|This article අනාථ ලිපියක් වන්නේ, වෙනත් කිසිම ලිපියක් එය වෙත නොබැඳෙන බැවිනි. (ජූනි 2013)|
|යෝනිමාර්ග ප්රදාහය (Vaginitis)|
|වර්ගීකරණය සහ බාහිර මූලාශ්ර|
|eMedicine||med/3369 med/2358 emerg/631 emerg/639|
බොහෝ කොටම යෝනිය ආසාදනය හෝ irritationබව නිසා වැලඳෙන රෝගයකි යෝනිමාර්ග ප්රදාහය. This leading to vulvovaginitis. It is a common problem.
- යෝනිය සහ අවට කැසීම
- ප්රදාහය (irritation, redness, and swelling caused by the presence of extra immune cells) of the labia majora, labia minora, or perineal area
- යෝනි මාර්ගයෙන් ස්රාව ගැලීම
- අප්රසන්න ගන්ධය
- ම්රතා පහකිරීමේ අපහසුව සහ මුත්රා දැවිල්ල
- යෝනි සංසර්ගයේදී වේදනාව
Vulvovaginitis can affect women of all ages and is very common. Specific forms of vaginitis are:
Infectious vaginitis accounts for 90% of all cases in reproductive age women and is represented by the triad:
- Candidiasis: vaginitis caused by Candida albicans (a yeast),
- Bacterial vaginosis: vaginitis caused by Gardnerella (a bacterium).
Vaginal infection are often (varies between countries between 20 to 40% of vaginal infections) a mix of various ethiologies, which present challenging cases for treatment. Indeed, when only one cause is treated, the other pathogens can gain in resistance and induce relapses and recurrences. The key factor is therefore to get a precise diagnosis and treat with broad spectrum anti-infective (often also inducing adverse effects).
Pre-pubescent girls may also have infectious vaginitis, although the causes are different than those for women:
- Bacterial vaginosis: vaginitis caused by Streptococcus spp..
- Improper hygiene, which may introduce bacteria or other irritants from the anal region to the vaginal area.
The PH balance in girls' bodies is not conducive to Candida albicans, so they are unlikely to contract a yeast infection.
Hormonal vaginitis includes atrophic vaginitis usually found in postmenopausal or postpartum women. Sometimes it can occur in young girls before puberty. In these situations the estrogen support of the vagina is poor.
Irritant vaginitis can be caused by allergies to condoms, spermicides, soaps, perfumes, douches, lubricants and semen. It can also be caused by hot tubs, abrasion, tissue, tampons or topical medications.
Foreign Body Vaginitis: Foreign bodies (most commonly retained tampons or condoms) cause extremely malodorous vaginal discharges. Treatment consists of removal, for which ring forceps may be useful. Further treatment is generally not necessary.
Role of STDs[සංස්කරණය]
Sexually Transmitted Diseases (STDs) can be a cause of vaginal discharge. Chlamydia and gonorrhea testing should be done whenever a sexually active individual complains of vaginal discharge even when the cervix appears normal.
මධු මේහය (දියවැඩියාව)[සංස්කරණය]
Diagnosis is made with microscopy and culture of the discharge after a careful history and physical examination have been completed. The color, consistency, acidity, and other characteristics of the discharge may be predictive of the causative agent. The International Statistical Classification of Diseases and Related Health Problems codes for the several causes of vaginitis are:
- (B37.) Candida Vaginitis Candidiasis usually causes a watery, white, cottage cheese like vaginal discharges. The discharge is irritating to the vagina and the surrounding skin.
- (N95.2) Atrophic vaginitis (or "Senile Vaginitis") usually causes scant vaginal discharge with no odour, dry vagina and painful intercourse. These symptoms are usually due to decreased hormones usually occurring during and after menopause.
- (B96.3) Bacterial Vaginitis Gardnerella usually causes a discharge with a fish-like odour. It is associated with itching and irritation, but not pain during intercourse.
- (A59.0) Trichonomas Vaginitis Trichomonas vaginalis can cause a profuse discharge with a fish-like odour, pain upon urination, painful intercourse, and inflammation of the external genitals.
- (A60.0) Herpes usually occurs as water blisters on the genital region, about one week after infection. There is tenderness, swollen glands, and fever. The water blisters are extremely painful and heal in about three weeks. However, herpes is usually an external infection and does not fall under the category of vaginitis.
- persistent discomfort
- superficial skin infection (from scratching)
- complications of the causative condition (such as gonorrhea and candida infection)
- Egan ME, Lipsky MS (2000). "Diagnosis of vaginitis". Am Fam Physician 62 (5): 1095–104. PMID 10997533. http://www.aafp.org/afp/20000901/1095.html.
- Jaquiery A, Stylianopoulos A, Hogg G, Grover S (1999). "Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract". Arch. Dis. Child. 81 (1): 64–7. doi:10.1136/adc.81.1.64. PMID 10373139. PMC 1717979. http://adc.bmj.com/cgi/pmidlookup?view=long&pmid=10373139.
- Brook I (2002). "Microbiology and management of polymicrobial female genital tract infections in adolescents". J Pediatr Adolesc Gynecol 15 (4): 217–26. doi:10.1016/S1083-3188(02)00159-6. PMID 12459228. http://linkinghub.elsevier.com/retrieve/pii/S1083318802001596.
- Joesoef MR, Schmid GP, Hillier SL (1999). "Bacterial vaginosis: review of treatment options and potential clinical indications for therapy". Clin. Infect. Dis. 28 Suppl 1: S57–65. doi:10.1086/514725. PMID 10028110.
- Pirotta M et al. (2004). "Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial". BMJ 329 (7465) (Aug 27): 548. doi:10.1136/bmj.38210.494977.DE.
- Ozkinay E et al. (2005). "The effectiveness of live lactobacilli in combination with low dose estriol to restore the vaginal flora after treatment of vaginal infections". IBJOG 112: 234–240; quiz 440–1. doi:10.1111/j.1471-0528.2004.00329.x.
- Tori Hudson (2007). Women's Encyclopedia of Natural Medicine. New York: McGraw-Hill. ISBN 0-07-146473-5.
- Reed BD, Slattery ML, French TK (1989). "The association between dietary intake and reported history of Candida vulvovaginitis". J Fam Pract 29 (5): 509–15. PMID 2553850.
- Rodgers CA, Beardall AJ (1999). "Recurrent vulvovaginal candidiasis: why does it occur?". Int J STD AIDS 10 (7): 435–9; quiz 440–1. doi:10.1258/0956462991914429. PMID 10454177. http://ijsa.rsmjournals.com/cgi/pmidlookup?view=long&pmid=10454177.