Friday, November 2, 2007

Vagina , Diseases

Diseases of Vagina

Penyakit dan Rawatan Faraj

Some tips

• Component of vagina secretions, sweat, sebaceous & Bartholin’s gland secretion
• Odour of vagina secretion is provided by Apocrine glands of vulva
• Mucous secretion of endocervical glands ( alkaline)
• The common cause of leocorrhoea is vagina infection
• Commonest site of coital tear is at anterior wall of vagina.
• Commonest site of carcinoma vagina is upper third of posterior vaginal wall.
• The most common cause of bacterial vaginitis in sexual active mature patient is “ gardnerelle vaginalis’
• Vagina bleeding or bloody discharge is the most common presenting complaint with vaginal carcinoma.
• Carcinoma of vagina is most common in 50 – 60 years of age.
• The pH of vagina in adult women is 4.5
• Vaginitis caused by Candida albican is predisposed by- Diabetes Mellitus.
• Trichmonas infection is common during child bearing age
• Strawberry vagina is seen in infection of ‘Trichomonas vaginalis’

Diseases of Cervix

• Acute Cervicitis occurs in ‘Septic abortion, puerperal sepsis, gonorrhoea.
• Causes of Chronic Cervicitis are; Infection during abortion, Instrumentation ( especially if cervix torn while dilatation)
• Following gonococcal infections , repeated injuries ( due to pessaries, tampons & chemical contraception)

Causes of Enlargement of Cervix ; Congenital hypertrophy, Haematocervix associated with atresia. Hypertrophy or elongation of the supra vaginal cervix ( associate with prolapse )
• Low standard of cleaniness, coitus or marriage at an early age, frequency of sexual intercourse and promiscuity of both partners are associate with increase incidence of cancer of servix.
• Jews and Muslim women are almost immune to cervical cancer ( may be due to husbands are circumcised in childhood & to restrict avoidance of coitus during menstruation )
• Cancer of cervix is almost unknown in groups of nuns.
• The commonest type of cervical carcinoma is “ Squanmous cell carcinoma’
• Carcinoma cervix without any therapy the most likely cause of death would be ‘Uremia.’

Diseases of Uterus

Causes of acute Endometrosis: Septic abortion, puerperal sepsis, Acute gonorrhoea, Infection
• Some Causes of Chronic Endometrosis; Infected myomatous polypi, carcinoma of cervix, carcinoma of body of uterus, retained product of conception, chronic salpingo-oophoritis, Elvic Cellulitis., Endometrium burns from caustics & radium.
• Myomas is a disease of fertile women with low fertility.
• Myomas are common who has never been pregnant at all or has had only one child.
• Myomas shrink after delivery, after stoppage of hormone intake & after menopause [ Androgens & GnRH cause shrinkage of myoma ]

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