Transcript VAGINAL DISCHARGE

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
AGE20-40Y
COMMON IN – PREGNANCY
DIABETIC
OBESE WOMEN
FEATURES - CURDY WHITE,ITENSE ITCHING
EXCORATION OF VULVA
SMEAR10%KOH-FUNGAL HYPHE SEEN
TREATMENT-CLOTRIMAZOLE-100MG BDx7D
200MGBDx3D
RECURRENT -FLUCONOZLOE 150 MG WX4W
CANDIDA VAGINITIS
CANDIDA VAGINITIS
TRICHOMONIAL VAGINITIS
• AGENT - TRICHOMONIA VAGINALIS
• AGE
-20-40YRS,SEX ACTIVITY
FEATURES
GREENISH,FROTHY,COPIOUS,ITCHING
STRAWBERRY SPOTS ON VAGINA
VAG. SMEAR-MOTILE ORGANISMS
TREATMENT- METRONIDAZOLE
- 200XBDX7D OR400XBDX3
-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-METRONIDAZOLE500XBD
X7DAYS
BACTERIAL VAGINOSIS
HOW TO ASSES..?
DETAILED HISTORY
COLOUR AMOUNT,SMELL,ITCHING
RELATION TO COITUS /MENSES,pH
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
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CLAMYDIA-CL.TRACHOMATIS
AGE
-20-40
MUCOPURULANT
SEXUAL TRANSMITTED
FLOROSCENT ANTIBODY TEST/CULT.
DOXYCYCLINE 100XBDX7D
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
IDENTIFY
IDENTIFY
IDENTIFY
THANK YOU