senile vaginitis
Introduction
Introduction to senile vaginitis Senile vaginitis, also known as atrophic vaginitis, is a non-specific vaginitis. Mainly manifested as low vaginal local resistance caused by various reasons before and after menopause, vaginal inflammation caused by pathogenic bacteria infection, severe vaginal stenosis or even atresia. It occurs mostly in women after menopause, but it can also occur after bilateral oophorectomy or lactation. The main reason is due to the decline of ovarian function, low or lack of estrogen levels in the body, reduction of glycogen in vaginal epithelial cells, alkaline pH in the vagina, reduced ability to kill pathogens, and atrophy of the vaginal mucosa, thin epithelium, and insufficient blood supply. To reduce vaginal resistance, to facilitate bacterial invasion and reproduction caused by inflammatory lesions, in addition, poor personal hygiene habits, lack of nutrition, especially vitamin B deficiency in group B, may be related to the incidence. basic knowledge Sickness ratio: 0.05% Susceptible people: elderly women Mode of infection: non-infectious Complications: urethritis
Cause
Causes of senile vaginitis
Cause (70%):
The main reason is due to the decline of ovarian function, low or lack of estrogen levels in the body, reduction of glycogen in vaginal epithelial cells, alkaline pH in the vagina, reduced ability to kill pathogens, and atrophy of the vaginal mucosa, thin epithelium, and insufficient blood supply. To reduce vaginal resistance, to facilitate bacterial invasion and reproduction caused by inflammatory lesions, in addition, poor personal hygiene habits, lack of nutrition, especially vitamin B deficiency in group B, may be related to the incidence.
Pathogenesis
When women's ovarian function declines and estrogen levels decrease, the vaginal wall shrinks, the mucosa becomes thinner, the glycogen content in the epithelial cells decreases, and the pH in the vagina increases, which is alkaline or nearly neutral, which can make other pathogenic bacteria an advantage. Bacteria, and infection occurs.
Prevention
Senile vaginitis prevention
Prevention and care:
(1) Put an end to all kinds of infections, keep the perineum clean and dry, clean the vulva with water every night, so that you can wash the vagina with your hands, do not wash the vagina with your hands, or use hot water, soap, etc. to wash the vulva, pelvic cavity When the inflammation is leucorrhea, the amount of leucorrhea is thick, so it is necessary to change the underwear, not wearing tight-fitting, chemical fiber underwear.
(2) menstrual period, after abortion and upper, after ring and other gynecological surgery, there is bleeding in the vagina, must prohibit sex, no swimming, bathing, washing the sauna, you must change the sanitary napkin, so the body resistance is reduced, resulting in The pathogen easily enters the plane and causes infection.
(3) Patients diagnosed with acute or subacute pelvic inflammatory disease must be actively treated according to the doctor's advice. Patients must rest in bed or take a semi-recumbent position to facilitate the localization of inflammation and the discharge of secretions. Patients with chronic pelvic inflammatory disease should not. Too tired, to work and rest, to control sexual intercourse, to avoid the symptoms worse.
(4) Patients with fever generally have more sweat during fever. Keep warm and keep the body dry. After sweating, change clothes and avoid blowing air conditioner or direct convection.
(5) Pay attention to observe the amount of leucorrhea, quality, color, taste, leucorrhea, color, yellowish thick, smelly smell, indicating that the condition is heavier, such as leucorrhea from yellow to white (or light yellow), the amount is more Less, the taste tends to normal (slightly sour taste) indicating that the condition has improved.
(6) patients with acute or subacute pelvic inflammatory disease should keep the stool smooth, and observe the characteristics of the stool, if you see pus in the stool or have a sense of urgency, you should go to the hospital immediately to prevent pelvic abscess from breaking the intestinal wall, causing acute peritonitis. .
(7) Some patients, due to chronic pelvic inflammatory disease, a little discomfort, self-administered antibiotics, long-term use can occur. Vaginal flora disorder, resulting in increased vaginal secretions, white slag-like vaginal discharge, at this time, should That is to go to the hospital for treatment, to rule out fungal vaginitis.
Complication
Complications of senile vaginitis Complications urethritis
Urinary tract infection.
Symptom
Symptoms of senile vaginitis Common symptoms of vaginal discharge of vaginal discharge, itching, urgency, dysuria, congestion, urinary frequency, vaginal adhesions, and even uterine empyema
1. Increased vaginal secretions, thin secretions, pale yellow, severely purulent leucorrhea, odor.
2. The secretion is stimulated, and the vulva has itching and burning sensation.
3. Vaginal mucosal atrophy, may be accompanied by sexual pain, and sometimes urinary incontinence.
4. Infection can also invade the urethra and cause urinary irritations such as frequent urination, urgency, and dysuria.
5. Gynecological examination showed that the vaginal mucosa showed atrophic changes, wrinkles disappeared, the epithelium was thin and smooth, the vaginal mucosa was congested, red and swollen, and there were bleeding spots or bleeding spots in the mucosa. The posterior epithelium and cervix were most obvious, and severe cases could also be formed. Ulcer or vulva flushing, ulcer surface can be adhered to the contralateral side, adhesion can be caused by separation when examination, vaginal stenosis or even atresia caused by severe adhesion, inflammatory discharge drainage is not formed to form vaginal empyema or uterine empyema.
Examine
Examination of senile vaginitis
[Laboratory Inspection]
1. The leucorrhea routine test is positive for the pus.
2. The secretion smear is microbiologically examined to exclude trichomoniasis and Candida infection.
3. Smear Gram staining, check whether there are Gram-negative diplococcus in the cells, and can be used as secretion secretion culture.
3. Vaginal pH > 4.5.
4. Vaginal epithelial cells detect ovarian function.
5. Polymerase chain reaction, genetic diagnosis of infectious diseases.
[Other inspections]
1. Cervical segmentation diagnosis, tissue biopsy to exclude genital malignant tumors.
2. Hysteroscopy is helpful for differential diagnosis.
Diagnosis
Diagnosis and diagnosis of senile vaginitis
diagnosis
According to the age and clinical manifestations, the diagnosis is generally not difficult, but the vaginal secretions should still be taken to check the trichomoniasis and Candida. The bloody vaginal discharge needs to be differentiated from the uterine malignant tumor, and the cervical smear should be routinely used. The vaginal wall granulation tissue and ulcers should be differentiated from vaginal cancer, and if necessary, segmental curettage or local biopsy.Differential diagnosis
1. Fungal vaginitis is rare in non-diabetic women. When the fungus is infected, the leucorrhea is in the form of bean curd or curd. The leucorrhea smear can find the hyphae and spore of the fungus to confirm the diagnosis.
2. Trichomonas vaginitis due to the increase of pH in the vagina of the elderly, is not conducive to the growth of trichomoniasis, so elderly women with less vaginal vaginitis, but because of its similarity with senile vaginitis, should be smeared with leucorrhea Find the Trichomonas to identify.
3. The spread of gonococcal vaginitis due to sexually transmitted diseases, postmenopausal women can also suffer from this disease, suspicious people taking cervical secretions smear for Gram staining, can also be used as secretion secretion culture, the current polymerase chain reaction is more sensitive Detection method.
4. Vulvar and vaginal cancer for long-term treatment of vulva, vaginal ulcers should be promptly biopsy to rule out the disease.
5. Cervical cancer, endometrial cancer, senile vaginitis with bloody vaginal discharge, should be highly vigilant whether there is cervical cancer and endometrial cancer, routine cervical smear for vaginal cytology, if necessary, do cervical biopsy and Segmentation diagnosis, pathological examination to identify.
