Vulvitis is a common inflammatory disease in girls, accounting for 70% of all cases of pediatric gynecology. It most often occurs between the ages of 1–8 years. The tendency to inflammation of the external genital organs is due to anatomical and physiological characteristics. Vulvitis is physically uncomfortable and requires immediate treatment. Otherwise, the disease can lead to complications affecting reproductive health.
Causes
Vulvitis is an inflammatory process in the external genital area, which includes the vestibule of the vagina, the external opening of the urethra, the clitoris, and the labia majora and labia minora. Most often, vulvitis is observed in girls aged 1–8 years due to anatomical and physiological characteristics.
Normally, the genital tract of girls is sterile from birth, only on the 5-7th day the mucous membrane is seeded by opportunistic microflora. Discharge in the first years of life is usually scarce and has a slightly alkaline or neutral reaction: the pH is 7.0. Lactobacilli are absent at an early age, they appear only by the 9th year of life, when the vaginal epithelium begins to produce glycogen and the reaction of the vaginal environment becomes 4.0–4.5. Until that moment, the girl's genitals are extremely vulnerable to infectious agents. The risk of vulvar inflammation is increased by incomplete closure of the genital fissure, reduced number of sweat and sebaceous glands, and vulnerable skin of the external genital organs. A full-fledged immune defense of the mucous membrane is formed with the onset of menstruation.
The disease can be caused by a nonspecific infection (opportunistic aerobic and anaerobic flora, viruses, fungi of the genus Candida, protozoa). The cause is also a specific infection (gonococcus, chlamydia, mycobacterium tuberculosis, diphtheria bacillus, etc.).
In newborn girls, the infection can be brought in by the transplacental method during the prenatal period. More often, infection occurs during childbirth when passing through the birth canal of the mother.
At an early age, the infection can penetrate as follows:
- through care items and common areas;
- with the help of foreign bodies falling on the genitals;
- due to a violation of the technique of washing the child;
- as an allergic reaction to household irritants (washing powder and fabric softener, creams and dusting powders, fragrant soaps, diapers);
- with diaper dermatitis.
The genitals of girls, whose mothers wash them too often, are especially vulnerable. The constant use of soap leads to a violation of the integrity of the epithelial integument, a decrease in local immunity and the development of vulvitis.
In adolescence, the sexual route of infection in girls with experience of sexual relations cannot be ruled out. But the reason can also be poor hygiene, allergic reactions, wearing tight underwear.
Other diseases can also contribute to vulvitis. So, inflammation of the genitals can develop with pharyngeal diphtheria, chronic tonsillitis, caries. Mycotic vulvitis can be observed during treatment with antibiotics, hypovitaminosis, immunodeficiency states, endocrine disorders. In addition, inflammation can occur when the vulva is affected by influenza, herpes, parainfluenza, adenovirus, cytomegalovirus, papillomavirus, etc.
The development of vulvitis can be facilitated by an anomaly in the structure of the organs of the genitourinary system, for example, a low location of the urethral opening, absence of posterior adhesions, gaping of the genital fissure, anomalies in the development of the external genital organs, neurogenic bladder, vaginal-urethral reflux.
Symptoms
Vulvitis can be acute, subacute and chronic. The clinical picture of acute vulvitis is characterized by redness and swelling of the labia and clitoris, redness and maceration can affect the skin of the pubis, groin, and thighs. Subjective sensations include itching and burning in the perineum, and they are aggravated by urination, touching and movement. At the same time, infants experience anxiety, cry, older girls comb and touch their genitals, complaining of discomfort. With some specific forms of vulvitis, areas of erosion and ulceration may appear on the mucous membrane.
The characteristic symptoms of vulvitis in girls include leucorrhoea - discharge from the genital tract of a watery and transparent nature. With E. coli vulvitis, a yellow-green discharge with a fecal odor is possible. If the cause is staphylococcus, yellow and viscous leucorrhoea appear, with candidiasis - white, thick, curdled consistency.
Common symptoms of vulvitis include fever, swollen lymph nodes, nervous behavior, sleep disturbances, tearfulness, irritability, and irritability. With pinworms, hyperemia and thickening of the anal folds, abdominal pain, and decreased appetite are possible.
In the absence of timely treatment, the acute process turns into a chronic stage. In this case, the symptoms subside, but itching and a moderate amount of pathological leucorrhoea persist. If vulvitis becomes recurrent, complications such as synechia of the labia minora, vaginal atresia, urethritis, cystitis, cervical erosion, imbibition are possible.
Diagnostics
A pediatrician can diagnose a disease in girls, further treatment and observation is carried out by a specialized doctor - a pediatric gynecologist.
First, anamnesis and complaints are collected, the general condition of the child and factors contributing to the development of pathology (obesity, diathesis, metabolic disorders, allergies, lack of hygiene) are studied.
A gynecological examination with vulvitis reveals swelling, redness, maceration of the external genital organs, the presence of ulceration, leucorrhoea, foamy, cheesy, purulent or bloody type. According to indications, a vaginoscopy is performed through the intact hymen, if necessary, foreign bodies are removed from the vagina.
With vulvitis, a general analysis of urine and blood, analysis for sugar, urine analysis according to Nechiporenko and for bacterial culture, analysis of feces for helminths, ultrasound of the pelvic organs is shown. To determine the type of causative agent of vulvitis, a smear from the vagina and urethra is examined for bacterial culture, the identified culture is checked for antibiotic resistance. If a specific infection is suspected, PCR and serological testing are performed.
After the examination, it may be necessary to consult other specialized specialists - a pediatric endocrinologist, allergist, gastroenterologist, etc.
Treatment
The tactics of treating vulvitis depends on the cause of the disease. First of all, therapy is carried out aimed at eliminating edema, eliminating itching and burning. For this purpose, lotions, irrigations and sitz baths with disinfectants are prescribed. It can be an aqueous solution of Furacillin, a pale pink solution of potassium permanganate, a solution of Chlorhexidine, Quinochol or Miramistin. The affected areas are lubricated with an oil solution of Chlorophyllipt, Sangiviritin (1%), in severe cases, a local antibiotic is prescribed (Tetracycline, Erythromycin or Olettrin ointment).
According to indications and according to the results of culture, antibiotics are prescribed for oral administration. For candidiasis, these are antimycotic drugs (Levorin, Fluconazole, Intraconazole) in combination with local treatment with antifungal ointments. When Trichomonas infection is detected, Metronidazole, Ornidazole or Tinidazole is indicated in a dosage appropriate for age. With gonococcal infection, antibiotics of the cephalosporin group are prescribed. With mycoplasmous and chlamydial vulvitis, broad-spectrum antibiotics are prescribed (Josamycin, Sumamed, Doxycycline).
Treatment for allergic vulvitis includes desensitizing therapy. Prescribed means to relieve itching and swelling - Suprastin, Diazolin. Valerian, motherwort are prescribed as sedatives, enzymatic preparations are shown to normalize the bowel function - Hilak Forte, Wobenzim, Baktisubtil. It is also recommended to take immunomodulators, vitamins A, C, E and group B, interferon inducers.
Simultaneously with the treatment, a diet with an increased amount of alkalizing products is prescribed, which is mineral water, fresh vegetables, boiled, stewed, milk. Acid-forming products (fried meat, broths, spices and smoked meats, pickled and fermented dishes, lemons, tomatoes) are limited. With allergic vulvitis, potential allergens are excluded (citrus, chocolate and chocolate products, seafood, eggs, walnuts, strawberries). When it comes to an infant, the diet is assigned to a nursing mother. When vulvitis occurs against the background of another disease, it is also subject to compulsory treatment.
Failure to treat vulvitis can lead to adhesion and adhesion of the labia minora between themselves or with the vagina. This pathology requires surgical intervention. When urea is involved in the inflammatory process, cystitis is possible, the symptoms of which include urination disorder and burning. Scarring at the site of the ulceration can lead to problems in the sex life in the future. If the disease takes on a chronic course, then the external genital organs may acquire a bluish color. This phenomenon is called imbibition. Pigmentation can persist for life and lead to the development of complexes and problems in sexual activity.
Prevention
Vulvitis prevention depends a lot on the skills of the parents. Hygiene must be carefully monitored. Washing is carried out after each act of defecation and before bedtime. Washing of the external genital organs is necessarily carried out in the direction from front to back. For care, you can use neutral soap (pH 7.0), but not more than 2-3 times a week. All bath accessories of the child must be individual, including a washcloth and a towel.
Teenage girls should give up synthetic underwear, tight-fitting clothing. Girls need to change sanitary pads more often, monitor good nutrition and treat all comorbidities and inflammatory diseases, including caries. At the first sign of vulvitis, you should immediately consult a doctor and not self-medicate.
Attention!
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.
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Last updated article: 06.04.2018
When it comes to children, especially when it comes to their health, the heart involuntarily "shrinks" not only from the parents, but also from the doctor. We begin to sort out in our thoughts what “this” is, where does “this” come from and how can “this” be treated? I would like to achieve a quick and positive result in the treatment of a small patient.
Obstetrician-gynecologist, reproductologist
In our article, we will talk about the inflammatory process in the genital area in girls, namely, about vulvitis.
By itself, the name vulvitis has the ending "it", which already speaks of the inflammatory process. Inflammation of the female sphere (and in our case, vulvitis in girls) is usually accompanied by pain, discharge (leucorrhoea), itching and burning of the genitals.
Pain
According to the World Health Organization, one in five people in the world suffers from chronic pain, and about 60% of chronic diseases are accompanied by pain.
Pain is one of the most common complaints from a child. The nature and intensity of pain depends on the state of the patient's nervous system. Pain in diseases of the genital area does not always correspond to the severity of the pathological process.
With a slight disorder of the genitals, the pain has an acute, sharp character, and in the chronic course of the process, sensations may be completely absent.
Therefore, when treating small patients, the doctor must find out the history of the disease, its beginning, where the pain is localized and where it spreads. The pronounced pain in the genital area, namely in the clitoris, labia minora, is explained by the richness of nerve endings in this area.
But the inflammatory processes of the vagina are not painful, they are manifested only by a feeling of pressure, burning, but if fatty tissue is involved in the process, then there is a sharp pain, especially when touched.
Beli
This symptom is also a "guide" of the inflammatory process of the genital area in adults and children. By the nature of the leucorrhoea, as well as the presence of odor, one can judge the disease.
Itching and burning
Itching and burning of the external genital organs also accompanies inflammation of the genital organs.
Now let's dwell in more detail on the inflammatory process of the external genital organs in children, namely vulvitis.
Vulvitis in children
As mentioned above, vulvitis is an inflammation of the external genital organs (namely, the vestibule of the vagina, labia majora and labia majora, clitoris and the outer part of the urethra). According to statistics, this disease occurs more often in girls from 1 to 8 years old and is about 65 - 70%. It should be noted that this form of inflammation often occurs with vaginitis and is called vulvovaginitis.
Vulvitis in girls can develop for a number of reasons.
These include several factors:
- structural features of the genitals and physiology (the absence of "useful" lactobacilli that protect the vagina, the vaginal environment is neutral or close to alkaline, more open external genital slit);
- increased purity "there" (when parents try to cleanly "wash" the child, thereby creating favorable conditions for the growth and reproduction of pathogenic bacteria. byaka "took from the baby! As it is said in the book of VE Radzinsky" Obstetric aggression ", the sterility of the vagina should not be allowed;
- constant wearing of diapers also creates a condition for the development of pathogenic microorganisms (when the effect of a "greenhouse" under the diaper is created, where it is warm and humid, especially if you do not change them in time and do not arrange "air baths").
- can be the cause of the development of the inflammatory process of the external genital organs in girls. Roundworms have the ability to crawl out of the child's priests at night and lay eggs around the anus, they can also crawl into the vagina, thereby contributing to the ingress of eggs and intestinal flora into the genitals, resulting in intense itching and, as a result, inflammation;
- mechanical factors, when in the process of studying the world around the girl begins to stick various small objects, toys into the vagina, or simply touches the genitals with dirty hands;
- chronic disorders in the work of the endocrine system, as well as the presence in the body of other foci of chronic infection (tonsillitis, carious teeth).
Vulvitis in a newborn is at risk of developing as a result of passing through the mother's birth canal.
Thus, there are a large number of reasons contributing to the development of the inflammatory process of the external genital organs in a girl, which means that every little princess is at risk. This places a lot of responsibility on the parents.
Factors that can cause vulvitis in girls have been described. However, it is worth talking about direct "culprits" of development. This is:
- viruses;
- fungi;
- bacteria;
- protozoa;
- chlamydia;
- gonococci, etc.
Depending on which of them caused the inflammatory process, a distinction is made between specific and nonspecific vulvitis.
Signs
Symptoms of the disease with vulvitis have all of the above signs, characteristic of the inflammatory process:
- Itching and burning in the genital area.
- Discharge from the genitals (which the mother can see on the child's panties), their nature depends on the specific pathogen. So, if the causative agent is a fungus, then the discharge will be cheesy, if it is Escherichia coli, then the discharge will be greenish-yellow with an unpleasant odor of feces, if the cause is Staphylococcus aureus - viscous and yellow, but mostly transparent leucorrhoea.
- Pain syndrome, especially aggravated by urination.
- Redness of the skin and mucous membranes, possibly the formation of ulcers as a result of scratching.
Other symptoms - lack of appetite, sleep disturbances, abdominal pain, and stool disturbances - may occur, but are extremely rare.
Three forms of the disease
Vulvitis in girls can manifest itself in one of three forms:
- the acute form is characterized by a bright onset, pronounced symptoms. Acute vulvitis lasts up to 1 month;
- a subacute form of vulvitis, characterized by a change in periods of exacerbation and remission, lasting up to 3 months;
- the chronic form of vulvitis is characterized by the possible absence of the above symptoms and only the presence of a burning sensation during urination, lasting more than 3 months.
Age factor
- vulvitis of infancy (0 to 12 months);
- vulvitis of childhood (from 1 to 8 years old);
- vulvitis in prepubertal period (from 8 years to the onset);
- vulvitis in puberty (after the onset of menarche).
Allergic vulvitis
It also happens allergic vulvitis, the development of which can be provoked by various food products (a large amount of sweets, citrus fruits), synthetic underwear, chemicals. With this form of vulvitis, identical symptoms will be observed, possibly less pronounced, as well as redness of the surrounding skin and mucous membranes.
Candidal vulvitis
Candidal vulvitis develops as a result of damage to the vulva by fungi of the genus Candida. With this type of vulvitis, the main symptom is discharge from the genital tract in the form of cottage cheese. Infection of a newborn often occurs during the passage of the contaminated birth canal of the mother, which suggests that during pregnancy it is necessary to sanitize vulvovaginitis of any etiology.
Treatment of this type of vulvitis is carried out with appropriate drugs acting on yeast-like fungi. Also, in the complex, you can use washing with herbal infusions (chamomile, calendula), which perfectly cope with inflammation and relieve itching.
Thus, when at least one of the listed signs appears, it is imperative to see a doctor for diagnosis and timely treatment. However, there is an opinion that vulvitis is a commonplace inflammation that occurs with a high frequency in girls and is also easily treatable. However, inflammation is also in "Africa" inflammation and entails certain consequences already in adulthood!
And recurrent vulvitis, that is, repeated repeated inflammation of the external genital organs, can lead to the development of complications: the appearance of ulcers of the mucous membranes due to intense itching of the skin, involvement in the inflammatory process of the urinary system with the development of cystitis, urethritis.
In most cases, when the above complaints appear, the mother and the girl turn to pediatricians.
The diagnosis of vulvitis can be made by a local pediatrician, however, further observation and treatment should be carried out by a pediatric gynecologist in order to avoid complications!
Diagnosis is based on examining a small patient, studying her life history and onset of the disease and laboratory examination.
The main research method that allows you to identify the causative agent of inflammation is microscopic examination and bacteriological sowing of vaginal secretions for flora and antibiotic sensitivity.
If there is a suspicion that the nature of vulvitis is of a specific nature, then scraping is examined by the polymerase chain reaction method. In addition, a general blood test, urine test, urine culture for flora and many other tests that a pediatric gynecologist will prescribe to you is mandatory.
Let's talk about how to treat a girl's vulvitis. The main thing in the treatment of vulvitis in children is to eliminate inflammation and suppress the cause of this inflammation.
Complex therapy, includes:
- anti-inflammatory baths with the addition of decoctions of chamomile, calendula, St. John's wort. To do this, pour 1 - 2 tablespoons of dry grass with 1 liter of boiling water, insist, cool, decant and carry out sessile baths for 3 - 5 minutes;
- washing the external genital organs with antiseptic solutions (Furacilin, Miramistin);
- symptomatic therapy aimed at eliminating itching, burning (antihistamines, anti-inflammatory ointments);
- in the case of bacterial vulvitis, antibacterial drugs are prescribed. If vulvitis is of a fungal nature, then antifungal drugs (Itraconazole, Fluconazole or topically Pimafucin cream, Clotrimazole). If the cause of Trichomonas is Metronidazole, Tinidazole. If vulvitis has developed as a result of the ingress of a foreign body, then it is removed, and with helminthic vulvitis, respectively, antihelminthic therapy;
- for allergic vulvitis, limit the use of foods that cause allergies (citrus fruits, sweets, chocolate).
In addition, in the complex treatment of vulvitis necessarily include:
- multivitamins (synthetic) or vitamin-fortified foods;
- preparations containing lactobacilli (Linex, Bifiform), in order to restore the microflora of the vagina;
- increasing the body's immune forces (walks in the fresh air, exercise).
Linex is a preparation containing live strains of lactobacilli, easy to use in children from 1 year old. Available in capsule and powder form.
100 grams of powder contains at least 1 * 10 * 8 CFU. But, it should be noted that the drug is widely prescribed by pediatricians and in infancy.
Newborns and children under 7 years old are assigned 1 sachet per day, children over 7 years old - 2 sachets per day, it is possible at one time. The duration of therapy is 30 days, if necessary, the course is repeated.
The drug is freely available in pharmacies without a doctor's prescription. The price of the drug ranges from 400 to 600 rubles per package.
Bifiform
Bifiform (baby, baby, complex) is a complex probiotic that has various forms of release for different age categories - from newborns to adults.
- Bifiform baby available in the form of a suspension (1 dose 1 time per day for 20 - 21 days).
- Bifiform baby(release form - sachet). It is prescribed for children from 1 to 3 years old, 1 sachet 2 - 3 times a day, over 3 years old - 2 sachets 2 - 3 times a day.
The drug can be freely purchased in pharmacies in the city, without a doctor's prescription. Its price is, on average, 350 rubles per package.
Bifidumbacterin Forte
Bifidumbacterin Forte is a 4th generation probiotic. One dose of the drug contains at least 1 * 10 * 7 CFU. The form of the drug is powder. Children under the age of 6 months are prescribed 2.5 doses 2 - 6 times a day, children aged 6 months to 3 years - 5 doses 1 - 2 times a day, children over 3 years old - 10 doses 1 - 2 times a day. day. The course of taking the drug is 2-3 weeks, with repetitions 2 - 3 times a year.
The drug is dispensed without a doctor's prescription. The price is about 130 rubles for 10 pieces.
Measures for the prevention of vulvitis in girls and women
Currently, there is a huge amount of information for young parents on how to properly hygiene newborns and older girls.
Yes, you understood correctly, the hygiene of babies is in the first place! It is necessary to wash off the girl correctly with warm running water after each act of bowel movement and before going to bed! Water procedures after each trip to the toilet completely flush out the entire microflora of the vagina, making it sterile, and therefore defenseless against pathogenic flora.
It is necessary to wash from top to bottom, that is, in the direction from the vulva, perineum to the anus. Use toilet soap no more than 2 times a week. In addition, girls should have separate hygiene items (towel, washcloth).
You can also reduce the risk of developing vulvitis in girls and women by stopping wearing synthetic and tight-fitting underwear, changing sanitary napkins, diapers and diapers in a timely manner as they become dirty or every 4 hours.
In addition, it is of great importance in the prevention of the development of inflammation of the external genital organs, and not only, balanced and nutritious nutrition of children, prevention and timely treatment of concomitant and chronic diseases, as well as fortification.
Vulvitis in girls is an inflammatory disease that refers to the pathology of the external genital organs. These include the labia majora and labia minora, the vestibule of the vagina, the clitoris, and the opening of the urethra.
This is one of the most common diseases in gynecological practice, almost every girl, regardless of age, faces this problem.
The risk group is the age of children from one to 7 years old, when pathology is most common. In addition, it requires immediate treatment, since the consequences can be very serious and in some cases entail changes in reproductive function.
Etiology
The main reason for the development of vulvitis, as a given disease, is tissue damage by microorganisms or fungi. The bacterial flora can be completely different, both specific and non-specific.
Factors contributing to the inflammatory process:
Particular attention should be paid to the appearance of such a common type of inflammation of the vulva of an allergic nature, which occurs against the background of increased sensitivity of the body to environmental factors:
Classification
Depending on the type of development, as well as the duration of vulvitis in girls, it should be divided into several groups:
- Acute inflammation (usually lasts up to 1 month)
- Subacute vulvar inflammation (may last for several months, with periodic fading or worsening of symptoms)
- Chronic (symptoms of the disease may worsen over several years)
Depending on the factors that caused the girls:
- Bacterial vulvitis
- Fungal vulvitis
- Non-infectious vulvitis (trauma, chemical damage, allergic nature)
By the mechanism of infection penetration:
- Primary. With direct contact of the pathogen with the body.
- Secondary. Persistence of the pathogen in the body, chronic infections.
Types of vulvitis by age, in which inflammation occurs:
- Vulvitis of newborns.
- When the child's age is under one year old.
- Vulvitis of childhood.
- Vulvitis prepubertal. Until the first menstruation appears.
- Vulvitis of puberty.
Symptoms of vulvitis in girls
Most often, the disease occurs acutely, a little time passes from the moment of exposure to the pathogen, therefore the incubation period does not drag on.
After penetration of the pathogen or its contact with the skin, symptoms of vulvitis begin to appear quickly:
Diagnosis of vulvitis in girls
Diagnostic steps:
Treatment
The regimen will depend primarily on the general condition, as well as the severity of the inflammatory process. If the treatment is light, the regimen remains the same, the treatment does not require a change in living conditions, only the correction of hygiene changes and the selection of medicines is carried out.
The condition of moderate severity is usually treated at home with adherence to bed rest. In case of severe course, hospitalization may be required.
As in the case of any inflammatory disease, adequate nutrition is prescribed, with a sufficient content of all necessary substances, including vitamins and minerals. But with vulvitis, there are some peculiarities in nutrition.
It is necessary to use those products that cause a change in the body's environment to the alkaline side, avoid the use of products that cause acidification of the environment:
If vulvitis is of an allergic nature, then the diet is prescribed taking into account the pathogenic component that caused it, as well as other highly allergenic products (these are any citrus fruits, honey, cocoa containing products).
Local treatment
The main part of local therapy is the use of antiseptic and anti-inflammatory solutions:
- For this, they can be used as a means of local herbal therapy., such as a decoction of oak bark, chamomile, calendula, St. John's wort.
- As well as medicinal antiseptics. The most common among them is the solution Furacilina which is prepared by mixing a tablet or powder with water. Same Potassium permanganate, which is dissolved in water and brought to a pale pink color. You can also use a ready-made solution. Chlorhexidine... The advantage of its use is simplicity of preparation, for this it is enough to buy a bottle with a solution of the required concentration. An analogue of this tool is Miramistin.
- In advanced cases, antibacterial ointments are prescribed, which are applied to the vulva. These include most often Tetracycline and Erythromycin. But the tetracycline ointment has age restrictions, so it should not be prescribed to girls under 8 years old.
Erythromycin ointment
Furacilin
Chlorhexidine
Miramistin
Potassium permanganate
Tetracycline ointment
Etiotropic therapy
Mainly in case of detection of a disease, especially in severe cases, before prescribing therapy, use the definition of sensitivity to antibacterial agents:
- If it is determined that the causative agent is a fungus, then the treatment is reduced to the appointment of antimycotic drugs. It could be Fluconazole, Miconazole, Itraconazole, Levorin, etc. These drugs are prescribed systemically in tablet form.
- And as a local therapy, agents such as Clotrimazole and Decamine ointment... With preliminary treatment of the vulva with a soda solution.
- The bacterial nature of vulvitis is treated with antibacterial agents such as Metronidazole or Ceftriaxone. A specific infection identified as a pathogen is transferred to a dermatovenerologist for treatment.
Clotrimazole
Fluconazole
Itraconazole
Miconazole
Ceftriaxone
Metronidazole
Hygiene
This is one of the fundamental rules in the treatment of vulvar inflammation. When girls get sick at a young age, hygiene skills are taught to parents or caregivers.
But if these are already girls in an older age, then the doctor explains to her the basic recommendations regarding hygiene:
Air baths are also mandatory for girls. This does not require special skills and training, a girl naked in the lower parts of the body is simply laid on a dry and clean diaper in a room with a comfortable temperature. The minimum duration of one procedure should be a quarter of an hour.
Normalization of the general condition with vulvitis
First of all, desensitizing agents are prescribed to facilitate overall well-being. They help relieve symptoms such as itching, burning, severe swelling. They can be used both locally and systemically.
The use of such agents as immunostimulants, vitamins and interferon inducers is shown. In the case of frequent relapses, hormonal agents based on estrogens begin to be used, since it is due to them that the process of formation of a normal microbiocenosis takes place. In addition, subsequently, agents are used to restore microbiocenosis based on lactobacilli.
Remediation of foci of infection
This is one of the mandatory items in the treatment of pathology. This is due to the fact that almost always vulvitis is provoked by another infection in the body.
The most common among them may be the following:
- carious damage to the teeth,
- inflammatory kidney disease, more often in the chronic stage of the course,
Therefore, first of all, it is necessary to deal with the identification and treatment of this pathology.
In addition, helminthic invasion can serve as a focus of infection; enterobiasis is one of the most common causes. Therefore, the use of anthelmintic therapy is required. A very rare case as a focus of chronic infection can serve as a foreign body. Therefore, it is required to remove it as safely as possible.
Physiotherapy for vulvitis in girls
This method of treating vulvitis in girls is not the main one, but at the same time it can significantly complement the drug one.
There are several different options for this:
Folk recipes for the treatment of vulvitis in girls
For the treatment of vulvitis in girls at home, baths with decoctions of medicines are used.
The main ones include:
Complications of vulvitis in girls
They arise against the background of a long-term inflammatory process without adequate and timely treatment started.
These include the following conditions:
Prevention of vulvitis in girls
It boils down to the basic rules that must be introduced into the lifestyle:
Vulvitis in girls is characterized by varying intensity of symptomatic manifestations, depending on the form of the disease. In both acute and chronic inflammatory processes, itching and burning sensations occur in the clitoris area, the vestibule of the vagina, and vaginal discharge of a different nature is often observed.
Causes of vulvitis in children
In a newborn girl, the genital tract is sterile. After 5-6 days, the vaginal mucosa is colonized by opportunistic microorganisms.
When a child is 1–2 years old, alkaline flora predominates in the vagina (lactobacilli are absent), which contributes to the occurrence.
Only during puberty does the vaginal microflora of a teenage girl approach in quantitative and qualitative composition to the microbiocenosis of women of reproductive age.
In most cases, this disease in girls is either allergic in nature. There are the following routes of infection with vulvitis:
Occurs in a number of cases:
Disease manifestations
The photo shows the characteristic signs of the disease. Vulvitis in girls is characterized by the following symptoms:
Diagnostic methods
The pediatrician can conduct an external examination, but further examination is carried out by the pediatric gynecologist.
Diagnosis of the disease in girls includes a number of such procedures:
Treatment of pediatric vulvitis
The therapeutic effect is as follows:
Complications
If vulvitis is observed in girls, the consequences may be of the following nature:
- Sticking of the labia minora, which requires a radical method of treatment.
- Cystitis.
- Scarring at the site of small punctate ulcers.
- Imbibition. The labia become bluish in color. This defect can persist throughout life, which becomes the cause of the development of psychosomatic diseases of the genitourinary system.
Prevention
There are a number of rules to follow:
- Daily hygiene of the girl's genitals (especially after a bowel movement and before bedtime). It is necessary to wash the child from front to back. Use a pH neutral soap.
- The child must have separate hygiene products (washcloth and towel).
- The girl should eat fermented milk products, fresh fruits and vegetables.
Do not self-medicate. At the first symptoms of vulvitis, you should consult a doctor.
My daughter is 1 year old, treated for vulvovaginitis for half a year, went to 6 different gynecologists, one daughter almost disfigured everything with brilliant green, which is why we had a chemical burn, we tried everything we could. As a result, I came across an interesting article that helped us a lot, they themselves passed the tests at the CMD and found out the pathogens, we had streptococci and Escherichia coli. I read the article, picked up the treatment and on the 12th day I can say that both in appearance and in the analyzes, almost everything went well with us. E. coli was taken out with SEXTOPHAG, and the dysbacteriosis was gone and it was also excreted in the urine.
Treatment of vulvovaginitis should be etiopathogenetic, complex.
In case of primary vulvovaginitis caused by hygienic disorders, it is sometimes enough to establish compliance with hygiene requirements, which boil down to maintaining the cleanliness of the body, perineum, external genital organs, and regularly changing the pre-ironed linen. At the same time, it is recommended to limit the consumption of carbohydrates, irritants, products containing various dyes and preservatives, and to follow a hypoallergenic diet. The predominance of fresh vegetables, fruits, herbs in the child's food is desirable. From dairy products, fermented milk drinks (yoghurts, kefir, acidophilus), fresh cottage cheese, cream, sour cream are shown.
In the treatment of secondary vulvovaginitis, in addition to eliminating the main cause that caused the inflammatory process, complex treatment is carried out, consisting of a general effect on the entire body of the child and local therapy.
Antibiotic therapy for vulvovaginitis is generally not indicated. The prescription of antibiotics is justified in the case of the severity of the general disease.
Basically, treatment is aimed at increasing the non-specific resistance of the body, improving metabolic processes and the general condition of the child.
Prescribe vitamins A, group B, E.
Vitamin A normalizes metabolic processes in the body, stimulates repair processes, increases non-specific immunity, increasing the production of interferon, lysozyme. It is used in the form of an oil solution and in dragees. The daily dose for children is up to 15,000 IU.
B vitamins are actively involved in redox processes, in the metabolism of fats, proteins, carbohydrates.
To replenish the deficiency of B vitamins, it is possible to recommend taking complexes of multivitamin preparations, where they are contained in a daily dose (Unicap-Yu, etc.), and also include buckwheat and oatmeal in the diet. Wheat germ flakes can be given.
Vitamin E is a natural antioxidant, antihypoxant, participates in protein synthesis, as well as tissue proliferation, and improves cell metabolism.
The daily dose for children is 50-70 mg.
At present, domestic preparations "biophytes" are becoming popular - products of processing fresh vegetables and fruits using vitamin-saving technology. These drugs have a variety of effects on the body, including serving as a source of easily assimilated vitamins. Biophytes "Carrot" are sources of vitamin A, "Oats" - vitamins of group B, etc.
Adaptogens are used that stimulate non-specific defense factors. One of the most popular adaptogens is Eleutherococcus. Eleutherococcus extract is used. Children are prescribed 1-2 drops for each year of the child's life, 2 times a day. The course of treatment is 3 weeks.
Complex multivitamin preparations containing vitamins with minerals are also adaptogens.
Due to the fact that with all vulvovaginitis, there are violations in the humoral and local links of immunity, in their complex therapy, the appointment of immunomodulators is of great importance to increase the non-specific resistance of the organism. It should be noted, however, that the appointment of immunomodulators as agents that stimulate the immune system should be careful in some types of acute vulvovaginitis and with a burdened allergic anamnesis.
From the group of widely used immunomodulators, the following are used: sodium nucleinate - stimulates humoral and cellular immunity. It is prescribed depending on age from 0.5 to 0.3 g 3 times a day; the course of treatment is 10-14 days. Levamisole is used for immunodeficiencies associated with impaired function of T-lymphocytes, which are responsible for cellular immunity. Assign at a dose of 2 mg / kg of body weight per day for 3 days. 2-3 courses of therapy are carried out with a break between courses of 6-7 days. Methyluracil stimulates cellular immunity, repair processes. Assign to children under 8 years of age 0.25 g 3 times a day, over 8 years old - 0.5 g 3 times a day. The course of treatment is 2-3 weeks.
The drug immunal (extract from the echinacea plant) is widely used. In addition to the immunostimulating echinacea, it exhibits antibacterial, antiviral and antifungal effects. Children under 6 years of age are prescribed up to 10 drops 3 times a day; under 12 years old - 15 drops, 3 times a day. The course of treatment is 1-3 weeks.
In the process of immunocorrection, drugs that stimulate the production of endogenous interferon are often used now. The interferon system protects the body from a wide range of infectious agents (viruses, bacterial, protozoal, myco- and uroplasmic, chlamydial infections, candidiasis).
Of the known inducers of interferon, neovir and cycloferon are prescribed.
Viferon is a representative of a new generation of interferon stimulants. It has no side effects, has no contraindications for use. Available in rectal suppositories. Viferon is used to treat young children (up to 7 years old), contains 150,000 IU of interferon, Viferon 2 is used in the treatment of children over 7 years old, contains 500,000 IU of interferon.
Viferon 1 is prescribed rectally 1 suppository 1-2 times a day for 5 days, Viferon 2 1-2 times a day for 10 days.
Since recently an increase in allergic reactions has been observed in children, the use of antihistamines in the complex treatment of vulvovaginitis is justified.
You can prescribe suprastin, pipolfen, diazolin in dosages usual for children for 10-14 days.
With vulvovaginitis arising against the background of inflammatory diseases of the gastrointestinal tract, the use of eubiotics is shown, which normalizes the intestinal flora. In pediatric gynecology, they have proven themselves well: bifidumbacterin, 5 doses are prescribed 1 time per day, 7-10 days; hilak-forte - for children under 1 year old, 15-20 drops 3 times a day before meals; over a year - 30-60 drops 3 times a day. Pre-diluted with milk or water.
You can prescribe the drug Narine.
The new generation of eubiotics is represented by the Vitoflor preparation, which contains a symbiosis of 2 strains of acidophilus bacillus, which increases its biological activity.
It is prescribed 100 ml per day for 7-10 days.
Local treatment of vulvovaginitis consists of 3 stages: antibiotic therapy, stimulation of repair, correction of the vaginal microflora.
Treatment begins with irrigation of the vagina with one of the antiseptic, antibacterial solutions: an aqueous solution of dioxidine, furacilin (0.02%), alcoholic solutions of chlorophyllipt, eucalyptus (1 tbsp. L. Per glass of water). With profuse purulent discharge, a 3% solution of hydrogen peroxide is used.
For acute vulvovaginitis, sessile baths with decoctions of herbs (sage, chamomile, calendula, eucalyptus, St. John's wort) are prescribed. After the acute process is removed, treatment can be continued by irrigating the vagina with decoctions of the same herbs using a rubber catheter.
After irrigation, vaginal sticks with various drugs are inserted into the vagina, depending on the etiology of the inflammatory process. The number of procedures is 6-10.
The most commonly used vaginal sticks have the following recipes:
1.sulfadimezin 0.2, furacilin 0.1, folliculin 250-500 U, cocoa butter 1-1.5 g.
2.polymyxin M - 80 thousand units, furagin 0.001, cocoa butter 1-1.5 g.
3.furatsilin 0.1, folliculin 250-500 IU, cocoa butter 1-1.5 g.
With pronounced staphylococcal-streptococcal flora, vaginal sticks include antibiotics:
For allergic vulvovaginitis, an ointment with dimidrol is used.
In the treatment of vulvitis and vulvovaginitis, applications on the vulva with 0.1% gentamicin, 1% tetracycline, 1% erythromycin ointments can be prescribed. A good effect is given by the use of 0.2% furacilin ointment and 5% synthomycin emulsion.
If vulvovaginitis proceeds with pronounced exudation, hyperemia, maceration, Shnyrev's paste is applied topically.
A good effect is observed when the external genitals and vagina are irrigated with Hyposol aerosol for 5 days.
The second stage of treatment consists in the use of drugs that improve the trophism of the skin and mucous membranes, stimulating the reparation processes.
Apply oil solutions of vitamins A, E, sea buckthorn oil, rose hips, Aekol preparations, carotolin; fish fat; 10% methyluracil ointment, Solcoseryl ointment.
Garlic oil has a good reparative effect with a pronounced anti-inflammatory effect.
Of particular interest is the new drug "Tykveol", which is an accumulator of biologically active substances contained in pumpkin: carotenoids, tocopherols, phospholipids, flavanoids, vitamins of group B, C, P, saturated and polyunsaturated fatty acids. The pharmacological action consists in reducing inflammatory processes and accelerating the regeneration of tissues and mucous membranes, and normalizing the metabolism in them.
"Tykveol" is applied in the form of applications for 10 days.
The third stage of treatment is to normalize the vaginal microflora. Eubiotic preparations are used: lactobacterin, bifidumbacterin, femilak.
The drugs are administered intravaginally in 3 doses 1 time per day for 10 days.
Recently, more and more often, doctors have begun to turn to alternative medicine in order to improve the body. One of its directions is the use of biologically active additives (BAA).
In connection with the growing importance, we will consider the treatment of vulvovaginitis caused by specific microflora.
Treatment of gonorrheal vulvovaginitis is carried out in a specialized station or a dermatovenerologic dispensary.
From antibiotics, benzylpenicillin is prescribed. Depending on age, a single dose ranges from 50 to 200 thousand units. Daily dose: 300 thousand units - 1200 thousand units
Additionally, sulfa drugs can be prescribed (at the rate of 25 mg / kg on the first day of treatment and 125 mg / kg in the next 5-7 days).
Local treatment begins from the moment an infection is detected. Prescribe sessile baths with decoctions of herbs: chamomile, sage, calendula. After the removal of acute inflammation, the vagina is instilled with a 1-2% solution of protargol, a 0.25% solution of silver nitrate, and a solution of dioxidine.
Nonspecific immunomodulators are also used according to the usual schemes (decaris, prodigiosan, sodium nucleinate, etc.).
The criterion for cure is a normal clinical picture and favorable results of repeated laboratory studies of the detached genitals after 3 provocations.
Combined provocations are the injection of a gonovaccine (150-200 ml of microbial bodies), lubrication of the vagina and vulva with Lugol's solution in glycerin, instilling 2-3 drops of 0.5-1% silver solution into the urethra, lubricating the lower rectum with Lugol's solution. No provocations are made for up to 3 years.
Treatment of trichomodal vulvovaginitis includes the appointment of trichomonacid drugs (trichopolum, metronidazole, flagil) in single doses, depending on age, 0.25-0.5 3 times a day. The course of treatment is up to 5-7 days. A good effect was noted with the use of a nitrofuran preparation, in particular, furazolidone.
It is advisable to start local treatment with sedentary baths with decoctions of oak bark, which relieve local inflammation well, soothe itching. After that, you can use vaginal sticks, which include Trichomonas drugs.
Treatment of viral vulvovaginitis should go in two directions: inhibition of the vital activity of the pathogen and an increase in the nonspecific resistance of the organism. Since a viral infection is incurable, the goal of treatment is to delay relapse.
Antiherpetic drugs are divided into inhibitors that block the reproduction of the virus, and interferon inducers. The first group includes acyclovir, zavirax, valocyclovir.
The second group includes neovir, ridostin, larifan, which stimulate the production of endogenous interferon.
Neovir is prescribed by injection. In the acute period, 1-2 ampoules (in 1 ampoule 200 mg) after 24 hours. Only 3 injections.
In case of remission - 1 injection 1 time per 7 days. Only 3 injections.
Ridostin - 2.0 (1 ampoule) 1 time per day - 3 days.
Stimulation of nonspecific resistance of the organism includes the appointment of adaptogens, vitamins, nonspecific immunostimulants.
For local treatment, ointments with antiviral activity are used: oxolinic, tetrophenic, bonafton. The ointment is applied to the vulva several times a day for 2 weeks.
When treating fungal vulvovaginitis, you should first find the cause of the disease in extragenital pathology, since vulvovaginitis is a secondary lesion of the mucous membranes of the vulva by fungi of the genus Candida. The emphasis is placed on activating the immune system of the mucous membranes, on the prevention and treatment of intestinal dysbiosis, on increasing the overall resistance of the body. Treatment is usually long-term.
