Lecture of reproductive tract infections

2021-03-21 12:00 AM

It is possible to have an acute and chronic morphology, but the most common chronic morphology, which causes many complications (infertility, menstrual disorders, cancer), is difficult to diagnose and treat.


Reproductive tract infections: inflammatory diseases of the genitals, also known as sexually transmitted diseases, play an important role in gynecological pathology because it affects health and reproductive performance. real estate

Features and favorable factors reproductive tract infections

Common disease, or concentrated in the sexually active age 80% of people with gynecological diseases have reproductive tract infections.

All parts of the reproductive tract can become infected.

It is possible to have an acute and chronic morphology, but the most common chronic morphology, which causes many complications (infertility, menstrual disorders, cancer), is difficult to diagnose and treat.

Early detection and treatment can be completely cured and complications can be avoided.

Good condition

Sexually transmitted.

Obstetrics and gynecology procedures.

Poor hygiene during menstruation, intercourse.

By the woman herself, by her lover and by health workers.

The anatomical and physiological features of the reproductive organs help the pathogen grow.


Bacteria: Gonocoque, Chlamydia Trachomatis, Syphilis, Staphylococcus aureus, Gardenella Vaginalis, E. coli ...

Parasites: Mushrooms, Trichomonas, Vaginalis.

Viruses: HPV, HIV.

Classification of reproductive tract infections

Vulvitis: Vaginal fungus, Papilome, Condylome, vulvar white spots, Bartholin's gland inflammation.

Vaginitis: Caused by all pathogens. Or in combination with cervicitis.

Cervicitis: Specific, nonspecific, inflammation of the cervical canal.

Inflammation of the uterus: Inflammation of the endometrium, chronic, inflammation of the entire uterine muscle.

Adnexitis: Acute, chronic inflammation.



General, characteristic symptoms of a reproductive tract infection.

Physiological fluid: Discharge of cervical and vaginal discharge during reproductive cycle.

Bad gas is an inflammatory fluid of the reproductive tract that makes a woman feel uncomfortable.

Classification of spoilage

 Bad gas.

 White deterioration gas.

 Damaged gas.

Vaginitis caused by fungus

Good condition

Pregnant women, diabetic women, taking antibiotics for a long time, taking estrogen drugs, corticosteroids, anticancer drugs, acid pH soaps.


Itching of the vulva, causing the woman to scratch, scratch the vulva, the vulvar inflammation area can spread to the groin

White spoiled gas powder.

The vagina is inflamed red, filled with white, messy, and is lumpy like milk residue.

Cervical inflammation, bleeding touch, smeared lugol.

Test: Especially during menstrual cycle damage, Giemsa stained fungal spores are growing, reproducing (active form).

Check for hair fungus, hands, husband.


Based on clinical symptoms and fungal tests.

Treatment Nistatin both spouses and vaginally (Mycostatin, Mycostat).

Drugs that change the vaginal environment: Natribicarbanate, glycerin borate.

Nistatin ointment applied to the skin, vulva.

Vaginitis caused by Trichomonas

Good condition

The endocrine deficient in the vaginal environment is alkaline, health declines, it spreads through water sources, and the male is the person who carries the parasite in the urinary tract but does not have the disease.


Burning vulva, pain during intercourse.

Yellowish-green damaged gas, foamy, bad smell.

Red inflamed vagina touching bleeding. Apply lugol with night star image.

Examination of fresh air damage showed Trichomonas, taking damaged gas before and after menstruation.


Flagyl orally and vaginally for 3-6 cycles, treating both couples.

Vaginitis caused by Chlamydia

Or there is subacute or subacute inflammation. Having an incubation period: 3-21 days, commonly seen in prostitutes.

There is no characteristic symptom of white or yellowish gas, which may be accompanied by abdominal pain and low fever.

 Cervical inflammation of the cervix.

A swollen groin can rupture yellow pus.

Vaginal examination reveals accompanying adnexitis.

Test: No bacteria could be found, only the presence in the body is detected through special serum reactions: chlamydia test. 


Tetraxycline, doxyxyclin 200 mg / day for 10 days.

Vaginitis caused by gonorrhea

There is an exacerbation of inflammation, adnexitis, peritonitis, common in prostitutes, and having sex with infected subjects.

The damaged gas is white and blue. Pus pee.

Inflammation of the bartholin gland, a sudden streak in the vulva, vulva.

Check both sexual partners with inflammation in the foreskin, pus.

Vaginal cervix inflammation, cervical ulceration, or genital warts.

Adnexitis, pelvic inflammatory disease, peritonitis.

Examination of damaged gas, urinary tract pus, purulent Skene gland showed coffee bean-shaped globules in the cells.

Serum reaction.

Treatment: The group of penixillin, systemic sullfamid and high dose has attack and reinforcement dose.

Vaginitis caused by bacteria

Common in the elderly, children, who have two ovaries removed.

Damaged gas.

Inflammation of the vulva, vagina. Atrophy of the vagina, cervix with subcellular hemorrhage. Getting pale lugol color.

Fresh smear shows bacteria.

Endocrine vaginal cells exhibit estrogen deficiency.

Treatment: antibiotics combined with estrogen (colpotrophin).

Chronic cervicitis

(Route of the cervix, cervicitis due to tuberculosis)

Or with vaginitis, with pathogens such as vaginitis.

Damage to the cervix after obstetric and gynecological procedures.

It is possible to inflammation of the extra cervical hole, inflammation of the cervical canal.

The cervix loses its sliced ‚Äč‚Äčintercellular layer (ulcer), benign regeneration (naboth cyst, portal gland, islets), suspected regeneration (white spot, stone paving, basal dot) touch bleeding if new lesions. Test Lugol (+).

Examination of damaged gas to find the cause of the disease

Vaginal cells - Cervix.

Colposcopy assesses lesions, biopsy is suspected to cause pathology

Curvature probe curettage.

Differential diagnosis of cervical cancer.

Treatment: anti-inflammatory, chemotherapy, electrocautery, heat, cryotherapy or laser. If chronic inflammation or suspicion of amputation or apical removal of the cervix.

Chronic endometritis

There is often a history of inadequate treatment of acute inflammation. After the procedure, obstetrics and gynecology does not guarantee sterility.

Damaged gas, menorrhagia, pre-menstrual bleeding, mid-cycle.

Examination of the vaginal cervix with inflammation, damaged gas flowing from the uterine cavity.

The uterus is larger than normal, less mobile, during exacerbations can see uterus enlargement, painful uterine mobility. May include adnexitis.

Laboratory tests: Culturing damaged gas, culturing menstrual blood to find the cause and making antibiotics, ultrasound to find the cause of bleeding bleeding.

Curettage of the uterine lining makes pathology.

Differential diagnosis: Endometrial cancer, chorio.

Treatment: Anti-inflammatory with systemic antibiotics, endometrial curettage, artificial menstrual cycle


(Inflammation of the ovaries, ovaries and ligaments 0

The cause is usually gonorrhea or chlamydia. Meeting in young people with many sex partners, prostitutes. Being atypical or common, diagnosis is difficult, late

Causes are the causes of reproductive tract infections.

The most common route of transmission is from the bottom up along the direct line of the cervix, the vagina to the uterus and the 2 appendages, which can spread through the lymphatic or blood lines.

Classification: Adnexitis, chronic, may be typical and atypical.


Abdominal pain, often pain in both sides of the pelvis, resting abdominal pain relieves. High fever, possibly dull fever, fever in the afternoon. A lot of bad gas.

On physical examination, the cervix, vagina inflammation, redness. A painful mobile uterus. The appendages are on both sides, the boundary is not clear, the pressure is very painful. The bags are painful

A blood count test shows increased leukemia infection, blood sedimentation rate, positive CRP allows diagnosis of infection and is a monitoring factor in treatment.

Clean the damaged air to find the bacteria that cause the disease and make an antibiotic.

Ultrasound found uneven echoes on both sides of the pelvic fossa. Eliminate adnexal tumors.

Hysteroscopy in case of chronic inflammation, laparoscopy to assess damage to the ovaries and ovaries, and to treat infertility.

Urine or blood hCG exclude pregnancy.

Immune response in the diagnosis of inflammation due to gonorrhea, syphilis and chlamydia. 

Differential diagnosis:

Adnexitis: Differential diagnosis with ectopic pregnancy, spiral ovarian tumor, appendicitis

Chronic adnexitis: ureteral stones, ovarian cysts, endometriosis.

Direction of treatment:


Treat both husband and wife or partner.

Prolonged treatment, according to the etiology and antibiotic regimen.

Systemic and local treatment.

Inflammation of the combination of antibiotic treatment allowance, according to antibiotic therapy.

Subframe purulent progression drains through the sac along the douglas.

Chronic adnexitis: antibiotics, short wave therapy, candle bundles.

Infertility, pain greatly affects the health of endoscopy, remove the appendage or re-open the speaker tube.

Direction of prevention

Sex education, hygiene for menstruation, hygiene during pregnancy.

Periodic gynaecological examination.

Respect the aseptic principles in the procedure, the hospital.

Management, care and treatment of social diseases. There is medical coordination with social organizations.