Causes

Vulvovaginitis - an inflammation of the external genitalia (vulva) and the vagina. The most common causative agents of inflammation are staphylococcus, streptococcus, E. coli, Trichomonas and yeast fungi Candida. Very rarely are agents of vulvovaginal gonorrhea. Predisposing factors for the development of vulvovaginitis is the uncontrolled use of antibiotics, which leads to the destruction of beneficial microflora of the vagina, and violations of the rules of personal hyenas. A special role is played in the emergence of vulvovaginal decrease in ovarian endocrine function, diabetes mellitus Diabetes - threatening and incurable disease , Obesity and other diseases, reducing the body's resistance to infections.

In healthy women of childbearing age and vulva vagina resistant to infection, it contributes to the process of self-purification of the vagina associated with the endocrine ovarian function. Therefore vulvovaginitis in this age there is much less common than in children and the elderly. Occurrence of vulvovaginitis at children promote anatomical and physiological features of the vulva and vagina (looseness, tenderness, vulnerability) as well as diseases such as measles Measles in children - may cause serious complications , Scarlet fever, pyelonephritis.

In adult women the disease occurs in the presence of the entrance gate for infection: skin lesions and vulvar (cracks, abrasions, scratches). Gonorrheal vulvovaginitis occurs rarely, without disturbing the skin and mucous membranes it can occur in children, pregnant women and the elderly.

Children begins with inflammation of the vulva and vagina becomes, in adult women - on the contrary, vaginal discharge Vaginal discharge   irritate the vulva with the accession of infection.

Vulvovaginitis can occur acutely and chronically.

Signs of acute vulvovaginal

In the acute stage of the process, patients complain of pain, worse while walking, touching and in a sitting position, itching, burning sensation, especially when urinating, sleep disturbances Dreams: how to understand our dreams . In severe vulvovaginal possible increase in body temperature and an increase in nearby lymph nodes.

The mucous membrane of the external genitalia and the vagina becomes red and edematous, appear purulent (sometimes sukrovichnye) allocation. In severe erosion can occur (surface compromising the integrity of the mucous membrane) of the vulva and vagina.

Sometimes in adults as a result of inflammatory edema of the mucosa point elevations are formed which remain in the chronic stage of the process. In marked inflammation of the vulva may be involved in the process of the mucous membrane of the urethra, and inner thighs (especially in obese women) - it is promoted from the genital tract.

With proper treatment of all the phenomena of inflammation disappear, but if there is a persistent focus of infection in the uterus and its appendages is a constant infection of the vagina. In this case, as well as a defective treatment process can become chronic.

Symptoms of chronic vulvovaginal

In the chronic stage vulvovaginal decreases swelling and redness of the mucous membranes of the vulva and vagina, pain subside. Basically, continue to disturb the itching and discharge from the genital tract.

In girls, this step may occur synechia (seam) in those areas where defects were epithelium (most often in the labia majora). In rare cases there is considerable damage and rejection of the vaginal mucosa.

Fungal process is characterized by itching in the vulva, thick whitish "cheesy" discharge and raids on the walls of the vagina and the vulva.

Diagnosis vulvovaginal

The basis of diagnosis is the examination, including the use of special instruments to examine the mucous membrane of the vagina (for women - a colposcope, for girls - Vaginoscopy).

Produced and bacteriological study of discharge from the genital tract to determine the pathogen and its sensitivity to antibiotics.

Treatment of vulvovaginal

Treatment of vulvovaginal have to be carried out under the supervision of laboratory tests, only in this case can be guaranteed a positive (without transition into a chronic process) outcome.

Antibiotics (in accordance with the sensitivity of the pathogens to them), and activates the immune restorative treatment.

Local vulva is washed with a weak solution of potassium permanganate, or infusion of chamomile, sitz baths are used with these solutions, then lubricate the mucous sea buckthorn oil. In identifying gonorrhea or trichomoniasis treatment is carried out in accordance with the general rules of treatment of these diseases.

Prevention vulvovaginal is careful prolechivanii all foci of infection in the body of the child.

Adenomyosis: diffuse nodular form

Adenomyosis - diffuse nodular form of the disease is a combination of diffuse (spread) and adenomyosis are located inside the endometriotic lesions (hosts). This combination is not uncommon, and today there are treatment methods that can stop the spread of the process.

What happens in the uterine wall at the diffuse nodular form of adenomyosis

When diffuse nodular form of adenomyosis diffuse germination of the uterus combine to form in the muscle layer of the uterus endometrial foci (units) ranging in size from 1 to 5 cm in diameter, not communicating with the cavity of the uterus, and without limiting their capsule.

In the wall of the uterus and changes occur that are typical for both diffuse and nodular for adenomyosis. The wall of the uterus gradually penetrated endometrial tissue, which can reach up to a serous layer of the uterus, grow it and move to nearby organs - the bladder or rectum. When such changes during the cyclic changes in the blood released by the smallest reported in the uterine cavity. In the uterus on the mucosal surface appear point - holes. Violation of the integrity of the endometrium results in the formation of adhesions in the uterus - the connective tissue strands. In the wall of the uterus of the muscle fibers also in time be replaced by connective tissue.

Formed in myometrial tissue nodes represent foci endometriotic tissue, which under the influence of hormones occur cyclical changes. Typically, these units are separate and do not have messages to the uterine cavity. During menstruation, endometrial tissue is rejected, accompanied by bleeding. This causes a reaction in the surrounding host tissue as inflammation and swelling. Ends this inflammatory process is usually the growth of connective tissue, including in places where the blood - so gradually forming endometrial knot.

Symptoms

This form of the disease and may initially be asymptomatic. But there is for less than in the diffuse form. The first signs of adenomyosis Symptoms of adenomyosis - characteristic and recognizable   They are, as usual, uterine bleeding and pain before and during menstruation.

The process can be slow to develop, respectively, will continue to grow slowly and symptoms of the disease. Yet increasingly diffuse nodular form of the disease is progressing quickly enough: growing pains, bleeding take as cyclic, acyclic and character developing iron deficiency anemia.

How to distinguish between diffuse nodular adeneomioza from other diseases

Differential diagnosis of diffuse nodular adenomyosis performed with tumors of genitals, rectum, urinary tract, inflammatory diseases of the genital organs.

The presence of fibroids and uterine cancer is confirmed by data gistroskopii, radiological examinations (gisterosalpingogorafii). During hysteroscopy usually taken from biopsies of the uterine wall for histological examination. It histological examination can put an end to the diagnosis.

Rectal tumors can be confirmed by means of X-ray inspection, data that does not depend on the phase of the menstrual cycle. Also, do not depend on the phase of the menstrual cycle identified by X-ray changes in the way the bladder.

In difficult cases to distinguish the tumor of an organ from diffuse nodular adenomyosis Nodal adenomyosis - the terrible diagnosis   It helps with magnetic resonance imaging (MRI).

Diagnostics

During a pelvic exam Gynecological examination: an important component of women's health   gynecologist can detect a spherical shape of the uterus, which is felt in the walls of one or more nodes. But the hosts if they are small, can be felt not always.

Changes in the uterine wall are clearly visible during ultrasound (US) on the background of increasing globular uterus The increase in the uterus - when the rate goes into pathology   and thickening of its walls with more or less uniform changes can be recorded uzlovidnye education without defined borders (from endometriosis sites are not capsules).

Part of the diagnosis can be confirmed by means of hysteroscopy: on the surface of the endometrium visible pin holes - a sign of diffuse adenomyosis. But "see" sites in the wall of the uterus during a hysteroscopy is likely to fail, the node will be visible only in the case if he bude issued to the uterus. Taken during hysteroscopic biopsies confirmed the diagnosis of adenomyosis.

Radiographic studies and magnetic resonance imaging can help to establish a definitive diagnosis.

Diffuse nodular form of adenomyosis may be more severe than other forms of it. It requires particularly close monitoring and individually tailored treatment.

Galina Romanenko