As society progresses and people become more aware of health care, the health care of this special group of girls is gradually becoming more important to parents and medical workers. More and more girls go to hospitals for vulvovaginitis, but currently girls face an awkward problem with gynecological diseases. The characteristics and treatment of girls are different from those of adults, but due to the lack of specialized clinics and professionals, they often have to go to adult gynecology clinics, which brings a great mental burden to the children and parents, and at the same time, the treatment methods used by adults lead to poor results or negative consequences. Therefore, we would like to briefly introduce the types and characteristics of pediatric gynecological diseases to parents to help them understand the occurrence of pediatric gynecological diseases, so as to enhance parents’ awareness of gynecological diseases in girls for early detection and early treatment.
According to a city survey, the proportion of genital infections among gynecological diseases in girls is as high as 80%, with vulvovaginitis as the main cause, which occurs in infants and toddlers and decreases after preschool. What are the reasons why girls are prone to genital infections? There are several reasons.
The physiological anatomy of girls is characterized by the lack of fat pads and pubic hair in the vulva, the thin epithelial tissue of the vulva and vagina, which is easily damaged and stimulated by external pathogens or chemicals, the small and thin labia, which provide little protection for the vestibule, and the close proximity of the anus to the vagina, which is easily contaminated by feces.
2. The low level of sex hormones in young girls, especially estrogen, leads to weak antibacterial power in the genital tract, which makes it easy to be contaminated by pathogenic bacteria and infections.
3.Improper local care and poor sanitary conditions; excessive cleaning can lead to local dysbiosis.
4.Infection of neighboring organs.
5, systemic diseases long-term heavy use of antibiotics, the body’s immunity decreases, dysbiosis, causing infection of the genital tract; obese children with poor local permeability of the vulva, coupled with hot and humid environment prone to infection.
Common pediatric vulvovaginitis include the following categories.
1, diaper dermatitis
It is a common skin disease in infants and children (especially those within a few months), starting with erythema and in severe cases blisters and shallow ulcers on the erythema, which can be followed by bacterial or fungal infections. Treatment: Improve hygiene, keep dry, wipe gently with saline or vegetable oil, and use corticosteroids if necessary under medical supervision.
2. Bacterial vulvovaginitis
The color and smell of the discharge will be different with different pathogens. The acute phase of inflammation is characterized by redness of the vulva, more discharge and mainly pain. In the subacute stage, itching is the main cause. In the chronic stage, the symptoms are mild, or only the vulva, vestibule and vaginal mucosa are congested. Treatment: Keep the vulva clean, and select the appropriate antibiotics for systemic and local application according to the type of pathogen and drug sensitivity test. For stubborn and recurrent inflammation, exclude vaginal foreign bodies, tumors or rare urethral and rectovaginal fistulas.
3.Fungal inflammation
Infections in infants and young children are mostly transmitted from mother to child, as the vaginal secretions are acidic in the first 1-2 weeks after birth, making it easy for fungi to grow. If there are recurrent fungal infections in young girls before puberty, diseases such as diabetes mellitus and immune deficiency should be excluded. Itchy vulva, flushed skin, and milk clot-like discharge. The diagnosis can be confirmed by finding pseudomycorrhizae and spores in the secretion. Treatment: 2%~4% sodium bicarbonate solution scrubbing vulva vagina after local application of miconazole ointment, oral mycophenolate tablets, repeat treatment for 2~3 courses. After treatment, 3 times negative fungal examination is considered as cure.
4.Vaginal foreign body
It is common for children aged 3-6 years to put foreign objects such as hand paper, pencil tips, erasers and toys into the vagina out of curiosity or in an attempt to relieve vulvar itching, resulting in secondary infection and increased vaginal discharge, which is purulent or bloody and has a foul odor. If parents find that their baby has bloody or purulent leucorrhea that does not heal, they should consider the possibility of vaginal foreign body and go to the hospital in time.
5. Chemical or allergic inflammation
The vulvar skin is stimulated by urine or due to obesity, the vulvar skin and the skin between the thighs rubbing against each other with fluid oozing out, or allergy to bathing liquid or talcum powder can cause inflammation. Removal of allergens, oral anti-allergy drugs can generally be cured.
6, sexually transmitted diseases, the pathogens include trichomonas, gonococcus, chlamydia trachomatis, syphilis, human immunodeficiency virus, etc.
Sexually transmitted diseases in infants and children are rare and are mostly transmitted vertically from mother to child or by accidental contact with contaminants.
Infantile vulvovaginitis is most commonly seen in children under 5 years of age. The pathogen is often transmitted indirectly through the hands, clothing, towels, and bath tubs of the affected child’s mother and caregiver. The clinical manifestations of vulvovaginitis in young girls are varied, such as unexplained crying, irritability, scratching of the pubic area, or discomfort in urination, or even difficulty in urination, all suggesting that our baby may have a vulvar infection. Since the history cannot be obtained directly from the child’s mouth, we must rely on the parents’ or guardians’ attention and observation. Therefore, improving parents’ general knowledge of hygiene in the care of girls and strengthening children’s health care can significantly reduce the incidence of genital tract infections in girls and improve the prognosis.