Senile vaginitis, also known as atrophic vaginitis, is a non-specific vaginitis. It is a non-specific vaginitis that manifests as vaginal inflammation due to low local resistance and infection by pathogenic bacteria before and after menopause, and can cause vaginal stenosis or even atresia in severe cases. It occurs mostly in postmenopausal women, but can also occur in women after bilateral oophorectomy or during lactation. Gynecologic examination shows atrophic changes in the vaginal mucosa, loss of folds, thin and smooth epithelium, congestion and redness of the vaginal mucosa, bleeding spots or bleeding patches on the mucosa, and in severe cases, ulcers or vulvar erosions. How can vaginal adhesions and even atresia be diagnosed?
Diagnosis of vaginal adhesions and atresia
I. Clinical manifestations
1. Increased vaginal discharge, thin and yellowish secretion, or in severe cases, purulent leucorrhea with foul odor.
2. Itching and burning sensation in vulva due to secretion stimulation.
3.Atrophy of vaginal mucosa, which may be accompanied by painful intercourse. Sometimes there is urinary incontinence.
4. The infection may also invade the urethra and cause irritation of the urinary system such as frequent, urgent and painful urination.
5. Gynecological examination shows atrophic changes of vaginal mucosa, disappearance of folds, thin and smooth epithelium, congestion, redness and swelling of vaginal mucosa, bleeding spots or bleeding spots on mucosa, most obvious in the posterior vault and cervix, and in severe cases, ulcers or flushed erosion of vulva. The ulcerated surface may adhere to the opposite side, and the adhesions may bleed during examination due to separation. In severe cases, the adhesions may cause vaginal stenosis or even atresia, and poor drainage of inflammatory secretions may lead to pus accumulation in the vagina or uterine cavity.
Diagnosis
According to the age and clinical manifestations, the diagnosis is generally not difficult. However, vaginal secretions should be taken for trichomonas and candida. Bloody leucorrhea should be distinguished from malignant tumor of uterus, and cervical scraping should be done routinely; granulation tissue and ulcer of vaginal wall should be distinguished from vaginal cancer, and segmental scraping or local biopsy should be done if necessary.
Laboratory tests
1.Pus globules positive in routine white belt test.
2.Smear of secretion for microbiological examination to exclude trichomonas and pseudohyphae infection.
3. Gram staining of the smear to check whether there are gram-negative diplococci in the cells, and culture of gonococci in the secretion.
4. Vaginal pH 4.5.
5.Vaginal epithelial cells to detect ovarian function.
6.Polymerase chain reaction for genetic diagnosis of infectious diseases.
Other tests
1.Cervical segmental scraping and tissue biopsy to exclude malignant tumors of the reproductive tract.
2.Hysteroscopy is good for differential diagnosis.
For those who have persistent red band, or those who have foul smelling band, it should be distinguished from malignant tumor of the reproductive tract.
To differentiate from atopic vaginitis, vaginal secretions should be taken for examination except trichomonas, mycobacteria and other pathogens.
Bloody leucorrhea should be distinguished from malignant tumor of the uterus. During gynecological examination, attention should be paid to the size and morphology of the uterus, the source of bleeding and vaginal cytology, and if necessary, cervical or endometrial biopsy should be performed.