-01-01

81

Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy  

PubMed Central

INTRODUCTION More commonly, a vaginal cuff dehiscence is a complication of robotic or laparoscopic hysterectomy while dehiscence is less commonly observed following total abdominal or vaginal hysterectomies. PRESENTATION OF CASE Three years after an uncomplicated total abdominal hysterectomy for fibroid uterus, a 50 year old female with a known, large adnexal mass presented with vaginal cuff dehiscence and prolapse of the adnexal mass through the vaginal cuff. DISCUSSION We discuss surgical risk factors including route of hysterectomy, method of colpotomy and vaginal cuff closure as contributing factors for vaginal cuff dehiscence in our patient. CONCLUSION Any large pelvic mass that may potentially exert pressure necrosis on the vaginal cuff, even remote from hysterectomy may result a vaginal cuff dehiscence. Emergent surgical intervention is warranted.

Nguyen, My-Linh T.; Anyikam, Adanna L.; Paolucci, Michele

2013-01-01

82

Preterm Singleton Breech in North Jordan: Vaginal versus Abdominal Delivery  

Microsoft Academic Search

The safety of vaginal birth for singleton preterm breech has not often been addressed before. We retrospectively compared the perinatal outcome of two groups of preterm breech delivery. Sixty-six patients delivered vaginally and 32 delivered abdominally between 26 and 36 completed weeks. Vaginal delivery was allowed under the same protocol for singleton breech delivery at term. Both groups had similar

Saeed Ziadeh; Adel T. Abu-Heija; Ellias El-Sunna; Mohammad F. El-Jallad; Ahmad Shatnawi; A. Obeidat

1997-01-01

83

Bacterial vaginosis and vaginal fluid defensins during pregnancy  

Microsoft Academic Search

Objective: The purpose of this study was to examine the association between Gram stain findings of vaginal fluid and the concentration of vaginal fluid neutrophil defensins. Study Design: Vaginal fluid specimens obtained from 749 women at 24 to 29 weeks of gestation were tested for bacterial vaginosis and assayed for neutrophil defensins. Bacterial vaginosis was studied as a categoric variable

Rukmini B. Balu; David A. Savitz; Cande V. Ananth; Katherine E. Hartmann; William C. Miller; John M. Thorp; R. Phillips Heine

2002-01-01

84

Protocols for vaginal inoculation and sample collection in the experimental mouse model of Candida vaginitis.  

PubMed

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 years. Predisposing factors include antibiotic usage, uncontrolled diabetes and disturbance in reproductive hormone levels due to pregnancy, oral contraceptives or hormone replacement therapies. Recurrent VVC (RVVC), defined as three or more episodes per year, affects a separate 5 to 8% of women with no predisposing factors. An experimental mouse model of VVC has been established and used to study the pathogenesis and mucosal host response to Candida. This model has also been employed to test potential antifungal therapies in vivo. The model requires that the animals be maintained in a state of pseudoestrus for optimal Candida colonization/infection. 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 properties. 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, Paul L

2011-12-08

85

Vaginal epithelial surface appearances in women using vaginal rings for contraception  

Microsoft Academic Search

Vaginal inspections using colposcopy before insertion of contraceptive vaginal rings and at 2-month intervals during ring use were conducted on 169 users of four different formulations. The rings studied released Nestorone® alone (50, 75, 100 ?g daily over 6 months); ethinyl estradiol: Nestorone (30:100 and 15:150 ?g daily over 6 months); ethinylestradiol:norethindrone acetate (20:1000 and 15:1000 ?g daily over 4

Ian S Fraser; Maria Lacarra; Daniel R Mishell Jr; Francisco Alvarez; Vivian Brache; Pekka Lähteenmäki; Kaisa Elomaa; Edith Weisberg; Harold A Nash

2000-01-01

86

Liposomal gels for vaginal drug delivery.  

PubMed

The aim of our study was to develop a liposomal drug carrier system, able to provide sustained and controlled release of appropriate drug for local vaginal therapy. To optimise the preparation of liposomes with regards to size and entrapment efficiency, liposomes containing calcein were prepared by five different methods. Two optimal liposomal preparations (proliposomes and polyol dilution liposomes) were tested for their in vitro stability in media that simulate human vaginal conditions (buffer, pH 4.5). To be closer to in vivo application of liposomes and to achieve further improvement of their stability, liposomes were incorporated in vehicles suitable for vaginal self-administration. Gels of polyacrylate were chosen as vehicles for liposomal preparations. Due to their hydrophilic nature and bioadhesive properties, it was possible to achieve an adequate pH value corresponding to physiological conditions as well as desirable viscosity. In vitro release studies of liposomes incorporated in these gels (Carbopol 974P NF or Carbopol 980 NF) confirmed their applicability as a novel drug carrier system in vaginal delivery. Regardless of the gel used, even 24 h after the incubation of liposomal gel in the buffer pH 4.5 more than 80% of the originally entrapped substance was still retained. PMID:11337174

Paveli?, Z; Skalko-Basnet, N; Schubert, R

2001-05-21

87

Adhesion of Tritrichomonas foetus to Bovine Vaginal  

Microsoft Academic Search

An in vitro culture system of bovine vaginal epithelial cells (BVECs) was developed to study the cytopatho- genic effects of Tritrichomonas foetus and the role of lipophosphoglycan (LPG)-like cell surface glycoconjugates in adhesion of parasites to host cells. Exposure of BVEC monolayers to T. foetus resulted in extensive damage of monolayers. Host cell disruption was measured quantitatively by a trypan

Epithelial Cells; B. N. SINGH; J. J. LUCAS; D. H. BEACH; S. T. SHIN; R. O. GILBERT

1999-01-01

88

Anterior vaginal wall repair using local anaesthesia  

Microsoft Academic Search

Background: The purpose of the present study was to describe the possibility of surgical repair of anterior vaginal prolapse including amputation of the cervix using local anaesthesia. The description was made according to postoperative complication, recurrence rate, influence on urinary incontinence, and satisfaction of the patient. Material and methods: Eighty-three women were consecutively operated in the anterior wall of the

Susanne Maigaard Axelsen; Karl Møller Bek

2004-01-01

89

[Vaginal polyp in an infant girl].  

PubMed

A case of vaginal polyp in an infant girl was presented. The tumor was polypoid shape and yellow so that it resembled sarcoma botryoides. Histopathological findings showed hamartomatous appearance with hemangiomatous portions in the stroma. For 5 years after simple resection, she has been well without recurrence. PMID:3425530

Takahashi, G

1987-08-01

90

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.…

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

2011-01-01

91

Radiation therapy for primary vaginal carcinoma  

PubMed Central

Brachytherapy plays a significant role in the management of cervical cancer, but the clinical significance of brachytherapy in the management of vaginal cancer remains to be defined. Thus, a single institutional experience in the treatment of primary invasive vaginal carcinoma was reviewed to define the role of brachytherapy. We retrospectively reviewed the charts of 36 patients with primary vaginal carcinoma who received definitive radiotherapy between 1992 and 2010. The treatment modalities included high-dose-rate intracavitary brachytherapy alone (HDR-ICBT; two patients), external beam radiation therapy alone (EBRT; 14 patients), a combination of EBRT and HDR-ICBT (10 patients), or high-dose-rate interstitial brachytherapy (HDR-ISBT; 10 patients). The median follow-up was 35.2 months. The 2-year local control rate (LCR), disease-free survival (DFS), and overall survival (OS) were 68.8%, 55.3% and 73.9%, respectively. The 2-year LCR for Stage I, II, III and IV was 100%, 87.5%, 51.5% and 0%, respectively (P = 0.007). In subgroup analysis consisting only of T2–T3 disease, the use of HDR-ISBT showed marginal significance for favorable 5-year LCR (88.9% vs 46.9%, P = 0.064). One patient each developed Grade 2 proctitis, Grade 2 cystitis, and a vaginal ulcer. We conclude that brachytherapy can play a central role in radiation therapy for primary vaginal cancer. Combining EBRT and HDR-ISBT for T2–T3 disease resulted in good local control.

Murakami, N.; Kasamatsu, T.; Sumi, M.; Yoshimura, R.; Takahashi, K.; Inaba, K.; Morota, M.; Mayahara, H.; Ito, Y.; Itami, J.

2013-01-01

92

Radiation therapy for primary vaginal carcinoma.  

PubMed

Brachytherapy plays a significant role in the management of cervical cancer, but the clinical significance of brachytherapy in the management of vaginal cancer remains to be defined. Thus, a single institutional experience in the treatment of primary invasive vaginal carcinoma was reviewed to define the role of brachytherapy. We retrospectively reviewed the charts of 36 patients with primary vaginal carcinoma who received definitive radiotherapy between 1992 and 2010. The treatment modalities included high-dose-rate intracavitary brachytherapy alone (HDR-ICBT; two patients), external beam radiation therapy alone (EBRT; 14 patients), a combination of EBRT and HDR-ICBT (10 patients), or high-dose-rate interstitial brachytherapy (HDR-ISBT; 10 patients). The median follow-up was 35.2 months. The 2-year local control rate (LCR), disease-free survival (DFS), and overall survival (OS) were 68.8%, 55.3% and 73.9%, respectively. The 2-year LCR for Stage I, II, III and IV was 100%, 87.5%, 51.5% and 0%, respectively (P = 0.007). In subgroup analysis consisting only of T2-T3 disease, the use of HDR-ISBT showed marginal significance for favorable 5-year LCR (88.9% vs 46.9%, P = 0.064). One patient each developed Grade 2 proctitis, Grade 2 cystitis, and a vaginal ulcer. We conclude that brachytherapy can play a central role in radiation therapy for primary vaginal cancer. Combining EBRT and HDR-ISBT for T2-T3 disease resulted in good local control. PMID:23559599

Murakami, N; Kasamatsu, T; Sumi, M; Yoshimura, R; Takahashi, K; Inaba, K; Morota, M; Mayahara, H; Ito, Y; Itami, J

2013-04-04

93

`Normal' vaginal microbiology of women of childbearing age in relation to the use of oral contraceptives and vaginal tampons  

PubMed Central

The vaginal microbiology of women attending a family planning clinic was found to be unrelated to the use of oral contraceptives and vaginal tampons. Beta haemolytic streptococci isolated from this `normal' population were compared with those from 1,104 women attending general practitioners complaining of vaginal discharge. There is a caution regarding the indications for antibiotic therapy. Observations were made on the effects of contamination of vaginal swabs with yeasts and ?-haemolytic streptococci from the vulva. The persistent character of the vaginal flora over a six-month period is described.

Morris, C. A.; Morris, Delia F.

1967-01-01

94

Benign vaginal polyp: a histological, histochemical and immunohistochemical study of 20 polyps with comparison to normal vaginal subepithelial layer.  

PubMed

Twenty benign vaginal polyps from 18 patients, together with sections from normal vaginal epithelium, were studied histologically, histochemically using elastic van Gieson stain and immunohistochemically using monoclonal antibodies against vimentin, desmin and actin. The striking finding was the similarity, both histologically and immunohistochemically, of the stroma of vaginal polyps to that of the loose subepithelial layer found in normal vagina. The important difference was the marked degeneration of the elastic tissue, increased number of stellate and giant fibroblasts and subepithelial condensation of fibroblasts in the polyps. These findings support the hypothesis that vaginal polyps may represent a reactive hyperplasia of the loose subepithelial zone of the vaginal wall. PMID:1302457

al-Nafussi, A I; Rebello, G; Hughes, D; Blessing, K

1992-02-01

95

Effect on vaginal pH of a polycarbophil vaginal gel compared with an acidic douche in women with suspected bacterial vaginosis: a randomized, controlled study  

Microsoft Academic Search

Background: Vaginal pH is a key factor in maintaining a healthy vaginal ecosystem. An increase in vaginal pH is commonly observed during bacterial vaginosis.Objective: This study was undertaken to compare the effects of polycarbophil, a new bioadhesive polymer in gel form, with those of an acidic vaginal douche on restoration of physiologic vaginal pH in women with a vaginal pH

Massimo Milani; Bruno Molteni; Ilaria Silvani

2000-01-01

96

Association between atopy and recurrent vaginal candidiasis  

PubMed Central

To determine whether there is an association between atopy and recurrent vaginal candidiasis (RVC) and to evaluate the type-2 immune response in patients with RVC. Evaluation of immediate hypersensitivity skin tests to aeroallergens, measurement of total IgE and Candida albicans specific IgE and levels of IL-5 in 44 women with RVC and 26 with sporadic vaginal candidiasis (SVC). Statistical analyses were performed by Mann–Whitney test and ?2 test with Yates correction. History of atopy (68%) and positive skin test (42%) were higher (P < 0·05) in RVC than in patients with SVC. No significant difference was found in total IgE, C. albicans specific IgE and IL-5 levels. There was a strong association between atopy and RVC, but type-2 immune response to C. albicans antigen was absent or similar in the two groups of patients.

Neves, NA; Carvalho, LP; De Oliveira, MAM; Giraldo, PC; Bacellar, O; Cruz, AA; Carvalho, EM

2005-01-01

97

Cytolytic vaginosis: misdiagnosed as candidal vaginitis.  

PubMed Central

OBJECTIVES: In this study, 210 women with vaginal discharge and other symptoms/signs of genital pathology suggestive of vulvovaginal candidiasis (VVC) were involved in order to distinguish true WC and cytolytic vaginosis (CV) cases. METHODS: Fungal cultures, 10% potassium hydroxide (KOH) and Gram stained preparations and pH measurements were performed on the vaginal discharge material of each patient. RESULTS: Fifteen patients (7.1%) were diagnosed with cytolytic vaginosis according to their clinical and microbiological findings, including abundant lactobacilli, fragmented epithelial cells and/or free nuclei due to cytolysis, seen in their discharge materials on microscopic examination, but no fungal growth. CONCLUSIONS: The results of this study may contribute to the reports in the literature indicating the importance of such disorders, which are generally misdiagnosed as candidiasis.

Cerikcioglu, Nilgun; Beksac, M Sinan

2004-01-01

98

Murine Models of Vaginal Trichomonad Infections  

PubMed Central

Trichomonas vaginalis and Tritrichomonas foetus cause common sexually transmitted infections in humans and cattle, respectively. Mouse models of trichomoniasis are important for pathogenic and therapeutic studies. Here, we compared murine genital infections with T. vaginalis and T. foetus. Persistent vaginal infection with T. foetus was established with 100 parasites but T. vaginalis infection required doses of 106, perhaps because of greater susceptibility to killing by mouse vaginal polymorphonuclear leukocytes. Infection with T. vaginalis persisted longest after combined treatment of mice with estrogen and dexamethasone, whereas infection was only short-lived when mice were given estrogen or dexamethasone alone, co-infected with Lactobacillus acidophilus, and/or pretreated with antibiotics. Infection rates were similar with metronidazole-resistant (MR) and metronidazole-sensitive (MS) T. vaginalis. High dose but not low dose metronidazole treatment controlled infection with MS better than MR T. vaginalis. These murine models will be valuable for investigating the pathogenesis and treatment of trichomoniasis.

Cobo, Eduardo R.; Eckmann, Lars; Corbeil, Lynette B.

2011-01-01

99

Probiotic and prebiotic applications for vaginal health.  

PubMed

Infections of the urogenital tract in women are extremely common, and there is no evidence of a reduction in incidence. Treatment and preventive strategies have been relatively unchanged for 50 years. The concept of using probiotic lactobacilli or prebiotics that stimulate the growth of protective organisms emerged in the mid-1980s and has led to several strains being tested successfully in women. With the advent of genomic profiling of the healthy vaginal microbiota, an improved understanding of metabolic systems within lactobacilli, and the ability to deliver products in food and supplement forms, the future should see new ways for women to restore and maintain their vaginal health, without the side effects of pharmaceutical agents. Indeed, studies indicate that probiotics can be taken in conjunction with the antibiotics and antifungal agents used to eradicate infections. In the future, probiotics and prebiotics will represent an important adjunct to pharmaceutical and other approaches used to care for feminine health. PMID:22468339

Reid, Gregor

100

Trial of vaginal breech delivery: current role.  

PubMed

Breech presentation occurs at term in approximately 3% to 4% of singleton gestations. This presentation is associated with a variety of maternal and fetal conditions including preterm labor, abnormal amniotic fluid volume, hydrocephaly, anencephaly, mullerian anomalies, abnormal placentation, and multifetal gestation. Cesarean delivery has been associated with increased risk of subsequent accreta, placenta previa, hemorrhage, and hysterectomy. The Term Breech Trial initially suggested that planned vaginal breech delivery is associated with increased neonatal morbidity and mortality compared with planned cesarean delivery. Long-term follow-up of these vaginally delivered infants contradict the initial findings. Current debate surrounds the dilemma of whether the untoward complications of cesarean delivery are warranted given uncertain minimal increases in neonatal survival and improvement in neurologic outcome with planned cesarean. PMID:17513938

Yamamura, Yasuko; Ramin, Kirk D; Ramin, Susan M

2007-06-01

101

[Vaginal metastasis of renal carcinoma (author's transl)].  

PubMed

Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear. PMID:924104

Carl, P; Marx, F J

1977-11-01

102

Can group B streptococci cause symptomatic vaginitis?  

PubMed Central

BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.

Honig, E; Mouton, J W; van der Meijden, W I

1999-01-01

103

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.

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

2011-01-01

104

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

PubMed

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4), which is an attribute of a healthy vagina. The effervescent mixture (citric acid and sodium bicarbonate) along with a superdisintegrant (Ac-Di-sol) was used to enhance the swellability of the bioadhesive tablet. The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as an antibacterial) were used in the formulation along with Lactobacillus acidophilus spores to treat mixed vaginal infections. From the ex vivo retention study it was found that the bioadhesive polymers hold the tablet for more than 24 hours inside the vaginal tube. The hardness of the acid-buffering bioadhesive vaginal tablet was optimized, at 4 to 5 kg hardness the swelling was found to be good and the cumulative release profile of the developed tablet was matched with a marketed conventional tablet (Infa-V). The in vitro spreadability of the swelled tablet was comparable to the marketed gel. In the in vitro antimicrobial study it was found that the acid-buffering bioadhesive tablet produces better antimicrobial action than marketed intravaginal drug delivery systems (Infa-V, Candid-V and Canesten 1). PMID:18181530

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

2007-12-14

105

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

106

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

107

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.

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

2007-01-01

108

Vernix Caseosa Peritonitis After Vaginal Delivery  

PubMed Central

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

Sadath, Shameema A.; Abo Diba, Fathiya I.; Nayak, Surendra; Shamali, Iman Al; Diejomaoh, Michael F.

2013-01-01

109

Vaginal route: a gynaecological route for much more than hysterectomy.  

PubMed

Vaginal hysterectomy is the method of choice for gynaecologists who carry out hysterectomies. Undertaking this procedure regularly will enhance the gynaecologist's level of skill and enable conditions such as ovarian cysts, broad ligament fibroids and other adnexal pathology to be dealt with vaginally during hysterectomy surgery without abdominal invasion. It is also important as the vaginal route allows access to the posterior cul-de-sac, which can facilitate surgery or offer an alternative route to achieving the desired outcome. In this chapter, we look at the main indications for vaginal surgery, and also at other conditions in which vaginal surgery may be suitable (e.g. benign and malignant conditions). We believe that gynaecologists who include vaginal surgery in their armamentarium are better equipped to serve their patients. PMID:21349773

Sheth, Shirish S; Paghdiwalla, Kurush P; Hajari, Anju R

2011-02-23

110

Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis  

PubMed Central

Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effects of some antibiotics on Lactobacilli isolates. Materials and Methods: In this study (110) vaginal swabs were obtained from women suffering from vaginitis who admitted to Babylon Hospital of Maternity and Paediatrics in Babylon province, Iraq. The study involved the role of intrauterine device among married women with vaginitis and also involved isolation of opportunistic bacterial isolates among pregnant and non pregnant women. This study also involved studying probiotic role of Lactobacilli by production of some defense factors like hydrogen peroxide, bacteriocin, and lactic acid. Results: Results revealed that a total of 130 bacterial isolates were obtained. Intrauterine device was a predisposing factor for vaginitis. The most common opportunistic bacterial isolates were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Klebsiella pneumoniae. All Lactobacilli were hydrogen peroxide producers while some isolates were bacteriocin producers that inhibited some of opportunistic pathogens (S. aureus, E. coli). Lactobacilli were sensitive to erythromycin while 93.3% of them were resistant to ciprofloxacin and (40%, 53.3%) of them were resistant to amoxicillin and gentamycin respectively. Results revealed that there was an inverse relationship between Lactobacilli presence and organisms causing vaginitis. This may be attributed to the production of defense factors by Lactobacilli. Conclusion: The types of antibiotics used to treat vaginitis must be very selective in order not to kill the beneficial bacteria (Lactobacilli) that help in preservation of vaginal health and ecosystem as being one of the probiotic bacteria.

Razzak, Mohammad Sabri A.; Al-Charrakh, Alaa H.; AL-Greitty, Bara Hamid

2011-01-01

111

Vaginal Foreign Bodies and Child Sexual Abuse: An Important Consideration  

PubMed Central

Vaginal foreign bodies are a complaint occasionally encountered in pediatric clinics and emergency departments, and when pediatric patients present with a vaginal foreign body sexual abuse may not be considered. We describe two children with vaginal foreign bodies who were found to have been sexually abused. Each child had a discharge positive for a sexually transmitted infection despite no disclosure or allegation of abuse. We recommend that all pre-pubertal girls who present with a vaginal foreign body should be considered as possible victims of sexual abuse and should receive a sexual abuse history and testing for sexually transmitted infections.

Closson, Forrest T.; Lichenstein, Richard

2013-01-01

112

[Vaginal disbacteriosis--social and sexual risk factors].  

PubMed

The vaginal microbe equilibrium could be impaired by different agents. Many of the risk factors can change the preventive mechanisms of the vagina and can lead to inflammation and disease. We even do not suppose about the role of most of them in impairing of vaginal microbe equilibrium. The exact understanding of those risk factors and mechanisms by which they disturb the vaginal microbe balance could reduce female morbidity of vaginal disbacteriosis and vaginal inflammations. The aim of this literature synopsis is to review some of the most frequent risk factors for vaginal disbacteriosis and about how they change vaginal micro-flora with dominant lactobacillus within it. The most informative and detailed articles on the theme which were found in the resent literature as well as in Medline for the period between 1990 and 2012 were selected. The risk agents for vaginal disbacteriosis are: endogenetic, social, sexual, infectious and iatrogenic. The social and sexual factors are the most frequent in our daily round. The intensity and the kind of sexual life, smoking, homosexual connections, vaginal douching and contraception methods are included in them. All these factors depend on us. Thus we hope that through their popularization and discussion will help to prevent the females' health. PMID:23807976

Kovachev, S

2013-01-01

113

Laparoscopically assisted repair of vaginal evisceration after hysterectomy.  

PubMed

Vaginal evisceration is a rare condition most commonly associated with previous vaginal surgery. It usually presents with vaginal bleeding, lower abdominal pain and a protruding mass, and requires immediate assessment and surgical management to salvage the prolapsed bowel. Any delay in the treatment may result in bowel ischaemia and perforation which is associated with higher morbidity and mortality. We report a case of spontaneous vaginal evisceration during defaecation in a 56-year-old postmenopausal women 11 months post hysterectomy. This case highlights the benefits of a combined laparoscopic and transvaginal approach in the successful management of this surgical emergency. PMID:23667228

Nikolopoulos, Ioannis; Khan, Hasan; Janakan, Gnananandan; Kerwat, Rajab

2013-05-09

114

Interleukin1 Receptor Antagonist Gene Polymorphism, Vaginal Interleukin1 Receptor Antagonist Concentrations, and Vaginal Ureaplasma urealyticum Colonization in Pregnant Women  

Microsoft Academic Search

Ureaplasma urealyticum is the microorganism most frequently isolated from amniotic fluids of women in preterm labor. The relationship between vaginal colonization with U. urealyticum, vaginal interleukin-1 recep- tor antagonist (IL-1ra) levels, and the IL-1ra genotype in pregnant women was examined. Vaginal specimens, obtained with a cotton swab from 207 women in their first trimester of pregnancy, were tested for IL-1ra

Parrin T. Barton; Stefan Gerber; Daniel W. Skupski; Steven S. Witkin

2003-01-01

115

Adenocarcinoma Arising from Vaginal Stump: Unusual Vaginal Carcinogenesis 7 Years After Hysterectomy due to Cervical Intraepithelial Neoplasia.  

PubMed

Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation. PMID:24071878

Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya

2013-11-01

116

Practical Guide to Diagnosing and Treating Vaginitis.  

PubMed

Bacterial vaginosis (BV), candidiasis, and trichomoniasis account for more than 90% of vaginal infections. BV typically is associated with a decrease in commensal, protective lactobacilli and a proliferation of other flora. Mobiluncus is pathognomonic but found in only 20% of cases. Presence of 3 of 4 criteria indicates BV: a homogenous noninflammatory discharge (not many WBCs); pH >4.5; clue cells (bacteria attached to borders of epithelial cells, > 20 % of epithelial cells); and a positive whiff test. New intravaginal BV preparations cause less-adverse systemic effects than oral regimens. Trichomonas vaginalis, a protozoan, appears to be sexually transmitted and causes up to 25% of vaginitis cases. Diagnosis is made by observation of a foul, frothy discharge; pH >4.5 (present in 70% of cases); punctate cervical microhemorrhages (25% of cases); and motile trichomonads on wet mount (50%-75% of cases). Recommended treatment is a single 2g dose of oral metronidazole. Treatment failure is usually due to nontreatment of the male partner. Candidiasis typically presents as a thick, "curdled" white discharge or vulvar pruritus, with a hyperemic vagina and an erythematous and/or excoriated vulva. Vaginal pH is usually in the normal range of 3.8-4.2 in uncomplicated candidiasis. Microscopic examination of the discharge reveals hyphae or budding yeast in 50%-70% of cases. While the most common offender is Candida albicans, Candida tropicalis and Candida glabrata have become increasingly prevalent. Approximately 15% of C albicans organisms are resistant to clotrimazole and miconazole. Recurrent infections may be treated with fluconazole 150mg weekly for up to 12 consecutive weeks. PMID:9746676

Plourd

1997-02-01

117

Optimisation techniques in vaginal cuff brachytherapy.  

PubMed

The aim of this study was to explore whether an in-house dosimetry protocol and optimisation method are able to produce a homogeneous dose distribution in the target volume, and how often optimisation is required in vaginal cuff brachytherapy. Treatment planning was carried out for 109 fractions in 33 patients who underwent high dose rate iridium-192 (Ir(192)) brachytherapy using Fletcher ovoids. Dose prescription and normalisation were performed to catheter-oriented lateral dose points (dps) within a range of 90-110% of the prescribed dose. The in-house vaginal apex point (Vk), alternative vaginal apex point (Vk'), International Commission on Radiation Units and Measurements (ICRU) rectal point (Rg) and bladder point (Bl) doses were calculated. Time-position optimisations were made considering dps, Vk and Rg doses. Keeping the Vk dose higher than 95% and the Rg dose less than 85% of the prescribed dose was intended. Target dose homogeneity, optimisation frequency and the relationship between prescribed dose, Vk, Vk', Rg and ovoid diameter were investigated. The mean target dose was 99+/-7.4% of the prescription dose. Optimisation was required in 92 out of 109 (83%) fractions. Ovoid diameter had a significant effect on Rg (p = 0.002), Vk (p = 0.018), Vk' (p = 0.034), minimum dps (p = 0.021) and maximum dps (p<0.001). Rg, Vk and Vk' doses with 2.5 cm diameter ovoids were significantly higher than with 2 cm and 1.5 cm ovoids. Catheter-oriented dose point normalisation provided a homogeneous dose distribution with a 99+/-7.4% mean dose within the target volume, requiring time-position optimisation. PMID:19470571

Tuncel, N; Garipagaoglu, M; Kizildag, A U; Andic, F; Toy, A

2009-05-26

118

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

119

[Vaginal infection caused by Saccharomyces cerevisiae].  

PubMed

In a woman of 26, who suffered from a vulvovaginal infection and had previously been treated for Candida vaginitis, Saccharomyces cerevisiae was cultured and identified. At her work she sold baking yeast. Topical treatment with amphotericin B 100 mg suppositories was successful. Microscopic examination (1000 x) of the discharge in saline showed haloed yeast cells. For treatment, oral ketoconazole or topical administration of amphotericin B or clotrimazole, in relatively high doses, may be applied. This yeast might be the cause of 'chronic candidiasis' more often than suspected, notably in women working in a bakery or a brewery. PMID:7783803

van Doorn, H C; Coelingh Bennink, F

1995-05-27

120

Vaginal contraceptive film gains wider acceptance.  

PubMed

In US health departments and family planning clinics, women are beginning to accept vaginal contraceptive film more widely. Further, direct sales of this method, which is also distributed over the counter, has increased. In fact, in 1991, vaginal contraceptive film was the top selling contraceptive in pharmacies. This 2.5 sq. inch water-soluble film is impregnated with nonoxynol-9. The woman uses her finger to insert the folded square as close as possible to the cervix 5-60 minutes before intercourse. If the time between acts of intercourse is greater than 1 hour, she must insert another square. After it dissolves, it is a firm gel removed by vaginal and cervical fluids. The company realizes that its relatively high cost (about $3.59 for 3 films) prevents some family planning providers from offering the film. It has tried to cut costs by not using extra packaging material and by manufacturing it in the US instead of ain England. A manager of the family planning clinic at R.E. Thomason County Hospital in El Paso, Texas, notes that user compliance is higher with the vaginal contraceptive film than foam. In fact, patients at the Planned Parenthood League of Middlesex County, New Jersey, favor the film because it is less messy than foam. Teenagers in El Paso prefer the film because of the privacy issue and gives them more control to protect themselves from pregnancy. A worker at the New Jersey clinic recommends the film as a backup method for women beginning to use oral contraceptives. She also suggests to patients requesting condoms to also use the film. The company makes the same recommendation. Yet, family planning workers note that some women cannot convince partners to use the condom. 90% of patients at the El Paso clinic are Hispanic, and they tend to not accept condom use. Some providers suggest using 2 applications of the film to defend against sexually transmitted diseases, but there is no evidence that double application actually does so. PMID:12317927

1992-09-01

121

New immunotherapeutic strategies to control vaginal candidiasis.  

PubMed

The widespread occurrence of mucosal infections caused by Candida, in particular recurrent vulvovaginal candidiasis among fertile-age women, together with the paucity of safe candidacidal antimycotics, have prompted a great number of investigations into the immunotherapy of candidal vaginitis. This article will discuss three different experimental approaches demonstrated to be potentially transferable to human disease: (1) the use of antibodies against well-defined cell-surface adhesins or enzymes; (2) the generation of yeast killer-toxin-like candidacidal anti-idiotypic antibodies and their engineered molecular derivatives (e.g. single chains, peptides); and (3) the generation of therapeutic vaccines and immunomodulators. PMID:11879772

Magliani, Walter; Conti, Stefania; Cassone, Antonio; De Bernardis, Flavia; Polonelli, Luciano

2002-03-01

122

Nasal and Vaginal Vaccinations Have Differential Effects on Antibody Responses in Vaginal and Cervical Secretions in Humans  

PubMed Central

Sexually transmitted diseases are a major health problem worldwide, but there is still a lack of knowledge about how to induce an optimal immune response in the genital tract of humans. In this study we vaccinated 21 volunteers nasally or vaginally with the model mucosal antigen cholera toxin B subunit and determined the level of specific immunoglobulin A (IgA) and IgG antibodies in vaginal and cervical secretions as well as in serum. To assess the hormonal influence on the induction of antibody responses after vaginal vaccination, we administered the vaccine either independently of the stage in the menstrual cycle or on days 10 and 24 in the cycle in different groups of subjects. Vaginal and nasal vaccinations both resulted in significant IgA and IgG anti-cholera toxin B subunit responses in serum in the majority of the volunteers in the various vaccination groups. Only vaginal vaccination given on days 10 and 24 in the cycle induced strong specific antibody responses in the cervix with 58-fold IgA and 16-fold IgG increases. In contrast, modest responses were seen after nasal vaccination and in the other vaginally vaccinated group. Nasal vaccination was superior in inducing a specific IgA response in vaginal secretions, giving a 35-fold increase, while vaginal vaccination induced only a 5-fold IgA increase. We conclude that a combination of nasal and vaginal vaccination might be the best vaccination strategy for inducing protective antibody responses in both cervical and vaginal secretions, provided that the vaginal vaccination is given on optimal time points in the cycle.

Johansson, Eva-Liz; Wassen, Lotta; Holmgren, Jan; Jertborn, Marianne; Rudin, Anna

2001-01-01

123

Vaginal and Oral Epithelial Cell Anti-Candida Activity  

Microsoft Academic Search

Candida albicans is the causative agent of acute and recurrent vulvovaginal candidiasis (VVC), a common mucosal infection affecting significant numbers of women in their reproductive years. While any murine host protective role for cell-mediated immunity (CMI), humoral immunity, and innate resistance by neutrophils against the vaginal infection appear negligible, significant in vitro growth inhibition of Candida species by vaginal and

Fatema Nomanbhoy; Chad Steele; Junko Yano

2002-01-01

124

Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis.  

PubMed

Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0-3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV. PMID:23209922

Boselli, F; Petrella, E; Campedelli, A; Muzi, M; Rullo, V; Ascione, L; Papa, R; Saponati, G

2012-10-30

125

Septate uterus associated with cervical duplication and vaginal septum  

Microsoft Academic Search

A woman had an unusual müllerian anomaly with a septate uterus, cervical duplication, and longitudinal vaginal septum. Gynecologists should be aware of the possibility of cervical duplication associated with uterine septum and not didelphic uterus, as this disorder in a patient with infertility or recurrent miscarriages can be treated surgically by resection of the uterine and vaginal septum. Embryologic explanations

Juan L. Giraldo; Antonia Habana; Antoni J. Duleba; Anuja Dokras

2000-01-01

126

Variation in vaginal breech delivery rates by hospital type  

Microsoft Academic Search

Objective: To relate vaginal breech delivery rates to the following hospital types: public, health maintenance organization, private teaching, or private nonteaching.Methods: In a retrospective study using administrative discharge data from Los Angeles County, California, we calculated the vaginal breech delivery rates of singleton breech deliveries during calendar years 1988 and 1991.Results: Ten thousand four hundred breech deliveries were identified, 8988

Kimberly D Gregory; Lisa M Korst; Michael Krychman; Patricia Cane; Lawrence D Platt

2001-01-01

127

Predictors of episiotomy use at first spontaneous vaginal delivery  

Microsoft Academic Search

Objective: To identify factors associated with the use of episiotomy at spontaneous vaginal delivery.Methods: We studied 1576 consecutive term, singleton, spontaneous vaginal deliveries in nulliparas at Brigham & Women’s Hospital between December 1, 1994 and July 31, 1995. The association of demographic variables and obstetric factors with the rate of episiotomy use were examined. Adjusted odds ratios (OR) and confidence

Julian N Robinson; Errol R Norwitz; Amy P Cohen; Ellice Lieberman

2000-01-01

128

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

129

[Physicopharmaceutical characteristics of ulinastatin vaginal suppositories prepared in a hospital].  

PubMed

We studied a locally applied vaginal preparation (vaginal suppositories) of ulinastatin (urinary trypsin inhibitor, UTI), designed to threatened premature delivery and maintain pregnancy. Witepsol S55 was chosen as the basic component of the vaginal suppositories based on the physical pharmaceutical characteristics of three kinds of hard fats. The average particle size of the UTI aqueous injection was approximately 70% as compared with that of the UTI lyophilized product, used as the base material for the preparation of UTI vaginal suppositories. We compared the physical pharmaceutical properties of UTI vaginal suppositories with water contents of 2.5%, 5.0%, and 7.5%, respectively. Preparation strength negatively correlated with the water content. The coefficient of viscosity positively correlated with the water content of the preparation. UTI vaginal suppositories with a water content of 5.0% had the highest average drug release rate on moment analysis. A comprehensive evaluation of the properties of UTI vaginal suppositories, including high strength due to disintegration resistance, the coefficient of viscosity and its influence on local retention, and drug release and its influence on the duration of effect, indicated that a 5.0% UTI aqueous solution for injection combined with Witepsol S55 as the base was the optimal formulation for the hospital preparation of vaginal suppositories. PMID:22041703

Satake, Kiyoshi; Nakajima, Takanori; Iwata, Masanori; Fujikake, Yoshio; Kimura, Masayuki

2011-01-01

130

Two cases of vaginal bleeding in pet rats  

PubMed Central

Two unrelated rats were presented to the Western College of Veterinary Medicine emergency service for vaginal bleeding. Each was taken to surgery due to marked blood loss and suspicion of uterine pathology. Despite similar clinical presentation, gross and histopathologic examination revealed 2 different underlying disease processes, uterine dilatation with mild endometritis and vaginal polyp.

Sadar, Miranda J.; Parker, Dennilyn L.; Burgess, Hilary; Wojnarowicz, Chris

2011-01-01

131

Two cases of vaginal bleeding in pet rats.  

PubMed

Two unrelated rats were presented to the Western College of Veterinary Medicine emergency service for vaginal bleeding. Each was taken to surgery due to marked blood loss and suspicion of uterine pathology. Despite similar clinical presentation, gross and histopathologic examination revealed 2 different underlying disease processes, uterine dilatation with mild endometritis and vaginal polyp. PMID:22210942

Sadar, Miranda J; Parker, Dennilyn L; Burgess, Hilary; Wojnarowicz, Chris

2011-07-01

132

Vaginal birth after cesarean among women with gestational diabetes  

Microsoft Academic Search

Objective: We sought to determine the pregnancy and infant outcomes of women with gestational diabetes who attempted vaginal birth after previous cesarean delivery. Study Design: We conducted a retrospective cohort study to compare women with gestational diabetes with matched control subjects without diabetes who attempted vaginal birth after cesarean at Grady Memorial Hospital, Atlanta, from January 1, 1989, through December

Traci L. Coleman; Hugh Randall; William Graves; Michael Lindsay

2001-01-01

133

Vaginal hygiene and douching: perspectives of Hispanic men  

Microsoft Academic Search

Vaginal douching is widely practised by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction and sexuality. Little previous research has addressed the beliefs and practices of Latina women and none has included the perspective of

Diane McKee; María Baquero; Matthew Anderson; Alison Karasz

2009-01-01

134

EVALUATION OF VAGINAL IMPLANT TRANSMITTERS IN ELK (CERVUS ELAPHUS NELSONI)  

Microsoft Academic Search

The effects of vaginal implant transmitters for tissue damage after 11 wk in 13 captive adult elk (Cervus elaphus nelsoni) and subsequent reproductive performance in 38 free-ranging elk were evaluated. Vaginal implant transmitters are designed to be shed at parturition and are used to locate birth sites of wild ungulates; however, potential adverse effects of these transmitters on tissues associated

Bruce K. Johnson; Terrance McCoy; Christopher O. Kochanny; Rachel C. Cook

2006-01-01

135

Predictive score for vaginal birth after cesarean section  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the relative weight of the different variables that may influence the chances of vaginal birth after one cesarean delivery, with the aim of developing a predictive score for success of such a trial. STUDY DESIGN: In this retrospective study, which covered a 10-year period (1981 to 1990), 471 women who attempted vaginal birth at

Daniel Weinstein; Abraham Benshushan; Vasilios Tanos; Ronit Zilberstein; Nathan Rojansky

1996-01-01

136

Why cobacterial infection in candida vaginitis is uncommon?  

Microsoft Academic Search

An interesting observation is that cobacterial infection in candida vaginitis is rare, while coinfection between other types\\u000a of vaginitis is common. The author hereby tried to explain this fact by the theory of internal alcoholic production as a cause.

Viroj Wiwanitkit

2008-01-01

137

The role of fomites in the transmission of vaginitis.  

PubMed Central

A role for fomites such as toilet seats in the transmission of vaginitis has never been proved or disproved. A compilation of clinical data from a university community showed that the organisms found in vaginal cultures of patients with vaginitis were, in order of frequency. Candida albicans, Escherichia coli, beta-hemolytic streptococci, Hemophilus vaginalis and Trichomonas vaginalis. In a concurrent bacteriologic survey of washroom fixtures, staphylococci and other micrococci were isolated most frequently. The overt pathogens associated with vaginitis were never found, and gram-negative organisms appeared to be suppressed by the disinfectant used by the cleaning staff. It is clear that fomites are not an important mode of transmission in vaginitis, although a search for specific pathogens on toilets is to be continued.

Andrew, D. E.; Bumstead, E.; Kempton, A. G.

1975-01-01

138

Vaginal Cleansing Practices in HIV Infected Zambian Women  

PubMed Central

Vaginal practices are a variety of behavioral techniques that women use to manage their sexual life and personal hygiene. Women perceive vaginal practices as a beneficial practice. However, vaginal cleansing has been identified as one of the main risk factors for bacterial vaginosis and is potentially implicated in Human Immune Deficiency Virus (HIV) and sexually transmitted infection transmission. This study examined the prevalence of vaginal practices and the types of practices used among a sample of HIV positive women living in Lusaka, Zambia. Over 90% of all women recruited engaged in vaginal practices. Certain practices, such as use of water or soap, were more frequently used for hygiene reasons. Herbs and traditional medicines were mainly used to please sexual partner. Strategies to decrease VP appear urgently needed in the Zambian community.

Alcaide, Maria L.; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah

2013-01-01

139

Vaginal Primary Malignant Melanoma: A Rare and Aggressive Tumor  

PubMed Central

Vaginal primary malignant melanoma is a rare and very aggressive tumor. It most commonly occurs in postmenopausal women, with a mean age of 57 years. Our patient is an 80-year-old, postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. On gynecologic examination there was a pigmented, raised, ulcerated, and irregular lesion 5 × 4.5?cm in the upper third of anterior vaginal wall. She underwent a wide local excision of the lesion. The histopathology revealed vaginal primary malignant melanoma with ulceration and no clear surgical margins. She denied any additional surgical interventions and underwent to postoperative adjuvant radiotherapy. Follow up 5 months after initial diagnosis revealed no evidence of local recurrence or distant metastasis. The prognosis of vaginal primary malignant melanoma is very poor despite treatment modality, because most of the cases are diagnosed at advanced stage. Particularly patients with no clear surgical margins and tumor size >3?cm needed postoperative adjuvant radiotherapy.

Terzakis, Emmanouil; Ioannidou, Georgia; Tsamandas, Athanasios; Decavalas, Georgios

2013-01-01

140

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.

2013-01-01

141

Vaginal Health: Insights, Views & Attitudes (VIVA) survey - Canadian cohort.  

PubMed

OBJECTIVE: To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey. METHODS: An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK, the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented (n = 500). RESULTS: Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), 'having a loving relationship with a partner' (39%) and 'overall quality of life' (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams). CONCLUSIONS: These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options. PMID:23201626

Frank, Sheldon M; Ziegler, Cleve; Kokot-Kierepa, Marta; Maamari, Ricardo; Nappi, Rossella E

2012-11-30

142

Vaginal microbial flora analysis by next generation sequencing and microarrays; can microbes indicate vaginal origin in a forensic context?  

PubMed

Forensic analysis of biological traces generally encompasses the investigation of both the person who contributed to the trace and the body site(s) from which the trace originates. For instance, for sexual assault cases, it can be beneficial to distinguish vaginal samples from skin or saliva samples. In this study, we explored the use of microbial flora to indicate vaginal origin. First, we explored the vaginal microbiome for a large set of clinical vaginal samples (n?=?240) by next generation sequencing (n?=?338,184 sequence reads) and found 1,619 different sequences. Next, we selected 389 candidate probes targeting genera or species and designed a microarray, with which we analysed a diverse set of samples; 43 DNA extracts from vaginal samples and 25 DNA extracts from samples from other body sites, including sites in close proximity of or in contact with the vagina. Finally, we used the microarray results and next generation sequencing dataset to assess the potential for a future approach that uses microbial markers to indicate vaginal origin. Since no candidate genera/species were found to positively identify all vaginal DNA extracts on their own, while excluding all non-vaginal DNA extracts, we deduce that a reliable statement about the cellular origin of a biological trace should be based on the detection of multiple species within various genera. Microarray analysis of a sample will then render a microbial flora pattern that is probably best analysed in a probabilistic approach. PMID:22282153

Benschop, Corina C G; Quaak, Frederike C A; Boon, Mathilde E; Sijen, Titia; Kuiper, Irene

2012-01-27

143

A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.  

PubMed

We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route. PMID:23919862

Agnaeber, K; Bodalal, Z

2013-08-01

144

[Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment].  

PubMed

Post-hysterectomy vaginal vault prolapse is a common disorder which generally manifests as a protrusion of the vagina through the genital hiatus, sometimes accompanied by urinary and gastrointestinal symptoms as well as sexual dysfunction. Risk factors for this condition include vaginal deliveries, obesity and previous hysterectomy, although genetic predisposition leading to reduced connective tissue and muscle strength may also play a role. Surgical correction of this disorder can be performed through either the abdominal or transvaginal approaches. Two prospective randomized trials have compared these approaches demonstrating better anatomic success rates for the abdominal approach as opposed to faster recovery and lower morbidity for the transvaginal approach. Laparoscopic and other transvaginal minimal access techniques for vaginal vault suspension have recently been advocated utilizing synthetic or biological adjuvant grafts. These techniques have been associated with high success rates albeit substantial graft complications such as erosion, contraction and dyspareunia. Suspension of the vaginal apex to the uterosacral ligaments (McCall culdoplasty) or to the sacrospinous ligaments at the time of vaginal hysterectomy is the mainstay for prevention of post hysterectomy vaginal vault prolapse. Our knowledge of the pathophysiology of post hysterectomy vaginal vault prolapse is quickly being refined, leading to more efficient surgical therapies for prevention and treatment of this disorder. PMID:18770962

Segev, Yakir; Auslander, Ron; Lavie, Ofer; Lissak, Arie; Abramov, Yoram

2008-05-01

145

Performing vaginal lavage, crystal violet staining, and vaginal cytological evaluation for mouse estrous cycle staging identification.  

PubMed

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

McLean, Ashleigh C; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A L

2012-09-15

146

Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification  

PubMed Central

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status.

McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

2012-01-01

147

Pathogenesis of urinary tract infection —experimental studies of vaginal resistance to colonization  

Microsoft Academic Search

The review summarizes studies of vaginal colonization resistance againstEscherichia coli in a primate model. The genital flora surrounding the urethral orifice exerts a strong colonization resistance. Amoxicillin profoundly disturbs the normal vaginal microflora, reduces its adherence to vaginal epithelial cells in vivo and promotes a persistent vaginalE. coli colonization. Certain cephalosporins may have a similar effect. The induced ecological changes

Jan Winberg; Maria Herthelius-Elman; Roland Miillby; Carl Erik Nord

1993-01-01

148

Magnitude of Interfractional Vaginal Cuff Movement: Implications for External Irradiation  

SciTech Connect

Purpose: To quantify the extent of interfractional vaginal cuff movement in patients receiving postoperative irradiation for cervical or endometrial cancer in the absence of bowel/bladder instruction. Methods and Materials: Eleven consecutive patients with cervical or endometrial cancer underwent placement of three gold seed fiducial markers in the vaginal cuff apex as part of standard of care before simulation. Patients subsequently underwent external irradiation and brachytherapy treatment based on institutional guidelines. Daily megavoltage CT imaging was performed during each external radiation treatment fraction. The daily positions of the vaginal apex fiducial markers were subsequently compared with the original position of the fiducial markers on the simulation CT. Composite dose-volume histograms were also created by summing daily target positions. Results: The average ({+-} standard deviation) vaginal cuff movement throughout daily pelvic external radiotherapy when referenced to the simulation position was 16.2 {+-} 8.3 mm. The maximum vaginal cuff movement for any patient during treatment was 34.5 mm. In the axial plane the mean vaginal cuff movement was 12.9 {+-} 6.7 mm. The maximum vaginal cuff axial movement was 30.7 mm. In the craniocaudal axis the mean movement was 10.3 {+-} 7.6 mm, with a maximum movement of 27.0 mm. Probability of cuff excursion outside of the clinical target volume steadily dropped as margin size increased (53%, 26%, 4.2%, and 1.4% for 1.0, 1.5, 2.0, and 2.5 cm, respectively.) However, rectal and bladder doses steadily increased with larger margin sizes. Conclusions: The magnitude of vaginal cuff movement is highly patient specific and can impact target coverage in patients without bowel/bladder instructions at simulation. The use of vaginal cuff fiducials can help identify patients at risk for target volume excursion.

Ma, Daniel J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Michaletz-Lorenz, Martha [Department of Education and Training, Elekta, Maryland Heights, MO (United States); Goddu, S. Murty [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

2012-03-15

149

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

150

Temporal Dynamics of the Human Vaginal Microbiota  

PubMed Central

Elucidating the factors that impinge on the stability of bacterial communities in the vagina may help in predicting the risk of diseases that affect women’s health. Here, we describe the temporal dynamics of the composition of vaginal bacterial communities in 32 reproductive age women over a 16-week period. The analysis revealed the dynamics of five major classes of bacterial communities and showed that some communities change markedly over short time periods, whereas others are relatively stable. Modeling community stability using new quantitative measures indicates that deviation from stability correlates with time in the menstrual cycle, bacterial community composition and sexual activity. The women studied are healthy, thus it appears that neither variation in community composition per se, nor higher levels of observed diversity (co-dominance) are necessarily indicative of dysbiosis, in which there is microbial imbalance accompanied by symptoms.

Gajer, Pawel; Brotman, Rebecca M.; Bai, Guoyun; Sakamoto, Joyce; Schutte, Ursel M.E.; Zhong, Xue; Koenig, Sara S.K.; Fu, Li; Ma, Zhanshan; Zhou, Xia; Abdo, Zaid; Forney, Larry J.; Ravel, Jacques

2012-01-01

151

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.

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

2013-01-01

152

Nickerson's Medium in the Diagnosis of Vaginal Moniliasis  

PubMed Central

One thousand one hundred and ninety-four cultures for vaginal moniliasis were performed on 1034 patients, using Nickerson's medium, to confirm the simplicity of the procedure and to demonstrate the inaccuracy of clinical impressions when compared to culture results. The error in the diagnosis of vaginal moniliasis on clinical impression and the wet-smear technique was as great as 60% when compared to the results of culture. The method employing this medium is easily adapted to routine office use, and offers an accurate and convenient means of diagnosis. The overall incidence of vaginal moniliasis in the variety of clinical groups studied was 21.3%.

O'Brien, J. R.

1964-01-01

153

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective  

PubMed Central

Vaginal bacterial communities are thought to help prevent sexually transmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid–producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexually transmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states.

Brotman, Rebecca M.

2011-01-01

154

Therapeutic Mechanisms of Treatment in Cervical and Vaginal Cancer  

PubMed Central

Cervical and vaginal cancers remain serious health problems. Worldwide, more than 530,000 women annually are diagnosed with these diseases, with most new incident cases occurring in nations with limited health resources and underdeveloped screening programs. For women whose disease is too bulky or widespread for surgery, radiochemotherapy should be looked upon as the standard of care. Randomized clinical trials have indicated that radiochemotherapy strategies that disrupt the repair of damaged DNA are key to the management of advanced stage cervical and vaginal cancers. Here, from a viewpoint of cancer cell molecular biology, treatments for advanced stage cervical and vaginal cancers are discussed.

Kunos, Charles A

2012-01-01

155

Intravaginal and Intranasal Immunizations Are Equally Effective in Inducing Vaginal Antibodies and Conferring Protection against Vaginal Candidiasis  

PubMed Central

Oophorectomized, estrogen-treated rats were immunized by the intravaginal or intranasal route with a mannoprotein extract (MP) or secreted aspartyl proteinases (Sap) of Candida albicans, with or without cholera toxin as a mucosal adjuvant. Both routes of immunization were equally effective in (i) inducing anti-MP and anti-Sap vaginal antibodies and (ii) conferring a high degree of protection against the vaginal infection by the fungus. These data suggest that appropriate fungal antigens and adjuvant can be used to protect against candidal vaginitis, by either route.

De Bernardis, Flavia; Boccanera, Maria; Adriani, Daniela; Girolamo, Antonietta; Cassone, Antonio

2002-01-01

156

Intravaginal and intranasal immunizations are equally effective in inducing vaginal antibodies and conferring protection against vaginal candidiasis.  

PubMed

Oophorectomized, estrogen-treated rats were immunized by the intravaginal or intranasal route with a mannoprotein extract (MP) or secreted aspartyl proteinases (Sap) of Candida albicans, with or without cholera toxin as a mucosal adjuvant. Both routes of immunization were equally effective in (i) inducing anti-MP and anti-Sap vaginal antibodies and (ii) conferring a high degree of protection against the vaginal infection by the fungus. These data suggest that appropriate fungal antigens and adjuvant can be used to protect against candidal vaginitis, by either route. PMID:11953420

De Bernardis, Flavia; Boccanera, Maria; Adriani, Daniela; Girolamo, Antonietta; Cassone, Antonio

2002-05-01

157

A rare case of vaginal vault evisceration and its management  

PubMed Central

A 66 year old woman presented to A&E with per vagina bleeding and a mass protruding from the vagina. The patient was examined under anaesthesia, which revealed vaginal prolapse with evisceration of approximately 20-30 cm of bowel. The patient had received an abdominal hysterectomy 30 years ago for menorrhagia. In the last decade, the patient had experienced other recurrent episodes of prolapse (cystocoele and retrocoele). Vaginal vault evisceration is a recognised rare complication of hysterectomy and is a gynaecological emergency. This patient’s condition was rapidly recognised and surgically managed. The repair was achieved in two surgeries. Initially, the small bowel was re-inserted into the peritoneal cavity through the vaginal wall defect and the vaginal defect repaired. After sufficient time for healing, a sacrocolpopexy was performed to repair the prolapse.

Pereira, FD Alves; Rai, H

2012-01-01

158

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.

Dan, Michael

1996-01-01

159

Moniliasis--The Use of Candicidin Vaginal Ointment for Treatment  

PubMed Central

Candicidin vaginal ointment, 0.14 mg per gm of petrolatum base, was used in the treatment of 25 patients with monilial vaginitis. Ten of these patients were pregnant. All 15 of the non-gravid patients were cured, as proved by repeated cultures, after a maximum of three weeks of therapy. Eight of the 10 gravid patients were cured. Of the two patients with resistant cases, one had severe diabetes and the other had endocervicitis. Of 50 patients treated by insertion of Candeptin vaginal tablets, 42 became free of vaginal moniliasis after one or two 14-day courses of home treatment. All 42 remained free of infection for one month following treatment, as proven by culture. There were no instances of sensitivity to the preparation.

Roberts, Chester L.; Sullivan, John J.

1965-01-01

160

Gynecologic bleeding revealing vaginal metastasis of renal cell carcinoma  

PubMed Central

Vaginal metastases of renal cell carcinoma have been rarely described. We report a case of a 75-year old woman, who underwent radical right nephrectomy for a renal cell carcinoma. Tumour was classified pT3bN0M0 and grade III of Furhmann grading. One year later, scanner discovered mediastinal and lombo-aortic lymph nodes. She received 2 months of immunotherapy associated with bevacizumab, but stopped because of intolerance. She was readmitted in our institute for vaginal bleeding. Clinical investigations showed a vaginal mass and biopsy revealed a renal cell carcinoma metastasis. This case suggests that retrograde venous dissemination may be at the origin of vaginal metastasis of renal cell carcinoma and emphasized the preventive value of early ligature of renal vein.

Benbrahim, Zineb; Chouaib, Ali; Mazeron, Renaud; Leger-Ravet, Marie Benedicte; Lefort, Catherine; Lhomme, Catherine; El Mesbahi, Omar; Escudier, Bernard

2013-01-01

161

Vaginal pH: Home-Use Tests  

MedlinePLUS

... type of test is this? This is a quantitative test -- you find out how acidic your vaginal ... Government For Press Combination Products Advisory Committees Science & Research Regulatory Information Safety Emergency Preparedness International Programs News & ...

162

Vaginal and Cervical Cytology of the Early Puerperium.  

National Technical Information Service (NTIS)

Cervical and vaginal smears were obtained from 160 women who had delivered one to eight days prior to cytologic examination. Preparations were examined for general morphology and graded for malignancy. The degree of cytologic abnormality was found to corr...

H. B. Soloway

1969-01-01

163

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

164

Optimized dose distribution of Gammamed plus vaginal cylinders.  

PubMed

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. PMID:19181251

Supe, Sanjay S; Bijina, T K; Varatharaj, C; Shwetha, B; Arunkumar, T; Sathiyan, S; Ganesh, K M; Ravikumar, M

2007-10-02

165

Female sexual dysfunction following vaginal surgery: Myth or reality?  

Microsoft Academic Search

This article reviews the mechanisms by which vaginal surgery affects female sexual function and related pathophysiology to\\u000a potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed\\u000a as they apply to vaginal surgery. Methods to avoid neurovascular damage during pelvic floor surgery have been corroborated\\u000a by supporting literature. The incidence of female sexual

Hari S. G. R. Tunuguntla; Angelo E. Gousse

2004-01-01

166

RASTREAMENTO DE CANDIDOSE VAGINAL DURANTE A PREVENÇÃO DO CÂNCER CÉRVICO-UTERINO SCREENING OF VAGINAL CANDIDOSIS DURING THE PREVENTION OF UTERINE CERVIX CANCER  

Microsoft Academic Search

Introduction: vaginal candidosis is one of the most prevalent infection of the lower genital tract around the world. Lately a huge increase in inciden- ce accounted for ranking this disease as the second more frequent vaginal infection in Brazil. These reasons led some authors to indicate the scree- ning of vaginal discharge in gynecology clinics. Objective: the aim of this

Vânia LN Cavalcante; Aldine T Miranda; Glenda MP Portugal

167

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

PubMed Central

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 differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62+ CD4+ subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62+ CD4? VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4+ and CD4? VDC subsets at 2 and 6 weeks after Candida infection. CD5? CD4? CD86? CD80? CD134L+ VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62+ VDCs from infected rats primed naïve CD4+ T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62+ VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62+ VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester.

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

2006-01-01

168

Phenotypic and functional characterization of vaginal dendritic cells in a rat model of Candida albicans vaginitis.  

PubMed

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 differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62(+) CD4(+) subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62(+) CD4(-) VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4(+) and CD4(-) VDC subsets at 2 and 6 weeks after Candida infection. CD5(-) CD4(-) CD86(-) CD80(-) CD134L(+) VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62(+) VDCs from infected rats primed naïve CD4(+) T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62(+) VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62(+) VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester. PMID:16790803

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

2006-07-01

169

Efficacy of Rifaximin Vaginal Tablets in Treatment of Bacterial Vaginosis: a Molecular Characterization of the Vaginal Microbiota  

PubMed Central

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV.

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo

2012-01-01

170

Efficacy of rifaximin vaginal tablets in treatment of bacterial vaginosis: a molecular characterization of the vaginal microbiota.  

PubMed

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV. PMID:22585228

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo; Vitali, Beatrice

2012-05-14

171

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

172

Species-level classification of the vaginal microbiome  

PubMed Central

Background The application of next-generation sequencing to the study of the vaginal microbiome is revealing the spectrum of microbial communities that inhabit the human vagina. High-resolution identification of bacterial taxa, minimally to the species level, is necessary to fully understand the association of the vaginal microbiome with bacterial vaginosis, sexually transmitted infections, pregnancy complications, menopause, and other physiological and infectious conditions. However, most current taxonomic assignment strategies based on metagenomic 16S rDNA sequence analysis provide at best a genus-level resolution. While surveys of 16S rRNA gene sequences are common in microbiome studies, few well-curated, body-site-specific reference databases of 16S rRNA gene sequences are available, and no such resource is available for vaginal microbiome studies. Results We constructed the Vaginal 16S rDNA Reference Database, a comprehensive and non-redundant database of 16S rDNA reference sequences for bacterial taxa likely to be associated with vaginal health, and we developed STIRRUPS, a new method that employs the USEARCH algorithm with a curated reference database for rapid species-level classification of 16S rDNA partial sequences. The method was applied to two datasets of V1-V3 16S rDNA reads: one generated from a mock community containing DNA from six bacterial strains associated with vaginal health, and a second generated from over 1,000 mid-vaginal samples collected as part of the Vaginal Human Microbiome Project at Virginia Commonwealth University. In both datasets, STIRRUPS, used in conjunction with the Vaginal 16S rDNA Reference Database, classified more than 95% of processed reads to a species-level taxon using a 97% global identity threshold for assignment. Conclusions This database and method provide accurate species-level classifications of metagenomic 16S rDNA sequence reads that will be useful for analysis and comparison of microbiome profiles from vaginal samples. STIRRUPS can be used to classify 16S rDNA sequence reads from other ecological niches if an appropriate reference database of 16S rDNA sequences is available.

2012-01-01

173

Acid Production by Vaginal Flora In Vitro Is Consistent with the Rate and Extent of Vaginal Acidification  

PubMed Central

Perinatally, and between menarche and menopause, increased levels of estrogen cause large amounts of glycogen to be deposited in the vaginal epithelium. During these times, the anaerobic metabolism of the glycogen, by the epithelial cells themselves and/or by vaginal flora, causes the vagina to become acidic (pH ?4). This study was designed to test whether the characteristics of acid production by vaginal flora in vitro can account for vaginal acidity. Eight vaginal Lactobacillus isolates from four species—L. gasseri, L. vaginalis, L. crispatus, and L. jensenii—acidified their growth medium to an asymptotic pH (3.2 to 4.8) that matches the range seen in the Lactobacillus-dominated human vagina (pH 3.6 to 4.5 in most women) (B. Andersch, L. Forssman, K. Lincoln, and P. Torstensson, Gynecol. Obstet. Investig. 21:19–25, 1986; L. Cohen, Br. J. Vener. Dis. 45:241–246, 1969; J. Paavonen, Scand. J. Infect. Dis. Suppl. 40:31–35, 1983; C. Tevi-Bénissan, L. Bélec, M. Lévy, V. Schneider-Fauveau, A. Si Mohamed, M.-C. Hallouin, M. Matta, and G. Grésenguet, Clin. Diagn. Lab. Immunol. 4:367–374, 1997). During exponential growth, all of these Lactobacillus species acidified their growth medium at rates on the order of 106 protons/bacterium/s. Such rates, combined with an estimate of the total number of lactobacilli in the vagina, suggest that vaginal lactobacilli could reacidify the vagina at the rate observed postcoitally following neutralization by the male ejaculate (W. H. Masters and V. E. Johnson, Human sexual response, p. 93, 1966). During bacterial vaginosis (BV), there is a loss of vaginal acidity, and the vaginal pH rises to >4.5. This correlates with a loss of lactobacilli and an overgrowth of diverse bacteria. Three BV-associated bacteria, Gardnerella vaginalis, Prevotella bivia, and Peptostreptococcus anaerobius, acidified their growth medium to an asymptotic pH (4.7 to 6.0) consistent with the characteristic elevated vaginal pH associated with BV. Together, these observations are consistent with vaginal flora, rather than epithelial cells, playing a primary role in creating the acidity of the vagina.

Boskey, E. R.; Telsch, K. M.; Whaley, K. J.; Moench, T. R.; Cone, R. A.

1999-01-01

174

Leukocyte Esterase Activity in Vaginal Fluid of Pregnant and Non-Pregnant Women With Vaginitis/Vaginosis and in Controls  

PubMed Central

Objectives: To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy.The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes. Methods: One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the condition during the previous year and who had consulted with an assumed new attack of the condition, were studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73 pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of the women was measured. Results: In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those with RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the second trimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested, the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation to LE activity in any of the groups studied. Conclusions: The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVCand BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation as evidenced by a positive LE test and inflammatory cells in genital smears.

Novikova, Natalia; Niklasson, Ola; Bekassy, Zoltan; Skude, Lennart

2003-01-01

175

Current status of contraceptive vaginal rings.  

PubMed

Contraceptive vaginal rings (CVR) offer a new, effective contraceptive option, expanding the available choices of hormonal contraception. Various ring prototypes have been evaluated: progestin-only rings and combined progestin-estrogen rings, as well as different combination of progestins and estrogens. The progestin-only ring is intended for continuous use, whereas the combined ring has been designed for cyclic 3-week in/1-week out use, although several studies have explored alternative schemes of extended use. However, only two ring designs have reached the market: NuvaRing, a 1-month combined ring that releases etonogestrel and ethinylestradiol, and Progering, a 3-month progesterone-releasing ring for use in lactating women. A one year Nestorone/ethinyl estradiol CVR is approaching the final stages of development, as the Population Council is preparing to submit a new drug application to the Food and Drug Administration. The main advantages of CVRs are their effectiveness (similar or slightly better than the pill), ease of use without the need of remembering a daily routine, user ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring, in comparison with oral contraceptives. Current prototypes in development include rings releasing progesterone receptor modulators, which would provide estrogen-free contraception, as well as combined rings releasing estradiol, instead of ethinyl-estradiol, providing a safer profile. Furthermore, intensive efforts towards developing dual protection rings, providing both contraception and protection against reproductive tract infections, offer hope that this greatly needed technology will soon undergo clinical testing and will be in the hands of women worldwide in the near future. PMID:23040125

Brache, Vivian; Payán, Luis José; Faundes, Aníbal

2012-10-04

176

Vaginal microbiota of women with frequent vulvovaginal candidiasis.  

PubMed

Vulvovaginal candidiasis (VVC) is an insidious infection that afflicts a large proportion of women of all ages, and 5 to 8% of affected women experience recurrent VVC (RVVC). The aim of this study was to explore the possible importance of vaginal bacterial communities in reducing the risk of RVVC. The species composition and diversity of microbial communities were evaluated for 42 women with and without frequent VVC based on profiles of terminal restriction fragment polymorphisms of 16S rRNA genes and phylogenetic analysis of cloned 16S rRNA gene sequences from the numerically dominant microbial populations. The data showed that there were no significant differences between the vaginal microbial communities of women in the two groups (likelihood score, 5.948; bootstrap P value, 0.26). Moreover, no novel bacteria were found in the communities of women with frequent VVC. The vaginal communities of most women in both groups (38/42; 90%) were dominated by species of Lactobacillus. The results of this study failed to provide evidence for the existence of altered or unusual vaginal bacterial communities in women who have frequent VVC compared to women who do not have frequent VVC. The findings suggest that commensal vaginal bacterial species may not be able to prevent VVC. PMID:19528218

Zhou, Xia; Westman, Rachel; Hickey, Roxana; Hansmann, Melanie A; Kennedy, Colleen; Osborn, Thomas W; Forney, Larry J

2009-06-15

177

Local treatment of colpitis with Betadine vaginal suppository.  

PubMed

Observations made with Betadine vaginal suppository in the treatment of 60 women suffering from colpitis have been discussed. The results of microbiological examinations of vaginal discharge sampled before 1 week and 4 weeks after the onset of therapy were compared. The effectiveness, tolerance of therapy, and the subjective opinion of the treated women were analysed. According to the results of the examinations in response to Betadine vaginal suppository the positivity of vaginal discharge for Candida decreased from 16 to 3 cases, for Trichomonas from 8 to 1 case, for aerobic bacteria from 16 to 7 cases, and the occurrence of mixed infections from 20 to 2 cases. Subjective complaints, burning, stinging sensation were rapidly moderated. In 52 of the 60 women discharge ceased, in another 4 cases it significantly decreased. In 51 cases burning sensation in the vagina ceased, and in 5 women it significantly decreased. Recurrence was not observed when a control examination was done after 1 month. The women tolerated Betadine vaginal suppository well and found it effective and easily applicable. At the beginning of treatment burning sensation was aggravated in 3 cases. These patients refused to further participate in the examination and received systemic treatment. Due to its broad bactericidal, fungicidal, protozoicide action and its good tolerability Betadine suppository was found to be useful for the local treatment of colpitis. PMID:8029781

Resch, B A; Szántó, F

1993-01-01

178

Large Vesico-Vaginal Fistula Caused by a Foreign Body  

PubMed Central

Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

Massinde, AN; Kihunrwa, A

2013-01-01

179

A functional ectopic vaginal anus: a rare clinical entity.  

PubMed

A case of functional ectopic vaginal anus is presented in a 20 years old girl. Patient complained of passage of stool through her vagina. She was continent and had no complaint of constipation. Her examination revealed imperforated anus with functional ectopic vaginal anus. Her surgery was performed in two stages. In first stage, anoplasty was performed at midpoint between the vulval and anal opening. The posterior vaginal wall was repaired in two layers and protective loop colostomy was made. In the second stage, after a period of 3 months loop colostomy was closed. Patient's recovery was smooth, she is not constipated and continent with Wexner score of 3. She was advised pelvic floor rehabilitation exercises.She improved within a month with Wexner score of zero. PMID:23058153

Mehboob, Mukhtar; Naz, Samina; Tabassum, Shahina; Khan, Jamil Ahmed

2012-10-01

180

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.

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

2013-01-01

181

Analysis of vaginal lactic acid producing bacteria in healthy women.  

PubMed

Vaginal lactic acid-producing bacteria of 80 pre-menopausal women were studied by isolation on Blood and DeMan-Rogosa-Sharpe agar, PCR with group-specific primers for Lactobacillus-denaturing gradient gel electrophoresis (DGGE), and PCR with specific primers for V3 region in 16S rRNA-temporal temperature gel electrophoresis (TTGE). Conventional isolation method on media detected only one lactobacillus (Lactobacillus brevis) while TTGE detected only Lactobacillus sp. DGGE detected seven Lactobacillus species; L. coleohominis, L. crispatus, L. iners, L. reuteri, L. rhamnosus, L. vaginalis, and Leuconostoc lactis. L. acidophilus and L. gasseri, which are prevalent in Western women, were not detected in Korean women. Furthermore, L. rhamnosus, Leuc. lactis, L. coleohominis, and Weissella cibaria, which were not previously reported in the vaginal microbiota of Korean women, were detected. The five most prevalent LABs in vaginal microbiota in Korean women were L. iners, Enterococcus faecalis, L. crispatus, Leuc. lactis, and W. cibaria. PMID:18176534

Nam, Hyeran; Whang, Kyunghee; Lee, Yeonhee

2007-12-01

182

Vaginal Birth After Cesarean Delivery: Deciding on a Trial of Labor After a Cesarean Delivery (TOLAC)  

MedlinePLUS

What is a vaginal birth after cesarean delivery (VBAC)? If you have had a previous cesarean delivery , you have two choices ... vaginal birth after cesarean delivery (VBAC). What is a trial of labor after cesarean delivery (TOLAC)? A ...

183

The Neurobiology of Sexual Solicitation: Vaginal Marking in Female Syrian Hamsters ( Mesocricetus auratus )  

Microsoft Academic Search

Vaginal marking is a reproductively-oriented scent marking response, in which female Syrian hamsters deposit vaginal secretions\\u000a in response to odor cues from male conspecifics. Converging lines of evidence suggest that vaginal marking functions as a\\u000a solicitational signal, or an advertisement of a female’s impending sexual receptivity. Although vaginal marking is commonly\\u000a used as an assay of proceptivity, the neural control

Laura Been; Aras Petrulis

184

Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora  

PubMed Central

A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

Vallone, Cristina; Rigon, Giuliano; Lucantoni, Valeria; Putignani, Lorenza; Signore, Fabrizio

2012-01-01

185

Uterine arteriovenous malformation with sudden heavy vaginal hemmorhage.  

PubMed

Dysfunctional uterine bleeding (DUB) is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM) is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility. PMID:24106528

Selby, Sarah T; Haughey, Marianne

2013-09-01

186

[Paralysis of the femoral nerve after abdominal and vaginal surgery].  

PubMed

Damages of the femoral nerve during gynaecological operations are more frequent than generally supposed. They are observed after abdominal and vaginal operations caused by pressure on the nerve. During abdominal procedures an unsuitable self-retaining retractor is due to the paralysis. If the legs of the patients are deposited on the shoulder-back-parties of the assistants during vaginal procedures there is the danger of pressing the femoral nerve against the inguinal ligament by strong bending and abduction of the thighs. We report about 3 cases of paralysis of this nerve; recommendations for avoidance are given. PMID:919868

Lau, H U

1977-01-01

187

Vaginal douching and adverse health effects: a meta-analysis.  

PubMed Central

OBJECTIVES: The meta-analysis described here reviewed the current literature on adverse health effects of vaginal douching. METHODS: Papers published in English from 1965 through 1995 were potentially eligible. RESULTS: One third of White women and two thirds of Black women of reproductive age reported douching regularly. Analyses indicated that vaginal douching increases the overall risk of pelvic inflammatory disease by 73% and the risk of ectopic pregnancy by 76%. Frequent douching was shown to be highly associated with pelvic inflammatory disease and modestly associated with cervical cancer. CONCLUSIONS: Current literature suggests that frequent douching increases the risk of pelvic inflammatory disease, ectopic pregnancy, and, possibly, cervical cancer.

Zhang, J; Thomas, A G; Leybovich, E

1997-01-01

188

Uterine Arteriovenous Malformation with Sudden Heavy Vaginal Hemmorhage  

PubMed Central

Dysfunctional uterine bleeding (DUB) is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM) is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility.

Selby, Sarah T.; Haughey, Marianne

2013-01-01

189

The diagnosis of bacterial vaginosis and vaginal flora changes  

Microsoft Academic Search

In a population of 956 women, attending for contraceptive advice, 131 (13.7%) were found to have BV acording to Amsel’s criteria.\\u000a Clue cells were detected in 200 (20.9%) women, a positive amine (’sniff’) test in 191 (20.0%), a vaginal pH?4.7 in 243 (25.4%)\\u000a and a ”characteristic” vaginal discharge in 104 (10.9%) women. Sensitivity, specificity, positive and negative predictive\\u000a values in

D. Hellberg; S. Nilsson; P.-A. Mårdh

2001-01-01

190

Laser surgery in the treatment of vaginal cysts  

NASA Astrophysics Data System (ADS)

The authors described the results of treatment of vaginal cysts with CO2 laser under colposcopic control in 12 women. In five of them the recurrent Bartholin's, in another five the Gartner's and in tow the endometrial cysts were diagnosed. All laser surgeries were done in the Department of Reproduction, Institute of Gynecology, Karol Marcinkowski School of Medical Sciences, Poznan, Poland between September 1995 and September 1996. In the authors' opinion the use of CO2 laser is the efficient method of treatment of vaginal cysts. The most of laser procedures are doing as the one-day surgery. There are no serious postoperative complications after laser surgery.

Wozniak, Jakub; Dydowicz, Piotr; Opala, Tomasz; Pisarska-Krawczyk, Magdalena; Wilczak, Maciej; Pisarski, Tadeusz

1997-10-01

191

Vaginal hysterectomy for the woman with a moderately enlarged uterus weighing 200 to 700 grams  

Microsoft Academic Search

Objectives: The purpose of this study was to compare the surgical outcomes of women with moderately enlarged uteri undergoing vaginal hysterectomy with those of women with uteri of normal size undergoing vaginal hysterectomy. A secondary objective was to investigate the roles of uterine morcellation and laparoscopically assisted vaginal hysterectomy in the treatment of these women. Study Design: Thirty consecutive women

James B. Unger

1999-01-01

192

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

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Powered vaginal muscle stimulator for therapeutic use...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...884.5940 Powered vaginal muscle stimulator for therapeutic use...Identification. A powered vaginal muscle stimulator is an...

2010-04-01

193

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

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Powered vaginal muscle stimulator for therapeutic use...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...884.5940 Powered vaginal muscle stimulator for therapeutic use...Identification. A powered vaginal muscle stimulator is an...

2009-04-01

194

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

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Powered vaginal muscle stimulator for therapeutic use...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...884.5940 Powered vaginal muscle stimulator for therapeutic use...Identification. A powered vaginal muscle stimulator is an...

2013-04-01

195

Preliminary experience with a prospective protocol for planned vaginal delivery of triplet gestations  

Microsoft Academic Search

Objective: The objective of the study was to evaluate a protocol for vaginal delivery of triplet gestations. Study Design: All women with triplet gestations managed between January 1, 1995, and December 31, 1997, by University Medical Center’s perinatal practice were offered enrollment in our vaginal delivery protocol. Our protocol offered attempt of vaginal delivery if triplet A was in vertex

Vito Alamia; Anthony B. Royek; Ronald K. Jaekle; Bruce A. Meyer

1998-01-01

196

Symptomatic Vaginal Bleeding in a Postmenopausal Woman Revealing Colon Adenocarcinoma Metastasizing Exclusively to the Vagina  

Microsoft Academic Search

Vaginal carcinomas are rare entities, accounting for 2% of all malignant cancers of the female genital tract, and the vast majority are metastatic. Adenocarcinoma of the colon metastasizing to the vagina is extremely rare, only 5 cases have been reported. We present the case of a woman who experienced vaginal bleeding as an isolated symptom of vaginal metastasis of colorectal

Marcello Ceccaroni; Amelia Paglia; Giacomo Ruffo; Marco Scioscia; Francesco Bruni; Anna Pesci; Luca Minelli

2010-01-01

197

Molecular analysis of the vaginal response to estrogens in the ovariectomized rat and postmenopausal woman  

Microsoft Academic Search

BACKGROUND: Vaginal atrophy (VA) is the thinning of the vaginal epithelial lining, typically the result of lowered estrogen levels during menopause. Some of the consequences of VA include increased susceptibility to bacterial infection, pain during sexual intercourse, and vaginal burning or itching. Although estrogen treatment is highly effective, alternative therapies are also desired for women who are not candidates for

Scott A Jelinsky; Sung E Choe; Judy S Crabtree; Monette M Cotreau; Ewa Wilson; Kathryn Saraf; Andrew J Dorner; Eugene L Brown; Bryan J Peano; Xiaochun Zhang; Richard C Winneker; Heather A Harris

2008-01-01

198

Randomized controlled trial of a prenatal vaginal birth after cesarean section education and support program  

Microsoft Academic Search

OBJECTIVE: Our objective was to assess whether, for women with previous cesarean section, a prenatal education and support program promoting vaginal birth after cesarean delivery increases the probability of vaginal delivery.STUDY DESIGN: Women with a single previous cesarean were recruited before 28 weeks' gestation. Women's self-assessed motivation to attempt vaginal birth after a previous cesarean delivery was measured on a

William Fraser; Elizabeth Maunsell; Ellen Hodnett; Jean-Marie Moutquin

1997-01-01

199

Uncommon complications of sacrospinous fixation for treatment of vaginal vault prolapse  

Microsoft Academic Search

Objective: The present study was undertaken to evaluate uncommon complications following trans- vaginal sacrospinous colpopexy for treatment of vaginal vault prolapse. Case reports: A series of three patients who developed uncommon complications following sacrospinous fixation are reported. A 64-year-old patient undergoing bilateral sacrospinous colpopexy for the treatment of an ICS stage III vaginal vault prolapse developed a perineal necrotizing infection.

Agnaldo L. Silva-Filho; Admário S. Santos-Filho; Octacílio Figueiredo-Netto; Sérgio A. Triginelli

2005-01-01

200

Vaginal Microbiome and Epithelial Gene Array in PostMenopausal Women with Moderate to Severe Dryness  

Microsoft Academic Search

After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding

Ruben Hummelen; Jean M. Macklaim; Jordan E. Bisanz; Jo-Anne Hammond; Amy McMillan; Rebecca Vongsa; David Koenig; Gregory B. Gloor; Gregor Reid

2011-01-01

201

Innervation of the Human Vaginal Mucosa as Revealed by PGP 9.5 Immunohistochemistry  

Microsoft Academic Search

In order to obtain a description of the innervation of the vaginal wall we employed an antiserum against the general neuronal marker, protein gene product 9.5, on normal human vaginal mucosa. Specimens were taken from the anterior and posterior fornices, from the anterior vaginal wall at the bladder neck level and from the introitus vaginae region, and then processed for

M. Hilliges; C. Falconer; G. Ekman-Ordeberg; O. Johansson

1995-01-01

202

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

203

Burkholderia cenocepacia Vaginal Infection in Patient with Smoldering Myeloma and Chronic Hepatitis C  

PubMed Central

We report a case of a vaginal infection caused by a strain of Burkholderia cenocepacia. The strain was isolated from vaginal swab specimens from a 68-year-old woman with smoldering myeloma and chronic hepatitis C virus infection who was hospitalized for abdominal abscess. Treatment with piperacillin/tazobactam eliminated B. cenocepacia infection and vaginal symptoms.

Petrucca, Andrea; Cipriani, Paola; Sessa, Rosa; Teggi, Antonella; Pustorino, Rosalia; Santapaola, Daniela

2004-01-01

204

Superiority of newly developed vaginal suppositories over vaginal use of commercial bromocriptine tablets: a randomized controlled clinical trial.  

PubMed

The objective of this study is to verify the safety and efficacy of new vaginal bioadhesive suppositories as compared with vaginal use of commercial bromocriptine tablets in hyperprolactinemic patients. This study is a randomized, double-blind, active comparator clinical trial in which a subset of patients had some pharmacokinetic measurements. The setting was an outpatient private infertility clinic in a developing country, and the subjects were 171 patients with hyperprolactinemia. A pilot phase comprised 32 patients who were divided into 2 groups. Group A comprised 16 patients who used vaginal suppositories containing 2.5 mg bromocriptine mesthylate with pluronics and bioadhesive agents once daily for 1 month, while group B included 16 patients who used commercial 2.5-mg bromocriptine mesthylate tablets inserted vaginally once daily for 1 month. The clinical phase comprised 139 patients who were again divided into 2 groups in the same way (group A, 68 patients; group B, 71 patients). Serum prolactin (SP) was measured before and after therapy in all cases. The main outcome measure was the decline of SP level after 1 month of therapy. In both groups, there was a significant decline of the SP. However, it was more significant in group A. Patient convenience was more evident, and local side effects were less in group A than group B in the clinical phase. The introduction of bioadhesive technology for bromocriptine mesylate/pluronic F-126 administration is valuable in achieving prominent serum prolactin reduction in hyperprolactinemic patients in a relatively short duration of therapy. The formulated vaginal suppositories expressed better convenience with minimal local side effects when compared with vaginally administered commercial bromocriptine tablets. PMID:17636242

Darwish, Atef M; Farah, Emad; Gadallah, Wafaa A; Mohammad, Ibraheem I

2007-04-01

205

Establishing and Sustaining a Healthy Vaginal Environment: Analysis of Data From a Randomized Trial of Periodic Presumptive Treatment for Vaginal Infections  

PubMed Central

Data from a randomized trial of oral periodic presumptive treatment (PPT) to reduce vaginal infections were analyzed to assess the effect of the intervention on a healthy vaginal environment (normal flora confirmed by Gram stain with no candidiasis or trichomoniasis). The incidence of a healthy vaginal environment was 608 cases per 100 person-years in the intervention arm and 454 cases per 100 person-years in the placebo arm (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.17–1.58). Sustained vaginal health (healthy vaginal environment for ?3 consecutive visits) was also more frequent in the intervention arm (HR, 1.69; 95% CI, 1.23–2.33). PPT is effective at establishing and sustaining a healthy vaginal environment.

Richardson, Barbra A.; Mandaliya, Kishorchandra; Kiarie, James; Jaoko, Walter; Ndinya-Achola, Jeckoniah O.; Marrazzo, Jeanne; Farquhar, Carey; McClelland, R. Scott

2011-01-01

206

Alexithymia Is Inversely Associated with Women's Frequency of Vaginal Intercourse  

Microsoft Academic Search

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

Stuart Brody

2003-01-01

207

Anorectal symptoms after various modes of vaginal delivery  

Microsoft Academic Search

The aim of this study was to determine the prevalence of, and the changes in, anorectal symptoms following different modes of vaginal delivery in primiparous women. Six hundred and seventeen questionnaires were distributed to primiparous women 3–4 years after delivery. The questionnaires were designed to obtain information regarding the development of anorectal symptoms, including the type of symptoms experienced, their

S. E. Schraffordt Koops; H. A. M. Vervest; H. J. M. Oostvogel

2003-01-01

208

Vaginal allergic response in women with vulvovaginal candidiasis  

Microsoft Academic Search

Objective: To determine the concentration of certain cytokines and immunoglobulin (Ig) E in the vaginal lavage fluid (VLF) of women with vulvovaginal candidiasis (VVC). Method: Cytokin and IgE concentrations were measured in the VLF of women with VVC; women free of any genital infections acted as controls. Result: The VLF concentrations of interleukin (IL)-2, IL-8, and interferon (INF)-? were higher

S. R. Fan; Q. P. Liao; X. P. Liu; Z. H. Liu; D. Zhang

2008-01-01

209

Candida albicans forms biofilms on the vaginal mucosa  

PubMed Central

Current understanding of resistance and susceptibility to vulvovaginal candidiasis challenges existing paradigms of host defence against fungal infection. While abiotic biofilm formation has a clearly established role during systemic Candida infections, it is not known whether C. albicans forms biofilms on the vaginal mucosa and the possible role of biofilms in disease. In vivo and ex vivo murine vaginitis models were employed to examine biofilm formation by scanning electron and confocal microscopy. C. albicans strains included 3153A (lab strain), DAY185 (parental control strain), and mutants defective in morphogenesis and/or biofilm formation in vitro (efg1/efg1 and bcr1/bcr1). Both 3153A and DAY815 formed biofilms on the vaginal mucosa in vivo and ex vivo as indicated by high fungal burden and microscopic analysis demonstrating typical biofilm architecture and presence of extracellular matrix (ECM) co-localized with the presence of fungi. In contrast, efg1/efg1 and bcr1/bcr1 mutant strains exhibited weak or no biofilm formation/ECM production in both models compared to wild-type strains and complemented mutants despite comparable colonization levels. These data show for the first time that C. albicans forms biofilms in vivo on vaginal epithelium, and that in vivo biotic biofilm formation requires regulators of biofilm formation (BCR1) and morphogenesis (EFG1).

Harriott, M. M.; Lilly, E. A.; Rodriguez, T. E.; Fidel, P. L.; Noverr, M. C.

2010-01-01

210

Effects of Ovarian Steroids on Vaginal Smears in the Rat  

Microsoft Academic Search

A correspondence between the appearance of vaginal smears and the layers of the epithelium from which the cells had desquamated was established in untreated rats during the estrous cycle, in control ovariectomized rats and in spayed rats injected with either estrogen or progesterone. The technique for preparing and staining the smears (modified Shorr’s staining procedure) is outlined. A simplified.system of

G. S. Monies; E. H. Luque

1988-01-01

211

Efficacy dilution in randomized placebo-controlled vaginal microbicide trials  

Microsoft Academic Search

BACKGROUND: To date different vaginal gel microbicides have been evaluated in phase 2b\\/3 trials, but none have demonstrated effectiveness for preventing HIV infection. Failure to demonstrate effectiveness however does not necessarily indicate that a product is truly inefficacious, as several sources of efficacy dilution may compromise our ability to identify products that may have been truly efficacious. METHODS: For four

Benoît R Mâsse; Marie-Claude Boily; Dobromir Dimitrov; Kamal Desai

2009-01-01

212

Voluntary vaginal musculature contractions as an enhancer of sexual arousal  

Microsoft Academic Search

In a study of the effects of vaginal musculature contractions (Kegel's exercises) on both subjective and physiological measures of sexual arousal, 30 normal females were randomly assigned to one of three groups. The first group was informed about these exercises and was asked to practice them both during lab sessions and during the week intervening between sessions. The second group

Madelyn Renée Messé; James H. Geer

1985-01-01

213

Vaginal-Assisted Laparoscopic Radical Hysterectomy: Rationale, Technique, Results  

PubMed Central

Objective: Total laparoscopic radical hysterectomy (TLRH) makes it difficult to resect adequate vaginal cuff according to tumor size and to avoid tumor spread after opening the vagina. Laparoscopic-assisted radical vaginal hysterectomy (LARVH) is associated with higher risk for urologic complications. Methods: The vaginal-assisted laparoscopic radical hysterectomy (VALRH) technique comprises 3 steps: (1) comprehensive laparoscopic staging, (2) creation of a tumor-adapted vaginal cuff, and (3) laparoscopic transsection of parametria. We retrospectively analyzed data of 122 patients who underwent VALRH for early stage cervical cancer (n=110) or stage II endometrial cancer (n=12) between January 2007 and December 2009 at Charité University Berlin. Results: All patients underwent VALRH without conversion. Mean operating time was 300 minutes, and mean blood loss was 123cc. On average, 36 lymph nodes were harvested. Intra- and postoperative complication rates were 0% and 13.1%, respectively. Resection was in sound margins in all patients. After median follow-up of 19 months, disease-free survival and overall survival for all 110 cervical cancer patients was 94% and 98%, and for the subgroup of patients (n=90) with tumors ?pT1b1 N0 V0 L0/1 R0, 97% and 98%, respectively. Conclusion: VALRH is a valid alternative to abdominal radical hysterectomy and LARVH in patients with early-stage cervical cancer and endometrial cancer stage II with minimal intraoperative complications and identical oncologic outcomes.

Gottschalk, Elisabeth; Lanowska, Malgorzata; Chiantera, Vito; Marnitz, Simone; Schneider, Achim; Brink-Spalink, Verena; Hasenbein, Kati

2011-01-01

214

Cervical and Vaginal Cancer Screening (Pap Test and Pelvic Exam)  

MedlinePLUS

... service covered? Search Medicare.gov for covered items Cervical & vaginal cancer screenings How often is it covered? Medicare Part ... doctor accepts assignment . Related resources National Cancer Institute—cervical cancer information CDC—cervical cancer information U.S. Preventive Services ...

215

Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies  

PubMed Central

Background and Objectives: To estimate the incidence of operative complications and compare operative cost and overall cost of different methods of benign hysterectomy including abdominal, vaginal, laparoscopic, and robotic techniques. Methods: We performed a retrospective cohort analysis (Canadian Task Force classification II-2) of all patients who underwent a hysterectomy for benign reasons in 2009 at a single urban academic tertiary care center using the ?2 test and Student t test. A multivariate regression analysis was also performed for predictors of costs. Cost data were gathered from the hospital's billing system; the remainder of data was extracted from patient's medical records. Results: In 2009, 688 patients underwent a benign hysterectomy; 185 (26.9%) hysterectomies were abdominal, 135 (19.6%) vaginal, 352 (51.5%) laparoscopic, and 14 (2.0%) robotic. The rate of intraoperative complication was 1.7% for abdominal, 0.8% for vaginal, 0.3% for laparoscopic, and 0 for robotic. Mean total patient costs were $43,622 for abdominal, $31,934 for vaginal, $38,312 for laparoscopic, and $49,526 for robotic hysterectomies. Costs were significantly influenced by method of hysterectomy, operative time, and length of stay. Conclusion: Though complication rates did not vary significantly among minimally invasive methods of hysterectomy, patient costs were significantly influenced by the method of hysterectomy.

Jonsdottir, Gudrun M.; Jorgensen, Selena; Shah, Neel; Einarsson, Jon I.

2012-01-01

216

Protection Against Vaginal SIV Transmission with Microencapsulated Vaccine  

Microsoft Academic Search

Although protection in animal models against intravenous challenges with simian immunodeficiency virus (SIV) has been reported, no previous vaccines have protected against a heterosexual route of infection. In this study, five of six macaques were protected against vaginal challenge when immunized with formalin-treated SIV in biodegradable microspheres by the intramuscular plus oral or plus intratracheal route. Oral immunization alone did

Preston A. Marx; Richard W. Compans; Agegnehu Gettie; Jay K. Staas; Richard M. Gilley; Mark J. Mulligan; Galina V. Yamshchikov; Dexiang Chen; John H. Eldridge

1993-01-01

217

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

218

Candida albicans forms biofilms on the vaginal mucosa.  

PubMed

Current understanding of resistance and susceptibility to vulvovaginal candidiasis challenges existing paradigms of host defence against fungal infection. While abiotic biofilm formation has a clearly established role during systemic Candida infections, it is not known whether C. albicans forms biofilms on the vaginal mucosa and the possible role of biofilms in disease. In vivo and ex vivo murine vaginitis models were employed to examine biofilm formation by scanning electron and confocal microscopy. C. albicans strains included 3153A (lab strain), DAY185 (parental control strain), and mutants defective in morphogenesis and/or biofilm formation in vitro (efg1/efg1 and bcr1/bcr1). Both 3153A and DAY815 formed biofilms on the vaginal mucosa in vivo and ex vivo as indicated by high fungal burden and microscopic analysis demonstrating typical biofilm architecture and presence of extracellular matrix (ECM) co-localized with the presence of fungi. In contrast, efg1/efg1 and bcr1/bcr1 mutant strains exhibited weak or no biofilm formation/ECM production in both models compared to wild-type strains and complemented mutants despite comparable colonization levels. These data show for the first time that C. albicans forms biofilms in vivo on vaginal epithelium, and that in vivo biotic biofilm formation requires regulators of biofilm formation (BCR1) and morphogenesis (EFG1). PMID:20705667

Harriott, M M; Lilly, E A; Rodriguez, T E; Fidel, P L; Noverr, M C

2010-08-12

219

Other Gynecologic Cancers: endometrial, ovarian, vulvar and vaginal cancers  

Microsoft Academic Search

HEALTH ISSUE: In Canada, cancers of the endometrium, ovaries, vulva, vagina, placenta and adnexa account for 11% of all malignant neoplasms in women and 81% of all genital cancers. Although the incidence and mortality from vulvar and vaginal cancers are very low, endometrium and ovarian cancer are important public health problems. KEY FINDINGS: In Canada, there has been no appreciable

Eliane Duarte-Franco; Eduardo L Franco

2004-01-01

220

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

221

[Clinical significance of betadine vaginal suppository treatment in pregnancy].  

PubMed

Clinical experience proved the efficacy of Betadine suppository in the treatment of bacterial vaginosis and mycotic infections of the vagina. Vaginal infections, frequently observed in pregnancy, can led to maternal and fetal complications, thus Betadine should be used both for prevention and therapy. One can ask if iodine absorbed from the vagina can influence the fetal thyroid function? 64 pregnant women received 7 day Betadine suppository (200 mg polyvidonum-iodine PVP) treatment for colpitis on 37-40 gestational week with excellent therapeutic result. TSH levels were measured by immunoassay in the serum of newborns 4-5 days after delivery, no signs of hypothyroidism were observed. Authors recommended 7 day Betadine vaginal suppository regimen for the prevention of intrauterine infections, treatment of mixed (bacterial, mycotical) vaginal infections, and restoration of the normal vaginal equilibrium of bacterias, since the risk of hypothyroidism is negligeable in mature newborns. In case of prematurity hypothyroidism is more frequently found also without iodine treatment therefore TSH level control is recommended in each case. PMID:9480620

Gimes, G; Péter, F

1997-11-01

222

21 CFR 884.5900 - Therapeutic vaginal douche apparatus.  

Code of Federal Regulations, 2013 CFR

...douche solutions. The apparatus is intended and labeled for use in the treatment of medical conditions except it is not for contraceptive use. After filling the therapeutic vaginal douche apparatus with a solution, the patient uses the device to direct a...

2013-04-01

223

Plasma prolactin concentrations after caesarean section or vaginal delivery  

Microsoft Academic Search

The umbilical venous plasma prolactin concentrations of three groups of term infants were compared immediately after birth. Samples were taken following seven vaginal deliveries, eight emergency caesarean sections performed during labour, and 12 elective caesarean sections before labour. Mean concentrations of prolactin were significantly lower in the elective caesarean section group compared with the labour groups. This result indicates that

Lindsay Heasman; John A D Spencer; Michael E Symonds

1997-01-01

224

Antifungal activity of lectins against yeast of vaginal secretion  

PubMed Central

Lectins are carbohydrate-binding proteins of non-imune origin. This group of proteins is distributed widely in nature and they have been found in viruses, microorganisms, plants and animals. Lectins of plants have been isolated and characterized according to their chemical, physical-chemical, structural and biological properties. Among their biological activities, we can stress its fungicidal action. It has been previously described the effect of the lectins Dviol, DRL, ConBr and LSL obtained from the seeds of leguminous plants on the growth of yeasts isolated from vaginal secretions. In the present work the experiments were carried out in microtiter plates and the results interpreted by both methods: visual observations and a microplate reader at 530nm. The lectin concentrations varied from 0.5 to 256?g/mL, and the inoculum was established between 65-70% of trammitance. All yeast samples isolated from vaginal secretion were evaluated taxonomically, where were observed macroscopic and microscopic characteristics to each species. The LSL lectin did not demonstrate any antifungal activity to any isolate studied. The other lectins DRL, ConBr and DvioL, showed antifungal potential against yeast isolated from vaginal secretion. These findings offering offer a promising field of investigation to develop new therapeutic strategies against vaginal yeast infections, collaborating to improve women's health.

Gomes, Bruno Severo; Siqueira, Ana Beatriz Sotero; de Cassia Carvalho Maia, Rita; Giampaoli, Viviana; Teixeira, Edson Holanda; Arruda, Francisco Vassiliepe Sousa; do Nascimento, Kyria Santiago; de Lima, Adriana Nunes; Souza-Motta, Cristina Maria; Cavada, Benildo Sousa; Porto, Ana Lucia Figueiredo

2012-01-01

225

New solid mucoadhesive systems for benzydamine vaginal administration  

Microsoft Academic Search

The aim of this work was the realization of new formulations for vaginal application to improve the pharmacological effect of benzydamine, displaying both anti-inflammatory and antiseptic activities. For this reasons, this drug was formulated in solid dispersions, by using the mucoadhesive polymers HPMC and\\/or Carbopol®, then compressed. Tablets were characterized by studies of friability, hardness, hydration, DSC, mucoadhesion and in

Luana Perioli; Valeria Ambrogi; Cinzia Pagano; Elena Massetti; Carlo Rossi

2011-01-01

226

Vaginal delivery and serum markers of ischemia\\/reperfusion injury  

Microsoft Academic Search

Objective: Vaginal deliveries have been associated with pelvic organ prolapse and incontinence. The objective was to show whether markers of ischemia\\/reperfusion injury are dependent upon the mode of delivery and length of labor. Method: Complete venipuncture sets were obtained on 62 subjects. All samples collected were analyzed for serum creatine phosphokinase (CPK) and lactate dehydrogenase (LDH). Lipid peroxidation was analyzed,

E. Conner; R. Margulies; Mengling Liu; S. W. Smilen; R. F. Porges; C. Kwon

2006-01-01

227

Identification and characterisation of vaginal lactobacilli from South African women  

PubMed Central

Background Bacterial vaginosis (BV), which is highly prevalent in the African population, is one of the most common vaginal syndromes affecting women in their reproductive age placing them at increased risk for sexually transmitted diseases including infection by human immunodeficiency virus-1. The vaginal microbiota of a healthy woman is often dominated by the species belonging to the genus Lactobacillus namely L. crispatus, L. gasseri, L. jensenii and L. iners, which have been extensively studied in European populations, albeit less so in South African women. In this study, we have therefore identified the vaginal Lactobacillus species in a group of 40 African women from Soweto, a township on the outskirts of Johannesburg, South Africa. Methods Identification was done by cultivating the lactobacilli on Rogosa agar, de Man-Rogosa-Sharpe (MRS) and Blood agar plates with 5% horse blood followed by sequencing of the 16S ribosomal DNA. BV was diagnosed on the basis of Nugent scores. Since some of the previous studies have shown that the lack of vaginal hydrogen peroxide (H2O2) producing lactobacilli is associated with bacterial vaginosis, the Lactobacillus isolates were also characterised for their production of H2O2. Results Cultivable Lactobacillus species were identified in 19 out of 21 women without BV, in three out of five women with intermediate microbiota and in eight out of 14 women with BV. We observed that L. crispatus, L. iners, L. jensenii, L. gasseri and L. vaginalis were the predominant species. The presence of L. crispatus was associated with normal vaginal microbiota (P = 0.024). High level of H2O2 producing lactobacilli were more often isolated from women with normal microbiota than from the women with BV, although not to a statistically significant degree (P = 0.064). Conclusion The vaginal Lactobacillus species isolated from the cohort of South African women are similar to those identified in European populations. In accordance with the other published studies, L. crispatus is related to a normal vaginal microbiota. Hydrogen peroxide production was not significantly associated to the BV status which could be attributed to the limited number of samples or to other antimicrobial factors that might be involved.

2013-01-01

228

Investigating the therapeutic effect of vaginal cream containing garlic and thyme compared to clotrimazole cream for the treatment of mycotic vaginitis  

PubMed Central

BACKGROUND: Vaginitis is the most prevalent gynecological problem for which women look for treatment and is responsible for 10 million physician visits annually. Use of herbal treatments has been recorded in many of patient groups as well as in general populations to increase health level. The present study was conducted with the purpose of determination and comparison of the effect of vaginal cream containing garlic and thyme compared to clotrimazole cream for the treatment of mycotic vaginitis. METHODS: This clinical trial is a prospective, multivariate, single-blind, two-stage, two-group study with randomized assignment of samples into the two groups. From the clinics in Isfahan in 2010, 64 cases (32 individuals in each group) entered the study. Data collection was accomplished by demographic information questionnaire and clinical performance checklist, and data analysis was performed by SPSS 16.0 software. RESULTS: Abundance distributions of clinical symptoms (vaginal discharge; vulval erythema and edema), patients’ complaints (secretions, itching, dyspareunia, painful urination, and vaginal irritation) and clinical symptoms (existence of germinating hypha, acidity under 4.5, and culture of vaginal secretions) were different in each group prior to and after the intervention; these factors however were not different between the two groups before and after the intervention. CONCLUSIONS: The vaginal cream containing garlic and thyme is effective as much as clotrimazole vaginal cream for the treatment of candida vaginitis and there is no difference between responses to treatment by these two drugs.

Bahadoran, Parvin; Rokni, Fatemeh Karimzadeh; Fahami, Fariba

2010-01-01

229

Application of the low-level laser therapy for the treatment of vaginitis  

NASA Astrophysics Data System (ADS)

Vaginitis is the most common female infectious disease. Females suffering from this disorder are annually increasing in number. There are a lot of modalities of treatment of vaginitis, but because of drug allergy and microbe's stability to drug the treatment of vaginitis is difficult. Our study compares the efficacy of laser-therapy with drug therapy in the treatment of non-specific vaginitis and vaginal candidiasis. Thirty women reci4eed the LLLT by local action with antiseptic liquid daily during ten days, 20 women received metronidazole and fluconozole and vaginal application of metronidazole. The results suggest that local laser-therapy is able to remove sights of vaginitis more efficiently and faster than drug therapy. Repair of normal vaginal microflora, which is the best indicator of recovery, was significantly at a faster rate in laser-therapy group. There were no report of adverse reaction with vaginal laser- therapy, whereas there were women on drug therapy who reported side effects. In conclusion, vaginal aser-therapy with antiseptic liquid is a suitable, effective, safe and chip alternative to drug therapy in the treatment of vaginitis.

Passeniouk, A. N.; Mikhailov, V. A.

2000-06-01

230

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

231

Nasal and Vaginal Vaccinations Have Differential Effects on Antibody Responses in Vaginal and Cervical Secretions in Humans  

Microsoft Academic Search

Sexually transmitted diseases are a major health problem worldwide, but there is still a lack of knowledge about how to induce an optimal immune response in the genital tract of humans. In this study we vaccinated 21 volunteers nasally or vaginally with the model mucosal antigen cholera toxin B subunit and determined the level of specific immunoglobulin A (IgA) and

EVA-LIZ JOHANSSON; LOTTA WASSEN; JAN HOLMGREN; MARIANNE JERTBORN; ANNA RUDIN

2001-01-01

232

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

PubMed

Abstract 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

233

Associations between Vaginal Pathogenic Community and Bacterial Vaginosis in Chinese Reproductive-Age Women  

PubMed Central

Background Bacterial vaginosis (BV) is one of the most common urogenital infections among women of reproductive age that represents shifts in microbiota from Lactobacillus spp. to diverse anaerobes. The aim of our study was to evalute the diagnostic values of Gardnerella, Atopobium, Eggerthella, Megasphaera typeI, Leptotrichia/Sneathia and Prevotella, defined as a vaginal pathogenic community for BV and their associations with vaginal pH and Nugent scores. Methods and Findings We investigated the vaginal pathogenic bacteria and Lactobacillus spp. with species-specific real-time quantitative PCR (qPCR) in 50 BV-positive and 50 BV-negative Chinese women of reproductive age. Relative to BV-negative subjects, a siginificant decline in Lactobacillus and an obvious increase in bacteria in the vaginal pathogenic community were observed in BV-postive subjects (P<0.05). With the exception of Megasphaera typeI, other vaginal pathogenic bacteria were highly predictable for BV with a better sensitivity and specificity. The vaginal pathogenic community was positively associated with vaginal pH and Nugent scores, while Lactobacillus spp., such as L. iners and L. crispatus was negatively associated with them (P<0.05). Conclusions Our data implied that the prevalance of vaginal pathogenic bacteria as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Vaginal microbiota shifts, especially the overgrowth of the vaginal pathogenic community, showed well diagnostic values in predicting BV. Postive correlations between those vaginal pathogenic bacteria and vaginal pH, Nugent score indicated the vaginal pathogenic community rather than a single vaginal microorganism, was participated in the onset of BV directly.

Luo, Yueqiu; Wu, Xiaoxing; Yuan, Li; Tong, Xiaojuan; Li, Lanjuan; Xiang, Charlie

2013-01-01

234

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.

2009-01-01

235

Sodium Dodecyl Sulfate and C31G as Microbicidal Alternatives to Nonoxynol 9: Comparative Sensitivity of Primary Human Vaginal Keratinocytes  

Microsoft Academic Search

Received 16 November 1999\\/Returned for modification 19 January 2000\\/Accepted 25 April 2000 A broad-spectrum vaginal microbicide must be effective against a variety of sexually transmitted disease pathogens and be minimally toxic to the cell types found within the vaginal epithelium, including vaginal keratinocytes. We assessed the sensitivity of primary human vaginal keratinocytes to potential topical vaginal microbicides nonoxynol-9 (N-9), C31G,

FRED C. KREBS; SHENDRA R. MILLER; BRADLEY J. CATALONE; PATRICIA A. WELSH; DANIEL MALAMUD; MARY K. HOWETT; BRIAN WIGDAHL

2000-01-01

236

High aspartyl proteinase production and vaginitis in human immunodeficiency virus-infected women.  

PubMed

Vaginal isolates of Candida albicans from human immunodeficiency virus-positive (HIV+) and HIV- women with or without candidal vaginitis were examined for secretory aspartyl proteinase (Sap) production in vitro and in vivo and for the possible correlation of Sap production with pathology and antimycotic susceptibility in vitro. HIV+ women with candidal vaginitis were infected by strains of C. albicans showing significantly higher levels of Sap, a virulence enzyme, than strains isolated from HIV+, C. albicans carrier subjects and HIV- subjects with vaginitis. The greater production of Sap in vitro was paralleled by greater amounts of Sap in the vaginal fluids of infected subjects. In an estrogen-dependent, rat vaginitis model, a strain of C. albicans producing a high level of Sap that was isolated from an HIV+ woman with vaginitis was more pathogenic than a strain of C. albicans that was isolated primarily from an HIV-, Candida carrier. In the same model, pepstatin A, a strong Sap inhibitor, exerted a strong curative effect on experimental vaginitis. No correlation was found between Sap production and antimycotic susceptibility, as most of the isolates were fully susceptible to fluconazole, itraconazole, and other antimycotics, regardless of their source (subjects infected with strains producing high or low levels of Sap, subjects with vaginitis or carrier subjects, or subjects with or without HIV). Thus, high Sap production is associated with virulence of C. albicans but not with fungal resistance to fluconazole in HIV-infected subjects, and Sap is a potentially new therapeutic target in candidal vaginitis. PMID:10203490

de Bernardis, F; Mondello, F; Scaravelli, G; Pachì, A; Girolamo, A; Agatensi, L; Cassone, A

1999-05-01

237

Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery  

Microsoft Academic Search

Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth)

Holly E. Richter; Cynthia G. Brumfield; Suzanne P. Cliver; Kathryn L. Burgio; Cherry L. Neely; R. Edward Varner

2002-01-01

238

Perineal-vaginal injuries in children: accident or abuse?  

PubMed

A large number of conditions have been mistaken for abuse. Differentiating accidental injuries from inflicted injuries is important in the management of injured children. In this work, the authors describe two cases of accidental perineal-vaginal injury in children. In case 1, a 4-year-old girl suffered a vaginal tear caused by violent stretching during play; in case 2, a 3-year-old girl had minor lacerations of labia minora and majora. The intervention of a multi-specialist team including a forensic pathologist and forensic psychiatrist was the key factor in being able to exclude abuse by third parties in the described cases. This leads to the appropriate recommendations to be adopted in the forensic medicine setting. PMID:20384916

Liuzzi, Claudia; Carabellese, Felice; Vinci, Francesco

2010-04-08

239

Mechanisms of Pelvic Floor Trauma During Vaginal Delivery  

Microsoft Academic Search

\\u000a Delivery is a crucial event in a woman’s life, a landmark in personal fulfillment and biological affirmation. Nevertheless,\\u000a the physical consequences of vaginal childbirth are important and may vary from mild subclinical conditions to significant\\u000a severe pathologies either immediately or in the long term. Systematic, exact research has focused on the main risks for pelvic\\u000a floor damage, providing a theoretical

Gianfranco Minini; Silvia Zanelli; Patrizia Inselvini; Marcello Caria; Sara Grosso; Davide Quaresmini

240

Analysis of vaginal lactobacilli from healthy and infected Brazilian women.  

PubMed

Culture-dependent PCR-amplified rRNA gene restriction analysis and culture-independent (PCR-denaturing gradient gel electrophoresis) methodologies were used to examine vaginal lactobacilli from Brazilian women who were healthy or had been diagnosed with vulvovaginal candidiasis (VVC) or bacterial vaginosis. Only Lactobacillus crispatus was detected accordingly by both methods, and H(2)O(2)-producing lactobacilli were not associated with protection against VVC. PMID:18502927

Martinez, Rafael C R; Franceschini, Sílvio A; Patta, Maristela C; Quintana, Silvana M; Nunes, Alvaro C; Moreira, João L S; Anukam, Kingsley C; Reid, Gregor; De Martinis, Elaine C P

2008-05-23

241

Vaginal Adhesions Caused by Stevens-Johnson Syndrome  

Microsoft Academic Search

Stevens-Johnson syndrome is a rare, life-threatening condition characterized by epidermal necrosis and involvement of the mucosal surfaces. We report a case of Stevens-Johnson syndrome with vaginal involvement in an 11-yr-old girl who was treated conservatively in the acute stage of the disease. After recovery from the profound systemic upset, she underwent vaginoscopy, which demonstrated some adhesions, which were divided. We

Roger Hart; Catherine Minto; Sarah Creighton

2002-01-01

242

Vaginal breech delivery: is it still an option?  

Microsoft Academic Search

Objective: To provide local data on term breech delivery for future guidance. Study design: Retrospective, ‘intended-mode-of-delivery’ analysis of 711 antenatally uncomplicated singleton breech deliveries at ?37 weeks: 445 (63%) planned for vaginal delivery (VD) (no fetal growth restriction, fetal weight 2000–4000g, adequate pelvic size, maternal consent) and 266 for cesarean section (CS). Outcome measures: Apgar score, cord blood acid–base status,

Charlotte Hellsten; Pelle G. Lindqvist; Per Olofsson

2003-01-01

243

Vaginal birth after cesarean (VBAC) in the 1980s.  

PubMed Central

The incidence of vaginal birth after cesarean (VBAC) and characteristics of VBAC births are investigated using 1980-85 National Hospital Discharge Survey Data collected by the National Center for Health Statistics. Only 3.4 per cent of mothers with previous cesarean delivery had VBAC in their subsequent 1980 delivery; this increased to 6.6 per cent in 1985. Because VBAC is a relatively infrequent event, 1980-85 data were combined and indicate that in this period 4.9 per cent of mothers with previous cesarean had a vaginal birth in their subsequent delivery. Combined 1980-85 VBAC rates are under 10 per cent for all age, race, marital status, region, hospital size, hospital ownership, and expected source of payment groups. Between 1980 and 1985, over 1.4 million repeat cesareans were performed for mothers having a live birth. Evidence suggests that potentially over 500,000 of these repeat cesareans could have been VBACs (over and above the 74,000 VBACs which occurred). VBAC mothers' mean length of hospital stay is 3.2 days, which compares closely with 3.0 days for other vaginal deliveries, but both contrast sharply with 5.6 days for repeat cesareans and 6.0 days for primary cesareans. Except for the uterine scar from the previous cesarean, VBAC mothers appear to have about the same history and frequency of complications as mothers with other vaginal deliveries. If the 500,000 repeat cesareans had been VBACs, surgical fees and costs for 1.2 million days of hospital stay would have been averted over the 1980-85 period.

Placek, P J; Taffel, S M

1988-01-01

244

Vaginal cuff dehiscence after intracavitary brachytherapy for endometrial cancer  

PubMed Central

We describe 2 unusual cases of vaginal dehiscence after intracavitary brachytherapy performed following robotic laparoscopic hysterectomy (RLH) along with their management. This unusual complication, which may be more common because of the robotic procedures, can be prevented by careful examination and possible delay of the onset of brachytherapy, if indicated. Our report reviews techniques of avoiding this complication and suggests that these complications should be discussed with the patients.

Shah, Karan; Potkul, Ronald

2012-01-01

245

Sexual Function after Tension-Free Vaginal Tape Procedure  

Microsoft Academic Search

Introduction: Aim of this cross-sectional study was to analyze the sexual function of women after tension-free vaginal tape (TVT) procedure. Patients and Methods: To evaluate the female sexual function after the TVT procedure, we designed a 36-item questionnaire including 21 questions on incontinence, 15 questions on sexuality and 3 questions on the personal impression of the procedure. Diagnostic workup consisted

Martin Marszalek; Michaela Roehlich; Ursula Racz; Martin Metzenbauer; Anton Ponholzer; Michael Rauchenwald; Stephan Madersbacher

2007-01-01

246

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.

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

1991-01-01

247

Recommendations for the management of postmenopausal vaginal atrophy.  

PubMed

Unlike hot flushes and night sweats which resolve spontaneously in time, atrophic symptoms affecting the vagina and lower urinary tract are often progressive and frequently require treatment. The prevalence of vaginal dryness increases as a woman advances through the postmenopausal years, causing itching, burning and dyspareunia, and sexual activity is often compromised. But, despite the various safe and effective options, only a minority (about 25% in the Western world and probably considerably less in other areas) will seek medical help. Some of this reluctance is due to the adverse publicity for hormone replacement therapy (HRT) over recent years that has suggested an increased risk of breast cancer, heart disease and stroke. But, regardless of whether these scares are justified, local treatment of vaginal atrophy is not associated with these possible risks of systemic HRT. Other reasons for the continued suffering in silence may be cultural and an understandable reluctance to discuss such matters, particularly with a male doctor, but the medical profession must also take much of the blame for failing to enquire of all postmenopausal women about the possibility of vaginal atrophic symptoms. Vaginal dryness can be helped by simple lubricants but the best and most logical treatment for urogenital atrophy is to use local estrogen. This is safe, effective and with few contraindications. It is hoped that these guidelines and recommendations, produced to coincide with World Menopause Day 2010, will help to highlight this major cause of distress and reduced quality of life and will encourage women and their medical advisers all over the world to seek and provide help. PMID:20883118

Sturdee, D W; Panay, N

2010-09-30

248

Spray Drying of a Vaginal Probiotic Strain of Lactobacillus acidophilus  

Microsoft Academic Search

This work presents a study of the spray-drying process of a vaginal strain of Lactobacillus acidophilus in order to enhance the cells viability and probiotics properties during storage. The results show that the powder obtained presents dried strain viability in the range of 10–10 (CFU\\/g) with product moisture content below 10%. Additionally, the dehydrated strain maintains its viability during two

B. Riveros; J. Ferrer; R. Bórquez

2009-01-01

249

Psychosocial characteristics of women and their partners fearing vaginal childbirth  

Microsoft Academic Search

Objectives To examine the personal characteristics and socio-economic background of women and their partners fearing vaginal childbirth.Design Questionnaire survey by the 30th week of pregnancy.Setting Sixteen outpatient maternity centres in the capital area of Finland.Participants Two hundred and seventy-eight women and their partners.Mainoutcome measures Personality traits, socio-economic factors, life and partnership satisfaction and pregnancy- and delivery-associated anxiety and fear.Results The

Terhi Saisto; Katariina Salmela-Aro; Jari-Erik Nurmi; Erja Halmesmäki

2001-01-01

250

Laparoscopy-assisted vaginal hysterectomy compared with abdominal hysterectomy.  

PubMed Central

The first 150 consecutive laparoscopic vaginal hysterectomy (LVH) cases done by Creighton University faculty members at Mercy Hospital, Council Bluffs, Iowa and at St Joseph Hospital, Omaha, Nebraska were compared with 194 abdominal hysterectomies (AHs) for benign or noninvasive disease. The results indicate that LVH can be accomplished with low morbidity, low length of stay, and with less patient discomfort than experienced by patients who undergo AH.

Garcia-Padial, J.; Osborne, N.; Sotolongo, J.; Ferrer, N.

1995-01-01

251

Combined vaginal-cesarean delivery of twin pregnancies  

Microsoft Academic Search

OBJECTIVE:To estimate the incidence and factors associated with combined vaginal-cesarean delivery in twin pregnancies.METHODS:We studied all twin births weighing 500 g or more during a 20-year period (1980–1999) at a tertiary care center. Major anomalies, monoamniotic and conjoined twins, and antepartum fetal deaths were excluded.RESULTS:During this 20-year period, 105,987 women delivered, of whom 1565 (1.5%) had twins. Of these, 1151

Vidia L Persad; Thomas F Baskett; Colleen M O’Connell; Heather M Scott

2001-01-01

252

Necrotizing fasciitis after tension-free vaginal tape (TVT) placement  

Microsoft Academic Search

A 62-year-old homemaker underwent an uneventful TVT (tension-free vaginal tape) procedure. Eleven days postoperatively she presented to the Emergency Department with agonizing low abdominal pain, elbow pain, fever, and drainage from her suprapubic puncture sites. Her evaluation was consistent with a diagnosis of necrotizing fasciitis and she was started on antibiotics and taken to surgery for exploration and debridement, where

Dallas W. Johnson; May ElHajj; Erin L. O´Brien-Best; Harold J. Miller; Paul M. Fine

2003-01-01

253

Osteomyelitis of the pubic symphysis after spontaneous vaginal delivery  

PubMed Central

Osteomyelitis ossis pubis is a painful disorder. It is rare following a normal vaginal delivery. In two cases, the diagnosis was verified by an ultrasound-guided needle aspiration postpartum. Both recovered after treatment with relevant antibiotics. The condition is easily misinterpreted as one of more common disorders like pelvic girdle pain, inflammation, diastasis or distortion of the pubic symphysis joint. If not recognised and treated, the condition can have severe consequences.

Dunk, Rikke Arildsen; Langhoff-Roos, Jens

2010-01-01

254

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.

Memon, Hafsa; Handa, Victoria L.

2013-01-01

255

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

256

Dorsal onlay vaginal graft urethroplasty for female urethral stricture  

PubMed Central

Introduction: Female urethral stricture is an underdiagnosed and overlooked cause of female bladder outlet obstruction. The possible etiologies may be infection, prior dilation, difficult catheterization with subsequent fibrosis, urethral surgery, trauma, or idiopathic. We present our technique and results of dorsal onlay full thickness vaginal graft urethroplasty for female urethral stricture. Materials and Methods: A retrospective review was performed on 16 female patients with mid-urethral stricture who underwent dorsal onlay vaginal graft urethroplasty from January 2007 to June 2011. Of these, 13 patients had previously undergone multiple Hegar dilatations, three had previous internal urethrotomies. The preoperative work up included detailed voiding history, local examination, uroflowmetry, calibration, and micturating cystourethrogram. Results: All patients had mid-urethral stricture. Mean age was 47.5 years. Mean Qmax improved from 6.2 to 27.6 ml/s. Mean residual volume decreased from 160 to 20 ml. Mean duration of follow-up was 24.5 months (6 months to 3 years). Only one patient required self-calibration for 6 months after which her stricture stabilized. None of the patient was incontinent. Conclusion: Dorsal vaginal onlay graft urethroplasty could be considered as an effective way to treat female urethral stricture.

Singh, Manmeet; Kapoor, Rakesh; Kapoor, Deepa; Kapoor, Rohit; Srivastav, Alok; Chipde, Saurabh

2013-01-01

257

Maternal and neonatal outcomes of hospital vaginal deliveries in Tibet  

PubMed Central

Introduction To determine the outcomes of vaginal deliveries in three study hospitals in Lhasa, Tibet Autonomous Region (TAR), People's Republic of China (PRC), at high altitude (3,650 m). Methods Prospective observational study of 1,121 vaginal deliveries. Results Pre-eclampsia/gestational hypertension (PE/GH) was the most common maternal complication 18.9% (n=212), followed by postpartum hemorrhage (blood loss ? 500 ml) 13.4%. There were no maternal deaths. Neonatal complications included: low birth weight (10.2%), small for gestational age (13.7%), preterm delivery (4.1%) and low Apgar (3.7%). There were 11 stillbirths (9.8/1,000 live births) and 19 early neonatal deaths (17/1,000 live births). Conclusion This is the largest study of maternal and newborn outcomes in Tibet. It provides information on the outcomes of institutional vaginal births among women delivering infants at high altitude. There was a higher incidence of PE/GH and low birth weight; rates of PPH were not increased compared to those at lower altitudes.

Miller, S; Tudor, C; Nyima; Thorsten, VR; Sonam; Droyoung; Craig, S; Le, P; Wright, LL; Varner, MW

2007-01-01

258

Immune Cell-Mediated Protection against Vaginal Candidiasis: Evidence for a Major Role of Vaginal CD4+ T Cells and Possible Participation of Other Local Lymphocyte Effectors  

PubMed Central

The protective roles of different lymphocyte subsets were investigated in a rat vaginal candidiasis model by adoptive transfer of vaginal lymphocytes (VL) or sorted, purified CD3+ T cells, CD4+ or CD8+ T cells, or CD3? CD5+ B cells from the vaginas of naïve or immune rats following three rounds of Candida albicans infection. The adoptive transfer of total VL from nonimmune animals did not alter the course of vaginal candidiasis of the recipient rats. In contrast, the animals receiving total VL or CD3+ T cells from immune rats showed a highly significant acceleration of fungus clearance compared with animals which received nonimmune VL. The animals with vaginal CD3? CD5+ B cells transferred from immune rats also had fewer Candida CFU than the controls, but fungal clearance was significantly retarded with respect to the animals administered immune T cells. Sorted, purified CD4+ and CD8+ vaginal T cells from immune rats were also adoptively transferred to naïve animals. Although both populations were seen to accelerate the clearance of the fungus from the vagina, CD4+ T cells were much more effective than CD8+ T cells. Overall, there was no difference between the antifungal effects of immune vaginal CD4+ T cells and those achievable with the transfer of whole, immune VL. Histological observations of the vaginal tissues of rats with adoptively transferred immune T cells demonstrated a remarkable accumulation of lymphocytes in the subepithelial lamina propria and also infiltrating the mucosal epithelium. These results strongly suggest that distinct vaginal lymphocyte subsets participate in the adaptive anti-Candida immunity at the vaginal level, with the vaginal CD4+ T cells probably playing a major role.

Santoni, Giorgio; Boccanera, Maria; Adriani, Daniela; Lucciarini, Roberta; Amantini, Consuelo; Morrone, Stefania; Cassone, Antonio; De Bernardis, Flavia

2002-01-01

259

Immune cell-mediated protection against vaginal candidiasis: evidence for a major role of vaginal CD4(+) T cells and possible participation of other local lymphocyte effectors.  

PubMed

The protective roles of different lymphocyte subsets were investigated in a rat vaginal candidiasis model by adoptive transfer of vaginal lymphocytes (VL) or sorted, purified CD3(+) T cells, CD4(+) or CD8(+) T cells, or CD3(-) CD5(+) B cells from the vaginas of naïve or immune rats following three rounds of Candida albicans infection. The adoptive transfer of total VL from nonimmune animals did not alter the course of vaginal candidiasis of the recipient rats. In contrast, the animals receiving total VL or CD3(+) T cells from immune rats showed a highly significant acceleration of fungus clearance compared with animals which received nonimmune VL. The animals with vaginal CD3(-) CD5(+) B cells transferred from immune rats also had fewer Candida CFU than the controls, but fungal clearance was significantly retarded with respect to the animals administered immune T cells. Sorted, purified CD4(+) and CD8(+) vaginal T cells from immune rats were also adoptively transferred to naïve animals. Although both populations were seen to accelerate the clearance of the fungus from the vagina, CD4(+) T cells were much more effective than CD8(+) T cells. Overall, there was no difference between the antifungal effects of immune vaginal CD4(+) T cells and those achievable with the transfer of whole, immune VL. Histological observations of the vaginal tissues of rats with adoptively transferred immune T cells demonstrated a remarkable accumulation of lymphocytes in the subepithelial lamina propria and also infiltrating the mucosal epithelium. These results strongly suggest that distinct vaginal lymphocyte subsets participate in the adaptive anti-Candida immunity at the vaginal level, with the vaginal CD4(+) T cells probably playing a major role. PMID:12183521

Santoni, Giorgio; Boccanera, Maria; Adriani, Daniela; Lucciarini, Roberta; Amantini, Consuelo; Morrone, Stefania; Cassone, Antonio; De Bernardis, Flavia

2002-09-01

260

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 Cell 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

2013-09-09

261

Trypan Blue Staining to Determine Vaginal Exposure in Two Types of Plastic Vaginal Applicators Containing Two Different Microbicide Formulations  

PubMed Central

Dye staining of applicators has been shown to be a reliable and objective method to test vaginal insertion in clinical microbicide trials, but different plastics, dyes and product formulations may impact the accuracy of this method. Reportedly used applicators returned from three clinical trials were stained with 1% Trypan Blue. In a phase 1 study (VivaGel®), using gel-filled HTI polypropylene applicators, 1271 (97%) of applicators stained positive. In two phase 1 and 2a studies (LACTIN-V) using linear low-density polyethylene applicators to deliver a dry powder formulation, 57 (95%) and 135 (86%) tested positive, respectively. Dye staining of vaginal applicators is an objective, low cost measure suitable for low resource settings.

Hemmerling, A; Harrison, WG; Brown, JM; Moscicki, AB; Oziemkowska, M; Bukusi, EA; Cohen, CR

2013-01-01

262

Clinical Trials with Agents Currently Used in the Management of Vaginitis  

PubMed Central

Results of treatment of 151 cases of vaginitis in patients attending a leukorrhea clinic were studied. The incidence of each type of vaginitis is recorded. Analysis of results of treatment with six compounds currently used in the therapy of vaginitis indicated that acetarsol or pimaricin compounds, with their broader spectra of activity, appeared to be most useful, prior to establishment of a definite diagnosis by means of cultures. Chlordantoin is an effective antifungal agent and is associated with a high percentage of “culture cures”. Resistant cases should be investigated for diabetes mellitus, and many are aided by a low carbohydrate diet. Metronidazole was used only for resistant cases of trichomoniasis, with a cure rate of over 80% when both partners were treated simultaneously. Triple-sulfa vaginal cream was effective in over 80% of patients with nonspecific vaginitis; no cases of resistant bacterial infections were encountered. Dienestrol cream was effective in relieving the symptoms of atrophic vaginitis.

O'Brien, J. R.

1964-01-01

263

The importance of the vaginal delivery route for antiretrovirals in HIV prevention  

PubMed Central

The HIV/AIDS pandemic continues to be a global health priority, with high rates of new HIV-1 infections persisting in young women. One HIV prevention strategy is topical pre-exposure prophylactics or microbicides, which are applied vaginally or rectally to protect the user from HIV and possibly other sexually transmitted infections. Vaginal microbicide delivery will be the focus of this review. Multiple nonspecific and specific antiretroviral microbicide products have been clinically evaluated, and many are in preclinical development. The events of HIV mucosal transmission and dynamics of the cervicovaginal environment should be considered for successful vaginal microbicide delivery. Beyond conventional vaginal formulations, intravaginal rings, tablets and films are employed as platforms in the hope to increase the likelihood of microbicide use. Furthermore, combining multiple antiretrovirals within a given formulation, combining a microbicide product with a vaginal device and integrating novel drug-delivery strategies within a microbicide product are approaches to successful vaginal-microbicide delivery.

Ferguson, Lindsay M; Rohan, Lisa Cencia

2012-01-01

264

HIV gp120 induced gene expression signatures in vaginal epithelial cells.  

PubMed

Gp120 is the envelope protein of HIV which binds to CD4 independent proteins on vaginal epithelial cells. HIV-gp120 has been reported to modulate gene expression in several cell types. How this interaction may alter the physiologic vaginal milieu during the earliest stages of vaginal transmission of HIV, is currently unknown. Vaginal epithelial cells were treated with HIV-gp120, and a global snapshot of changes in gene expression profiles, were unraveled by microarray analysis. The differentially expressed genes were involved in diverse cellular functions. Genes of immunomodulatory processes and induction of proteases were highly enriched. We propose that the induction of inflammation and proteases may act in concert to weaken the vaginal epithelium, making it more permeable to viral entry. Identification of the gene signatures involved in vaginal-HIV dialogue would aid in understanding the environ induced by HIV itself, as the virus invades and gains entry into its host. PMID:23867815

Fanibunda, Sashaina E; Modi, Deepak N; Bandivdekar, Atmaram H

2013-07-15

265

A laparoscopic bipolar cutting forceps can assist in a case of difficult vaginal hysterectomy.  

PubMed

A vaginal approach to hysterectomy can become challenging when visualization is limited by poor or absent uterine descent, obesity, or other factors that make an approach to the uterine pedicles difficult. When factors occur that make application or visualization of conventional vaginal instruments difficult, using an instrument designed for laparoscopic application, with its thin, elongated shape, may permit continuation of a vaginal approach. In such a case, a Gyrus bipolar laparoscopic cutting forceps was used for coagulation and transection of the uterine pedicles during a vaginal hysterectomy. This represents a way to expand on traditional techniques for completion of difficult vaginal hysterectomy, which may be used concurrently. Surgical techniques that more easily and safely permit completion of hysterectomy by the vaginal approach can improve outcomes for all. PMID:16825076

Fenton, Bradford W; Hutchings, Tim; Flora, Robert F; Fanning, James

266

Assessment of the durability of robot-assisted laparoscopic sacrocolpopexy for treatment of vaginal vault prolapse  

Microsoft Academic Search

Transabdominal sacrocolpopexy has been shown, in multiple long-term studies of its success and durability, to be the definitive\\u000a treatment option for post-hysterectomy vaginal vault prolapse. It is, however, associated with greater morbidity than vaginal\\u000a repair. We describe a minimally invasive technique for vaginal vault prolapse repair and present our experience with a minimum\\u000a of one-year follow-up. The surgical technique involves

Daniel S. Elliott; Sameer A. Siddiqui; George K. Chow

2007-01-01

267

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

268

In search of sexual pleasure and fidelity: vaginal practices in KwaZulu?Natal, South Africa  

Microsoft Academic Search

Vaginal practices, such as intra?vaginal cleansing, drying and tightening, are suspected of placing women at higher risk of acquiring HIV and STIs. Yet, there is limited understanding of what these practices entail, what motivates women to undertake them and what their socio?cultural and historical meanings are. This paper explores the range of vaginal practices used by women in KwaZulu?Natal, South

Fiona Scorgie; Busisiwe Kunene; Jennifer A. Smit; Ntsiki Manzini; Matthew F. Chersich

2009-01-01

269

A randomized controlled trial of vaginal misoprostol for cervical priming before hysteroscopy  

Microsoft Academic Search

Objective: To evaluate the effectiveness and side effects of vaginal misoprostol for cervical dilation in nonpregnant women before hysteroscopy.Methods: Ninety-one women scheduled to have hysteroscopy were randomized to receive either vaginal misoprostol or placebo. Cervical response, outcome of hysteroscopy, and side effects of vaginal misoprostol were assessed.Results: The mean cervical dilatation estimated by Hegar dilator and the mean duration of

Sangchai Preutthipan; Yongyoth Herabutya

1999-01-01

270

The excision of uterine fibroids by vaginal myomectomy: a prospective study  

Microsoft Academic Search

Objective: To evaluate the clinical effectiveness and safety of the excision of uterine fibroids by vaginal myomectomy.Design: Prospective study.Setting: A gynecology department of a university teaching hospital.Patient(s): Women with menorrhagia, pelvic pain, symptoms of pressure, or subfertility attributable to moderate-sized uterine fibroids who otherwise would have required abdominal or laparoscopic myomectomy.Intervention(s): Vaginal myomectomy.Main Outcome Measure(s): The feasibility of vaginal surgery,

Anthony Davies; Roger Hart; Adam L Magos

1999-01-01

271

Vaginal misoprostol in the management of first-trimester missed abortions  

Microsoft Academic Search

Objective: To evaluate the efficacy of a regimen of vaginal misoprostol in causing the complete expulsion of first-trimester missed abortions, or alternatively dilating the cervix for surgical evacuation. Method: Seventy-four women with a transvaginal ultrasound diagnosis of a first-trimester missed abortion and no more than slight vaginal bleeding were consecutively enrolled. Misoprostol (600 ?g) was administered vaginally and repeated 4

D Ayres-de-Campos; J Teixeira-da-Silva; I Campos; B Patr??cio

2000-01-01

272

Coitus induced vaginal evisceration in a premenopausal woman: a case report  

PubMed Central

Vaginal evisceration in premenopausal women after trans-abdominal hysterectomy is extremely rare in occurrence and only few cases have been documented in worldwide literature. Here we report a premenopausal woman with coitus induced trans-vaginal evisceration who had undergone trans-abdominal hysterectomy two years ago. This article highlights coitus as a trigger event for inducing vaginal evisceration and that vaginal evisceration caused by sexual intercourse should be considered in the field of surgery when a pre-menopausal woman presents with acute abdominal pain with no history of any other traumatic episode.

2011-01-01

273

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

2003-11-19

274

Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!  

PubMed Central

Objective: To determine the appropriateness of vaginal approach for gynecological supratrigonal vesicovaginal fistulae. Patients and Methods: Retrospective review of consecutive women with gynecological supratrigonal Vesico Vaginal Fistulae (VVF) repaired at the fistula unit of Urogynecology department between 1996 and 2011 was done.Out of 48 cases of supratrigonal VVF of gynecological origin identified; 34 (70.8%) cases were repaired vaginally and 14 (36.8%) abdominally with a mean follow-up period of 52.8 (2-132) months. Results: Overall 95.8% were successfully cured at first attempt. The success rate of vaginal repair (94.8%) at first attempt was comparable to that of abdominal repair (100%) (P value = 0.8946). Amongst two failed vaginal repairs, one was successfully cured by subsequent vaginal repair and other by abdominal repair. Conclusion: Three fourth gynecological supratrigonal VVF can be repaired vaginally in first attempt with success rate comparable to abdominal approach. On the basis of this study we postulate that vaginal approach should be preferred over abdominal approach for repair of all vaginally accessible supratrigonal VVF of gynecological origin.

Rajamaheswari, N.; Chhikara, Archana Bharti; Seethalakshmi, K.; Bail, Anupama; Agarwal, Sugandha

2012-01-01

275

[Hysterectomy: indications and advantages of the vaginal route in Mali].  

PubMed

The purpose of this report was to determine the frequency of hysterectomy and describe its indications and outcomes. A retrospective, descriptive study related to active hysterectomy of was conducted at the reference health centre of commune V in Bamako, Mali from January 1st, 2004 to December 31st, 2008. All hysterectomy patients with complete medical files were included. A total of 172 files were identified including 152 that were complete. Hysterectomy accounted for 1.38% of all interventions during the study period. The procedure was carried out in emergency in 0.14% and electively in 13.39%. Mean patient age was 47.9 +/- 11.7 years; 89 patients were older than 45 years. The indications for hysterectomy were complicated uterine fibroids in 82 patients, genital prolapse in 44, adenomyosis in 10, obstetrical hysterectomy in 13 and cervical dysplasia in 3. The abdominal route was used in 100 patients (65.8%) and the vaginal rout in 52 (34.2%). The duration of the procedure and hospital stay was longer after hysterectomy by the abdominal (p<0.05). Perioperative complications were observed in 17% of patients after abdominal hysterectomy versus 7.69% after vaginal hysterectomy. Two maternal deaths due to hemorrhagic shock were observed after obstetrical hysterectomy. Hysterectomy is a frequent intervention that is not without complication risks. Choice of route depends on the indication and skill of the operator. Although endoscopic surgery is still difficult to perform in developing countries, development of vaginal hysterectomy is necessary to reduce perioperative complications. PMID:22393643

Traoré, M; Togo, A; Traoré, Y; Dembélé, B T; Diakité, I; Traoré, S O; Traoré, O M; Coulibaly, A; Keita, S I; Diabaté, A

2011-12-01

276

Trials point to effectiveness of new vaginal ring.  

PubMed

Results of a large multicentered clinical trial of a new contraceptive vaginal ring show that the new ring may be about as effective as oral contraceptives but with fewer side effects. The ring, which is a little smaller than a 75 mm diaphragm and has a Silastic inner core and outer tubing, is avilable in 2 sizes (50 mm or 58 mm) and contains a middle layer with a steroid mixture of estrogen and progestin. Both types of ring contain about 100 mg levonorgestrel and 50 mg estradiol. Ovulation is suppressed by the steroids in the ring. The ring is placed in the vagina for about 3 weeks and then removed for 1 week. Withdrawal bleeding occurs when the ring is removed. Comparative studies of the effectiveness of the ring and a pill (Nordette, which contains 150 mcg levonorgestrel and 30 mcg estradiol) show that after a year's use, both type of contraceptives had a pregnancy rate of about 3 pregnancies per 100 users. Ring users had higher continuation rates than pill users (50/100 women for the ring vs. 30/100 for the pill). Reasons for discontinuation for the ring include occurrence of vaginal discharge, vaginitis, and menstrual problems. Ring users had lesser incidence of nausea and headache compared to pill users; they also did not experience an increase in angiotensinogen levels or blood pressure. Another advantage of the ring is its once-a-month administration. Investigators are still testing the best method for using the ring. However, as testing is not yet complete, application for approval by the Food and Drug Administration may take quite some time. PMID:12279158

1982-02-01

277

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.

Gao, Yajing; Katz, David F.

2013-01-01

278

Vaginal Discharge: An Approach to Diagnosis and Management  

PubMed Central

Vaginal discharge is a frequent presenting complaint in an office practice. The authors of this article review the most common causes of this condition, namely Candidiasis, Trichimoniasis, and Bacterial Vaginosis (Gardnerella), as well as the more serious causes, namely gonorrhea, chlamydia, and Herpes simplex. Symptoms and physical signs are generally insufficient to distinguish specific etiologic agents and, as treatment for each is different, diagnostic examination of smears in the office is critical to the management of these patients. A clinical approach and method of office diagnosis is described.

Watson, William J.; DeMarchi, Gregory

1987-01-01

279

Mesh kits for anterior vaginal prolapse are not cost effective  

Microsoft Academic Search

Introduction and hypothesis  To analyze the cost-effectiveness of traditional anterior colporrhaphy (AC), hand-cut mesh, and mesh kit anterior vaginal\\u000a prolapse (AVP) repair.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A decision analysis model was built using mean operating room (OR) times, mesh extrusion rates, and recurrence rates obtained\\u000a from a meta-analysis along with Medicare reimbursement for surgeon fees and office visits, and hospital costs of supplies,\\u000a OR time,

Sunshine Murray; Rashel M. Haverkorn; Yair Lotan; Gary E. Lemack

2011-01-01

280

Risk factors for vaginal trichomoniasis among women in Basra, Iraq.  

PubMed

We investigated Trichomonas vaginalis infection among 352 women with vaginal discharge, 46 were found to be infected, an infection rate of 13%. There were no significant differences in the isolation rate of T. vaginalis in women according to occupation, educational level, economic status, age, marital status, parity, menstrual status and contraception use. The difference in the isolation rates of T. vaginalis in women with a history of abortion (7.6%) and in women with no history of abortion (15.7%) was statistically significant. PMID:15332733

Mahdi, N K; Gany, Z H; Sharief, M

2001-11-01

281

Characterization of vaginal lactobacilli in women after kidney transplantation.  

PubMed

Limited number of publications described vaginal microflora after kidney transplantation. Our PubMed search revealed only 18 publications including words "vaginal bacteria & kidney transplant" in the period of 1978-2011. The aim of this study was to characterize lactobacilli isolated from vaginal swabs of women after kidney transplantation, compared with healthy women. Eighteen renal transplant recipients (mean age 36.1) and 20 healthy women (mean age 36.0) were evaluated. Lactobacilli were cultured on MRS and Columbia blood agars. Biochemical identification with API 50 CHL (bioMerieux, Marcy L'Etoile, France) and multiplex PCR according to Song et al. was performed. Lactobacilli were tested for production of H(2)O(2). Minimal inhibitory concentrations (MICs) of selected antimicrobial agents were determined with E-tests (bioMerieux, Marcy L'Etoile, France) and interpreted with CLSI and EUCAST criteria. No bacterial vaginosis was found among studied women. Two strains of group I were identified as Lactobacillus delbrueckii; 18 strains as Lactobacillus gasseri and 15 strains as Lactobacillus crispatus. Only 3 strains from group II were not identified by species-specific mPCR. Group IV was represented with 2 unidentified strains. Vaginal lactobacilli isolated from healthy women represented more homogenous group compared with heterogenous renal transplant recipients. Biochemical identification of lactobacilli by API 50 CHL kits was concordant with mPCR results only in 7 cases (17.5%), all 7 strains were identified as L. crispatus. Majority (93%) of lactobacilli were H(2)O(2) producers. All isolated lactobacilli (100%) demonstrated high resistance to metronidazole (MIC > 256 ?g/ml). Only 2 strains resistant to vancomycin (MICs: 32 and 256 ?g/ml respectively), in the study and control group, and one to moxifloxacin (MIC = 32 ?g/ml), were found. Resistance to metronidazole and vancomycin was concordant in CLSI and EUCAST (2010) criteria. Although significant differences between lactobacilli isolated from vaginas of kidney transplant and healthy women were not demonstrated, we demonstrated strains resistant to metronidazole, vancomycin and moxifloxacin in groups of examined women. Our study was performed on a small group of kidney transplant recipients and further more detailed molecular studies on a larger group of patients are required to confirm our results. PMID:22240292

Martirosian, G; Radosz-Komoniewska, H; Pietrzak, B; Ekiel, A; Kami?ski, P; Aptekorz, M; Dole?ych, H; Samulska, E; Jó?wiak, J

2011-12-21

282

Nifuratel Compared with Metronidazole in the Treatment of Trichomonal Vaginitis  

PubMed Central

Nifuratel (Magmilor) was compared with metronidazole (Flagyl) in the treatment of trichomonal vaginitis by a randomized double-blind trial. Only 18 out of 47 patients (38%) treated with nifuratel were found to be cured, whereas 42 out of 49 patients (85%) treated with metronidazole were cured. Severe reactions, necessitating withdrawal of treatment, occurred in three patients treated with nifuratel. There were no serious side-effects with metronidazole. The results of this trial indicate that nifuratel is not a satisfactory substitute for metronidazole in the treatment of trichomoniasis.

Evans, B. A.; Catterall, R. D.

1970-01-01

283

Nifuratel compared with metronidazole in the treatment of trichomonal vaginitis.  

PubMed

Nifuratel (Magmilor) was compared with metronidazole (Flagyl) in the treatment of trichomonal vaginitis by a randomized double-blind trial. Only 18 out of 47 patients (38%) treated with nifuratel were found to be cured, whereas 42 out of 49 patients (85%) treated with metronidazole were cured. Severe reactions, necessitating withdrawal of treatment, occurred in three patients treated with nifuratel. There were no serious side-effects with metronidazole. The results of this trial indicate that nifuratel is not a satisfactory substitute for metronidazole in the treatment of trichomoniasis. PMID:4913962

Evans, B A; Catterall, R D

1970-05-01

284

Regulation of natural antimicrobial defences in human vaginal epithelial cells  

Microsoft Academic Search

BackgroundThe involvement of natural antimicrobial peptides in infection-associated preterm birth is unknown. Our aim was to assess regulation by granulocyte-macrophage colony-stimulating factor, monocyte-chemotactic-protein-1 (GM-CSF and MCP-1, interleukin-1 (IL) and lipopolysaccharide (LPS) in cultured human vaginal epithelial cells.MethodsVK2\\/E6E7 cells were treated with IL-1, MCP-1 and GM-CSF (20\\/100\\/200\\/500 pg\\/ml and 1 ng\\/ml) at 2 h, 4 h, 6 h and 24 h

C Foster; E Chin-Smith; R Tribe

2011-01-01

285

Inefficient Vaginal Transmission of Tenofovir-Resistant HIV-1  

PubMed Central

Transmission of drug-resistant HIV has been postulated to be a threat to current first-line antiretroviral therapy (ART) regimens and the efficacy of several antiretroviral-based preexposure prophylaxis (PrEP) strategies being tested. Here we evaluated the effect of the common tenofovir (TFV) resistance mutation K65R on vaginal HIV transmission. Our results demonstrate that despite no overt loss of overall replication competence in vivo, this mutation results in significantly reduced mucosal transmission. When transmitted, the mutant virus eventually reverted to the wild type in 2 of 3 animals examined.

Chateau, Morgan; Swanson, Michael D.

2013-01-01

286

Use of a topical antibiotic spray in vaginal surgery.  

PubMed Central

During vaginal hysterectomy with or without colporrhaphy a topical aerosol spray containing neomycin sulfate, polymyxin B sulfate and zinc bacitracin was used in 50 patients to decrease the change of postoperative pelvic infection; a placebo spray was used in another 50 patients. All patients were treated preoperatively with povidone iodine and postoperatively with nitrofurantoin and an antibacterial irrigating solution for the bladder if catheter drainage was necessary. The frequency of postoperative pelvic infection was 16% in the group sprayed with the antibiotic combination and 34% in the group sprayed with the placebo, a significant difference (P less than 0.05).

Wright, V. C.; Lanning, N. M.; Natale, R.

1978-01-01

287

The association of preterm labor with vaginal colonization of group B streptococci  

Microsoft Academic Search

Background: Group B streptococcus is regarded as a potential factor for adverse outcomes of pregnancy such as preterm birth. Objective: To study the association of maternal vaginal colonization with group B streptococcus (GBS) and preterm labor. Materials and Methods: From April 2005 to May 2006, vaginal culture for GBS were conducted in 101 laboring women with a gestational age of

Bibi Shahnaz Aali; Hamid Abdollahi; Nouzar Nakhaee

288

Epidemiological Investigation of Vaginal Saccharomyces cerevisiae Isolates by a Genotypic Method  

Microsoft Academic Search

Saccharomyces cerevisiae is a ubiquitous, ascomycetous yeast, and vaginitis caused by this organism has been reported only very rarely. The aim of the present investigation was to assess the epidemiological relatedness of a group of vaginal and commercial S. cerevisiae isolates by a previously reported genetic typing method, which divided the isolates into two broad groups with numerous subtypes. Nineteen

MICHAEL J. MCCULLOUGH; KARL V. CLEMONS; CLAUDIO FARINA; JOHN H. MCCUSKER; DAVID A. STEVENS

1998-01-01

289

Cytokine and Chemokine Production by Human Oral and Vaginal Epithelial Cells in Response to Candida albicans  

Microsoft Academic Search

Oropharyngeal and vaginal candidiases are the most common forms of mucosal fungal infections and are primarily caused by Candida albicans, a dimorphic fungal commensal organism of the gastrointestinal and lower female reproductive tracts. Clinical and experimental observations suggest that local immunity is important in host defense against candidiasis. Accordingly, cytokines and chemokines are present at the oral and vaginal mucosa

Chad Steele

2002-01-01

290

Limitations of antifungal agents in the treatment of Candida vaginitis: future challenges  

Microsoft Academic Search

The availability of several potent antifungal agents, systemic or topical, over the counter or prescription would suggest that therapeutic needs for Candida vaginitis are minimal or absent. Unfortunately, unmet needs still exist. Moreover, the pharmaceutical industry has abandoned Candida vaginitis and no new agents or studies are imminent. Perhaps the most important advance in the last decade has been the

Jack D. Sobel

1999-01-01

291

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

292

Vaginal delivery and pelvic floor dysfunction: current evidence and implications for future research  

Microsoft Academic Search

Vaginal delivery is the major risk factor for the development of pelvic organ prolapse and urinary and fecal incontinence,\\u000a resulting from damage to the pelvic floor muscles, nerves and connective tissue. This article reviews the perineal trauma\\u000a mechanism during vaginal delivery and discusses implications of current and future research projects.

M. A. T. Bortolini; H. P. Drutz; D. Lovatsis; M. Alarab

2010-01-01

293

Evaluation of a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section  

Microsoft Academic Search

Objective: Our purpose was to evaluate, with respect to obstetric intervention and neonatal outcome, a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section. Study design: A clinical follow-up study was performed between 1984 and 1992 of all term singleton deliveries in breech presentation. Each case selected for vaginal delivery had a matched control in vertex

Susanne Albrechtsen; Svein Rasmussen; Hallvard Reigstad; Trond Markestad; Lorentz M. Irgens; Knut Dalaker

1997-01-01

294

Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies  

Microsoft Academic Search

Background. To compare neonatal and maternal outcomes for breech first twins according to whether vaginal or cesarean delivery was planned and to verify that in appropriate selected cases, attempted vaginal delivery is a reasonable choice. Methods. A retrospective study of all twin pregnancies with the first twin in breech position and gestational age at least 35 weeks at birth at

Loïc Sentilhes; François Goffinet; Alain Talbot; Alain Diguet; Eric Verspyck; Dominique Cabrol; Loïc Marpeau

2007-01-01

295

Estrogen-Like Action of Tamoxifen on Vaginal Epithelium in Breast Cancer Patients  

Microsoft Academic Search

The action of prolonged administration of Tamoxifen on the vaginal epithelium in postmenopausal breast cancer patients has been investigated by means of exfoliative cytology. Our study gives quite convincing evidence of a clear-cut estrogenic effect of Tamoxifen on vaginal epithelium. The relationship between estrogenic properties of Tamoxifen and breast cancer management is discussed.Copyright © 1981 S. Karger AG, Basel

F. Boccardo; P. Bruzzi; A. Rubagotti; G. Nicolò; R. Rosso

1981-01-01

296

Beneficial lactobacilli: effects on the vaginal tract in a murine experimental model.  

PubMed

Vaginal probiotics containing lactic acid bacteria with activity towards pathogenic microorganisms that cause urogenital tract infections have been proposed as a valid strategy for their prophylaxis and therapy. A murine experimental model was set up to evaluate the colonization capability of beneficial human lactobacilli and their effects on the mouse vaginal mucosa and innate immune cells. Five Lactobacillus strains were intravaginally inoculated into previously estrogenized BALB/c mice. The significance of the effects observed in the vaginal tract was determined by analysis of variance using the general linear model. The numbers of viable vaginal lactobacilli were significantly higher at proestrous-estrous than those at the metaestrous-diestrous phase and decreased markedly on the days after inoculation. Lactobacilli inoculation did not cause cytological or histological modifications of the murine vaginal tract. Moreover, the intravaginal administration of Lactobacillus salivarius CRL (Centro de Referencia para Lactobacilos culture collection) 1328 and Lactobacillus gasseri CRL 1263 did not affect the amounts of granulocytes and macrophages present in vaginal washings. In conclusion, the results demonstrate that vaginal lactobacilli did not produce adverse effects on the murine vaginal tract. Therefore, they could be proposed as safe probiotic candidates to promote a balanced microbiota in the urogenital tract. PMID:22638932

De Gregorio, Priscilla Romina; Juárez Tomás, María Silvina; Santos, Viviana; Nader-Macías, María Elena Fatima

2012-05-26

297

mRNA profiling for vaginal fluid and menstrual blood identification.  

PubMed

The detection and identification of human biological fluids, including vaginal secretions and menstrual blood, are highly important in forensic biology. Previous studies have proposed a few mRNA and bacterial markers for vaginal fluid detection, but they have not proven to be specific and reliable. The aim of this project was to develop, validate and evaluate a reliable, specific test for vaginal fluid identification that would combine detection of vaginal mRNAs and Lactobacilli. We have developed a hexaplex that detects HBD1 (human beta-defensin 1), MUC4 (mucin 4), menstrual blood marker MMP11 (matrix metalloproteinase 11), housekeeping gene G6PDH (glucose 6-phosphate dehydrogenase) and the 16S-23S rRNA intergenic spacer region of Lactobacillus crispatus and Lactobacillus gasseri/Lactobacillus johnsonii. We analysed the specificity of the markers and variations among women, as well as the sensitivity of the test and its ability to detect vaginal fluid in mixtures with semen and blood. This approach allows for the detection of vaginal fluid in stains that were up to 2 years old, if stored at room temperature and up to 18 years old if stored frozen. Through simultaneous analysis of 5 vaginal markers, the proposed hexaplex ensures high specificity and reliability in the detection of vaginal material. PMID:23273817

Jakubowska, Joanna; Maciejewska, Agnieszka; Paw?owski, Ryszard; Bielawski, Krzysztof Piotr

2012-12-28

298

'A hidden disorder until the pieces fall into place' - a qualitative study of vaginal prolapse  

Microsoft Academic Search

BACKGROUND: Vaginal prolapse affects quality of life negatively and is associated with urinary, bowel, and sexual symptoms. Few qualitative studies have explored women's experiences of vaginal prolapse. The objective of the study was to elucidate the experiences of living with prolapse and its impact on daily life, prior to surgical intervention. METHODS: In-depth interviews were conducted with 14 women with

Mojgan Pakbaz; Margareta Persson; Mats Löfgren; Ingrid Mogren

2010-01-01

299

Interactions between Trichomonas vaginalis and vaginal flora in a mouse model.  

PubMed

To study the role of vaginal flora and pH in the pathogenesis of Trichomonas vaginalis, an intravaginal mouse model of infection was established. By employing this model, the vaginal flora and pH of mice could be monitored for changes caused by the parasite. As a baseline, the endemic vaginal flora of BALB/c mice was examined first and found to consist mainly of Staphylococcus aureus and Enterococcus species (32-76%). Lactobacilli and enteric bacilli were moderate (16-32%) in their frequency of isolation, and the prevalence of both anaerobic species and coagulase-negative staphylococci was low (4-16%). Vaginal pH was recorded at 6.5 +/- 0.3. Estrogenization, which was required for a sustained T. vaginalis infection, did not significantly alter vaginal flora; however, a slight rise in the number of bacterial species isolated per mouse and a drop in vaginal pH (6.2 +/- 0.5) were observed. Trichomonas vaginalis-infected mice did not appear to show significant changes in vaginal flora although vaginal pH was slightly increased. This mouse model could have applications in both immunologic and pathogenic studies of T. vaginalis and, with further modifications, aid in the study of protist-bacterial interactions. PMID:1310732

Meysick, K C; Garber, G E

1992-02-01

300

Trichomonas Vaginalis in Vaginal Smears of Women Using Intrauterine Contraceptive Device  

Microsoft Academic Search

Aims: To detect the association between the use of an intrauterine contraceptive device (IUCD) and the presence of Trichomonas vaginalis (Tv) in the vaginal smears. Study design and setting: Vaginal smears were collected from 800 women who attended the Gynaecology and Obstetrics unit at Federal Government Hospital (Polyclinic) Islamabad, between June 1995 - June 1997. Results: Among 45 IUCD users,

J A Nasir; J Najma; F Tahir; M Nadeem Asghar; Javed Iqbal

301

Estrous changes in vaginal nociception in a rat model of endometriosis  

Microsoft Academic Search

A rat model of endometriosis, in which pieces of uterine horn (versus fat in controls) are autotransplanted into the abdomen where they form cysts, reduces fecundity and produces vaginal hyperalgesia. The cysts gradually enlarge over a 2-month period postsurgically and then plateau. Cysts regress with low estrogen levels and reappear when they rise. Based on the hypothesis that the vaginal

Angie M. Cason; Chad L. Samuelsen; Karen J. Berkley

2003-01-01

302

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

303

What is the biblical attitude towards personal hygiene during vaginal bleeding?  

Microsoft Academic Search

Objective: To analyze biblical passages associated with personal hygiene during vaginal bleeding. According to the Bible, a woman who is menstruating or who has pathological vaginal bleeding is unclean. Anybody who touches such a woman’s bed or her personal things is also regarded as unclean and should therefore, wash carefully. Sexual relations are forbidden within 7 days from the beginning

2003-01-01

304

A masked randomized comparison of oral and vaginal administration of misoprostol for labor induction  

Microsoft Academic Search

Objective: To test the null hypothesis that administering misoprostol orally or vaginally will result in no difference in time to vaginal birth, and to determine whether different frequencies of tachysystole and hyperstimulation are associated with route of administration.Methods: Two hundred six women after 37 completed weeks’ gestation who presented with an indication for induction were randomly assigned to receive misoprostol

Kelly A. Bennett; Kimberly Butt; Joan M. G. Crane; Donna Hutchens; David C. Young

1998-01-01

305

Psychological and gynecological morbidity in women presenting with vaginal discharge in Pakistan  

Microsoft Academic Search

Gynecological morbidity has been reported to be associated with psychological distress among women. However, no formal research has been conducted in Pakistan on psychological and gynecological morbidity in women presenting with vaginal discharge. This study aimed (1) to examine whether women presenting with a primary complaint of vaginal discharge are more likely to have a Common Mental Disorder compared with

N. Khan; R. Kausar; C. Flach; L. Howard

2011-01-01

306

ESTRUS AND LH RELEASE IN OVARIECTOMIZED HEIFERS FOLLOWING VAGINAL DEVICES CONTAINING OVARIAN STERIODS 1 ,s  

Microsoft Academic Search

Summary An experiment was conducted to study the effects of Silastic vaginal devices containing either estradiol-1713, progesterone or progester- one + estradiol-1713 on estrus and luteinizing hormone (LH release in ovariectomized heifers. All heifers treated with a vaginal device that contained estradiol-1713 exhibited estrus and LH release, whereas none of those treated with devices that contained progesterone + estradiol-1713 exhibited

R. Rajamahendran; P. C. Lagu; R. D. Baker

307

Villous adenoma presenting as a vaginal polyp in a rectovaginal tract.  

PubMed

A 72-year-old woman had a villous adenoma of endodermal derivation involving the rectovaginal septum and contiguous mucosal surfaces that presented clinically as a vaginal polypoid tumor. To explain the vaginal involvement, we postulate that the adenoma traversed a tract of developmental origin within the rectovaginal septum. This is the first report of such a unique constellation of findings. PMID:3610138

Ciano, P S; Antonioli, D A; Critchlow, J; Burke, L; Goldman, H

1987-08-01

308

Lichen sclerosus with vaginal involvement: report of 2 cases and review of the literature.  

PubMed

IMPORTANCE Lichen sclerosus (LS) is an uncommon chronic inflammatory disease that most commonly affects anogenital skin of postmenopausal women. It typically manifests as atrophic white plaques, which may be accompanied by purpura or fissuring. Rarely, LS has been observed to affect mucosal tissues in the mouth and the penile urethra. It is generally taught that LS does not affect the vagina, unlike lichen planus. To our knowledge, only one case report of LS with vaginal involvement exists in the literature. OBSERVATIONS Two cases of severe vulvar LS with vaginal involvement are reported. Both cases exhibited characteristic features of LS on vaginal biopsy, and both patients were followed up clinically without further treatment of the vagina. CONCLUSIONS AND RELEVANCE Vaginal LS may be more common than previously thought and may be underdiagnosed. Patients with more severe disease or with significant vaginal atrophy may be more likely to have involvement of the vagina. In addition, patients with pelvic organ laxity may be at increased risk if their vaginal walls are chronically exposed because of prolapse. Physicians managing patients with vulvar LS should be aware of the possibility of vaginal involvement so that vaginal lesions may be diagnosed and followed up appropriately. PMID:23925660

Zendell, Kate; Edwards, Libby

2013-10-01

309

Determinantes del uso inconsistente del condón en mujeres que tienen sexo vaginal, oral y anal  

Microsoft Academic Search

Title: Consistent condom use determinants among woman that have vaginal, oral and anal sex. Abstract. Some variables from the psychological prevention model ap- plied to AIDS were examined as predictors of consistent condom use dur- ing vaginal, oral and anal sex among university woman. A cross-sectional correlational design was used with a sample of 355 university female stu- dents' age

Susana Robles Montijo; Julio Alfonso; Piña López; Diana Moreno Rodríguez

310

Primary Vaginal Stone in an 11YearOld Recumbent Girl  

Microsoft Academic Search

Primary vaginal stones are extremely rare, particularly in young women. We describe the occurrence of a primary vaginal calculus in a severely retarded 11-year-old girl who was not diagnosed until she was examined using computerized tomography. We postulate that the calculus was formed as a consequence of urinary contamination of the vagina in association with incontinence and prolonged maintenance in

Toshihiro Yoshimura; Yasushi Nagata; Kohei Matsuura; Hitoshi Okamura

2000-01-01

311

A Randomised Comparison of Oral and Vaginal Misoprostol for Medical Management of First Trimester Missed Abortion  

Microsoft Academic Search

The present study was done to compare the safety and efficacy of misoprostol administered orally and vaginally for medical management of first trimester missed abortion. 100 women with diagnosed missed abortion were taken for this prospective study. Group A comprised of 50 women who were given oral misoprostol and another 50 in-group B were administered vaginal misoprostol. Clinical outcome, time

Shashi Gupta; Surender Kumar

312

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

313

Modified Fletcher's 3-channel brachytherapy system with vaginal line source loading versus uterine tandem and vaginal cylinder system in Stage IIIA cervical cancer  

PubMed Central

Purpose The uterine tandem with open-ended vaginal cylinder is the most commonly used brachytherapy system for Federation Internationale de Gynecologie et d'Obstetrique (FIGO) Stage IIIA cervix cancer at the National Cancer Centre, Singapore. Without the 3-channel ovoid system, the dose to the parametrium is often compromised. In this study, a vaginal cylinder that could potentially be incorporated with the 3-channel system was developed, hence addressing the problem of treating both the vaginal disease extension and the parametrium. Methods and materials A hollow cylinder of 3 cm in diameter was incorporated with the Fletcher's 3-channel tandem and ovoid system. Treatment plans were generated with the single tandem line source with a vaginal cylinder applicator and the modified Fletcher's system using the Abacus version 3 brachytherapy treatment planning software. A nominal dose of 5 Gy was prescribed to point H for both plans. The perpendicular distance of the 5 Gy isodose line from the uterine tandem plane at the centre of the ovoid and the vaginal cylinder plane 1 cm below the os guard were then compared. Results The 5 Gy isodose line was 1.7 cm from the uterine tandem source at the location lateral through the centre of the ovoids on the plan with the uterine tandem and vaginal cylinder system as compared to a distance of 3.3 cm using the modified 3-channel Fletcher system. The 5 Gy isodose line was 2 cm lateral to the central source at the vaginal cylinder plane 1 cm below the os guard on the uterine tandem and vaginal cylinder system as compared to a distance of 2.5 cm on the Modified-Fletcher system. This corresponds to an increase of 1.6 cm and 0.5 cm depth of treated parametrium on the uterine tandem plane and vaginal cylinder plane respectively with the modified Fletcher's applicator as compared with the single line source cylinder system. Conclusion As compared with the single uterine tandem and open-ended vaginal cylinder system, an addition of 1.6 cm of the parametrium was covered within the 5Gy isodose on the uterine tandem plane and 0.5 cm on the vaginal cylinder plane with the modified Fletcher's applicator. A feasibility study was started to address the ease of insertion of this modified Fletcher system into patients.

Low, JSH; Ng, KB

2006-01-01

314

Laxity of the vaginal introitus after childbirth: nonsurgical outpatient procedure for vaginal tissue restoration and improved sexual satisfaction using low-energy radiofrequency thermal therapy.  

PubMed

Abstract Introduction: Vaginal childbirth may result in vaginal introital laxity, altered genital sensation during sexual intercourse, and reduced sexual satisfaction. We report the long-term effectiveness of a single nonsurgical procedure with radiofrequency (RF) energy for laxity at the vaginal introitus. Materials and Methods: Prospective single-arm study of 30 premenopausal women (21-52 year) with one 30-minute office procedure using RF applied to the vaginal introitus; 12-month outcome assessments included the linguistic validated Japanese versions of the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) and the Vaginal Laxity and Sexual Satisfaction Questionnaires. Results: Sexual function improved significantly throughout 6 months (30 subjects); mean FSFI total score was 22.4±6.7 before treatment and then improved to mean 26.0±5.8 at month 6 (P=0.002), inclusive of improved scores in five of six FSFI domains except desire (P<0.001 -<0.01). In the 22 of 30 subjects remaining evaluable at 12 months, the mean was 26.0±5.2 (P=0.08). Distress related to sexual activity decreased significantly; baseline FSDS-R mean score of 15.8±11.7 improved to 9.8±8.0 at one month and was sustained throughout 12 months (P<0.001?-?0.002). Subjects reported decreased vaginal laxity within the first month after the procedure (P<0.001); responses peaked, and effectiveness was sustained through 12 months (P<0.001). Conclusions: A single nonsurgical office-based RF procedure for vaginal introital laxity achieved significant and sustainable 12-month effectiveness with respect to improved integrity at the vaginal introitus and improved sexual satisfaction. Treatment was well-tolerated with no adverse events. PMID:23952177

Sekiguchi, Yuki; Utsugisawa, Yukari; Azekosi, Yoko; Kinjo, Manami; Song, Mihyon; Kubota, Yodhinobu; Kingsberg, Sheryl A; Krychman, Michael L

2013-08-16

315

An Evaluation of Risk Factors in Pregnant Women with Candida Vaginitis and the Diagnostic Value of Simultaneous Vaginal and Rectal Sampling  

Microsoft Academic Search

In this study, we investigated the epidemiological characteristics of VVC among pregnant women. We conducted a prospective\\u000a survey among 372 pregnant women to investigate the prevalence, clinical forms, etiological agents, and predisposing factors\\u000a of VVC. In addition, we determined the relationship between vaginal and rectal flora by simultaneously obtaining one high\\u000a vaginal swab and one rectal swab from each patient

Ahmet Bar?? Guzel; Macit Ilkit; Refik Burgut; ?brahim Ferhat Urunsak; Fatma Tuncay Ozgunen

316

Modified Fletcher's 3-channel brachytherapy system with vaginal line source loading versus uterine tandem and vaginal cylinder system in Stage IIIA cervical cancer  

Microsoft Academic Search

Purpose: The uterine tandem with open-ended vaginal cylinder is the most commonly used brachytherapy system for Federation Internationale de Gynecologie et d'Obstetrique (FIGO) Stage IIIA cervix cancer at the National Cancer Centre, Singapore. Without the 3-channel ovoid system, the dose to the parametrium is often compromised. In this study, a vaginal cylinder that could potentially be incorporated with the 3-channel

JSH Low; KB Ng

2006-01-01

317

Oral treatment of candida vaginitis: experience at the Special Treatment Clinic University College Hospital, Ibadan, Nigeria.  

PubMed

Seventy-four patients with clinical and laboratory diagnosis of candida vaginitis at Special Treatment Clinic, U.C.H., Ibadan were treated with daily dose of 400mg Ketoconazole (Nizoral) for 5 days. Forty had primary infection and 34 (46.0%) had recurrent infection. Vaginal skin infection, discharge, vulva pruritus and dyspareunia were the key symptoms and signs. Follow-up showed disappearance of findings a week following treatment except vaginal infection which was still present in 2 (2.9%) patients. Four weeks after treatment, 4--7% of the cases had one symptom or the other but more experienced dyspareunia. Mycological tests showed positive results in wet smear examination in 6.7%. Nevertheless, 80% of the 34 with recurrent infection preferred oral treatment to topical vaginal applications which they had had in the past. The implication of this result in treatment of acute and chronic vaginal candidosis in our community is discussed. PMID:1304794

Ojengbede, O A; Ochei, J

318

Outcome of pregnancy in HIV-positive women planned for vaginal delivery under effective antiretroviral therapy.  

PubMed

This retrospective cohort study was conducted at Newham University Hospital, London to investigate maternal outcome of planned vaginal delivery as well as rate of maternal-to-child transmission. Between June 2004 and June 2006, 23 (16%) women of 144 HIV-infected pregnant women opted for planned vaginal delivery. Offer of vaginal delivery was based on maternal HIV RNA count <50 cells/ml around 36 weeks' gestation. All women received antiretroviral therapy. Fifteen (65%) women achieved vaginal delivery. Babies were followed up over 18 months. All babies had antiretroviral prophylaxis. No babies were breast-fed. There was no report of maternal-to-child transmission in any of these babies. Our study suggests that planned vaginal delivery could be safe with antiretroviral therapy in pregnancy, optimal intrapartum care, viral load of <1000 copies/ml at delivery, retroviral prophylaxis for babies and avoidance of breast-feeding. PMID:20121502

Islam, S; Oon, V; Thomas, P

2010-01-01

319

Complete imperforate tranverse vaginal septum with septate uterus: A rare anomaly  

PubMed Central

The isolated, complete, transverse vaginal septum is one of the most infrequent anomalies of the female genital tract, and when it coexists with a septate uterus, it is even rarer. This report describes a case of transverse vaginal septum with septate uterus. A 12-year-old girl sought medical assessment because of severe cyclic lower abdominal cramping and pelvic pain. Local examination revealed a blind vaginal pouch of 2 cm and on rectal examination a tender pelvic mass was noted. Radiological examination showed transverse vaginal septum in the lower vagina with bicornuate uterus. Surgical resection of the vaginal septum was done under laparoscopic guidance. Hysteroscopy revealed presence of uterine septum which was resected by a resectoscope. Post-operative dilatation of vagina was done to prevent restenosis. Laparoscopic guided abdominoperineal approach is better in such a case as multiple mullerian anomalies may coexist with each other.

Jain, Nutan; Gupta, Anjali; Kumar, Ravindra; Minj, Agnes

2013-01-01

320

Complete imperforate tranverse vaginal septum with septate uterus: A rare anomaly.  

PubMed

The isolated, complete, transverse vaginal septum is one of the most infrequent anomalies of the female genital tract, and when it coexists with a septate uterus, it is even rarer. This report describes a case of transverse vaginal septum with septate uterus. A 12-year-old girl sought medical assessment because of severe cyclic lower abdominal cramping and pelvic pain. Local examination revealed a blind vaginal pouch of 2 cm and on rectal examination a tender pelvic mass was noted. Radiological examination showed transverse vaginal septum in the lower vagina with bicornuate uterus. Surgical resection of the vaginal septum was done under laparoscopic guidance. Hysteroscopy revealed presence of uterine septum which was resected by a resectoscope. Post-operative dilatation of vagina was done to prevent restenosis. Laparoscopic guided abdominoperineal approach is better in such a case as multiple mullerian anomalies may coexist with each other. PMID:23869157

Jain, Nutan; Gupta, Anjali; Kumar, Ravindra; Minj, Agnes

2013-01-01

321

New solid mucoadhesive systems for benzydamine vaginal administration.  

PubMed

The aim of this work was the realization of new formulations for vaginal application to improve the pharmacological effect of benzydamine, displaying both anti-inflammatory and antiseptic activities. For this reasons, this drug was formulated in solid dispersions, by using the mucoadhesive polymers HPMC and/or Carbopol(®), then compressed. Tablets were characterized by studies of friability, hardness, hydration, DSC, mucoadhesion and in vitro release. Kinetics, responsible for drug delivery, was investigated as well. Tablets prepared by using only HPMC showed the best results in terms of swelling and mucoadhesion (time and force) together with prolonged and complete drug release, by diffusive mechanism, through gelled layer. Despite the good mucoadhesive properties, Carbopol(®) does not represent a good excipient because, after the contact with water, it generates a spongy gel layer, not homogeneous, stiff, brittle and with breaking tendency when highly swelled. This kind of gel does not guarantee a linear drug release and could provoke discomfort because of fragment release. HPMC mucoadhesive tablets could be a proper delivery system for benzydamine administration representing a good alternative to traditional dosage forms for vaginal topical therapy. PMID:21354770

Perioli, Luana; Ambrogi, Valeria; Pagano, Cinzia; Massetti, Elena; Rossi, Carlo

2011-02-01

322

Vaginal myofibroblastoma with glands expressing mammary and prostatic antigens.  

PubMed

A case of unusual vaginal myofibroblastoma containing glands which expressed mammary and prostatic markers is described. The tumor occurred in 70-year-old woman in the proximal third of the vagina. It showed morphology and immunophenotype typical of so-called cervicovaginal myofibroblastoma. The peripheral zone of the lesion contained a few groups of glands suggesting vaginal adenosis or prostatic-type glands on initial examination. The glands showed a surprising simultaneous expression of mammary markers mammaglobin and GCDFP-15 and prostatic markers prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP). Immunostains for alpha-smooth muscle actin, p63 and CD10 highlighted the myoepithelial cell layer of the glands. The finding indicates that simultaneous use of both mammary and prostatic markers for examination of unusual glandular lesions in the vulvovaginal location can be helpful for an exact diagnosis, and can contribute to better understanding of prostatic and mammary differentiations in the female lower genital tract. PMID:22716011

Wallenfels, I; Chlumská, A

2012-01-01

323

[The vaginal Bifidobacterium flora in women of reproductive age].  

PubMed

The composition of vaginal bifidoflora in 56 clinically healthy women of reproductive age was studied. The study revealed that four species of bifidobacteria, viz. Bifidobacterium bifidum, B. breve, B. adolescentis 2 and B. longum, dominated in the composition of this bifidobacterial population. Nine out of 11 isolated strains were found to be capable of inhibiting indicator microorganisms Staphylococcus aureus and Enterococcus faecalis when tested in vitro; in addition, strains B. adolescentis 2 F1, B. bifidum G1, B. breve P2 and B. longum Z4 inhibited Klebsiella ozaenae, Pseudomonas aeruginosa, Escherichia coli and were also active acid producers. Three of these 4 bifidobacterial strains were capable of adhesion to vaginal epitheliocytes, while B. bifidum G1 was practically incapable of adherence to these cells, similarly to B. bifidum strain 791 of intestinal origin. In addition, the spectra of antibiotic susceptibility varied from strain to strain, but all bifidobacterial strains were susceptible to benzylpenicillin and resistant to lomefloxacin, most of them being also resistant to cyprofloxacin and gentamicin. Thus the data presented in this work are indicative of the possibility and advantages of using bifidobacterial strains belonging to this ecological niche as probiotics for the correction of the microflora of the urogenital tract in females. PMID:10852059

Korshunov, V M; Gudieva, Z A; Efimov, B A; Pikina, A P; Smeianov, V V; Reid, G; Korshunova, O V; Tiutiunnik, V L; Stepin, I I

324

[Tubulosquamous vaginal polyp. Case report with respect to histogenesis].  

PubMed

Tubulosquamous vaginal polyp is a rare form of lesion. It is thought to derive from displaced paraurethral Skene's gland which is the female equivalent of the prostate gland in men. We report on a case of tubulosquamous vaginal polyp in a 77-year-old female patient. Histological examination showed prominent epithelial nests in a spindle cell-rich stroma. The nests were predominantly squamous in type with small tubules at the periphery of the island. Using immunohistochemistry the tubules were found to be positive for CK7, prostate-specific acidic phosphatase (PAP) and androgen receptor (AR) but negative for CK 5/6 and prostate-specific antigen (PSA). The solid parts were positive for CK5/6 and most interestingly, also expressed AR but not CK7, PAP or PSA. The stroma also showed strong staining for AR but not for the other markers applied. To our knowledge this is the first report on AR expression in this benign polyp. Our findings confirm the view that tubulosquamous polyp of the vagina is derived from paraurethral Skene's gland. PMID:22350170

Hansen, T; Macchiella, D; Kirkpatrick, C J

2012-03-01

325

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

326

Effects of multiple applications of benzalkonium chloride and nonoxynol 9 on the vaginal epithelium in the pigtailed macaque ( Macaca nemestrina)  

Microsoft Academic Search

Objective: Safe and effective vaginally applied microbicides could help to control the continuing spread of sexually transmitted diseases. Study Design: This study used nonhuman primates to test the effects of multiple applications of nonoxynol 9, benzalkonium chloride, or a combination on vaginal flora and lower reproductive tract tissues. Fourteen monkeys (Macaca nemestrina) received daily vaginal applications of nonoxynol 9, benzalkonium

Dorothy L. Patton; Gretchen Ganzle Kidder; Yvonne Cosgrove Sweeney; Lorna K. Rabe; Sharon L. Hillier

1999-01-01

327

Clinical effects of selective estrogen receptor modulators on vulvar and vaginal atrophy.  

PubMed

OBJECTIVE: Vaginal estrogen therapy at the lowest effective dose is generally recommended for the treatment of vulvar and vaginal atrophy (VVA), but not all women are candidates. Selective estrogen receptor modulators (SERMs) aim to elicit specific positive effects on targeted tissues with neutral or minimal negative effects on other tissues. This review compares the vaginal effects of currently available and investigational SERMs. METHODS: Relevant English-language articles published between 1980 and 2012 were identified through the PubMed database (search string "[Selective Estrogen Receptor Modulator OR SERM] AND [Vulvar OR Vaginal] AND Atrophy"), article reference lists, and EMBASE searches for individual SERMs. Both authors reviewed all articles, which formed the basis of this narrative literature review. RESULTS: Activity profiles of SERMs in various tissues are distinct. Tamoxifen and arzoxifene have no specific positive vaginal effects but have reported variable or adverse gynecologic effects. Raloxifene does not improve VVA but can be used safely in combination with vaginal estrogen. Bazedoxifene has no demonstrated efficacy for VVA but, in combination with oral conjugated equine estrogens, improves the signs and symptoms of VVA. SERMs with positive vaginal effects (such as improvement in the vaginal maturation index, reduced vaginal pH, and improvement in the signs and symptoms of VVA) on postmenopausal symptomatic women include lasofoxifene (clinical development on hold) and ospemifene, which was recently approved for the treatment of VVA-related dyspareunia, with a class effect warning of potential venous thrombosis risk. CONCLUSIONS: SERMs that specifically target the pathophysiology underlying VVA may provide an alternative to vaginal or systemic estrogen therapy. PMID:23777900

Pinkerton, Joann V; Stanczyk, Frank Z

2013-06-18

328

Dietary supplementation with probiotics during late pregnancy: outcome on vaginal microbiota and cytokine secretion  

PubMed Central

Background The vaginal microbiota of healthy women consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the genus Lactobacillus. The activity of lactobacilli helps to maintain the natural healthy balance of the vaginal microbiota. This role is particularly important during pregnancy because vaginal dismicrobism is one of the most important mechanisms for preterm birth and perinatal complications. In the present study, we characterized the impact of a dietary supplementation with the probiotic VSL#3, a mixture of Lactobacillus, Bifidobacterium and Streptococcus strains, on the vaginal microbiota and immunological profiles of healthy women during late pregnancy. Results An association between the oral intake of the probiotic VSL#3 and changes in the composition of the vaginal microbiota of pregnant women was revealed by PCR-DGGE population profiling. Despite no significant changes were found in the amounts of the principal vaginal bacterial populations in women administered with VSL#3, qPCR results suggested a potential role of the probiotic product in counteracting the decrease of Bifidobacterium and the increase of Atopobium, that occurred in control women during late pregnancy. The modulation of the vaginal microbiota was associated with significant changes in some vaginal cytokines. In particular, the decrease of the anti-inflammatory cytokines IL-4 and IL-10 was observed only in control women but not in women supplemented with VSL#3. In addition, the probiotic consumption induced the decrease of the pro-inflammatory chemokine Eotaxin, suggesting a potential anti-inflammatory effect on the vaginal immunity. Conclusion Dietary supplementation with the probiotic VSL#3 during the last trimester of pregnancy was associated to a modulation of the vaginal microbiota and cytokine secretion, with potential implications in preventing preterm birth. Trial registration ClinicalTrials.gov NCT01367470

2012-01-01

329

An audit of singleton breech deliveries in a hospital with a high rate of vaginal delivery.  

PubMed

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

330

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.

Chinawa, JM; Obu, HA; Uwaezuoke, SN

2013-01-01

331

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.

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

2009-01-01

332

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.

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

2010-01-01

333

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

334

A novel itraconazole bioadhesive film for vaginal delivery: design, optimization, and physicodynamic characterization.  

PubMed

The purpose of this work was to design and optimize a novel vaginal drug delivery system for more effective treatment against vaginal candidiasis. Itraconazole was formulated in bioadhesive film formulations that could be retained in the vagina for prolonged intervals. The polymeric films were prepared by solvent evaporation and optimized for various physicodynamic and aesthetic properties. In addition, percentage drug retained on vaginal mucosa was evaluated using a simulated dynamic vaginal system as function of time. A polymeric film containing 100 mg itraconazole per unit (2.5 cm x 2.5 cm) have been developed using generally regarded as safe listed excipients. The pH of vaginal film was found to be slightly acidic (4.90 +/- 0.04) in simulated vaginal fluid and alkaline (7.04 +/- 0.07) in water. The little moisture content (7.66 +/- 0.51% w/w) was present in the film, which helps them to remain stable and kept them from being completely dry and brittle. The mechanical properties, tensile strength, and percentage elongation at break (9.64 N/mm(2) and 67.56% for ITRF(65)) reveal that the formulations were found to be soft and tough. The films (ITRF(65)) contained solid dispersion of itraconazole (2.5)/hydroxypropyl cellulose (1)/polyethylene glycol 400 (0.5), which was found to be the optimal composition for a novel bioadhesive vaginal formulation, as they showed good peelability, relatively good swelling index, and moderate tensile strength and retained vaginal mucosa up to 8 h. Also, the film did not markedly affect normal vaginal flora (lactobacillus) and was noncytotoxic as indicated by the negligible decrease in cell viability. PMID:19629707

Dobaria, Nitin B; Badhan, A C; Mashru, R C

2009-07-24

335

Evaluation of vaginal pH for detection of bacterial vaginosis.  

PubMed

Background & objectives : Bacterial vaginosis (BV) is highly prevalent among women in reproductive age group. Little information exists on routine vaginal p H measurement in women with BV. We undertook this study to assess the utility of vaginal p H determination for initial evaluation of bacterial vaginosis. Methods : In this cross-sectional study vaginal swabs were collected from women with complaints of white discharge, back ache and pain abdomen attending a government hospital and a community health clinic, and subjected to vaginal p H determination, Gram stain, wet mount and whiff test. Nugent score and Amsel criteria were used for BV confirmation. Results : Of the 270 women included in the analysis, 154 had BV based on Nugents' score. The mean vaginal p H in women with BV measured by p H strips and p H glove was 5 and 4.9, respectively. The vaginal p H was significantly higher in women with BV. Vaginal discharge was prevalent in 84.8 per cent women, however, only 56.8 per cent of these actually had BV by Nugent score (NS). Presence of clue cells and positive whiff test were significant for BV. Vaginal p H >4.5 by p H strips and p H Glove had a sensitivity of 72 and 79 per cent and specificity of 60 and 53 per cent, respectively to detect BV. Among the combination criteria, clue cells and glove p H >4.5 had highest sensitivity and specificity to detect BV. Interpretation & conclusions : Vaginal p H determination is relatively sensitive, but less specific in detecting women with BV. Inclusion of whiff test along with p H test reduced the sensitivity, but improved specificity. Both, the p H strip and p H glove are equally suitable for screening women with BV on outpatient basis. PMID:24135180

Hemalatha, R; Ramalaxmi, Baru Anantha; Swetha, Eluru; Balakrishna, N; Mastromarino, Paola

2013-09-01

336

Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy  

PubMed Central

Objective The aim of this study was to demonstrate the efficacy of an ultra-low-dose vaginal estriol 0.03 mg in combination with viable Lactobacillus acidophilus KS400 (Gynoflor® vaginal tablets) in the short-term therapy and to investigate the long-term maintenance dose in the treatment of vaginal atrophy. Methods This was a double-blind, randomized, placebo-controlled study (Controlled phase – initial therapy) followed by an open-label follow-up (Open phase – test medication initial and maintenance therapy). Included were postmenopausal women with vaginal atrophy symptoms and Vaginal Maturation Index (VMI) of ? 40%. The method of treatment was initial therapy with test medication (or placebo in first phase), one vaginal tablet daily for 12 days, followed by maintenance therapy, one tablet on two consecutive days weekly for 12 weeks. Results A total of 87 women completed the study. The Controlled phase results for a change in VMI demonstrated superiority of the 0.03 mg estriol–lactobacilli combination to placebo (p < 0.001). In the test group, the positive change in VMI was 35.2%, compared to 9.9% in the placebo group. In the Open phase after the initial therapy, the VMI was increased to 55.4% and, during maintenance therapy, it stayed at a comparable level (52.8–49.4%). The maturation of epithelium was followed by improvement of clinical symptoms and normalization of the vaginal ecosystem. Conclusions The ultra-low-dose, vaginal 0.03 mg estriol–lactobacilli combination (Gynoflor®) was superior to placebo with respect to changes in VMI after the 12-day initial therapy, and the maintenance therapy of two tablets weekly was sufficient to prevent the relapse of vaginal atrophy.

2013-01-01

337

Genetic basis for recurrent vulvo-vaginal candidiasis.  

PubMed

Vulvovaginal candidiasis (VVC) is a frequent disease affecting more than 75% of all women at least once in their lifetime. Up to 8% of them suffer from recurrent VVC (RVVC) characterized by at least three episodes each year. Several risk factors, such as antibiotic use, diabetes, or pregnancy, are known, but the vast majority of women with RVVC develop the infection without having any risk factor, implying that a genetic component most likely plays an important role in the susceptibility to RVVC. This review summarizes the immunogenetic alterations that lead to an increased susceptibility to vaginal infections with Candida albicans. Different mutations and polymorphisms in innate immune genes alter the mucosal immune response against fungi and are likely to have an important role in susceptibility to RVVC. A better understanding of the genetic and immunological mechanisms leading to RVVC is important for both the understanding of the pathophysiology of the disease and the design of novel therapeutic strategies. PMID:23354953

Jaeger, Martin; Plantinga, Theo S; Joosten, Leo A B; Kullberg, Bart-Jan; Netea, Mihai G

2013-04-01

338

Vaginal vascular malformation mimicking pelvic organ prolapse requiring serial embolizations.  

PubMed

Vaginal vascular malformation (VVM) is rare. There are, in fact, less than ten cases reported to date. VVM often presents as a mass protruding from the vagina, mimicking pelvic organ prolapse (POP). It can coexist with POP, thereby usually exaggerating the severity of POP. We report a case of VVM in a premenopausal woman who presented as severe POP and urinary incontinence. The diagnosis was confirmed with computed tomography (CT) scan and angiography. The patient underwent conservative management with embolization. These procedures had to be repeated three times in 1.5 years due to lesion recurrence. In mitigation, conservative treatment eliminates the risks associated with surgery, e.g. massive hemorrhage and visceral injuries. It does, however, require a long course of treatment and follow-up. PMID:23430075

Pue, Leng Boi; Lo, Tsia-Shu; Wu, Pei-Ying

2013-02-21

339

[Exfoliative vaginal cytology in the bitch - indications, procedure, interpretation].  

PubMed

Exfoliative vaginal cytology as an essential part of the gynaecological examination is a simple, non-invasive method for the determination of the phases of the oestrous cycle (anoestrus, prooestrus/oestrus, metoestrus) and is additionally applied in cases of silent heat, or suspected ovarian cysts, ovarian remnant syndrome, postpartal disturbances in the endometrial involution or Sticker sarcoma. The exfoliated cells reflect the hormonal, in particular the oestrogenic state, of the bitch. Due to the oestrogenic influence, an increase in cell layers, keratinisation and exfoliation is observed in the follicular phase during prooestrus, such that the 3-4 layered epithelium in anoestrus becomes 20-layered during oestrus. The cells change characteristically in size and nuclear morphology. In anoestrus, predominantly parabasal cells with a large nucleus and homogenous cytoplasm are found. During early prooestrus, single parabasal cells are identified among erythrocytes and intermediate cells. As this phase progresses, the percentage of large intermediate cells and nucleated superficial cells increases. The oestrus is characterised by a high cell number, initially superficial cells with pyknotic nuclei, later anucleated squamous cells that are located in cell nests. The switch to metoestrus is associated with a large number of neutrophil granulocytes and a sudden change of cytology within 24-48 hours. Vaginal cytology can be performed in any practice due to its simplicity and the limited equipment necessary (speculum, cotton wool wad, slide, staining and microscope). Because the results are rapidly available, it is a useful addition to gynaecological examination to differentiate the stage of the cycle (anoestrus, prooestrus/oestrus, metoestrus) and to diagnose infectious, inflammatory and tumorous conditions in the bitch. PMID:23958711

Wehrend, A; von Plato, K; Goericke-Pesch, S

2013-08-20

340

Changes in uterine size after vaginal delivery and cesarean section determined by vaginal sonography in the puerperium.  

PubMed

There have been few reports on postpartum changes in the uterus during the three months after delivery. The aim of this study was to evaluate uterine morphological changes in women after vaginal delivery (n=262-351) and in women after cesarean section (n=64-82) and to evaluate the relation between breast-feeding and parity, and uterine involution at 1 and 3 months postpartum measured by vaginal ultrasonography. There were no significant differences in parity between the vaginal delivery group and the cesarean section group. The length of the uterus at one month (7.93+/-1.16 cm, mean+/-SD) and, three months (7.03+/-1.19 cm) and the width of the uterus at three months (3.83+/-0.94 cm) after delivery in the cesarean section group were greater than in the transvaginal group (7.64+/-1.03 cm, 6.65+/-0.99 cm, 3.57+/-0.62 cm, respectively). Increasing maternal parity was associated slightly with larger uterine size at one month post partum. The length of the uterus of women with a breast-feeding rate of 80% or more per day was 6.35+/-0.85 cm, and shorter than in women with a rate of 20% or less 7.03+/-1.04 cm, at three months after delivery. The width of the uterine body of women with a breast-feeding rate of 80% or more per day was 3.32+/-0.45 cm, and shorter than in women with a rate of 20% or less 3.87+/-0.66 cm, at 3 months after delivery. Stepwise regression and multiple regression analysis among parity, the history of cesarean section, the breast-feeding rate at one and three months after the delivery, and the restoration of the menses at three months after the delivery showed that the uterine size at one month after the delivery was related to the cesarean section and that the uterine size at three months after delivery was mostly related to the rate of breast-feeding. These results indicated that uterine involution was related to delivery mode at one and three months postpartum, feeding mode at three months postpartum, the menses restoration, and parity. The rate of breastfeeding was mostly related to the uterine size at three months postpartum. PMID:10728621

Negishi, H; Kishida, T; Yamada, H; Hirayama, E; Mikuni, M; Fujimoto, S

1999-11-01

341

The vaginal microbiome: New information about genital tract flora using molecular based techniques  

PubMed Central

Vaginal microbiome studies provide information which may change the way we define vaginal flora. Normal flora appears dominated by one or two species of Lactobacillus. Significant numbers of healthy women lack appreciable numbers of vaginal lactobacilli. Bacterial vaginosis (BV) is not a single entity, but different bacterial communities or profiles of greater microbial diversity than is evident from cultivation-dependent studies. BV should be considered a syndrome of variable composition which results in different symptoms, phenotypical outcomes, and responses to different antibiotic regimens. This information may help to elucidate the link between BV and infection-related adverse outcomes of pregnancy.

Lamont, Ronald F.; Sobel, Jack D.; Akins, Robert A.; Hassan, Sonia S.; Chaiworapongsa, Tinnakorn; Kusanovic, Juan Pedro; Romero, Roberto

2011-01-01

342

A young woman with distant recurrent metastatic primary vaginal carcinoma salvaged with radical radiotherapy.  

PubMed

The incidence of distant recurrent metastatic primary vaginal carcinoma is rare. The prognosis in such cases is poor, with cure being extremely rare. We report the case of a young woman, with distant recurrent metastatic primary vaginal carcinoma in which the patient remains disease-free 5 years after completing salvage radical radiotherapy. The clinical management of recurrent metastatic primary vaginal carcinoma must be tailored to the site of recurrence and the patient's performance status. Complete clinical remission and long-term survival without evidence of disease may be achieved in rare cases with radical radiotherapy. PMID:18935926

Thoms, John; Berendt, Richard; Pearcey, Robert

2008-09-01

343

Relation between vaginal and endocervical pH in pre- and post-menopausal women  

Microsoft Academic Search

We aimed to verify whether vaginal fornix pH is related to endocervical pH and whether or not acid pH could contribute to the prophylactic treatment of vaginal infections. Four groups of healthy women with or without uterus were selected: pre-menopausal (>39 years) and post-menopausal (PP=0.009). Pre- and post-menopausal hysterectomized women presented more acid vaginal pH than non-hysterectomized women, 4.35 versus 5.1

Eddie F. C. Murta; Antônio C. A. Filho; Ana C. M. Barcelos

2005-01-01

344

Adaptation process of the skin graft to vaginal mucosa after McIndoe vaginoplasty  

Microsoft Academic Search

Objective  There are many methods of treatment of vaginal agenesis.\\u000a \\u000a \\u000a \\u000a Methods  In this study, patients who underwent McIndoe vaginoplasty were evaluated for development of vaginal mucosa. Vaginal pH measurements,\\u000a smears, and punch biopsies were obtained from seven patients postoperatively at 3, 6, and 12 months after having McIndoe vaginoplasty.\\u000a \\u000a \\u000a \\u000a Results  Neovaginal smears indicated no specific data for mucosal development at the 3rd and 6th

M. Bekerecioglu; O. Balat; M. Tercan; M. Karakok; M. G. Ugur; D. Isik

2008-01-01

345

Differences in Vaginal Lactobacilli Composition of Iranian Healthy and Bacterial Vaginosis Infected Women: A Comparative Analysis of Their Cytotoxic Effects with Commercial Vaginal Probiotics  

PubMed Central

Background Vaginal flora of healthy women is dominated by Lactobacillus species which can prevent bacterial vaginosis. Objectives The current study aimed to determine the differences in vaginal lactobacilli composition of Iranian healthy and bacterial vaginosis (BV) infected women and compared their cytotoxic effects with commercial vaginal probiotics. Patients and Methods One hundred and seventy eight vaginal specimens were collected from healthy and BV infected women. Lactobacillus colonies were obtained by culturing on laked blood BHI and MRS medias and genetically defined by 16s rRNA sequencing. Differentiating the specimens to normal, intermediate and BV infected were carried out by Ison and Hey grading protocol. Identification of Lactobacillus strains in vaginal specimens were performed by Multiplex PCR. The inhibitory effects of lactobacilli on Hela (tumoral cervical cells) and HNCF-pi52 (normal cervical cells) were conducted by MTT and trypan blue assays. Results L. crispatus, L. gasseri, L. iners, L. jensenii, L. acidophilus and L. rhamnosus were the most frequently occurring species in vagina of healthy Iranian women. L. crispatus and L. jensenni were significantly higher in the normal than in the BV infected groups. Also the cytotoxic effect of L. crispatus on tumoral cervical cells was higher than other lactobacilli including commercial probiotics. Conclusions As L. crispatus and L. jensenni were significantly higher in BV infected women and the cytotoxic effect of L. crispatus on tumoral cervical cells was high, introduction of new probiotics seems necessary.

Motevaseli, Elahe; Shirzad, Mahdieh; Raoofian, Reza; Hasheminasab, Seyyed-Mohammad; Hatami, Maryam; Dianatpour, Mehdi; Modarressi, Mohammad-Hossein

2013-01-01

346

Angiographic findings after vaginal gauze packing: New insight into an old technique.  

PubMed

We had a transferred case of cervical ectopic pregnancy with hemorrhagic shock at 6 weeks of gestation. Upon arrival at hospital, we performed tight and full vaginal gauze packing to push the uterus upward to control the patient's hemorrhage. Following stabilization of her general condition, she was treated with uterine artery embolization. Using angiography, the effectiveness of vaginal gauze packing for emergency hemostasis by the presumed mechanism of impairing blood flow through the uterine artery was demonstrated. To our knowledge, there are no reports that have previously demonstrated angiographic findings similar to ours after vaginal gauze packing. Vaginal gauze packing is an effective, rapid, and convenient hemostatic procedure able to be carried out in a time-sensitive and challenging situation. As a result, this procedure gives clinicians more time to improve the patients' general status and arrange for transfusion and further definitive treatment. PMID:23551298

Koyama, Shinsuke; Maeda, Munehiro; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko

2013-04-03

347

A surgical window to access the obliterated posterior cul-de-sac at vaginal hysterectomy  

Microsoft Academic Search

ObjectiveTo perform vaginal hysterectomy and adnexectomy without laparoscopic assistance in women with ovarian endometriosis by accessing the posterior cul-de-sac via the posterior uterocervical–broad ligament space.

Shirish S. Sheth

2009-01-01

348

LAPAROSCOPIC VAGINAL RECONSTRUCTION USING A SIGMOID COLON SEGMENT: A PRELIMINARY REPORT  

Microsoft Academic Search

Purpose:Sigmoid vaginoplasty is an alternative technique for vaginal replacement. We describe the successful use of laparoscopy for reconstruction of a vagina in patients with the Mayer-Rokitansky-Kuster-Hauser syndrome.

W. URBANOWICZ; J. STARZYK; J. SULISLAWSKI

2004-01-01

349

Complications and untoward effects of the tension-free vaginal tape procedure  

Microsoft Academic Search

ObjectiveTo report our experience with our first 350 cases of tension-free vaginal tape (TVT), specifically assessing intraoperative complications, postoperative morbidity, and untoward effects of the procedure.

Mickey M. Karram; Jeffery L. Segal; Brett J. Vassallo; Steven D. Kleeman

2003-01-01

350

Sedation with local versus general anesthesia for the tension-free vaginal tape Secur hammock procedure  

Microsoft Academic Search

ObjectiveTo compare the intraoperative and immediate postoperative results achieved with the tension-free vaginal tape Secur (TVT-S) hammock procedure performed under local anesthesia (LA) versus general anesthesia (GA).

Francesco Araco; Gianpiero Gravante; Roberto Sorge; John Overton; Francesca Castrì; Mario Primicerio; Emilio Piccione

2011-01-01

351

Caesarean delivery or vaginal birth: preference of Turkish pregnant women and influencing factors.  

PubMed

The aim of this study was to assess the preference of pregnant women for mode of delivery in an uncomplicated pregnancy and reasons of their choice, also to determine if maternal characteristics were predictors of maternal preference. Pregnant women applying to the antenatal clinic for a routine control visit were recruited. After verbal consents, a questionnaire was administered to 1,588 pregnant women. Of the women questioned, 84.1% opted for vaginal delivery whereas only 15.9% opted for an elective caesarean delivery. The main reasons for vaginal delivery preference were; earlier healing and earlier hospital discharge, being a more physiological way of delivery and previous vaginal delivery history. The most common reasons for choosing caesarean delivery were; fear of vaginal delivery, tubal ligation demand and to avoid labour pain. Educational status, occupation and gestational age were not found to be influencing factors but age, parity and monthly income were found to be influencing factors for maternal preference. PMID:20143975

Buyukbayrak, E E; Kaymaz, O; Kars, B; Karsidag, A Y K; Bektas, E; Unal, O; Turan, C

2010-02-01

352

Vaginal Wall Sling for Anatomical Incontinence and Intrinsic Sphincter Dysfunction: Efficacy and Outcome Analysis  

Microsoft Academic Search

PurposeA prospective cohort study was done to determine the efficacy and clinical outcome of a new technique for anterior vaginal wall sling construction to treat urinary incontinence due to intrinsic sphincter dysfunction or anatomical incontinence.

Shlomo Raz; Lynn Stothers; George P. H. Young; Julie Short; Barbara Marks; Ashok Chopra; Gregory R. Wahle

1996-01-01

353

Vaginal evisceration 3 years after abdominal hysterectomy and bilateral salpingo-oophorectomy.  

PubMed

Vaginal evisceration after a pelvic operation is a rare gynecological emergency. When intercourse is the cause, most cases occur within 1 year of surgery. A 53-year-old woman presented to the emergency room for vaginal evisceration half a day after the first postoperative occurrence of intercourse 3 years after an abdominal hysterectomy and bilateral salpingo-oophorectomy. In an emergency laparotomy, the protruding small bowel was replaced within the abdominal cavity. The avulsed vaginal cuff, which measured 6 cm in length and had atrophic but non-necrotic margins, was sutured. Women who go for long periods without intercourse after a hysterectomy, especially post-menopausal women, should be made aware of unrecognized vaginal atrophy that could, in some cases, lead to rupture and evisceration during the next occurrence of intercourse. PMID:22612271

Orito, Seiya; Masuya, Norio; Sakurabashi, Ayako; Minoura, Shigeki

2012-05-21

354

Volatile fatty acid findings in vaginal fluid compared with symptoms, signs, other laboratory results, and susceptibility to tinidazole of malodorous vaginal discharges.  

PubMed Central

The relevance of volatile fatty acids as a diagnostic test in 79 women with abnormal vaginal discharge was evaluated by a blind, randomised, and placebo controlled trial of tinidazole as a single oral 2 g dose. Automated gas chromatography of ether extracts of discharges taken before treatment showed volatile fatty acids in 18. Volatile fatty acids correlated with malodorous, colour, and microscopically assessed altered bacterial flora and clue cells. At follow up one week later, the odour, colour, and volatile fatty acids in the vaginal discharge of women treated with tinidazole had become normal more often than in those receiving placebo. The disappearance of volatile fatty acids correlated with clinically assessed improvement in women treated with tinidazole. The volatile fatty acid test as an indicator of anaerobic bacterial flora is objective, technically simple and fast, has few problems of sample size and transportation, and may be useful in the aetiological classification and follow up treatment of non-specific vaginal discharges.

Jokipii, A M; Jokipii, L; Vesterinen, E; Purola, E; Vartiainen, E; Paavonen, J

1986-01-01

355

The Secreted Aspartyl Proteinases Sap1 and Sap2 Cause Tissue Damage in an In Vitro Model of Vaginal Candidiasis Based on Reconstituted Human Vaginal Epithelium  

PubMed Central

Secreted aspartyl proteinases (Saps) contribute to the ability of Candida albicans to cause mucosal and disseminated infections. A model of vaginal candidiasis based on reconstituted human vaginal epithelium (RHVE) was used to study the expression and role of these C. albicans proteinases during infection and tissue damage of vaginal epithelium. Colonization of the RHVE by C. albicans SC5314 did not cause any visible epithelial damage 6 h after inoculation, although expression of SAP2, SAP9, and SAP10 was detected by reverse transcriptase PCR. However, significant epithelial damage was observed after 12 h, concomitant with the additional expression of SAP1, SAP4, and SAP5. Additional transcripts of SAP6 and SAP7 were detected at a later stage of the artificial infection (24 h). Similar SAP expression profiles were observed in three samples isolated from human patients with vaginal candidiasis. In experimental infection, secretion of antigens Sap1 to Sap6 by C. albicans was confirmed at the ultrastructural level by using polyclonal antisera raised against Sap1 to Sap6. Addition of the aspartyl proteinase inhibitors pepstatin A and the human immunodeficiency virus proteinase inhibitors ritonavir and amprenavir strongly reduced the tissue damage of the vaginal epithelia by C. albicans cells. Furthermore, SAP null mutants lacking either SAP1 or SAP2 had a drastically reduced potential to cause tissue damage even though SAP3, SAP4, and SAP7 were up-regulated in these mutants. In contrast the vaginopathic potential of mutants lacking SAP3 or SAP4 to SAP6 was not reduced compared to wild-type cells. These data provide further evidence for a crucial role of Sap1 and Sap2 in C. albicans vaginal infections.

Schaller, Martin; Bein, Matthias; Korting, Hans C.; Baur, Stefan; Hamm, Gerald; Monod, Michel; Beinhauer, Sabine; Hube, Bernhard

2003-01-01

356

Bacterial vaginosis: what is physiological in vaginal bacteriology? An update and opinion.  

PubMed

Bacterial vaginosis (BV) was originally described as a sexually transmitted infection caused by a single microbe. The prevailing concept describes BV as a polymicrobial coitus-associated disease of uncertain origin. In this overview the natural history of BV as a monobacterial and polymicrobial entity is examined with respect to the physiological concept of BV in relation to sexual behavior before and after introduction of the hormonal contraceptive pill. Bacterial vaginosis, characterized by low vaginal acidity (elevated pH) and replacement of vaginal Lactobacillus by Gardnerella vaginalis flora, could be caused by unprotected intercourse when a low pH changes through the neutralizing power of male ejaculate, vaginal coital transudate and vaginal neurogenic transudate. A monobacterial form, G. vaginalis vaginitis, could be a physiological post-coital condition for protection of ejaculated spermatozoa, characterized by 'pure'Gardnerella flora and elevated pH as an immediate result of an incidental unprotected coital act through neutralization of vaginal acid and replacement of Lactobacillus by Gardnerella flora. A polymicrobial form of BV could be autoinfection of the post-coital physiological G. vaginalis flora, characterized by a mixture of G. vaginalis, Mycoplasma hominis and anaerobic bacteria at lower vaginal acidity, possibly resulting from suppression of normal vaginal acidity through repeated sexual acts, with a resultant higher pH and transfer of enteric bacteria from the perianal region. Monobacterial and polymicrobial auto-infectious forms of BV may be clinically distinct and share a common origin. The understanding of BV as a basic physiological entity could influence the prophylaxis and treatment of the largely therapy-resistant polymicrobial BV. PMID:21916857

Leppäluoto, Pentti A

2011-10-17

357

Efficiency of lyticase (bacterial enzyme) in experimental candidal vaginitis in mice.  

PubMed

Lyticase (a bacterial enzyme) was tested as a new antimycotic drug. Of all objects studied, Cellulomonas cellulans AC-870 strain proved to be most productive for this enzyme. A technology for lyticase isolation and purification was proposed. An experimental model of recurrent vaginal candidiasis was created. The model includes combined antibiotic and estradiol therapy. Antimycotic effect of lyticase on the model of recurrent vaginal candidiasis in mice was demonstrated. PMID:21165431

Sachivkina, N P; Kravtsov, E G; Wasileva, E A; Anokchina, I V; Dalin, M V

2010-11-01

358

Planned cesarean section versus planned vaginal delivery: comparison of lower urinary tract symptoms  

Microsoft Academic Search

We compared the prevalence and risk of lower urinary tract symptoms in healthy primiparous women in relation to vaginal birth\\u000a or elective cesarean section 9 months after delivery. We performed a prospective controlled cohort study including 220 women\\u000a delivered by elective cesarean section and 215 by vaginal birth. All subjects received an identical questionnaire on lower\\u000a urinary tract symptoms in late

Åsa Ekström; Daniel Altman; Ingela Wiklund; Christina Larsson; Ellika Andolf

2008-01-01

359

Adjuvant materials in anterior vaginal wall prolapse surgery: a systematic review of effectiveness and complications  

Microsoft Academic Search

The objective of this study is to assess the objective recurrence and complications of adjuvant materials in the treatment\\u000a of anterior vaginal wall prolapse. The inclusion criteria were randomised controlled trials (RCTs) using adjuvant materials\\u000a versus standard surgery for anterior vaginal wall prolapse. The main outcome measures were objective recurrence and complications.\\u000a Ten RCTs (1,087 patients) were included in the

Richard Foon; Philip Toozs-Hobson; P. M. Latthe

2008-01-01

360

Development and Testing of a Vaginal Pressure Sensor to Measure Intra-abdominal Pressure in Women  

PubMed Central

Aims Elevated intra-abdominal pressure may be a potentially modifiable risk factor for pelvic floor disorders. However, limited evidence exists due to the lack of instruments suitable to measure abdominal pressures in real world settings. The aim of this study was to develop and test a vaginal sensor prototype to measure intra-abdominal pressure in women. Methods We developed a non-directional vaginal sensor by housing pressure-sensing circuit boards in 1.2 × 3cm radially symmetric silicon capsules. We characterized the response in a standardized pressure chamber. Eight women wore a sensor intra-vaginally while undergoing filling cystometry. We compared peak pressures during coughing, valsalva, squatting, and jumping to those obtained using a #10 french rectal balloon urodynamics catheter. We calculated Pearson’s correlation coefficients between rectal and vaginal sensors for each event. Results The vaginal sensors exhibited linear responses during initial bench testing. Each transducer correlated well with the rectal balloon catheter during coughing, valsalva, and squatting (r= 0.97, 0.94, and 0.97, respectively). However, the rectal balloon catheter recorded higher peak and lower, often negative, trough pressures during jumping. The vaginal sensor showed no such artifact. Conclusions This vaginal pressure sensor can be used as a surrogate for measuring intra-abdominal pressure in women without advanced prolapse. By measuring pressure at the physiological source, the vaginal sensor is less prone to extraneous noise and error than current transducers. Using this prototype, we will next develop a remote wireless version to capture a range of abdominal pressures experienced outside of the laboratory setting.

Rosenbluth, Evan M; Johnson, Paul J; Hitchcock, Robert W; Nygaard, Ingrid E

2013-01-01

361

Perinatal Outcome in Breech Presentation Depending on the Mode of Vaginal Delivery  

Microsoft Academic Search

Aim: To compare the influence of different modes of vaginal delivery in breech presentation on perinatal outcome. Materials and Methods: During the period 2000–2005, perinatal outcome of newborns was compared in 144 vaginal breech deliveries divided into 5 groups depending on the mode of delivery used (Bracht, Thiessen, Müller, Mauriceau-Levret-Veit-Smellie (MLVS), classical arm release). Neonates transferred to the neonatal intensive

Maja Vranješ; Dubravko Habek

2008-01-01

362

Wet and dry sex—the impact of cultural influence in modifying vaginal function  

Microsoft Academic Search

In a number of countries, but especially in sub-Saharan Africa, many women practice so-called “dry sex” usually by instilling vaginally various astringent substances to dry up the normal lubrication fluid created by sexual arousal and give the impression the vagina is still virginal tight and “hot”. This behaviour is normally undertaken to conform to male-dominated cultural concepts that vaginal lubrication

Roy J. Levin

2005-01-01

363

Diagnosing Vaginal Infections: It’s Time to Join the 21st Century  

Microsoft Academic Search

Vaginal infections are one of the most common reasons for medical healthcare visits in the United States and Western Europe.\\u000a These diseases are also significantly associated with HIV acquisition in resource-constrained settings throughout the world.\\u000a However, despite ample opportunity to improve diagnosis, and therefore management, of vaginitis and vaginosis, the healthcare\\u000a community continues to rely on diagnostic methods with poor

Barbara Van Der Pol

2010-01-01

364

Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland  

Microsoft Academic Search

Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors,\\u000a including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral,\\u000a and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled\\u000a in a behavioral intervention trial

Danielle C. Ompad; Steffanie A. Strathdee; David D. Celentano; Carl Latkin; Jeanne M. Poduska; Sheppard G. Kellam; Nicholas S. Ialongo

2006-01-01

365

Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion  

PubMed Central

Objectives: To compare the effectiveness and tolerability of misoprostol as a cervical ripening agent in first trimester abortion through three different routes of administration before surgical evacuation (SE). Materials and Methods: It was a hospital based prospective randomized open labeled parallel study. A total of 150 randomly selected married women were divided in three groups for sublingual (S/L), vaginal and oral 400 ?g of misoprostol single dose administration. The drug was administered 3-4 h before SE in the S/L and vaginal groups and 12 h before the procedure in the oral group. Efficacy was assessed on the basis of time taken for ripening, dilatation achieved, duration of the procedure, intra-operative blood loss, and pain score. The tolerability was noted on the basis of side effects. Results: The mean time taken for cervical ripening was less in sublingual administration (3.7±1.2 hr) as compared to the vaginal and oral routes. The S/L group had significant cervical dilatation (P<0.001) and the duration of SE was less as compared to the vaginal and oral routes. However, the mean intraoperative blood loss was more in sublingual as compared to the vaginal and oral groups. The intra-operative pain score of the S/L group was significantly lower (1.9±1.1, P<0.05) as compared to the vaginal (2.6±1.7) or oral route (3.3±1.7). Loose motions and nausea/vomiting were more with the S/L and oral routes while blood loss was more in the vaginal route. Conclusion: Administration of misoprostol by the sublingual route is better than the oral and vaginal routes for cervical ripening.

Parveen, Shagufta; Khateeb, Zaffar Abbas; Mufti, S.M.; Shah, M.A.; Tandon, Vishal R.; Hakak, S.; Singh, Z.; Yasmeen, Shagufta; Mir, Shakeel A.; Tabasum, Rehana; Jan, Nasreen

2011-01-01

366

Pregnancy in an untreated case of transverse vaginal septum with vesicovaginal fistula.  

PubMed

An 18-year-old woman presented with history of cyclic hematuria, abdominal pain, and a mass in the hypogastrium. She was found to have transverse vaginal septum in the lower one-third of her vagina with congenital vesicovaginal fistula (VVF) and a dead fetus of approximately 20 weeks gestation. She underwent vaginotomy and removal of the dead fetus. Vaginal repair of VVF was carried out 3 months later. PMID:16897124

Srinath, N; Misra, D N

2006-08-09

367

Immunity to vaginal HSV-2 infection in immunoglobulin A knockout mice.  

PubMed Central

An immunoglobulin A (IgA) knockout (KO) mouse was used to study the role of IgA in protective immunity against vaginal infection with herpes simplex virus-type 2 (HSV-2). Intact and KO mice were immunized intravaginally (IVAG) with attenuated HSV-2, challenged IVAG with wild-type virus 6 weeks later and evaluated for vaginal infection and neurological disease. Non-immunized/challenged intact and KO mice showed vaginal infection and succumbed to neurological disease, while immunized/challenged mice exhibited reduced or no vaginal infection and no neurological disease. Log 2.5 enzyme-linked immunoassay (ELISA) titres of viral IgA, immunoglobulin G (IgG) and immunoglobulin M (IgM) in vaginal secretions collected from intact immune mice before challenge were 0.6+/-0.3, 6.4+/-0.32 and 0.0, while those in KO immune mice were 0.0, 6.7+/-0.19 and 3.0+/-0.29, respectively. Twenty-four hours after challenge, the percentage of vaginal epithelium that was infected in non-immune intact and KO mice was 2.0+/-0.6 and 2.4+/-0.6, which was reduced to 0.2+/-0.1 and 0.1+/-0.06 in immune intact and KO mice, respectively. No shed virus protein was detected in vaginal secretions 3 days after challenge in any immune mouse, whereas titres were 1400 and 1700 in the two groups of non-immune mice. Thus, immune protection against vaginal HSV-2 infection was similar in both KO and intact mice, indicating that this mucosal immunity does not depend mainly on IgA. Images Figure 1 Figure 2

Parr, M B; Harriman, G R; Parr, E L

1998-01-01

368

An international study of the interobserver variation between interpretations of vaginal smear criteria of bacterial vaginosis.  

PubMed

An international workshop on vaginal smear-based diagnosis of bacterial vaginosis was organized where 13 investigators scoring 258 slides with smears from vaginal fluid. Interobserver reproducibility of interpretations of Nugent scores, Hay/Ison scores and wet smear scores for the diagnosis of bacterial vaginosis was shown to be high. Detailed analysis of individual scoring results however indicated that basic standards of quality control to ensure robust individual readings of slides must be adhered to. PMID:12596717

Forsum, U; Jakobsson, T; Larsson, P G; Schmidt, H; Beverly, A; Bjørnerem, A; Carlsson, B; Csango, P; Donders, G; Hay, P; Ison, C; Keane, F; McDonald, H; Moi, H; Platz-Christensen, J-J; Schwebke, J

2002-11-01

369

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.

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

2010-01-01

370

Detection of bacterial 16S ribosomal RNA genes for forensic identification of vaginal fluid.  

PubMed

To preliminarily evaluate the applicability of bacterial DNA as a marker for the forensic identification of vaginal fluid, we developed and performed PCR-based detection of 16S ribosomal RNA genes of Lactobacillus spp. dominating the vagina and of bacterial vaginosis-related bacteria from DNA extracted from body fluids and stains. As a result, 16S ribosomal RNA genes of Lactobacillus crispatus, Lactobacillus jensenii and Atopobium vaginae were specifically detected in vaginal fluid and female urine samples. Bacterial genes detected in female urine might have originated from contaminated vaginal fluid. In addition, those of Lactobacillus iners, Lactobacillus gasseri and Gardnerella vaginalis were also detected in non-vaginal body fluids such as semen. Because bacterial genes were successfully amplified in DNA samples extracted by using the general procedure for animal tissues without any optional treatments, DNA samples prepared for the identification of vaginal fluid can also be used for personal identification. In conclusion, 16S ribosomal RNA genes of L. crispatus, L. jensenii and A. vaginae could be effective markers for forensic identification of vaginal fluid. PMID:22316585

Akutsu, Tomoko; Motani, Hisako; Watanabe, Ken; Iwase, Hirotaro; Sakurada, Koichi

2012-02-07

371

Vaginal symptoms of unknown aetiology: a study in Dutch general practice.  

PubMed Central

Vaginal symptoms are frequently presented by women to general practitioners. In many cases, the aetiology of these symptoms remains unknown. This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors modifying this course. In a group of 610 women presenting to their general practitioner with vaginal symptoms (itching, irritation, abnormal but non-bloody discharge) the distribution of diagnoses was studied and factors associated with symptoms of unknown aetiology were identified using logistic regression analysis. During a three month follow up, the course of symptoms and signs was studied in 139 women with unexplained vaginal symptoms, using survival analysis methods. It was found that 25% of all the women had symptoms of unknown aetiology. A larger number of these women, compared with women with other diagnoses, were Caucasian, married, more highly educated, used oral contraceptives and reported psychological distress. During the follow-up period, a specific infection was diagnosed in less than 20% of the women with unexplained vaginal symptoms. Over half of the women (54%) recovered within three months. Short duration of symptoms before presentation was associated with a higher probability of recovery. From the study, it was found that many women visiting the general practitioner for vaginal symptoms had no demonstrable microbial disorder. Often these symptoms were transient and disappeared without intervention. Persistent symptoms may call for further examination where somatic, as well as psychosocial, factors should be taken into account.

Dekker, J H; Boeke, A J; Janssens, J; Van Eijk, J T

1993-01-01

372

Elimination of vaginal colonization with Escherichia coli by administration of indigenous flora.  

PubMed Central

A persistent vaginal colonization with a pyelonephritogenic strain of Escherichia coli, induced by administration of amoxicillin, was established in four adult cynomolgus monkeys. This colonization mimicked the one seen in urinary tract infection-prone human females. Attempts to eliminate the E. coli colonization and restore normal conditions were made. Either suspensions of lactobacilli or vaginal fluid from a healthy unmanipulated monkey was administered as repeated vaginal flushes for 5 to 9 days. A total elimination of vaginal E. coli was observed in two of six experiments with lactobacilli, and a decrease was observed in the other four. A better result was obtained with flushes of vaginal fluid, which eliminated the E. coli colonization in eight of eight experiments. In two of these, a single flush was sufficient to obtain a decolonization. The ability of fresh vaginal fluid to eliminate E. coli from the vagina could be transferred from one monkey to another. This study demonstrates the role of the normal flora in the defense against genital colonization with potentially pathogenic adhering E. coli. The possible clinical relevance of these findings must be further examined.

Herthelius, M; Gorbach, S L; Mollby, R; Nord, C E; Pettersson, L; Winberg, J

1989-01-01

373

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

374

Pharmacokinetic profiles of controlled-release hydrogel polymer vaginal inserts containing misoprostol.  

PubMed

Misoprostol, a prostaglandin E1 analogue, is commonly administered intravaginally for cervical ripening and induction of labor. There is uncertainty regarding the correct dose because of the need to divide the tablets, and there is difficulty in removing the product when there is an adverse event. A proprietary hydrogel polymer containing a removable controlled-release reservoir dose of misoprostol is being developed for vaginal administration (misoprostol vaginal insert) to address these drawbacks while maintaining efficacy. This study investigated the pharmacokinetic profiles of these vaginal inserts and orally administered misoprostol. Twelve nonpregnant women received 100-, 200-, and 400-microg misoprostol vaginal inserts and separately received an oral dose of 200 microg of misoprostol. Values for area under the plasma concentration versus time curve, from time 0 to the last measurable concentration, were dose proportional with 481, 1026, and 2191 pg.h/mL for the 100-, 200-, and 400-microg misoprostol vaginal inserts, respectively. Maximum plasma concentrations were 33.1, 73.4, and 144 pg/mL for the 100-, 200-, and 400-microg misoprostol vaginal inserts, compared with 609 pg/mL for the 200 microg of oral misoprostol. After administration of the insert, plasma misoprostol acid levels increased gradually with time of the maximum measured plasma concentration at 5 to 9 hours. Following removal of the insert, misoprostol acid was eliminated rapidly from the systemic circulation with a mean half-life <1 hour. PMID:18071191

Powers, Barbara L; Wing, Deborah A; Carr, Denis; Ewert, Karine; Di Spirito, Mike

2007-12-10

375

Vaginal tumors in childhood: the experience of St. Jude Children's Research Hospital  

PubMed Central

Background/Purpose To retrospectively analyze the clinical presentation, histology, treatment and outcomes of children with vaginal tumors who were treated at a single institution. Methods A retrospective review was conducted of medical records and pathologic materials of all children with vaginal tumors treated at St Jude Children’s Research Hospital between 1970 and 2009. Results Eighteen patients (median age 3.7 years, range 0.1–15) were identified. Three different histologies were found: rhabdomyosarcoma (RMS) (N=13), germ cell tumor (GCT) (N=3) and clear cell adenocarcinoma (CCA) (N=2). Bleeding or blood-tinged discharge was the most common clinical presentation (66%) followed by a protruding mass (39%). Vaginal and uterine salvage was 44.4% (8 of 18 patients). Thirteen patients (72.2%) remain disease-free with a median follow-up of 23.2 years (range, 2–39). Four patients (22.2%) died of disease progression (1 RMS, 2 GCT and 1 CCA) and 1 RMS patient died of colon cancer 12 years after the primary diagnosis had been made. Conclusions Vaginal tumors are extremely rare in the pediatric population. Early recognition of symptoms like bleeding and a protuding vaginal mass may prevent morbidity and mortality. Our findings confirm the good prognosis of vaginal RMS.

Fernandez-Pineda, Israel; Spunt, Sheri L; Parida, Lalit; Krasin, Matthew J; Davidoff, Andrew M; Rao, Bhaskar N

2012-01-01

376

Efficacy of sustained-release vaginal oestriol in alleviating urogenital and systemic climacteric complaints.  

PubMed

In a double-blind, placebo-controlled study, 109 patients suffering from local and vasomotor postmenopausal complaints were randomly assigned to treatment with either depot vaginal suppositories containing 3.5 mg oestriol (E3) or a placebo. The treatment schedule comprised one vaginal suppository twice weekly for 3 weeks initially, followed by maintenance therapy with one vaginal suppository weekly for the 6-month study period. The effectiveness of the therapy was assessed on the basis of questionnaires (Kupperman index for vasomotor complaints and an original urogenital index for local complaints) and gynaecological examinations which included assessments of vaginal cytology, vaginal pH and Döderlein bacilli. To rule out induced endometrial proliferation, endometrial biopsies were performed in 50 women before and after the study. The vaginal depot (E3) formulation showed highly significant superiority over the placebo with respect to therapeutic effect on local urogenital complaints and alleviation of vasomotor complaints, including hot flushes. Analysis of the endometrial biopsies indicated that the monotherapy used caused no endometrial stimulation. Taking into account the minimal rate of adverse effects, the 3.5 mg E3 depot formulation studied represents a useful variant in the range of preparations available for the treatment of post-menopausal complaints. PMID:1921739

Foidart, J M; Vervliet, J; Buytaert, P

1991-06-01

377

Oral micronized progesterone combined with vaginal progesterone gel for luteal support.  

PubMed

The aim of the present study was to compare the efficacy and satisfaction rate of combined therapy of oral micronized progesterone capsules and vaginal progesterone gel versus monotherapy with vaginal progesterone gel in luteal support. A case-control study was performed on a total number of 370 women aged <45 years undergoing IVF-ET treatment. The patients received either combination of Crinone 8% vaginal gel, 90 mg daily dose and Utrogestan oral capsules 3 x 100 mg, or Crinone 8% vaginal gel, 90 mg daily. Progesterone supplementation begun on the day of oocyte retrieval and continued until pregnancy was tested and in the case of pregnancy until week 8. The comparable rates of ongoing pregnancies were noted with use of combined-progesterone therapy (39.5%) and progesterone-monotherapy (33.5%). Abortion rate (6.4% vs. 15.6%) was significantly lower with the use of combined therapy. Tolerability and satisfaction of both supplements was almost equal but bleeding occurred more frequently in the progesterone-monotherapy group. In conclusion, the efficacy, satisfaction and tolerability of combined and vaginal progesterone supplements were comparable, but bleeding in early pregnancy and abortion rate presented more frequently with the use of vaginal progesterone. PMID:21504340

Tomic, Vlatka; Tomic, Jozo; Klaic, Djurdja Zigmundovac

2011-04-19

378

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.

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

2012-01-01

379

Sexual function after anterior vaginal wall prolapse surgery  

PubMed Central

OBJECTIVE: The aim of this study was to compare female sexual function after surgical treatment of anterior vaginal prolapse with either small intestine submucosa grafting or traditional colporrhaphy. METHODS: Subjects were randomly assigned, preoperatively, to the small intestine submucosa graft (n?=?29) or traditional colporrhaphy (n?=?27) treatment group. Postoperative outcomes were analyzed at 12 months. The Female Sexual Function Index questionnaire was used to assess sexual function. Data were compared with independent samples or a paired Student's t-test. ClinicalTrials.gov: NCT00827528. RESULTS: In the small intestine submucosa group, the total mean Female Sexual Function Index score increased from 15.5±7.2 to 24.4±7.5 (p<0.001). In the traditional colporrhaphy group, the total mean Female Sexual Function Index score increased from 15.3±6.8 to 24.2±7.0 (p<0.001). Improvements were noted in the domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. There were no differences between the two groups at the 12-month follow-up. CONCLUSIONS: Small intestine submucosa repair and traditional colporrhaphy both improved sexual function postoperatively. However, no differences were observed between the two techniques.

Feldner, Paulo Cezar; Delroy, Carlos Antonio; Martins, Sergio Brasileiro; Castro, Rodrigo Aquino; Sartori, Marair Gracio Ferreira; Girao, Manoel Joao Batista Castello

2012-01-01

380

Understanding vaginal microbiome complexity from an ecological perspective.  

PubMed

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

2012-03-06

381

New concepts and trends in vaginal prolapse surgery.  

PubMed

Despite poor results in prolapse surgery, the operative procedures have basically remained unchanged for 100 years. It has been postulated that lifting restrictions and other measures of inactivation are crucial for the success. Even though most of what is done in prolapse repair is not evidence based, few have challenged the prevailing concepts. However, tradition-based policies are now being scrutinized and in accordance with other operations, time of hospitalization is sharply reduced at many institutions. The reintroduction of local anesthesia and sedation offers potential advantages compared to regional- or general anesthesia. Although augmentation by foreign material is not altogether a new concept, the introduction of commercial kits make mesh procedures more standardized, but not necessarily technically more easy to perform. As molecular biology provides more and more evidence about the importance of the quality of the connective tissue, it is conceivable that foreign material in prolapse repair is here to stay. In this period of time it is more essential than ever to scientifically document the results of the new concepts. In the Nordic countries, where the first registries were set up for Tensionfree Vaginal Tape (TVT), a cooperative effort among 53 institutions is under way to evaluate mesh repairs in prolapse surgery. PMID:19172442

Flam, Folke; Söderberg, Marie Westergren

2009-01-01

382

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.

Norman, P; Kostovcik, S; Lanning, A

1993-01-01

383

The impact of lubricants on latex condoms during vaginal intercourse.  

PubMed

The objective was to evaluate the impact of additional lubricant on condom breakage and slippage. Two hundred and sixty-eight couples used 6 new and 6 aged condoms during vaginal intercourse and were instructed to use 2 of each type with either water-based lubricant, oil-based lubricant or no additional lubricant. The use of either oil-based or water-based lubricant increased slippage rates of new and aged condoms, although only one pairwise comparison (oil-based lubricant vs. no additional lubricant) was statistically significant (8.5% vs. 3.8%, P = 0.004). The use of oil-based lubricant increased breakage, although not statistically significantly, in both new and aged condoms. Water-based lubricant did not impact the breakage rate of the new condoms and decreased the breakage rate of the aged condoms (no additional lubricant 4.5% vs. water-based lubricant 2.1%, P = 0.029). From a functional perspective, this study suggests that condom users should be told not to use oil-based lubricants. The negative impact of water-based lubricant on slippage may be outweighted by the protective influence on breakage, especially for aged condoms. Over three-quarters of the couples (76%) had at least some incorrect knowledge, according to current condom instructions, of the type of lubricant that should be used with condoms. PMID:8142525

Steiner, M; Piedrahita, C; Glover, L; Joanis, C; Spruyt, A; Foldesy, R

384

Antagonistic activity against pathogenic bacteria by human vaginal lactobacilli.  

PubMed

This study attempted to isolate lactobacilli strains from healthy vaginal ecosystem to search for a new effective antibacterial probiotic strain. The strains were identified and characterized for their probiotic properties including bile salt and acid tolerance, growth at acidic pH, their ability to utilize protein, starch, and lipid, the production of hydrogen peroxide and bacteriocin as well as their antibiotic resistance patterns. The antibacterial activity of the culture supernatant of these strains were tested against a wide range of Gram-positive and Gram-negative pathogenic bacteria including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae. Salmonella typhi, and Salmonella typhimurium. None of the strains inhibited the growth of Gram-negative bacteria. Contrastly, the culture supernatant of strain L 22, identified as Lactobacillus reuteri, significantly inhibited all of the clinical isolates of methicillin-resistant S. aureus (MRSA). The antibacterial effect of the selected strain L 22 was further investigated. In the presence of L 22, the bacterial growth was assessed in vitro by viable bacterial counting. The numbers of viable cells were significantly lower in L 22-containing broth than those in the control by 6h. This finding clearly demonstrates that strain L 22 can produce an anti-MRSA effect. The antibacterial ability of the strain L 22 was fundamentally attributed to their bacteriocin production which can cause both cell inhibition and cell death. PMID:16931064

Voravuthikunchai, Supayang Piyawan; Bilasoi, Sopa; Supamala, Orawan

2006-08-23

385

Early pregnancy threshold vaginal pH and Gram stain scores predictive of subsequent preterm birth in asymptomatic women  

Microsoft Academic Search

Objective: The study was undertaken to identify early pregnancy vaginal markers predictive of subsequent preterm birth. Study Design: In a multicenter Bacterial Vaginosis (BV) Trial, 21,554 women were screened with a vaginal pH and of these, two populations were studied. These included 12,041 who had a pregnancy outcome in the database and 6838 women who had a vaginal pH of

John C. Hauth; Cora MacPherson; J. Christopher Carey; Mark A. Klebanoff; Sharon L. Hillier; J. M. Ernest; Kenneth J. Leveno; Ronald Wapner; Michael Varner; Wayne Trout; Atef Moawad; Baha Sibai

2003-01-01

386

Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis.  

PubMed

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

2013-03-19

387

Cervical mucins carry alpha(1,2)fucosylated glycans that partly protect from experimental vaginal candidiasis.  

PubMed

Cervical mucins are glycosylated proteins that form a protective cervical mucus. To understand the role of mucin glycans in Candida albicans infection, oligosaccharides from mouse cervical mucins were analyzed by liquid chromatography-mass spectrometry. Cervical mucins carry multiple alpha(1-2)fucosylated glycans, but alpha(1,2)fucosyltransferase Fut2-null mice are devoid of these epitopes. Epithelial cells in vaginal lavages from Fut2-null mice lacked Ulex europaeus agglutinin-1 (UEA-I) staining for alpha(1-2)fucosylated glycans. Hysterectomy to remove cervical mucus eliminated UEA-I and acid mucin staining in vaginal epithelial cells from wild type mice indicating the cervix as the source of UEA-I positive epithelial cells. To assess binding of alpha(1-2) fucosylated glycans on C. albicans infection, an in vitro adhesion assay was performed with vaginal epithelial cells from wild type and Fut2-null mice. Vaginal epithelial cells from Fut2-null mice were found to bind increased numbers of C. albicans compared to vaginal epithelial cells obtained from wild type mice. Hysterectomy lessened the difference between Fut2-null and wild type mice in binding of C. ablicans in vitro and susceptibility to experimental C. albicans vaginitis in vivo. We generated a recombinant fucosylated MUC1 glycanpolymer to test whether the relative protection of wild type mice compared to Fut2-null mice could be mimicked with exogenous mucin. While a small portion of the recombinant MUC1 epitopes displayed alpha(1-2)fucosylated glycans, the predominant epitopes were sialylated due to endogenous sialyltransferases in the cultured cells. Intravaginal instillation of recombinant MUC1 glycanpolymer partially reduced experimental yeast vaginitis suggesting that a large glycanpolymer, with different glycan epitopes, may affect fungal burden. PMID:19326211

Domino, Steven E; Hurd, Elizabeth A; Thomsson, Kristina A; Karnak, David M; Holmén Larsson, Jessica M; Thomsson, Elisabeth; Bäckström, Malin; Hansson, Gunnar C

2009-12-01

388

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

2012-01-29

389

The value of chronic suppressive therapy with itraconazole versus clotrimazole in women with recurrent vaginal candidiasis.  

PubMed Central

OBJECTIVE--To determine the comparative efficacy of oral itraconazole versus intravaginal clotrimazole in suppressing recurrent episodes of vulvovaginal candidiasis. DESIGN--Prospective randomised open study of women with recurrent vulvovaginal candidiasis. Clinical and microbiological assessments were made monthly for 12 months. SETTING--Women's Clinic of a University teaching hospital. SUBJECTS--Forty-four otherwise healthy, non-pregnant women, with at least four proven episodes of candida vaginitis in the last year were enrolled into the study. INTERVENTION--After an acute episode of candida vaginitis, 22 women received oral itraconazole 200 mg daily for five days, then 200 mg twice weekly for six months; and 22 women received intra-vaginal clotrimazole 200 mg ovules daily for five days, then 200 mg twice weekly for six months. MAIN OUTCOME MEASURES--Symptomatic recurrent clinical vulvovaginal candidiasis during the first six months of suppressive therapy was the major endpoint. A secondary endpoint was recurrent candida vaginitis within six months after completion of therapy. RESULTS--Six patients did not complete the study, one in the itraconazole group and five in the clotrimazole group. Of the evaluable patients, seven of 21 patients (33.3%) in the itraconazole group versus none (0%) of 17 patients on clotrimazole were failures on suppressive therapy, p = 0.02. Following discontinuation of suppressive therapy, recurrences of candida vaginitis were similar, 10 (47.6%) of patients on itraconazole (95% confidence interval (CI) 27-67%), versus 11 (64%) patients on clotrimazole (CI 41-87%), p = 0.15. CONCLUSION--Intermittent suppressive therapy with clotrimazole was more effective than itraconazole in preventing recurrent candida vaginitis, provided patients adhered to the regimen. Recurrence of vaginitis was common with both regimens after stopping suppressive therapy.

Fong, I W

1992-01-01

390

Postoperative vaginal radiation in endometrial cancer using a remote afterloading technique.  

PubMed

Carcinoma of the endometrium is the most common malignancy of the female genital tract. In early stage endometrial cancer, surgery remains the primary mode of treatment while radiation therapy plays an adjuvant role. Prophylactic vaginal radiation has been shown to reduce significantly the incidence of vaginal recurrences. Between the years 1969-1976, 330 patients with FIGO Stages I and II endometrial cancer were treated according to a standard departmental policy in which 40 Gy of external radiation was given to high risk Stage I and all Stage II patients in combination with surgery and intravaginal radiation. Stage I was considered high risk if the tumor was of high grade or exhibited deep myometrial invasion. Vault radiation was delivered with a remote afterloading technique to a point .5 cm from the surface of the applicator; a total dose of 21 Gy was delivered in three fractions spaced two weeks apart over four elapsed weeks. With this regimen, the mucosal surface received a total equivalent dose of 40 Gy. These treatments were given on an outpatient basis without the need for any sedation or analgesics. All patients, regardless of stage, grade, or depth of myometrial invasion received adjuvant post-operative vaginal radiation. The minimum follow-up was 5 years, with a median follow-up of 8.5 years. The overall pelvic and/or vaginal recurrence rate was 2.7%. The incidence of vaginal complications was 3.7%. It appears that the remote afterloading treatment (RAT) for vaginal radiation is a very cost-effective therapeutic alternative, which produces minimal early or late complications and gives complete protection from radiation exposure to the medical staff. The advantages of a remote afterloading technique in delivering vaginal vault radiation in endometrial cancer are discussed in this paper. PMID:3972659

Mandell, L; Nori, D; Anderson, L; Hilaris, B

1985-03-01

391

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.

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

2013-01-01

392

Effects of Long-Term Use of Nonoxynol-9 on Vaginal Flora  

PubMed Central

OBJECTIVE Products containing nonoxynol-9 have been used as spermicidal contraceptives for many years, but limited data have been published describing the long-term effects of nonoxynol-9 use on the vaginal microbial ecosystem. This longitudinal study was conducted to examine the effects of nonoxynol-9 on the vaginal ecology. METHODS Vaginal swabs were obtained from 235 women enrolled in a randomized clinical trial before initiation of use of 1 of 5 different formulations of nonoxynol-9 for contraception, and up to 3 more samples were gathered over 7 months of use. The swab samples were evaluated in a single laboratory. The prevalence of several constituents of the normal vaginal flora was evaluated. The associations between nonoxynol-9 dosage, formulation, average product use per week, and number of sex acts per week were calculated. RESULTS The changes in prevalence of vaginal microbes after nonoxynol-9 use were minimal for each of the different nonoxynol-9 formulations. However, when both nonoxynol-9 concentration and number of product uses are taken into account, nonoxynol-9 did have dose-dependant effects on the increased prevalence of anaerobic gram-negative rods (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1–5.3), H2O2-negative lactobacilli (OR 2.0, 95% CI 1.0–4.1), and bacterial vaginosis (OR 2.3, 95% CI 1.1–4.7). CONCLUSION This study demonstrated that most nonoxynol-9 users experienced minimal disruptions in their vaginal ecology. There were no differences between the different formulations evaluated with respect to changes in vaginal microflora. However, independent of the nonoxynol-9 formulation, there was a dose-dependent effect with increased exposure to nonoxynol-9 on the risk of bacterial vaginosis and its associated flora. LEVEL OF EVIDENCE II-2

Schreiber, Courtney A.; Meyn, Leslie A.; Creinin, Mitchell D.; Barnhart, Kurt T.; Hillier, Sharon L.

2006-01-01

393

Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women  

PubMed Central

Objectives Some vaginal bacterial communities are thought to prevent infection by sexually transmitted organisms. Prior work demonstrated that the vaginal microbiota of reproductive-age women cluster into five types of bacterial communities; 4 dominated by Lactobacillus species (L. iners, L. crispatus, L. gasseri, L. jensenii), and one (termed community state type (CST) IV) lacking significant numbers of lactobacilli and characterized by higher proportions of Atopobium, Prevotella, Parvimonas, Sneathia, Gardnerella, Mobiluncus, and other taxa. We sought to evaluate the relationship between vaginal bacterial composition and Trichomonas vaginalis. Methods Self-collected vaginal swabs were obtained cross-sectionally from 394 women equally representing four ethnic/racial groups. T. vaginalis screening was performed using PCR targeting the 18S rRNA and ?-tubulin genes. Vaginal bacterial composition was characterized by pyrosequencing of barcoded 16S rRNA genes. A panel of eleven microsatellite markers was used to genotype T. vaginalis. The association between vaginal microbiota and T. vaginalis was evaluated by exact logistic regression. Results T. vaginalis was detected in 2.8% of participants (11/394). Of the eleven T. vaginalis-positive cases, eight (72%) were categorized as CST-IV, two (18%) as communities dominated by L. iners and one (9%) as L. crispatus-dominated (p-value:0.05). CST-IV microbiota were associated with an 8-fold increased odds of detecting T. vaginalis compared to women in the L. crispatus-dominated state (OR:8.26, 95% CI:1.07–372.65). Seven of the 11 T. vaginalis isolates were assigned to two genotypes. Conclusion T. vaginalis was associated with vaginal microbiota consisting of low proportions of lactobacilli and high proportions of Mycoplasma, Parvimonas, Sneathia, and other anaerobes.

Brotman, Rebecca M.; Bradford, L. Latey; Conrad, Melissa; Gajer, Pawel; Ault, Kevin; Peralta, Ligia; Forney, Larry J.; Carlton, Jane M.; Abdo, Zaid; Ravel, Jacques

2012-01-01

394

Vaginal gel formulation based on theaflavin derivatives as a microbicide to prevent HIV sexual transmission.  

PubMed

We previously demonstrated that a commercially available natural product preparation with high content (>90%) of theaflavin derivatives (TFmix) exhibited potent anti-HIV activities. Here we developed a TFmix gel formulation as a topical microbicide candidate. The effect of TFmix on the amyloid fibril formation of semen-derived enhancer of virus infection (SEVI) peptide was detected by transmission electron microscopy. The toxicity of the TFmix gel was evaluated using human vaginal and cervical epithelial cell lines and rabbit vaginal irritation models, respectively. Levels of proinflammatory cytokines (IL-1?, IL-6, IL-8, and TNF-?) and immunoregulatory cytokines (IL-10 and GM-CSF) in cervicovaginal lavages (CVLs) were measured by ELISA kits. Proliferating cell nuclear antigen (PCNA) immunostaining was performed to evaluate inflammation in the vaginal tissues. TFmix gel could degrade SEVI-specific amyloid fibrils and showed low cytotoxicity to epithelial cells of the female reproductive tract. No apparent cervicovaginal toxicity was observed at any time point evaluated following the intravaginal administration of TFmix gel to rabbits, whereas application of N-9 gel resulted in damage to the vaginal epithelium. Neither proinflammatory nor immunoregulatory cytokine production was triggered by TFmix gel. Only low expression of PCNA was observed in vaginal tissues of TFmix gel-treated rabbits. The concentration of TFmix in plasma was very low (below the lower limit of quantitation) 1?h after a single vaginal administration of TFmix gel. However, TFmix was still detected in the cervicovaginal lavages (CVLs) 6?h after treatment, indicating that it could be retained in the vaginal cavity for a long period of time. With its potent anti-HIV-1 activity, marked stability at acidic condition, low mucosal toxicity, and lack of systemic absorption, TFmix gel can be considered as an inexpensive and safe microbicide candidate for the prevention of HIV sexual transmission. PMID:22867271

Yang, Jie; Li, Lin; Jin, Hong; Tan, Suiyi; Qiu, Jiayin; Yang, Lei; Ding, Yanqing; Jiang, Zhi-Hong; Jiang, Shibo; Liu, Shuwen

2012-09-11

395

The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics.  

PubMed

Whether or not treatment with antibiotics or probiotics for bacterial vaginosis (BV) is associated with a change in the diversity of vaginal microbiota in women was investigated. One hundred fifteen women, consisting of 30 healthy subjects, 30 BV-positive control subjects, 30 subjects with BV treated with a 7-day metronidazole regimen, and 25 subjects with BV treated with a 10-day probiotics regimen, were analyzed to determine the efficacy and disparity of diversity and richness of vaginal microbiota using 454 pyrosequencing. Follow-up visits at days 5 and 30 showed a greater BV cure rate in the probiotics-treated subjects (88.0 and 96 %, respectively) compared to the metronidazole-treated subjects (83.3 and 70 %, respectively [p = 0.625 at day 5 and p?=?0.013 at day 30]). Treatment with metronidazole reduced the taxa diversity and eradicated most of the BV-associated phylotypes, while probiotics only suppressed the overgrowth and re-established vaginal homeostasis gradually and steadily. Despite significant interindividual variation, the microbiota of the actively treated groups or participants constituted a unique profile. Along with the decrease in pathogenic bacteria, such as Gardnerella, Atopobium, Prevotella, Megasphaera, Coriobacteriaceae, Lachnospiraceae, Mycoplasma, and Sneathia, a Lactobacillus-dominated vaginal microbiota was recovered. Acting as vaginal sentinels and biomarkers, the relative abundance of Lactobacillus and pathogenic bacteria determined the consistency of the BV clinical and microbiologic cure rates, as well as recurrent BV. Both 7-day intravaginal metronidazole and 10-day intravaginal probiotics have good efficacy against BV, while probiotics maintained normal vaginal microbiota longer due to effective and steady vaginal microbiota restoration, which provide new insights into BV treatment. PMID:23250116

Ling, Zongxin; Liu, Xia; Chen, Weiguang; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, Karen E; Huang, Shaolei; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie

2012-12-19

396

Association between first trimester vaginal bleeding and uterine artery Doppler measured at second and third trimesters of pregnancy.  

PubMed

Abstract Objective: To evaluate the prevalence of first trimester vaginal bleeding among patients with abnormal second and third trimester uterine artery Doppler. Methods: A prospective study of patients with a uterine artery Doppler measurement between 27 and 42 weeks' gestation was undertaken. A comparison was made between two groups: patients with and without first trimester vaginal bleeding. Abnormal uterine artery Doppler was defined as PI >95th% or the presence of a diastolic notch. Results: Of the 277 patients that were included in the study, 65 (23%) had first trimester vaginal bleeding. No differences were noted in uterine artery Doppler waveforms among patients with and without first trimester vaginal bleeding. Among patients with first trimester vaginal bleeding, 9 (14%) had a bilateral uterine artery notch and 56 (86%) did not, compared with 51 (24%) and 161 (76%), in the control group, respectively. Patients with first trimester vaginal bleeding, and a bilateral uterine artery notch had significantly higher rates of small for gestational age neonates, low-Apgar scores (<7) at one minute and cesarean deliveries compared to patients with first trimester vaginal bleeding who did not have bilateral uterine artery notch. Conclusion: First trimester vaginal bleeding was not associated with a higher incidence of abnormal uterine artery waveforms or with placental related conditions. However, adverse perinatal outcomes were found when first trimester vaginal bleeding was associated with second and third trimester bilateral uterine artery notchs. PMID:23617256

Pariente, Gali; Shwarzman, Paulina; Aricha-Tamir, Barak; Weintraub, Adi Y; Hershkovitz, Reli

2013-05-17

397

Vaginal Anomalies: Vaginal Agenesis  

MedlinePLUS

... specialists will be able to harvest an egg, fertilize it with her partner's sperm, and implant it ... to urinate. urination: The passing of urine. urine: Liquid waste product filtered from the blood by the ...

398

Vaginal Microbicide Preferences Among Midwestern Urban Adolescent Women  

PubMed Central

Purpose The purpose of this study was to assess adolescent women’s preferences for specific microbicide characteristics including: pregnancy prevention, timing of application, potential for side effects, and whether it targeted Human Immunodeficiency Virus (HIV) or other sexually transmitted infections (STI). Potential differences in microbicide preferences by adolescent age group and behavioral patterns, including engaging in sexual intercourse and use of hormonal contraception, were examined, as it was hypothesized that as adolescents progress into adulthood and gain sexual experience their preferences in microbicide characteristics may shift. Method Adolescent and young women (N = 405, 56.0% African American; 24.0% Euro-American) between the ages of 14 and 20 (M = 17.0, SD = 1.8) were recruited from urban community-based clinics. Video-Audio Computer-Assisted Self-Interviews (VACASI) were conducted with the young women during which they were asked about their preferences regarding the characteristics of hypothetical vaginal microbicides. Conjoint analysis was utilized to determine adolescent women’s relative preferences for each microbicide characteristic and intent-to-purchase microbicides based upon a combination of the selected properties. Results Overall, the results suggest adolescent and young women had an ordered preference for a microbicide with (1) no side effects, (2) pregnancy prevention, (3) post-coital application, and (4) protection against HIV. Age and behavioral group conjoint analyses resulted in the same pattern of preferences as those reported for the entire group. However, women having sex and not using hormonal contraception had a stronger preference for post-coital application. Conclusion The findings suggest that young women’s ratings of microbicides were sensitive to characteristics such as side effects, pregnancy prevention, and timing of application. The conjoint analysis approach is useful in understanding microbicide preferences and should be utilized with other populations to assess preferences for specific microbicide characteristics.

Tanner, Amanda E.; Katzenstein, Jennifer M.; Zimet, Gregory D.; Cox, Dena S.; Cox, Anthony D.; Fortenberry, J. Dennis

2008-01-01

399

Human papillomavirus in vulvar and vaginal carcinoma cell lines.  

PubMed Central

A number of reports associate human papillomavirus (HPV) with cervical cancer and cancer cell lines derived from this tumour type. Considerably fewer reports have focused on the role of HPV in carcinomas from other sites of female anogenital squamous epithelia. In this study we have tested for the presence of HPV in eight low-passage vulvar carcinoma cell lines and one extensively passaged cell line, A431. One cell line from a primary vaginal carcinoma was included. The presence of the HPV was evaluated by the polymerase chain reaction (PCR), by Southern blot analysis and by two-dimensional gel electrophoresis. General primer-mediated PCR was applied by using primers from the L1 region, E1 region and HPV 16 E7 region. Southern blot hybridisation was performed under low-stringency conditions (Tm = -35 degrees C) using a whole genomic HPV 6/16/18 probe mixture and under high stringency conditions (Tm = -18 degrees C) with the whole genomic probes of HPV 16 and 33. HPV 16 E6-E7 mRNA was assessed by ribonuclease protection assay (RPA). HPV was found in only one vulvar carcinoma cell line, UM-SCV-6. The identified type, HPV 16, was integrated in the cell genome and could be amplified with all primers used. Also E6-E7 transcripts were found in these cells. Five original tumour biopsies were available from the HPV-negative cell lines for in situ hybridisation. All these were HPV negative with both the HPV 6/16/18 screening probe mixture under low stringency and the HPV 16 probe under high stringency. The results indicate that vulvar carcinoma cell lines contain HPV less frequently than cervical carcinoma cell lines and suggest that a significant proportion of vulvar carcinomas may evolve by an HPV-independent mechanism. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6

Hietanen, S.; Grenman, S.; Syrjanen, K.; Lappalainen, K.; Kauppinen, J.; Carey, T.; Syrjanen, S.

1995-01-01

400

Group B Streptococcus CovR regulation modulates host immune signalling pathways to promote vaginal colonization.  

PubMed

Streptococcus agalactiae (Group B?Streptococcus, GBS) is a frequent commensal organism of the vaginal tract of healthy women. However, GBS can transition to a pathogen in susceptible hosts, but host and microbial factors that contribute to this conversion are not well understood. GBS CovR/S (CsrR/S) is a two component regulatory system that regulates key virulence elements including adherence and toxin production. We performed global transcription profiling of human vaginal epithelial cells exposed to WT, CovR deficient, and toxin deficient strains, and observed that insufficient regulation by CovR and subsequent increased toxin production results in a drastic increase in host inflammatory responses, particularly in cytokine signalling pathways promoted by IL-8 and CXCL2. Additionally, we observed that CovR regulation impacts epithelial cell attachment and intracellular invasion. In our mouse model of GBS vaginal colonization, we further demonstrated that CovR regulation promotes vaginal persistence, as infection with a CovR deficient strainresulted in a heightened host immune response as measured by cytokine production and neutrophil activation. Using CXCr2 KO mice, we determined that this immune alteration occurs, at least in part, via signalling through the CXCL2 receptor. Taken together, we conclude that CovR is an important regulator of GBS vaginal colonization and loss of this regulatory function may contribute to the inflammatory havoc seen during the course of infection. PMID:23298320

Patras, Kathryn A; Wang, Nai-Yu; Fletcher, Erin M; Cavaco, Courtney K; Jimenez, Alyssa; Garg, Mansi; Fierer, Joshua; Sheen, Tamsin R; Rajagopal, Lakshmi; Doran, Kelly S

2013-01-30

401

Feasibility of histological scoring and colony count for evaluating infective severity in mouse vaginal candidiasis.  

PubMed

Qualitative measurement of the infective level is relatively difficult in experimental vaginal candidiasis. Female BALB/c mice aged 8 to 10 weeks were randomly divided into E1, E2 and E0 groups, which received subcutaneous injection of 0.05 mg, 0.1 mg of estradiol benzoate or 0.1 ml soybean oil 3 days before vaginal inoculation, respectively, and hormone treatment continued every other day thereafter. Each group was further divided into infected and noninfected subgroups. The infected mice were inoculated intravaginally with 10 ?l (5 × 10(4) conidia) of Candida albicans suspension, while the noninfected mice were inoculated with 10 ?l phosphate-buffered saline. Direct microscopic examination, colony count and vaginal histopathology including infection degree and inflammation extent were performed at 3, 7 and 14 days post inoculation. Estrogen treatment increased the vaginal fungal burden and extent of infection and inflammation compared with the control group, and 0.3 mg/week estrogen generally induced more severe infection and inflammation than 0.15 mg/week estrogen did. Colony count peaked on day 3 and decreased remarkably after 7 days. Infection score increased gradually during the first 7 days and decreased on day 14, while inflammation extent exacerbated progressively over the course of 14 days. This study demonstrates that the modified histological scoring system might be more feasible than colony count for evaluation of infectivity and dynamic change in experimental vaginal candidiasis. PMID:23903055

Zhang, Jin-E; Luo, Dan; Chen, Rong-Yi; Yang, Yan-Ping; Zhou, Ying; Fan, Yi-Ming

2013-01-01

402

Th17 Cells and IL-17 in Protective Immunity to Vaginal Candidiasis  

PubMed Central

Background Th17 cells play a major role in coordinating the host defence in oropharyngeal candidiasis. In this study we investigated the involvement of the Th17 response in an animal model of vulvovaginal candidiasis (VVC). Methods To monitor the course of infection we exploited a new in vivo imaging technique. Results i) The progression of VVC leads to a strong influx of neutrophils in the vagina soon after the challenge which persisted despite the resolution of infection; ii) IL-17, produced by vaginal cells, particularly CD4 T cells, was detected in the vaginal wash during the infection, reaching a maximum 14 days after the challenge; iii) The amount and kinetics of IL-23 in vaginal fluids were comparable to those in vaginal cells; iv) The inhibition of Th17 differentiation led to significant inhibition of IL-17 production with consequent exacerbation of infection; v) An increased production of ?defensin 2 was manifested in cells of infected mice. This production was strongly reduced when Th17 differentiation was inhibited and was increased by rIL-17 treatment. Conclusions These results imply that IL-17 and Th17, along with innate antimicrobial factors, have a role in the immune response to vaginal candidiasis.

Pietrella, Donatella; Rachini, Anna; Pines, Mark; Pandey, Neelam; Mosci, Paolo; Bistoni, Francesco; d'Enfert, Cristophe; Vecchiarelli, Anna

2011-01-01

403

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.

Ratzan, Jerome J.

1969-01-01

404

Prevalence of HIV among women with vaginal discharge in a gynecological clinic.  

PubMed Central

OBJECTIVE: Vaginal discharge is a common complaint among women with sexually transmitted diseases (STDs) in Nigeria. Given the association between STDs and HIV and the alarming rise in the prevalence of HIV in Nigeria, we performed this study to determine the prevalence of HIV in patients with vaginal discharge. STUDY DESIGN: Between April 2000 and August 2000, women who attended the Lagos University Teaching Hospital and complained of vaginal discharge were adequately counseled for HIV serotest. High vaginal/endocervical swabs and venous blood were taken for microbiological studies and HIV serotest, respectively. RESULTS: Out of the 230 women counseled for HIV serotest 140 (60.9%) consented. The mean age of the 140 was 31.1+/-6.9 years (range 18-50 years). In 31 (22.1%), Candida albicans was isolated, in 26 Gardnerella vaginalis (18.8%), in 17 Staphylococcal spp. (12.1%); and E. coli, Trichomonas vaginalis, and Neisseria gonococcus in 7.9%, 4.3%, and 1.4%, respectively. Four (2.9%) of the 140 patients were HIV seropositive, and all had Candida albicans isolated. The prevalence of HIV among patients with Candida albicans was 12.9%. Association between HIV seropositivity and Candida albicans infection is significant (X2=14.48; p=0.002). CONCLUSION: Candida albicans is a common cause of vaginal discharge among HIV-seropositive women in Lagos.

Anorlu, Rose; Imosemi, Donald; Odunukwe, Nkiru; Abudu, Olalekan; Otuonye, Mirable

2004-01-01

405

Non-surgical treatment of vaginal agenesis using a simplified version of Ingram's method.  

PubMed

Non-surgical vaginal dilation is a safe and effective method for the creation of neovagina in the patient with vaginal agenesis. Compared to surgical methods, non-surgical vaginal dilation has the advantage of low morbidity, the creation of a more physiologic vaginal milieu, and no surgical scarring. To overcome some technical limitations of original Frank's method, in 1981 Ingram proposed a modification of the technique that used dilators of gradually increasing size mounted on a bicycle seat stool. Although several studies have shown satisfactory outcomes using Ingram's method, there are some practical difficulties in making and handling the bicycle seat stool. This article reports a case of a 24-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome whose vaginal agenesis is successfully treated with a simplified version of Ingram's method. This method uses dilators of gradually increasing size mounted on an ordinary chair instead of a bicycle seat stool. When necessary, the patient may use a fulcrum under the dilator. PMID:17191323

Lee, Mee-Hwa

2006-12-31

406

Involvement of Fas in regression of vaginal epithelia after ovariectomy and during an estrous cycle.  

PubMed Central

Fas, also called APO-1, belongs to the tumor necrosis factor/nerve growth factor receptor family and transmits an apoptotic signal within the cell by binding to the Fas ligand. Fas has been implicated in the activation-induced suicide of T cells and cytotoxic T cell activity in the immune system. Non-immune cells such as those in liver, lung and ovary also express Fas, but its role in these cells remains unclear. Ovariectomy has been used to study homeostasis of female reproductive organs, which is regulated by sex hormones. Here we analyzed Fas function in the ovariectomy-induced regression of mouse vaginal epithelial cells. Fas expression was detected in vagina and was elevated after ovariectomy. Fas-deficient lpr and lpr(cg) mice did not exhibit ovariectomy-induced regression of vaginal epithelia, whereas uterine regression induced by ovariectomy was not affected in these mice. The vaginas of lpr and lpr(cg) mice were in a persistent estrous stage with cornification of vaginal epithelia, as judged from the cell types in the vaginal fluid. Thus, Fas appears to be involved directly in the regression of vaginal epithelia induced by ovariectomy and during the estrous cycle, suggesting that the physiological role of this receptor extends beyond that exerted on immune cells. This is the first evidence of a role for Fas inducing physiological apoptosis in non-immune cells. Images

Suzuki, A; Enari, M; Eguchi, Y; Matsuzawa, A; Nagata, S; Tsujimoto, Y; Iguchi, T

1996-01-01

407

Safety Study of an Antimicrobial Peptide Lactocin 160, Produced by the Vaginal Lactobacillus rhamnosus  

PubMed Central

Objective. To evaluate the safety of the antimicrobial peptide, lactocin 160. Methods. Lactocin 160, a product of vaginal probiotic Lactobacillus rhamnosus 160 was evaluated for toxicity and irritation. An in vitro human organotypic vaginal-ectocervical tissue model (EpiVaginal) was employed for the safety testing by determining the exposure time to reduce tissue viability to 50% (ET-50). Hemolytic activity of lactocin160 was tested using 8% of human erythrocyte suspension. Susceptibility of lactobacilli to lactocin160 was also studied. Rabbit vaginal irritation (RVI) model was used for an in vivo safety evaluation. Results. The ET-50 value was 17.5 hours for lactocin 160 (4.9 hours for nonoxynol 9, N9). Hemolytic activity of lactocin 160 was 8.2% (N9 caused total hemolysis). Lactobacilli resisted to high concentrations of peptide preparation. The RVI model revealed slight vaginal irritation. An average irritation index grade was evaluated as “none.” Conclusions. Lactocin 160 showed minimal irritation and has a good potential for intravaginal application.

Dover, Sara E.; Aroutcheva, Alla A.; Faro, S.; Chikindas, Michael L.

2007-01-01

408

Maternal Goals for Childbirth Associated with Planned Vaginal and Planned Cesarean Birth  

PubMed Central

We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (p = 0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, p <0.001). This research furthers our understanding of women’s attitudes regarding cesarean childbirth and definitions of a successful birth experience.

Quiroz, Lieschen H.; Blomquist, Joan L.; Macmillan, Deborah; Mccullough, Alexis; Handa, Victoria L.

2011-01-01

409

Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.  

PubMed

We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (P ?=? 0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, P ?

Quiroz, Lieschen H; Blomquist, Joan L; Macmillan, Deborah; McCullough, Alexis; Handa, Victoria L

2011-06-09

410

Antiviral and immunological effects of tenofovir microbicide in vaginal herpes simplex virus 2 infection.  

PubMed

The anti-HIV microbicide, tenofovir (TFV) gel, has been shown to decrease HIV-1 acquisition by 39% and reduce herpes simplex virus 2 (HSV-2) transmission by 51%. We evaluated the effect of a 1% TFV gel on genital HSV-2 infection in a mouse vaginal challenge model. In vitro plaque assays and luminex multiplex bead analysis were used, respectively, to measure postinfection vaginal viral shedding (day 1) and cytokine secretion (day 2). To further investigate the anti-HSV-2 properties, we evaluated the direct antiviral effect of TFV and the oral prodrug tenofovir disoproxil fumerate (TDF) in cell culture. Compared to placebo-treated mice, TFV-treated mice had significantly lower clinical scores, developed later genital lesions, and showed reduced vaginal viral shedding. Furthermore, the levels of IFN-?, IL-2, TNF-?, and other cytokines were altered in the vaginal fluid following topical tenofovir treatment and subsequent HSV-2 challenge. Finally, we found that both TFV and TDF inhibited HSV-2 infection in vitro; TDF showed a 50-fold greater potency than TFV. In conclusion, we confirmed that the microbicide TFV had direct anti-HSV-2 effects in a murine vaginal challenge model. Therefore, this model would be suitable for evaluating present and future microbicide candidates. Furthermore, the present study warrants further investigation of TDF in microbicides. PMID:22867119

Vibholm, Line; Reinert, Line S; Søgaard, Ole S; Paludan, Søren R; Østergaard, Lars; Tolstrup, Martin; Melchjorsen, Jesper

2012-09-25

411

Vaginal brachytherapy alone is sufficient adjuvant treatment of surgical stage I endometrial cancer  

SciTech Connect

Purpose To determine the efficacy and complications of adjuvant vaginal high-dose-rate brachytherapy alone for patients with Stage I endometrial cancer in whom complete surgical staging had been performed. Methods and Materials Between April 1998 and March 2004, 100 patients with Stage I endometrial cancer underwent surgical staging (total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic {+-} paraaortic nodal sampling) and postoperative vaginal high-dose-rate brachytherapy at our institution. The total dose was 2100 cGy in three fractions. Results With a median follow-up of 23 months (range 2-62), no pelvic or vaginal recurrences developed. All patients underwent pelvic dissection, and 42% underwent paraaortic nodal dissection. A median of 29.5 pelvic nodes (range 1-67) was removed (84% had >10 pelvic nodes removed). Most patients (73%) had endometrioid (or unspecified) adenocarcinoma, 16% had papillary serous carcinoma, and 11% had other histologic types. The International Federation of Gynecology and Obstetrics stage and grade was Stage IA, grade III in 5; Stage IB, grade I, II, or III in 6, 27, or 20, respectively; and Stage IC, grade I, II, or III in 13, 17, or 10, respectively. The Common Toxicity Criteria (version 2.0) complications were mild (Grade 1-2) and consisted primarily of vaginal mucosal changes, temporary urinary irritation, and temporary diarrhea. Conclusion Adjuvant vaginal high-dose-rate brachytherapy alone may be a safe and effective alternative to pelvic external beam radiotherapy for surgical Stage I endometrial cancer.

Solhjem, Matthew C. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)]. E-mail: petersen.ivy@mayo.edu; Petersen, Ivy A. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Haddock, Michael G. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)

2005-08-01

412

Simultaneous bladder and vaginal reconstruction using ileum in complicated vesicovaginal fistula  

PubMed Central

Objectives: To discuss the outcome of surgical repair in complicated vesicovaginal fistula with simultaneous bladder and vaginal reconstruction using ileum. Materials and Methods: Four female patients in the age group of 12-30 years are included. All the patients had complicated vesicovaginal fistula with vaginal stenosis secondary to obstetric hysterectomy (except one secondary to the genitourinary tuberculosis). Repair of vesicovaginal fistula with simultaneous bladder augmentation, ureteric reimplantation, and reconstruction of vagina using ileum was performed in all the cases. Results: All the patients had successful repair of fistula. Vaginal reconstruction using ileum, resulted in capacious vagina. Adult patients resumed to normal sexual life. Mucus discharge was the only complaint in postoperative period. Conclusions: Malnutrition, anemia, obstructed labor, Intra uterine fetal death (IUFD), postpartum hemorrhage following forceps delivery in a rural setting followed by an emergency obstetric hysterectomy after a delay of 6-8 h (due to transfer to a tertiary center) were the few contributing factors leading to the formation of vesicovaginal fistula (VVF). Preoperative assessment of bladder capacity and vaginal capacity in such cases is mandatory. The small bowel is a readily available vascular tissue for restoring bladder and vaginal capacity.

Patwardhan, Sujata K.; Sawant, Ajit; Ismail, Mohammad; Nagabhushana, M.; Varma, Radheshyam R.

2008-01-01

413

Isolation and identification of fungi from vaginal flora in three species of captive Leontopithecus.  

PubMed

The ability to reproduce in captivity is an essential component of lion tamarin (Leontopithecus) conservation programs. However, infections such as vaginitis, cervicitis, and endometritis are important diseases that may influence the reproduction of these animals. Therefore, it is important to detect continuous or occasional vaginal microbial populations, and to understand their potential role as an endogenous source of infection [Collins, 1964; Blue, 1983; Pugh et al., 1986]. Vaginal swabs were collected from 25 female tamarins of the three currently available species (L. rosalia, L. chrysopygus, and L. chrysomelas) at the Center of Primatology in Rio de Janeiro, Brazil. The swabs were processed according to standard mycological protocols, and isolates were biochemically characterized. Fungal isolates were recovered from 16 animals (64.0%). The results showed that 70.6% of the isolated microorganisms consisted of yeast, including three species of Candida (mainly C. glabrata). We suggest that this species is a resident member of the normal vaginal flora in Leontopithecus. Filamentous fungi (mainly from Trichosporon, Aspergillus, and Penicilliumgenera) constituted 29.4% of the isolates, and were considered to be transitory contaminants of the genital area. We suggest that colonization of the vaginal environment is related to the endocrine pattern associated with the reproductive status of these animals, but not to parity. PMID:15538760

Moraes, Ismar A; Stussi, Jussara S P; Lilenbaum, Walter; Pissinatti, Alcides; Luz, Fabio P; Ferreira, Ana Maria R

2004-11-01

414

Treatment of recurrent vulvo-vaginal candidiasis with sustained-released butoconazole pessary.  

PubMed

Vulvo-vaginal candidiasis (VVC) is a common infection among women. 5% of women with acute infection experience recurrent vulvo-vaginal candidiasis (RVVC). There is currently no optimal or recommended regime for RVVC. Although antifungal agents, such as imidazoles, have been successfully used as a first-line treatment for acute VVC, its effectiveness is limited in RVVC. This could be due to patient factors, drug application (such as leakage) or dosing factors. A sustained-release (SR) bioadhesive vaginal cream (2% butoconazole nitrate) has incorporated VagiSite technology, a topical drug delivery system that allows SR of the drug. We describe its efficacy and the successful use of a butoconazole-SR formulation in the treatment of two cases of RVVC. PMID:23268172

Heng, Ling Zhi; Chen, Yujia; Tan, Thiam Chye

2012-12-01

415

A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse.  

PubMed

A 66-year-old female presented with symptoms suggestive of pelvic organ prolapse, history of fibroid uterus, and rectal pressure. Pelvic examination revealed a large pelvic mass filling the posterior cul-de-sac, occupying the rectovaginal septum, and compressing the rectum. There was a stage II pelvic organ prolapse of the posterior vaginal wall with distal vaginal wall extending to the hymen during valsalva. A CT scan confirmed the large pelvic mass distinct from the uterus measuring 9.4 × 9.8 × 6.2 cm. Colorectal workup revealed adenocarcinoma of colon on screening colonoscopy with biopsies. Patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, colon resection, and abdominal resection of the pelvic mass in the rectovaginal septum and inferior to the uterus. The patient did not require any concomitant pelvic reconstruction and the posterior vaginal wall prolapse resolved after resecting the pelvic mass. PMID:21416285

Cui, Nuan; Zormpa, Maria; Lazarou, George

2011-03-17

416

Evisceration occurred 1 year after vaginal vault repair for relapsed pelvic organ prolapse.  

PubMed

This report describes the case of an 81-year-old woman with sudden evisceration of the small intestine through the vagina. It occurred one year after repair of a vaginal vault prolapse, which was initially treated by vaginal hysterectomy and colporrhaphy three years prior to the repair. On examination, we found a 70-80-cm loop of bowel prolapsing through a 3-cm oval defect in the vaginal vault. The patient underwent emergency exploratory laparotomy under general anesthesia. After careful reduction of the eviscerated small intestine, the hernia hiatus was closed and the widened cul-de-sac was obliterated by performing a Moschcowitz culdoplasty. Rapid intervention by abdominovaginal surgery may enable smooth repositioning of the eviscerated intestine, thus preventing subsequent morbidity. PMID:22574740

Muraoka, Mitsue; Nagano, Hiroaki; Takagi, Koichiro

2012-05-10

417

Management of chronic vaginal prolapse in an eastern bongo (Tragelaphus eurycerus isaaci).  

PubMed

A 4.5-yr-old multiparous female eastern bongo (Tragelaphus eurycerus isaaci) presented with a prolapsed vagina 4 mo after dystocia and vaginal extraction of a large calf. The prolapse was corrected via manual reduction and vulvoplasty (Caslick operation). A melengesterol acetate contraceptive implant was placed and the bongo was asymptomatic for 6 yr until vaginal prolapse recurrence. The vaginal prolapse recurred four times over a 2-yr span and was managed with repeat Caslick procedures and several epidural injections using 95% grain alcohol. Complications secondary to long-term progestin implant usage, acquired urovagina, as well as perineal atony from the alcohol epidurals are believed to have contributed to prolapse recurrence. Ovariohysterectomy and vaginoplasty ultimately were elected and were curative. According to a survey conducted in response to this case, obstetrical issues and female reproductive tract problems appear to occur sporadically in captive bongo but are not uncommon. PMID:19110705

Gyimesi, Zoltan S; Linhart, Richard D; Burns, Roy B; Anderson, David E; Munson, Linda

2008-12-01

418

Staphylococcal Cassette Chromosome mec type and antibiotic susceptibility profiles of vaginal and nonvaginal MRSA clinical isolates.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) causes nosocomial and community-associated infections, representing significant healthcare concerns. Limited studies have investigated cervicovaginal MRSA colonization and antibiotic susceptibility. Upon comparing clinical cervicovaginal MRSA isolates to nonvaginal isolates by Staphylococcal Cassette Chromosome mec type, presence of Panton-Valentine Leukocidin toxin, antibiotic susceptibility, and presence of associated resistance genes, no significant differences were observed between the anatomical sites, but were observed between our hospital- and community-associated MRSA isolates. There was a significant increase in erythromycin resistance in our vaginal MRSA isolates compared to previous vaginal MRSA reports and an increase in clindamycin, doxycycline, and mupirocin resistance in our nonvaginal MRSA isolates compared to previously reported community-based skin and soft tissue MRSA isolates. Additionally, this is the first report of mupirocin resistance in vaginal MRSA isolates. PMID:22867728

Chadwick, Sean G; Hart, Caitlin E; Mordechai, Eli; Adelson, Martin E; Gygax, Scott E

2012-08-04

419

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

PubMed

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 O Z; Yiu, Chu Yiu; Oke, Olatokunbo

2011-10-28

420

A virosomal vaccine against candidal vaginitis: immunogenicity, efficacy and safety profile in animal models.  

PubMed

A novel vaccine (PEV7) consisting of a truncated, recombinant aspartyl proteinase-2 of Candida albicans incorporated into influenza virosomes was studied. This vaccine candidate generated a potent serum antibody response in mouse and rat following intramuscular immunization. Anti-Sap2 IgG and IgA were also detected in the vaginal fluid of rats following intravaginal or intramuscular plus intravaginal administration. In a rat model of candidal vaginitis, PEV7 induced significant, long-lasting, likely antibody-mediated, protection following intravaginal route of immunization. PEV7 was also found to be safe in a repeated-dose toxicological study in rats. Overall, these data provide a sound basis to envisage the clinical development of this new candidate vaccine against candidal vaginitis. PMID:22561143

De Bernardis, Flavia; Amacker, Mario; Arancia, Silvia; Sandini, Silvia; Gremion, Christel; Zurbriggen, Rinaldo; Moser, Christian; Cassone, Antonio

2012-05-03

421

Lumbosacral plexus injury following vaginal delivery with epidural analgesia -A case report-  

PubMed Central

A 26 year old, healthy, 41 week primiparous woman received a patient-controlled epidural analgesia (PCEA) and experienced paraplegia 11 hours later after a vaginal delivery. This was thought to be the result of complications from PCEA but there was no specific abnormality on magnetic resonance imaging (MRI) of the lumbosacral spine. On an electromyography (EMG) study performed 15 days following delivery, signs of tibial neuropathy were present and peripheral nerve injury during vaginal delivery was suspected. Motor weakness and hypoesthesia of both lower extremities improved rapidly, but a decrease in the desire to urinate or defecate, followed by urinary incontinence and constipation persisted, We suspected the sacral plexus had been severely damaged during vaginal delivery. Seven months later, the patient's conditions improved but had not fully recovered.

Park, Seil; Park, Sung Wook

2013-01-01

422

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

2013-01-23

423

Pharmacokinetics and topical vaginal effects of two tenofovir gels in rabbits.  

PubMed

Tenofovir (TFV) 1% gel has proven effective in preclinical and clinical studies in preventing sexual transmission of HIV-1. The impact of changing the current gel formulation to reduce its osmolality was evaluated using pharmacokinetic assessments and local tissue effects in the rabbit. Following vaginal administration of TFV 1% gel and reduced-glycerin TFV 1% gel, TFV was measured in plasma, vaginal tissues, vaginal fluids, and iliac lymph nodes. After a single dose, plasma C(max) and AUC(0-4h) were significantly higher in the TFV 1% gel group compared with the reduced-glycerin TFV 1% gel group. After 14 days of once-daily dosing, differences in these parameters were insignificant. Vaginal fluid concentrations were ?100??g/ml following the first dose and up to a mean of about 500??g/ml after 14 once-daily doses. Mean (and median) cranial TFV tissue concentrations were generally in excess of 100??g/g following a single dose and 14 once-daily doses of both gels; concentrations in the caudal vaginal tissues were comparatively lower, although in nearly all cases mean values exceeded 10??g/g. Treatment of tissues with phosphatase to liberate TFV from its diphosphate and monophosphate metabolites increased recovery of TFV by 60-120%. Median TFV concentrations in iliac lymph nodes ranged from 44?ng/g to 196?ng/g; differences between iliac lymph node TFV concentrations following dosing of the two gels were insignificant. There were no differences observed in histological evaluation in the cranial vagina following 14 days of once-daily dosing of either gel. There was an apparent impact of TFV on rabbit vaginal epithelium (increased secretory depletion and increased cellular vacuolization) independent of formulation. These data indicate that the reduced-glycerin TFV 1% gel may be a suitable alternative to TFV 1% gel. PMID:22394281

Clark, Meredith R; Friend, David R

2012-04-17

424

Assisted Vaginal Deliveries in Mothers Admitted as Public or Private Patients in Western Australia  

PubMed Central

Background Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. Methods and findings We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA) Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (<7), neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI?=?1.68–1.80). Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08–1.45), neonatal resuscitation (OR?=?1.69, 1.42–2.00) and admission to special care nursery (OR?=?1.64, 1.53–1.76). The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR?=?2.13) than public patients (OR?=?1.55, pinteraction?=?0.03). Conclusions Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a higher rate of fetal indications for assisted vaginal delivery remains to be answered.

Einarsdottir, Kristjana; Haggar, Fatima A.; Stock, Sarah; Gunnell, Anthony S.; Stanley, Fiona J.

2013-01-01

425

Safe and sustained vaginal delivery of pyrimidinedione HIV-1 inhibitors from polyurethane intravaginal rings.  

PubMed

The potent antiretroviral pyrimidinediones IQP-0528 (PYD1) and IQP-0532 (PYD2) were formulated in polyurethane intravaginal rings (IVRs) as prophylactic drug delivery systems to prevent the sexual transmission of HIV-1. To aid in the selection of a pyrimidinedione candidate and the optimal loading of the drug in the IVR delivery system, four pyrimidinedione IVR formulations (PYD1 at 0.5 wt% [PYD1(0.5 wt%)], PYD1(1 wt%), PYD2(4 wt%), and PYD2(14 wt%)) were evaluated in pigtail macaques over 28 days for safety and pyrimidinedione vaginal biodistribution. Kinetic analysis of vaginal proinflammatory cytokines, native microflora, and drug levels suggested that all formulations were safe, but only the high-loaded PYD2(14 wt%) IVR demonstrated consistently high pyrimidinedione vaginal fluid and tissue levels over the 28-day study. This formulation delivered drug in excess of 10 ?g/ml to vaginal fluid and 1 ?g/g to vaginal tissue, a level over 1,000 times the in vitro 50% effective concentration. The in vitro release of PYD1 and PYD2 under nonsink conditions correlated well with in vivo release, both in amount and in kinetic profile, and therefore may serve as a more biologically relevant means of evaluating release in vitro than typically employed sink conditions. Lastly, the pyrimidinediones in the IVR formulation were chemically stable after 90 days of storage at elevated temperature, and the potent nanomolar-level antiviral activity of both molecules was retained after in vitro release. Altogether, these results point to the successful IVR formulation and vaginal biodistribution of the pyrimidinediones and demonstrate the usefulness of the pigtail macaque model in evaluating and screening antiretroviral IVR formulations prior to preclinical and clinical evaluation. PMID:22155820

Johnson, Todd J; Srinivasan, Priya; Albright, Theodore H; Watson-Buckheit, Karen; Rabe, Lorna; Martin, Amy; Pau, Chou-Pong; Hendry, R Michael; Otten, Ron; McNicholl, Janet; Buckheit, Robert; Smith, James; Kiser, Patrick F

2011-12-12

426

Epidemiological investigation of vaginal Saccharomyces cerevisiae isolates by a genotypic method.  

PubMed

Saccharomyces cerevisiae is a ubiquitous, ascomycetous yeast, and vaginitis caused by this organism has been reported only very rarely. The aim of the present investigation was to assess the epidemiological relatedness of a group of vaginal and commercial S. cerevisiae isolates by a previously reported genetic typing method, which divided the isolates into two broad groups with numerous subtypes. Nineteen S. cerevisiae isolates obtained from patients suffering from vaginitis and four isolates from commercial products in the same city were analyzed. The cellular DNA from each isolate was digested with the restriction endonuclease EcoRI, and restriction fragment length polymorphisms were generated by horizontal gel electrophoresis. The results showed that although vaginal isolates did not cluster in any particular genetic subtype, multiple patients were infected with indistinguishable strains (there were nine distinct strains among 23 isolates). For two of three patients, all three with two episodes of S. cerevisiae vaginitis, different strains were isolated during the recurrence of this disease. Three other patients with indistinguishable isolates were epidemiologically related in that two were practitioners in the same clinic and the third was a patient at this clinic. We also found that one commercial strain was indistinguishable from the strain isolated from three different women at the time that they were suffering from vaginitis. The findings of the present study suggest that some S. cerevisiae strains may possess properties permitting persistence in the human host. Furthermore, person-to-person contact and the proliferation of the use of S. cerevisiae as a health-food product, in home baking, and in home brewing may be a contributing factor in human colonization and infection with this organism. PMID:9466776

McCullough, M J; Clemons, K V; Farina, C; McCusker, J H; Stevens, D A

1998-02-01

427

A Novel Low Dose Fractionation Regimen for Adjuvant Vaginal Brachytherapy in Early Stage Endometrial Cancer  

PubMed Central

Purpose To evaluate local control, survival and toxicity in patients with early-stage endometrioid adenocarcinoma of the uterus treated with adjuvant high-dose-rate (HDR) vaginal brachytherapy (VB) alone using a novel low dose regimen Methods We reviewed records of 414 patients with stage IA to stage II endometrial adenocarcinoma treated with VB alone from 2005 to 2011. Of these, 157 patients with endometrioid histology received 24 Gy in 6 fractions of HDR vaginal cylinder brachytherapy and constitute the study population. Dose was prescribed at the cylinder surface and delivered twice weekly in the post-operative setting. Local control and survival rates were calculated by the Kaplan-Meier method. Results All 157 patients completed the prescribed course of VB. Median follow-up time was 22.8 months (range, 1.5–76.5). Two patients developed vaginal recurrence, one in the periurethral region below the field and one in the fornix after treatment with a 2.5-cm cylinder. Three patients developed regional recurrence in the para-aortic region. Two patients developed distant metastasis (lung and carcinomatosis). The 2-year rate of vaginal control was 98.6%, locoregional control was 97.9% and disease-free survival was 96.8%. The 2-year overall survival rate was 98.7%. No Grade 2 or higher vaginal, gastrointestinal, genitourinary or skin long-term toxicity was reported for any patient. Conclusion Vaginal brachytherapy alone in early-stage endometrial cancer provides excellent results in terms of locoregional control and disease-free survival. The fractionation scheme of 24 Gy in 6 fractions prescribed to the cylinder surface was well-tolerated with minimal late toxicity.

Townamchai, Kanokpis; Lee, Larissa; Viswanathan, Akila N.

2012-01-01

428

Safe and Sustained Vaginal Delivery of Pyrimidinedione HIV-1 Inhibitors from Polyurethane Intravaginal Rings  

PubMed Central

The potent antiretroviral pyrimidinediones IQP-0528 (PYD1) and IQP-0532 (PYD2) were formulated in polyurethane intravaginal rings (IVRs) as prophylactic drug delivery systems to prevent the sexual transmission of HIV-1. To aid in the selection of a pyrimidinedione candidate and the optimal loading of the drug in the IVR delivery system, four pyrimidinedione IVR formulations (PYD1 at 0.5 wt% [PYD10.5wt%], PYD11wt%, PYD24wt%, and PYD214wt%) were evaluated in pigtail macaques over 28 days for safety and pyrimidinedione vaginal biodistribution. Kinetic analysis of vaginal proinflammatory cytokines, native microflora, and drug levels suggested that all formulations were safe, but only the high-loaded PYD214wt% IVR demonstrated consistently high pyrimidinedione vaginal fluid and tissue levels over the 28-day study. This formulation delivered drug in excess of 10 ?g/ml to vaginal fluid and 1 ?g/g to vaginal tissue, a level over 1,000 times the in vitro 50% effective concentration. The in vitro release of PYD1 and PYD2 under nonsink conditions correlated well with in vivo release, both in amount and in kinetic profile, and therefore may serve as a more biologically relevant means of evaluating release in vitro than typically employed sink conditions. Lastly, the pyrimidinediones in the IVR formulation were chemically stable after 90 days of storage at elevated temperature, and the potent nanomolar-level antiviral activity of both molecules was retained after in vitro release. Altogether, these results point to the successful IVR formulation and vaginal biodistribution of the pyrimidinediones and demonstrate the usefulness of the pigtail macaque model in evaluating and screening antiretroviral IVR formulations prior to preclinical and clinical evaluation.

Johnson, Todd J.; Srinivasan, Priya; Albright, Theodore H.; Watson-Buckheit, Karen; Rabe, Lorna; Martin, Amy; Pau, Chou-Pong; Hendry, R. Michael; Otten, Ron; McNicholl, Janet; Buckheit, Robert; Smith, James

2012-01-01

429

Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery  

Microsoft Academic Search

Purpose. Disturbance of anal continence is a well-known problem after vaginal delivery. However, only few and incongruent data on the incidence and pathogenesis of postpartum incontinence are available. This study examined the effects of vaginal delivery on anal continence prospectively. Methods. In 42 unselected women anal vector manometry and endoanal ultrasonography were performed, and pudendal nerve terminal motor latency (PNTML)

S. Willis; A. Faridi; S. Schelzig; F. Hoelzl; R. Kasperk; W. Rath; V. Schumpelick

2002-01-01

430

Dilation as treatment for vaginal agenesis and hypoplasia: A pilot exploration of benefits and barriers as perceived by patients  

Microsoft Academic Search

Summary Reconstructive surgery has been the traditional treatment for the short vagina. Recently vaginal dilation has been recommended due to its low morbidity. Small retrospective studies have reported success rates of up to 80% but include neither clear definitions of 'success' nor exploration of factors associated with compliance and outcome. The first 10 women prescribed vaginal dilation treatment at a

L. M. LIAO; J. DOYLE; N. S. CROUCH; S. M. CREIGHTON

2006-01-01

431

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

432

ORIGINAL RESEARCH—WOMEN'S SEXUAL HEALTH A Woman's History of Vaginal Orgasm is Discernible from Her Walk  

Microsoft Academic Search

Introduction. Research has demonstrated the association between vaginal orgasm and better mental health. Some theories of psychotherapy assert a link between muscle blocks and disturbances of both character and sexual function. In Functional-Sexological therapy, one focus of treatment is amelioration of voluntary movement. The present study examines the association of general everyday body movement with history of vaginal orgasm. Aim.

Aurelie Nicholas; Stuart Brody; Pascal de Sutter; François de Carufel

433

Two cases of post-coital vaginal cuff dehiscence with small bowel evisceration after robotic-assisted laparoscopic hysterectomy  

PubMed Central

INTRODUCTION Vaginal cuff dehiscence following robotic surgery is uncommon. Published reports of vaginal cuff dehiscence following robotic surgery are increasing, but the true incidence is unknown. PRESENTATION OF CASE Case 1. A 45 year old female had sexual intercourse and presented with a vaginal cuff dehiscence complicated by small bowel evisceration 4 months after RA-TLH. Case 2. A 44 year old female had sexual intercourse and presented with a vaginal cuff dehiscence with small bowel evisceration 6 weeks after RA-TLH. DISCUSSION We discuss the rate of vaginal cuff dehiscence by mode of hysterectomy, surgical and non-surgical risk factors that may contribute to vaginal cuff dehiscence, and proposed preventative methods at the time of RA-TLH to reduce this complication. CONCLUSION Vaginal cuff dehiscence with associated evisceration of intraabdominal contents is a potentially severe complication of hysterectomy. We recommend counseling patients who undergo RA-TLH to abstain from vaginal intercourse for a minimum of 8–12 weeks.

Nguyen, My-Linh T.; Kapoor, Monica; Pradhan, Tana S.; Pua, Tarah L.; Tedjarati, Sean S.

2013-01-01

434

Surgical repair of vaginal prolapse: a gynaecological hernia.  

PubMed

Female pelvic organ prolapse refers to the descent of the pelvic organs towards or through the vagina. The similarities between vaginal prolapse and herniae in their aetiology and treatment make this an interesting area for all those operating in the pelvis. It is a common condition with prevalence estimates varying from 2% for symptomatic prolapse to 50% for asymptomatic prolapse [Samuelsson EC, Arne Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 1999;180:299-305]. Approximately 50% of parous women will have some degree and only 10-20% of these seek medical help [Beck RP. Pelvic relaxation prolapse. In: Kase NG, Weingold AB, editors. Principles and practice of clinical gynecology. New York: John Wiley; 1983. p. 677-85]. The lifetime risk for surgery for prolapse has been estimated to be around 11.1%, and 30% will undergo re-operation for recurrent prolapse [Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapsed and urinary incontinence. Obstet Gynecol 1997;89:501-6]. The aetiology of prolapse is multifactorial. Advancing age, parity and collagen weakness are all quoted as significant predisposing factors [Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapsed and urinary incontinence. Obstet Gynecol 1997;89:501-6; Maclennan AH, Taylor AW, Wilson, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. Br J Obstet Gynaecol 2000;107:1460-70]. Pathophysiological mechanisms that have been proposed include pelvic floor denervation, direct trauma to the pelvic floor musculature, abnormal synthesis and degradation of collagen and defects in endopelvic fascia [Al-Rawi ZS, Al-Rawi ZT. Joint hypermobility in women with genital prolapse. Lancet 1982;I:439-41; Gilpin SA, Gosling JA. Smith ARB, Warrell DW. The pathogenesis of genitourinary prolapse and stress incontinence in women. A histological and histochemical study. Br J Obstet Gynaecol 1989;96:15-23; Smith ARB, Hosker GL, Warrell DW. The role of partial denervation of the pelvic floor in the aetiology of genitourinary prolapse and stress incontinence of urine. A neurophysiological study. Br J Obstet Gynaecol 1989;96:24-8; Allen RE, Hosker GL, Smith ARB, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 1990;97:770-9]. The procedure of choice for reconstructive surgery to the vagina should be tailored to the individual patient and be of low morbidity and mortality, but at the same time with long-term durability. PMID:17462358

Chaliha, Charlotte; Khullar, Vik

2005-12-22

435

[Use of phytostimolin vaginal cream and lavage in cervical dystrophy after DTC of the cervix].  

PubMed

The study evaluated the efficacy and tolerance of the active components of "phytostimolin" cream and vaginal lavage, Triticum Vulgare and Ether glycoethylen-mono-phenolic, in 40 patients suffering from dystrophic cervico-vaginal pathologies (group 1), and in 20 patients following DTC of the portio due to ectropion (group 2). The study was double blind. An overall efficacy of 70% was observed in group 1 and 90% in group 2. The results obtained, the absence of side effects, and the good level of tolerance confirm the value of the above components in the pathology in question. PMID:2057103

Bottino, G; Menna, C; Miradoli, P; Rosa, M O; Denzio, G

1991-03-01

436

Modification of the Ingram bicycle seat stool for the treatment of vaginal agenesis and stenosis.  

PubMed

The use of nonsurgical techniques for the creation of a neovagina for vaginal agenesis and stenosis has been successful for many patients and is currently recommended as first-line therapy. The Ingram bicycle seat stool technique, a nonsurgical approach, has largely replaced the surgical McIndoe technique as the method of choice for vaginal dilation. It provides an easy and comfortable way for patients to engage in dilation. However, the Ingram bicycle seat stool is not height adjustable. We have created a bicycle seat stool that is height adjustable and will likely provide patients with an improved, more comfortable, and individualized method of dilation. PMID:18603249

Lankford, Jillian A; Haefner, Hope K

2008-07-07