VAGINAL DISCHARGE DR Sathisha Nayak Dept of O

VAGINAL DISCHRGE OBJECTIVES : 1. WHAT IS LEUCORRHOEA? 2. IS IT NORMAL? 3. NORMAL

LEUCORRHOEA • EXECESSIVE VAGINAL DISCHARGE NOT DUE TO INFECTION(EXECESSIVE CERVICAL MUCUS OR VAGINAL TRANSUDATION)

IS VAGINAL DISCHARGE NORMAL? • COULD BE PATHOLOGICAL • YES –SOME SITUATIONS IT CAN

CLASSIFICATION • PHYSIOLOGICAL • PATHIOLOGICAL - INFECTIVE - NON INFECTIVE- NEOPLASTIC - ATROPHIC -

INFECTIVE CAUSES • VAGINAL - CANDIDA VAGINITIS - TRICHOMONIAL VAGINITIS - BACTERIAL VAGINOSIS •

CANDIDA VAGINITIS AGE 20 -40 Y COMMON IN – PREGNANCY DIABETIC OBESE WOMEN FEATURES

TRICHOMONIAL VAGINITIS • AGENT - TRICHOMONIA VAGINALIS • AGE -20 -40 YRS, SEX ACTIVITY

BACTERIAL VAGINOSIS AGENT–G. VAGINALIS+ANAEROBIC AGE -20 -40 YRS FEATURES-WHITISH GREY, COPIOUS NO ITCHING, FISHY

HOW TO ASSES. . ? DETAILED HISTORY COLOUR AMOUNT, SMELL, ITCHING RELATION TO COITUS

CERVICAL INFECTIONS GONORRHOEA-NEISS. GONORRHOEAE -85 %ASYMPTOMATIC - MUCOPURULANT - SMEAR FROM CX O&URETHRA -

CERVICAL INFECTIONS • • • CLAMYDIA-CL. TRACHOMATIS AGE -20 -40 MUCOPURULANT SEXUAL TRANSMITTED FLOROSCENT

BEWARE ! IN ANY VAGINAL DISCHARGE R/O-CARCINOMA CERVIX, CA ENDOMET. (FOUL SMELL OR BLOOD

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VAGINAL DISCHARGE DR Sathisha Nayak Dept. of O & G MMMC

IDENTIFY !!

VAGINAL DISCHRGE OBJECTIVES : 1. WHAT IS LEUCORRHOEA? 2. IS IT NORMAL? 3. NORMAL VS BNORMAL 4. CLASSIFICATION 5. COMMON CAUSES 6. CLINICAL FEATURES 7. EVALUATION 8. MANAGEMENT

LEUCORRHOEA • EXECESSIVE VAGINAL DISCHARGE NOT DUE TO INFECTION(EXECESSIVE CERVICAL MUCUS OR VAGINAL TRANSUDATION) ECTROPION, CERVICAL TEARS.

IS VAGINAL DISCHARGE NORMAL? • COULD BE PATHOLOGICAL • YES –SOME SITUATIONS IT CAN BE - PUBERTAL - PREGNANCY - PREMENSTRUAL - OC PILLS -SCANTY, NO SMELL, WHITISH, NO ITCHING NOT BLOOD STAINED.

NORMAL CERVIX

CLASSIFICATION • PHYSIOLOGICAL • PATHIOLOGICAL - INFECTIVE - NON INFECTIVE- NEOPLASTIC - ATROPHIC - ALLERGIC, FB

INFECTIVE CAUSES • VAGINAL - CANDIDA VAGINITIS - TRICHOMONIAL VAGINITIS - BACTERIAL VAGINOSIS • CERVICAL - GONORRHOEA CERVICITIS - CHLAMYDIA CERVICITIS

CANDIDA VAGINITIS AGE 20 -40 Y COMMON IN – PREGNANCY DIABETIC OBESE WOMEN FEATURES - CURDY WHITE, ITENSE ITCHING EXCORATION OF VULVA SMEAR 10%KOH-FUNGAL HYPHE SEEN TREATMENT-CLOTRIMAZOLE-100 MG BDx 7 D 200 MGBDx 3 D RECURRENT -FLUCONOZLOE 150 MG WX 4 W

CANDIDA VAGINITIS

TRICHOMONIAL VAGINITIS • AGENT - TRICHOMONIA VAGINALIS • AGE -20 -40 YRS, SEX ACTIVITY FEATURES GREENISH, FROTHY, COPIOUS, ITCHING STRAWBERRY SPOTS ON VAGINA VAG. SMEAR-MOTILE ORGANISMS TREATMENT- METRONIDAZOLE - 200 XBDX 7 D OR 400 XBDX 3 -COUPLE TREATED TOGETHER

TRICHOMONIAL VAGINITIS

BACTERIAL VAGINOSIS AGENT–G. VAGINALIS+ANAEROBIC AGE -20 -40 YRS FEATURES-WHITISH GREY, COPIOUS NO ITCHING, FISHY SMELL VAG. SMEAR-CLUE CELLS TREATMENT-METRONIDAZOLE 500 XBD X 7 DAYS

BACTERIAL VAGINOSIS

HOW TO ASSES. . ? DETAILED HISTORY COLOUR AMOUNT, SMELL, ITCHING RELATION TO COITUS /MENSES, p. H CLINICAL EXAMINATION-EX GENITAL P/S EXAM INVESTIGATIONS-VAGINAL SMEAR -CULTURE

CERVICAL INFECTIONS GONORRHOEA-NEISS. GONORRHOEAE -85 %ASYMPTOMATIC - MUCOPURULANT - SMEAR FROM CX O&URETHRA - INTRACELL. GM –VE DIPLOCOCCI -SINGLE DOSE CEFETRIOXONE

CERVICAL INFECTIONS • • • CLAMYDIA-CL. TRACHOMATIS AGE -20 -40 MUCOPURULANT SEXUAL TRANSMITTED FLOROSCENT ANTIBODY TEST/CULT. DOXYCYCLINE 100 XBDX 7 D

CERVICAL INFECTIONS

BEWARE ! IN ANY VAGINAL DISCHARGE R/O-CARCINOMA CERVIX, CA ENDOMET. (FOUL SMELL OR BLOOD STAINED) -POLYPS, FB, VAG DOUCH(CHEMICAL) -STD-PARTNER SCREENING -DIABETES/HIV IN CANDIDA

DYSPLASIA

IDENTIFY

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