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The lower genital infections Print

The lower genital infections represent the cause of one third of all visits to a gynecologist and include:
 Vulvovaginitis – inflammation of vulva and vagina usually coexist and is manifested through vulvar or vaginal itching, different type of discharges depending on the etiological factor, dysuria and pollakiuria, painful intercourse. The diagnosis is confirmed through vaginal smear and bacteriological examination of vaginal secretions. The most frequent causes of vulvovaginitis are nonspecific, trichomoniasis, mycoses, and mycoplasma. The colpitis can be atrophic (it develops predominantly in late adult age given the important decrease of hormonal function of ovaries and thinner vaginal epithelium), granulous (characterized by a strong hyperemia and many small papilliform prominences on the vaginal mucosa), emphysematous (characterized by the occurrence of multiple blisters containing gas or liquid on the vaginal mucosa; predominantly occurring in pregnancy and disappears in two weeks after birth).
The treatment is specific and depends on antibiotics sensibility of the causing microbes.

 Bartolinitis – the inflammation of Bartholin glands, can be caused by a large bacterial spectrum. Can be acute (altered general state, fever, severe pain and walking discomfort; locally a resistant tumor is palpated within the thickness of the large labia with edema and local hyperemia with pus elimination from the gland’s orifice) and chronic (often cystic, with local discomfort, and painful at palpation; if the cyst gets infected it becomes an abscess with a clinical picture of an acute bartolinitis). In CALMED Medical Center the treatment consists in purulent collection opening and draining, cyst marsupialization or cystectomy.

 Skeenitis – paraurethral glands inflammation. An acute form of disease evolves to abscess form. In CALMED Medical Center the treatment consists in incisions in acute forms and treatment with antibiotics in chronic forms.

 Cervicitis represents a group of inflammatory pathologies of the uterine cervix which can be acute or chronic.
  The acute cervicitis is usually associated with vulvovaginitis. The purulent leucorrhea is very common.
  In subacute and chronic cervicitis, which are very frequent and usually neglected, inflammation and infection develop on dystrophic lesions. Three clinical forms are distinguished:
1. Exocervicitis – manifested through erosions – ulcerations that bleed at contact
2. Ectopy (pseudoerrosion, endocervicosis) – is caused by endocervical glandular epithelium gliding outside the external cervical orifice, and characterized by the replacement of a normal squamous epithelium with a cylindrical epithelium, which bleeds at contact.
3. Ectropion – endocervical mucosa eversion caused by a scar (occurring postpartum or after abortion), and is represented by a reddish rim with longitudinal plicae.
The epidermisation develops starting from the periphery of the lesion, generating a region in which the cylindrical epithelium tends to be replaced by a squamous epithelium, leading to glandular orifices’ blockage in the unformed cylindrical epithelium. Thus, liquid containing mucipar cysts are formed, a.k.a. Naboth ovula
If untreated the subacute and chronic cervicitis have a slow evolution with acute relapses (menstruations, pregnancies). The chronic cervicitis can be cured undergoing a process of epidermisation. Epitheliation through metaplasia can also occur, leading to a normal scarring or to a dysplasia.
 The Diagnosis of cervicitis is based on:
- Patient’s accuses on glerous or purulent leucorrhea, pelvioabdominal pain, painful intercourse, cystalgia, and asthenia.
- Valve examination
- Vaginal smear and sampling for bacteriological examination
- Cytological examination of the uterine cervix in order to establish a cytodiagnosis and to exclude the cervical cancer
- Schiller’s test determining possible iodine-negative areas.
- Colposcopy with acetic acid treatment, the diagnosis of cervicitis being only a colposcopic diagnosis
The acute and subacute cervicitis are treated in CALMED Medical Center with antibiotics eliminated through cervical mucus, as well as with anti-inflammatory remedies and gynecological ovula.
 The treatment of chronic cervicitis is based on the principle of mucosa destruction, which allows epithelium regeneration. This procedure is performed in CALMED Medical Center by means of laser photovalorization. Despite the fact that electrocauterization and diathermocoagulation are very popular and highly accessible, these methods do not possess any of the laser treatment’s advantages. The use in Calmed Clinic of a CO2 laser with a light bundle in fiber and with a light bundle emission in short pulsations with the highest maximal power (unique in Moldova) makes the photodestructive effect to be completely superior to the photothermic one. As a result, it is ideal for procedures requiring the minimization of thermal affection of the tissues and a maximized rate of their destruction.
Remark: For more information access “Services provided in CALMED Medical Center”.


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