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 BNORMAL4.CLASSIFICATION5.COMMON CAUSES6.CLINICAL FEATURES7.EVALUATION8.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- 20-40Y COMMON IN – PREGNANCY DIABETIC OBESE WOMENFEATURES - CURDY WHITE,ITENSE ITCHING EXCORATION OF VULVASMEAR- 10%KOH-FUNGAL HYPHE SEENTREATMENT-CLOTRIMAZOLE-100MG BDx7D 200MGBDx3D RECURRENT -FLUCONOZLOE 150 MG WX4W
CANDIDA VAGINITIS
CANDIDA VAGINITIS
TRICHOMONIAL VAGINITIS
• AGENT - TRICHOMONIA VAGINALIS• AGE -20-40YRS,SEX ACTIVITYFEATURES GREENISH,FROTHY,COPIOUS,ITCHING STRAWBERRY SPOTS ON VAGINAVAG. SMEAR-MOTILE ORGANISMSTREATMENT- 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
• 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