| ID | 319 |
|---|---|
| Name | LEUCORRHOEA |
| Cause | Causes: 1. At birth- new born babies may have a mucoid vaginal discharge for 1-10 days. 2. Puberty- usually few days before and after menarche. 3. Active and passive congestion of the pelvic organs, especially of the cervix- this is due to increased secretory activity of the glands as in prolonged ill-health, anxiety states and neurosis, sedentary occupation, prolapse and an unsatisfied sex urge. 4. The most common cause is infection of the lower reproductive tract in the form of trichomonas vaginitis, vaginal candidiasis etc. Pregnancy, diabetes are the predisposing factors. 5. An increase of glandular elements of cervix as in erosion. 6. Vaginal adenomatosis. 7. Oestrogen or progestogen oral contraceptives. 8. Regular douching. 9. At ovulation. 10. In some, during pre-menstrual phase. |
| Signs Symptoms | With an increased white discharge from the body, a woman can experience weakness. In some cases, leucorrhoea can also be accompanied by other symptoms such as abdominal or lower back pain, constipation, headaches, menstrual cramps and frequent urination |
| Diagnosis | Leukorrhea can be confirmed by finding >10 WBC per high-power field under a microscope when examining vaginal fluid. Vaginal discharge is normal, and causes of change in discharge include infection, malignancy, and hormonal changes |
| Investigations | Investigation: 1. Blood Hb%, TC, DC, ESR. 2. Vaginal smear for gram stain and cytology. 3. Vaginal swab culture- to see the growth of tricomonas. |
| Management | Systematically treat vaginal infections but the risk of cervical infection is also assessed. If the risk assessment is positive, the patient should be given additional treatment for gonococcal infection and chlamydia |
| Introduction | A white, cream, yellow or greenish vaginal discharge which is often loosely called leucorrhoea. Or, leucorrhoea means whitish discharge per vagina. |
| History | |
| Etiology | see under causes |
| Clinical Features | Clinical features: Patient complains of passage of whitish, brownish, yellowish, or greenish discharge per vagina, but without any itching or foul smell. It stains clothings and causes excoriation & soreness of the vulva, pelvic discomfort, backache. |
| Preventions | As vaginal discharge is natural, it's not possible to prevent it. But can take measures to reduce the chance of infections. Gently wash around your vagina with water, avoiding scented products and douches that may cause irritation. Drying the area thoroughly and wearing breathable cotton underwear can also help |
| Treatment | Treatment: A Reassurance. B Treatment of the cause- 1. For Trichomonas vaginitis- both partners should be treated by metronidazole 400mg t.d.s for 7 days. 2. For Candida albicans- a. Systemic antifungal like nystatin 50,000 to 100,000 i.u 4 times daily for 7 days, b. Local antifungal like- i. Gentian violet, should be applied locally. ii. Nystatin vaginal tablet 1 tab. should be used daily for 14 days, iii. Clotrimazole vaginal tablet- 1 tab. b.d or 2 tab. at bedtime for 3 days. Or, 1 tab. at bedtime for 6 days, iv. Miconazole nitrate (2%) should be opplied locally at bedtime for 7 days. C. Correction of pelvic congestion by- 1. Physical exercise 2. Regular bowel habit & 3. Daily cold baths. D. Anxiety states should be corrected. E Cauterization of the cervix- if there is cervical erosion. |
| Complications | Pelvic inflammatory disease and infertility |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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