Vaginal adhesions or even atresia
Introduction
Introduction Senile vaginitis, also known as atrophic vaginitis, is a non-specific vaginitis. Mainly manifested as vaginal inflammation caused by various local vaginal resistance caused by various causes 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. 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. In severe cases, ulcers or vulva flushing could form. The ulcer surface can be adhered to the contralateral side. When the adhesion is severe, the vagina is narrowed or even blocked, and the inflammatory secretions are not well drained to form vaginal empyema or uterine empyema.
Cause
Cause
The cause of vaginal adhesions and even atresia:
(1) Causes of the disease:
The main reason is due to the decline of ovarian function, the low or lack of estrogen levels in the body, the reduction of glycogen in vaginal epithelial cells, the vaginal pH value, and the ability to kill pathogens. At the same time, due to atrophy of the vaginal mucosa, the epithelium is thin and the blood supply is insufficient, which reduces the vaginal resistance and facilitates the invasion and reproduction of bacteria to cause inflammatory lesions. In addition, poor personal hygiene habits, lack of nutrition, especially vitamin B deficiency in group B, may be related to the disease.
(2) Pathogenesis:
Women's ovarian function decline and estrogen levels will decrease, vaginal wall atrophy, mucosal thinning, decreased glycogen content in epithelial cells, increased intravaginal pH, alkaline or near neutral, can make other pathogenic bacteria an advantage Bacteria, and infection occurs.
Examine
an examination
Related inspection
Vaginal pathogen examination, uterine cavity culture, vaginal trichomoniasis, hysteroscopic direct smear examination
Diagnostic diagnosis of vaginal adhesions and even atresia:
[clinical manifestations]
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 associated with sexual pain. Sometimes there is 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 form. Ulcer or vulva flushing. The ulcer surface can be adhered to the contralateral side, and the adhesion can cause bleeding due to separation. When the adhesion is severe, the vagina is narrowed or even blocked, and the inflammatory secretions are not well drained to form vaginal empyema or uterine empyema.
diagnosis
According to age and clinical manifestations, diagnosis is generally not difficult. However, vaginal secretions should still be taken for trichomoniasis and candida. Bloody vaginal discharge needs to be differentiated from uterine malignant tumors. It should be routinely used for cervical smear; vaginal wall granulation tissue and ulcers should be differentiated from vaginal cancer, and if necessary, segmental curettage or local biopsy.
[Laboratory Inspection]
1. The leucorrhea routine test is positive for the pus.
2. Secretion smear for microbiological examination to exclude trichomoniasis, 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.
For those who continue to red belt, or bring odor and odor, they should be differentiated from genital malignant tumors.
Identification with specific vaginitis, vaginal secretions should be taken to check for pathogens such as trichomoniasis and mold.
Bloody vaginal discharge should be differentiated from uterine malignancies. At the time of gynecological examination, attention should be paid to the size and shape of the uterus, the source of bleeding and vaginal cytology, and if necessary, cervical or endometrial biopsy.
Diagnosis
Differential diagnosis
Symptoms of vaginal adhesions and even occlusion are confusing:
Complete occlusion of the vagina, mostly due to congenital malformation, the patient's uterus is often underdeveloped, so even if surgery is used to correct the vagina, the chance of conception is minimal. Incomplete vaginal atresia is often a scar contracture stenosis caused by birth injury, corrosive drugs, surgery or infection. It has only small holes in the center, and the lower position of the lock can affect sexual life. In pregnancy, scars can be softened and softened as the pregnancy progresses. For example, only mild annular or semi-circular stenosis, the first exposed part of the scar has a continuous expansion effect on the annular scar, and often overcomes such obstacles and completes the delivery. If the position of the lock is low, one-sided or bilateral preventive perineal side-cutting may be performed according to the situation to prevent severe perineal laceration. If the scar is wide and the part is high, it is not suitable for vaginal delivery. Partial vaginal atresia, chronic inflammation caused by local granulation tissue hyperplasia, scar formation, severely affected by menstrual blood.
