Possibilities of using neodymium laser to improve the condition of vaginal mucosa in women of various ages with initial stages of genital prolapse

2021 ◽  
pp. 61-69
Author(s):  
Ekaterina Nikolaevna Zhumanova ◽  
Dagmara Isaevna Kolgaeva ◽  
Tatyana Vladimirovna Shapovalenko

Genital prolapse is a sort of epidemic and is registered today in 30% to 56% of women of both reproductive and menopausal ages. Until now, the initial stages of prolapse were not taken into account; as a rule, the correction began immediately with surgical treatment, the results of which were not always satisfactory, and the recurrence rate with plastic correction with one’s own tissues ranged from 37 to 45%. One of the main manifestations of prolapse of the vaginal walls, especially n perimenopause, is vulvovaginal mucosal atrophy, which directly depends on the pH in the vagina. The study is devoted to the analysis of the effectiveness of using neodymium laser to improve the condition of the vaginal mucosa in women of different age groups with initial degrees of genital prolapse. Purpose: scientific substantiation of using neodymium laser in patients of different age groups with grade I–II cysto-rectocele. Material and research methods. Studies were carried out in 69 women aged 31 to 52 years with cysto-rectocele of grade I–II (ICD-10 code N81.6), with the duration of the disease from 4 to 15 years. All patients, depending on their age and the method of treatment used, were divided into 2 groups comparable in terms of clinical and functional characteristics — the main and control groups, each of which had 2 subgroups. In the main group: subgroup 1 included 27 patients of reproductive age with grade I–II cysto-rectocele, who underwent a neodymium laser course with Magic Gyno, consisting of 3 intravaginal procedures with an interval of 28 days; subgroup 2 included 22 patients of perimenopausal and menopausal age with grade I–II cysto-rectocele, who underwent a course of 3 intravaginal procedures with Magic Gyno neodymium laser with an interval of 28 days. The control group included 20 patients with grade I–II cysto-rectocele, who underwent a special complex of exercise therapy; depending on their age, they were also divided into two subgroups: 1 (10 patients) — of reproductive age, 2 (10 patients) — of perimenopausal and menopausal age. The results obtained indicate a pronounced effect of the course application of intravaginal exposure by a neodymium laser on the state of the vulvovaginal mucosa in patients with grade I–II cysto-rectocele, of both reproductive and, most importantly, peri-menopausal age, which was manifested in the normalization of the pH of vaginal discharge and elimination of signs of atrophy of the mucous membrane of the vulva and vagina and was confirmed by the data of pH-metry and the Vaginal Health Index Score. Conclusion. The course use of a neodymium laser in patients of different age groups with grade I–II cysto-rectocele contributes to the formation of a pronounced tropho-stimulating effect, which is manifested in the normalization of the pH of the vaginal discharge and the elimination of signs of atrophy of the mucous membrane of the vulva and vagina.

Author(s):  
В.В. Поворознюк ◽  
Н.В. Григорьева ◽  
И.В. Гопкалова

Гипертиреоз - одна из частых причин вторичного остеопороза. Изучение темпов потери костной ткани при гипертиреозе (тиреотоксикозе) в различных возрастных группах является важным и мало изученным процессом. Цель работы - изучение влияния длительного введения высоких доз L-тироксина на показатели минеральной плотности костной ткани самок-крыс в различные возрастные периоды. Методика. Исследование выполнено на 50 самках крыс Wistar 2 мес., 5-6 мес. и 24 мес. L-тироксин (25 мкг на 100 г) вводили внутримышечно в течение 30 сут. Животные были разделены на группы: неполовозрелые самки (контроль), неполовозрелые самки, получавшие L-тироксин; самки репродуктивного возраста (контроль), самки репродуктивного возраста, получавшие L-тироксин; старые самки (контроль), старые самки, получавшие L-тироксин. Прижизненное определение показателей минеральной плотности костной ткани (МПКТ) проводили на двухфотонном рентгеновском денситометре «Prodigy» (GE Mediсal systems, LUNAR, model 8743, 2005; USA; программа «Experimental animals») дважды (в начале эксперимента и через 30 сут.). Исследовали позвоночник, кости таза, задние конечности и показатель МПКТ всего скелета. Результаты. Установлено, что введение высоких доз L-тироксина статистически значимо увеличивает показатели МПКТ во всех отделах скелета только у неполовозрелых животных. У крыс репродуктивного возраста введение высоких доз L-тироксина вызывало снижение показателя МПКТ, при этом максимальная потеря костной ткани была выявлена на уровне позвоночника и задних конечностей. Снижение показателя МПКТ было статистически значимым не только по сравнению с соответствующим показателем контрольной группы, но и по сравнению с исходными значениями. У старых крыс гипертиреоз вызывал менее значимое повышение МПКТ. Заключение. Выявленные возрастные особенности динамики показателей МПКТ следует учитывать при интерпретации данных рентгеновской денситометрии, в частности при изучении экспериментального вторичного остеопороза вследствие тиреотоксикоза. Hyperthyroidism is one of the common causes of secondary osteoporosis in patients of different ages, so the study of the rate of bone loss in different age groups is very important and little studied. The purpose was to study the effect of prolonged administration of high doses of L-thyroxin on bone mineral density (BMD) parameters of different regions of the skeleton of Wistar female rats at different age periods. Methods. The study was performed on 50 female Wistar rats of three age groups (2 months, 5-6 months and 24 months). L-thyroxin in a dose of 25 mcg per 100 g of body weight, was administered intramuscularly for 30 days. The animals were divided into the following groups: immature females of the control group; Immature female rats who received L-thyroxine; rats of the reproductive age of the control group; rats of reproductive age who received L-thyroxine; Old females of the control group; Old females who received L-thyroxine. In-vivo determination of BMD parameters was performed on a two-photon x-ray densitometer «Prodigy» (GE Medial Systems, LUNAR, model 8743, 2005, USA, Experimental animals program) twice (at the beginning of the experiment and after 30 days). The following sections of the skeleton were examined: the spine, pelvic bones, hind limbs and the BMD index of the entire skeleton. Results. It was found that high doses of L-thyroxine significantly increases BMD indices in all parts of the skeleton only in immature female rats. High doses of L-thyroxine to the animals of reproductive age caused declines in BMD, maximum bone loss was detected at the level of the spine and hind limbs. The decline in BMD was statistically significant, not only in comparison with the corresponding index of the control group, but also in comparison with the baseline values. In old rats the hyperthyroidism caused less significant increase in BMD. Conclusion. Identified age features of the dynamics of BMD indices should be considered in the interpretation of X-ray densitometry data, in particular in the studies of the experimental secondary osteoporosis due to hyperthyroidism.


Author(s):  
Tiwari Richa ◽  
Pushpalatha Buduru ◽  
Bharathi K

Cervical erosion is a most common condition seen in women of reproductive age groups. Its prevalence is between 50-85% of all the gynecological conditions. In modern system of medicine diathermy cauterization or cryosurgery are generally advised for treatment but these procedures have their own side effects and complications like excessive vaginal discharge, secondary infertility, bleeding per vagina, infection, stenosis etc.. So still it is one of the most troublesome diseases for patients as well as for gynaecologists. Due to the serious consequences of the disease it is the need of hour to develop an accurate therapy for pathological erosion. This is an attempt to throw some more light on the clinical studies on cervical erosion. On cervical erosion total eight clinical studies in PG level has been completed out at National Institute of Ayurveda, Jaipur. Out of eight clinical studies, five works on Kshara Karma Karma (application of caustics), two works on Agnikarma (cauterization), two works on Kushthadi churna, one work on kushthadi varti, one work on Virechana. The drugs and procedures used in the research studies have chedana, Bhedan, Sosahana, Lekhana, Shodhana, Shothaghna, Raktprasadana, Vrana Shodhana (ulcer cleansing), Vrana Ropana (ulcer healer), krimihara, Kushtaghna (anti-dermatosis), Kandughna (anti-pruritic) properties. Maximum studies are carried out on Bahya Parimarjana (external application).


2019 ◽  
Vol 65 (6) ◽  
pp. 857-863 ◽  
Author(s):  
Paulo César Giraldo ◽  
Thais Coelho de Souza ◽  
Guilherme Lindman Henrique ◽  
Ilza Monteiro ◽  
Rose Amaral ◽  
...  

SUMMARY OBJECTIVE: To evaluate endocervical and vaginal environment changes in women using a levonorgestrel-releasing intrauterine system (LNG-IUS). METHODS: A quasi-experimental study included sixty women who had an LNG-IUS inserted in the Family Planning Clinic of UNICAMP between April and November of 2016. Women in reproductive age, non-pregnant, without the use of antibiotics and contraceptives seeking for LNG-IUS insertion were selected for this study. All women were evaluated with regard to vaginal and endocervical pH, vaginal and endocervical Gram-stained bacterioscopy, and Pap-smear before and two months after LNG-IUS insertion. Clinical aspects such as cervical mucus, vaginal discharge, and cervical ectopy were also observed. RESULTS: After LNG-IUS insertion, there was an increase in the following parameters: endocervical pH>4.5 (p=0.02), endocervical neutrophil amount (p<0.0001), vaginal cytolysis (p=0.04). There was a decrease in vaginal discharge (p=0.01). No statistically significant changes were found in vaginal pH, neutrophils amount in the vaginal mucosa, vaginal discharge appearance, vaginal candidiasis, bacterial vaginosis, vaginal coccobacillary microbiota, cervical mucus appearance, or cervical ectopy size. CONCLUSIONS: Short-term LNG-IUS use did not increase vulvovaginal candidiasis or bacterial vaginosis, and led to diminished vaginal discharge. Notwithstanding, this device promoted reactional changes in the vaginal and endocervical environment, without modification on cervical ectopy size.


2020 ◽  
Vol 26 (3) ◽  
pp. 58-63
Author(s):  
M.V. Lytvynenko ◽  
V.V. Gargin

Enhancing each other’s effects – HIV infection and the changes caused by alcohol abuse, trigger a chain of pathological reactions that sometimes lead to reversible and often irreversible pathological processes in the cervix uteri (CU). Local and general decrease in immunoresistance invariably leads to disturbance of physiological CU microbiome. Given all the above, the aim of our work was to identify pathological changes in CU that occur in HIV-infected women on the background of chronic alcoholism. Section material of 110 women of reproductive age from 20 to 40 years, which were divided into four groups, was studied. After the manufacture of micropreparations, a morphometric study was performed. Significant pathological changes in CU were revealed in HIV-infected women suffering from alcoholism. The maximum thickness of nonkeratinized stratified squamous epithelium (734.23±61.33 x10-6m) was characteristic of a group of HIV-infected women suffering from chronic alcoholism. In HIV-infected women, this figure is 3.14% lower and is 711.21±59.28 x10-6m. In women suffering from alcoholism without concomitant HIV infection, this figure is 697.8±47.88 x10-6m, which is 5% less than in the group with combined pathology. As expected, the lowest value was in the comparison group, where it was 527.23±44.37 x10-6m. There was a significant difference between the comparison group of HIV-infected women with alcoholism and the control group, which is 28.2%. In the studied material of HIV-infected patients, a high degree of distribution of the severity of cervical dysplasia was determined – 9.1%. Moderate and low degree, respectively, 19.42 and 37.12% in this group of subjects. When studying the degree of infiltration of the lamina propria mucosa in the study groups, it was found that the largest number of cases of severe infiltration (44.5%) was found in the group suffering from chronic alcoholism, and in the HIV groups no such case was detected. On the basis of the conducted research it is possible to assume the combined influence of the factors promoting development of pathological processes both in an epithelium, and in a mucous membrane of CU. Thus, HIV infection and alcohol abuse can exacerbate each other’s pathological effects and lead to pronounced pathomorphological changes in CU, namely: thickening of the mucosal epithelium due to frequent development of various types of warts, mucosal dysplasia and even severe cellular infiltration of the mucous membrane.


Author(s):  
Shriraj Katakdhond ◽  
Padmaja Samant

Background: Vaginal discharge is a distressing commonplace gynecological condition seen in all age groups albeit from different causes. This study evaluates the outcome of cryotherapy on benign cervical lesions over a period of 2 years in a tertiary care centre. Efficacy of cryotherapy in making patient symptom free. Efficacy of cryocauterization in healing the cervical lesion.Methods: This is prospective observational study of 30 women of reproductive age group attending outpatient department for complaint of vaginal discharge. Cervical cytology was performed for all women and out of the women advised cryotherapy, those fitting inclusion criteria and consenting for study were enrolled. Their findings and investigations were noted. After they underwent cauterization, they were followed for period of 3 months. Findings, complications and level of satisfaction were noted down.Results: Healing of cervical lesion was complete in 96% women at the end of 12 weeks. There was 1 failure of therapy among sample size of 30. Satisfaction rate was high.Conclusions: Cervical cryocauterization is a cheap, effective and simple procedure for treatment of cervical lesions. There are few complications and patient satisfaction is high. It is an easily accessible and safe procedure and helps preserve fertility of women at the same time addressing the vaginal discharge.


2017 ◽  
pp. 77-82
Author(s):  
V.O. Beyuk ◽  
◽  
O.A. Shcherba ◽  
L.D. Lastovetska ◽  
◽  
...  

Bacterial vaginosis is the most common cause of the treatment of women of reproductive age to the gynecologist. It accounts for up to 50% of cases of pathological discharge from the genital organs. In 50-75% of cases, bacterial vaginosis is asymptomatic. The examination of the patient occupies one of the key positions in the effective treatment of the patient. Nitrosamines, which are metabolites of obligate anaerobic bacteria and coenzymes of carcinogenesis, and may be one of the cause for the genesis of cervical cancer. The objective: assess the condition of the mucous membrane of the vagina and cervix in bacterial vaginosis, the effectiveness of its treatment in women of reproductive age. Materials and methods. Оf investigation 64 women of reproductive age with bacterial vaginosis were examined and treated, of which 34 patients (group I of the study) conducted our therapy which received the Tyloron and the local combined preparation of dexpanthenol and chlorhexidine bigluconate, followed by the introduction of lactobacilli in standard doses. 30 patients (group II of the study) received standard treatment. The control group consisted of 27 healthy women. Results. Results of treatment of bacterial vaginosis in women of reproductive age are presented. In 94.1% and a group of cases, we achieved a clinically significant effect, compared with group II (76.7%) of 10 days of treatment. Three months after the end of treatment, 97.1% of the patients in the main group recovered (group II – 86.6%). Conclusions. The use of the complex therapy of bacterial vaginosis proposed by us showed a high rate of recovery, and a low rate of recurrence in women of reproductive age. Key words: bacterial vaginosis, diagnosis, treatment, tyrolon, dexpanthenol, chlorhexidine.


2021 ◽  
pp. 77-82
Author(s):  
N.V. Kosei ◽  
S.I. Reheda ◽  
M.I. Hlamazda ◽  
L.A. Vasylchenko

Vulvovaginal candidiasis is an urgent medical and social problem, a common reason for women to see a doctor. This disease occurs in women of different ages, which leads to a significant decrease in the quality of life, and to more serious complications in some cases (genitourinary system diseases, miscarriage, vaginal stenosis, etc.).Research objective. Comprehensive assessment of the effectiveness of treatment and prevention of recurrent vulvovaginal candidiasis (RVVC) with Candivac (contains inactivated microorganisms in the form of frozen lyophilized 4 original strains, which are the most common causative agents of vaginal candidiasis).Materials and methods. 76 women of reproductive age with RVVC were examined and randomized into 2 groups: the main group consisted of 40 patients who received anti-candidiasis therapy with fluconazole and Candivac; the control group included 36 women who received only the standard fluconazole antifungal regimen. The duration of observation was 12 months.Criteria for evaluating treatment efficacy were no/reduction of clinical symptoms and changes in the vaginal mucosa, positive dynamics of laboratory tests (with control after 3 and 12 months) from the start of treatment. Results. Clinical efficacy of treatment (regression of complaints and normalization of objective data) in two groups was observed in the majority of patients. At the same time, clinical efficiency in the main group was 87% and exceeded that in the comparison group (63%), which was accompanied by the normalization of the vaginal microbiocenosis. However, after complex therapy with Candivac a more reliable result was observed, which was accompanied by a significant decrease in the frequency of disease recurrence.Conclusions. Study showed that Candivac in combination with antifungal therapy and probiotic promotes the elimination of systemic inflammation and the rapid return of normal intravaginal microflora, and reduces the number of RVVC recurrences.


Author(s):  
E. N. Zhumanova ◽  
K. V. Lyadov ◽  
K. V. Kotenko

Background. The specific weight of genital prolapse among gynecological nosologies in Russia in the departments of operative gynecology ranges from 28 to 38.9% and in the structure of planned indications for surgical treatment ranks third after benign tumors and endometriosis. Aim. Development and implementation of new comprehensive rehabilitation programs for women with IIIII degree rectocele after surgical treatment. Methods. The article presents the treatment data for 100 women of different age groups with IIIII degree rectocele who, in the early postoperative period after plastic surgery for rectocell, used to improve the condition of the vaginal mucosa with general magnetotherapy, electromyostimulation with biological connection of the pelvic floor muscles, a special complex of physiotherapy exercises and intravaginal procedures of fractional microablative carbon dioxide laser therapy. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics; within each group, depending on age, they were divided into 2 subgroups: women of childbearing age were included in subgroup A, and peri- and menopausal women were included in subgroup B. To assess the condition of the vaginal mucosa and maturity of the vaginal epithelium after surgery in patients included in the study, a pH-metry of the vaginal discharge was performed and the Vaginal Health Index was determined. Results. As a result of the studies, it was found that a more pronounced therapeutic effect was obtained with the use of the complex, which includes a course of general magnetotherapy from the first day after surgery, as well as a month after surgery, a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex of physiotherapy exercises and 2 intravaginal procedures of fractional microablative carbon dioxide laser therapy. Conclusion. The obtained results indicate a pronounced therapeutic effect of the complex, which includes a course of General magnetotherapy from the first day after surgery, a course of electromyostimulation with biological connection of pelvic floor muscles and a special complex of physical therapy, as well as 2 intravaginal procedures of fractionation microablative therapy with a carbon dioxide laser 1 month after surgery..


2020 ◽  
Vol 6 (1) ◽  
pp. 17-20
Author(s):  
Rahmawani Fauza ◽  
Debora Lestari Simamora

ABSTRAK   Hipertensi adalah masalah global. Data dari WHO menunjukkan bahwa angka kematian yang disebabkan oleh komplikasi hipertensi pada tahun 2013 mencapai 9,4 kematian di seluruh dunia. Analisis lebih lanjut yang dilakukan oleh RISKESDAS 2013 (Riset Kesehatan Dasar 2013) menggambarkan bahwa persentase hipertensi pada wanita usia reproduksi adalah 23,6%. Wanita dengan hipertensi kronis dapat menyebabkan komplikasi selama kehamilan dibandingkan dengan mereka yang tidak menderita hipertensi. Tujuan dari penelitian ini adalah untuk mengidentifikasi dan menganalisis faktor-faktor yang mempengaruhi hipertensi pada wanita pasangan usia reproduksi 15-49 tahun di Puskesmas Bangun Purba, Kabupaten Deli Serdang, pada tahun 2017. Penelitian ini adalah studi kasus kontrol yang tidak tertandingi. Penelitian ini dilakukan di Puskesmas Bangun Purba, Kabupaten Deli Serdang. Populasi adalah semua wanita pasangan usia subur yang hipertensi atau tidak yang datang berobat di Puskesmas Bangun Purba dari Januari 2016-Maret 2017 yaitu 541 wanita. Sampel terdiri dari 49 responden masing-masing dalam kelompok kasus dan kontrol. Analisis data terdiri dari analisis univariat, analisis bivariat dengan chi square. Hasil penelitian menunjukkan bahwa variabel usia mempengaruhi hipertensi pada wanita pasangan usia reproduksi 15-49 tahun. nilai OR = 3,6 (95% CI=1,448 - 9,054) Hal ini berarti bahwa responden yang berumur > 35 tahun beresiko 3,6 kali lebih besar mengalami dibandingkan dengan responden yang berumur ≤ 35 tahun.Berdasarkan analisis pengaruh obesitas terhadap hipertensi, diperolehnilaip< 0,05 Kesimpulannya, variabel konsumsi garam, obesitas dan usia mempengaruhi kejadian hipertensi dan variabel yang paling berpengaruh adalah variabel konsumsi garam. Pengaturan diet untuk mengonsumsi garam tidak lebih dari 5 gr sehari dan menjaga berat badan ideal bagi wanita pasangan usia reproduksi 15-49 tahun yang hipertensi atau tidak.  Kata kunci: Kejadian hipertensi, Pasangan usia subur, umur ABSTRACT Hypertension is a global problem. Data from WHO shows that the mortality rate caused by hypertension complications in 2013 reached 9.4 deaths worldwide. Further analysis conducted by RISKESDAS 2013 (Basic Health Research 2013) illustrates that the percentage of hypertension in women of reproductive age is 23.6%. Women with chronic hypertension can cause complications during pregnancy compared to those without hypertension. The purpose of this study was to identify and analyze the factors that influence hypertension in women of reproductive age groups 15-49 years at the Bangun Purba Health Center, Deli Serdang Regency, in 2017.This research is a case control study that is unmatched. This research was conducted at the Bangun Purba Health Center, Deli Serdang Regency. The population was all women of childbearing age couples who were hypertensive or not who came for treatment at Puskesmas Bangun Purba from January 2016-March 2017, namely 541 women. The sample consisted of 49 respondents each in a case and control group. Data analysis consisted of univariate analysis, bivariate analysis with chi square.The results showed that the age variable affected hypertension in female partners of reproductive age 15-49 years. OR value = 3.6 (95% CI = 1,448 - 9,054) This means that respondents aged> 35 years at risk are 3.6 times more likely to experience compared to respondents aged ≤ 35 years. Based on an analysis of the effect of obesity on hypertension, a value of <0.05In conclusion, the variable salt consumption, obesity and age affect the incidence of hypertension and the most influential variable is the salt consumption variable. Dietary arrangements to consume salt no more than 5 grams a day and maintain ideal body weight for women of reproductive age groups 15-49 years who are hypertensive or not.


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