COLPITIS (colpitis; grech, kolpos female bosom, vagina + itis; synonym vaginitis) — inflammation of a vagina.
To. is among frequent gynecologic diseases.
Etiology and pathogeny
Activators K. there can be staphylococcus, streptococci, colibacillus, a pyocyanic stick, a hemophilic vaginal stick, proteas, a trichomonad, fungi, viruses, gonokokk. The role of mycoplasmas is studied. The microbes getting into a vagina (especially at sexual contacts), in most cases die in process of self-cleaning of a vagina inherent in an organism of the healthy woman (see. Vagina ). More often women of mature age are ill. To emergence To. the following factors promote: decrease in endocrine function of ovaries, diseases of various bodies and systems, penetration into a vagina of pathogenic or opportunistic microflora as a result of non-compliance with rules personal hygiene (see) and hygiene of sex life, and also as a result of existence of pathology from a reproductive system (a gaping of a sexual crack, omission of walls of a vagina, urinogenital fistulas, the breaking-up tumor of a neck of uterus etc.); the changes in a mucous membrane of a vagina arising under the influence of mechanical, chemical, thermal and other influences (the wrong syringing, irrational use of contraceptives, sexual excesses etc.). An etiology and a pathogeny To. are in many respects similar with vulvovaginitis (see).
A clinical picture
the Clinical picture of an acute stage To. it is characterized by complaints to pains in a vagina, plentiful allocations, heavy feeling in the bottom of a stomach, the itch and burning at an urination is sometimes noted. In hron, stages To. the main complaint are allocations from a genital tract (bleach), is more rare — an itch and unpleasant feelings in a vagina. Hron. To. it is characterized by duration of a current, tendency to recuring. At a number of patients To. can proceed in the latent or asymptomatic form.
In an acute stage To. the mucous membrane of a vagina is hyperemic, edematous, quite often bleeds at mechanical influence (careless introduction of mirrors, wiping).
Depending on character of an inflammation there is a purulent or seroznognoyny exudate, in Krom impurity of an ichor is sometimes noted. At the expressed inflammatory reaction destruction and desquamation of a cover epithelium of a mucous membrane of a vagina, especially in the field of sublime sites of a papillary layer is observed (these sites have an appearance of small bright red spots). At considerable infiltration of a papillary layer of a mucous membrane of a vagina dot eminences (colpitis granularis) are formed. At insufficiently effective treatment these changes are observed also in hron, K. Otechnost's stages and a hyperemia in hron, stages To. disappear or takes place moderate diffusion or focal vasodilatation.
At To. process can extend to area of a vulva (see. Vulvovaginitis ) and upper parts of a reproductive system; there are synechias (an union, pasting) and narrowing of a gleam of a vagina less often (hl. obr. at children and elderly).
the Diagnosis is made on the basis of the anamnesis, complaints of the patient, a wedge, pictures and results of inspection. Survey of walls of a vagina by means of mirrors allows to reveal changes of a mucous membrane of a vagina, to define the nature of allocation: serous, purulent, serous and purulent with impurity of vials of gas (it is characteristic for mecotic To.), curdled (it is characteristic for mycotic To.).
Kolposkopiya (see) reveals changes in vascular network and destructive changes in an epithelial cover of a mucous membrane of a vagina. The bacteriological and bakterioskopichesky research of allocations allows to specify nonspecific or specific character of K. Opredelyayut sensitivity to antibiotics of activators nonspecific To. According to indications apply a method of allocation of a virus.
Treatment nonspecific To. it is directed to elimination of associated diseases and functional disturbances. Therapy, corrective function of ovaries and eliminating deficit of their hormones in an organism is of great importance. The choice of a method of treatment depends on a stage of process and character of the activator. However there are rules of treatment, the general for nonspecific and specific To.: local antiinflammatory therapy, the termination of sex life (in an acute stage and during treatment), simultaneous inspection and treatment of the sexual partner (according to indications), the subsequent dispensary observation.
Topical treatment consists in syringing of a vagina infusion of a camomile, a sage or disinfecting solutions (1% solution of Rivanolum, solution of potassium permanganate 1: 6000). From desinfectants apply hlorofillipt to syringing (1 table. l. 1% of solution for 1 l of water) and treatments of the tampons (2% oil solution) entered into a vagina.
During the subsiding of signs of an acute inflammation it is possible to apply solution of lactic acid to syringing (1 chayn. l. on 5 glasses of water). Syringing is done 1 time a day within 5 — 7 days; prolonged use of this procedure is not recommended because of a possibility of desquamation of a cover epithelium of a mucous membrane of a vagina and a delay of processes of regeneration.
Antibiotics and sulfanamide drugs are appointed at a persistent current To. and definition of sensitivity to them of the activator, they are applied locally in the form of solutions and emulsions.
In case of insufficient efficiency of treatment, tendency to a recurrence and at the expressed hypo-ovaria topical administration of oestrogenic hormones (estrone and others) in the form of emulsions or together with sea-buckthorn oil in small doses (0,2 — 0,5 mg) within 10 — 15 days is recommended (further according to indications).
Prevention consists in elimination of conditions of penetration of the microbes and the reasons promoting their pathogenic action (observance of rules of personal and sexual hygiene; treatment of the revealed diseases, in particular the gynecologic, reducing endocrine function ovaries).
Forecast at the correct treatment favorable.
Bibliography: Bodyazhina V. I. Chronic nonspecific inflammatory diseases of female generative organs, M., 1978; Flying A. A. Results of complex treatment of nonspecific colpitises, Akush, and ginek., No. 5, page 64, 1975; Teokharovb. And. and Flying A. A. Etiologiya and features of a clinical current of nonspecific colpitises, in the same place, page 34; LabhardtA. Die Entziindungen der ausseren Geschlech-tsorgane, in book: Biol. u. Path. d. Weibes, hrsg. v. L. Seitz u. A. J. Amreich, Bd 4, S. 7, B. u. a., 1955.
See also bibliography to St. Vulvovaginitis .
V. I. Bodyazhina.