Colpitis (vaginitis) is an inflammatory process in the vagina due to its infection, metabolic, endocrine disorders, injuries. Signs of the disease are abundant whiteness, itching, pain in the vagina and lower abdomen. The neglect of the inflammatory process in the vagina can lead to the fusion of its walls, the ascent of infection and the development of inflammatory diseases of the uterus and appendages, erosion of the cervix and, as a consequence, ectopic pregnancy or infertility.The main diagnosis of colpitis includes colposcopy and bacteriological examination.
Colpitis (synonyms: nonspecific colpitis, vaginitis) is an infectious and inflammatory disease in which the vaginal mucosa is affected by conditionally pathogenic microflora (Staphylococcus, streptococcus, proteus, E. coli, Hemophilus bacillus, as well as fungi of the genus Candida, etc.) Can occur in acute, subacute, and chronic (with relapses) forms. Colpitis is often found in women of childbearing age, but can develop in old age and even childhood.
The development of the inflammatory process in colpitis is promoted by both general and local causes. Depending on the localization of the initial focus of infection, there are:
- primary colpitis – immediately develop into the vagina
- secondary colpitis: ascending – when infection enters the vagina from the vulva and descending – when the inflammatory process passes from the uterus.
There are also serous-purulent and diffuse vaginitis (colpitis). Clinical manifestations of serous-purulent vaginitis are very diverse: from minor inflammation of the vaginal mucosa to pronounced edema and erosion of the mucosa with copious purulent discharge.
Normally, the natural microflora of the vagina is mainly represented by lactic acid bacteria. The acidic reaction of the secret protects the genitals from the penetration and reproduction of foreign microorganisms. Factors adversely affecting the microflora, reducing the local immunity of the mucous membranes of the genitals and the resistance of the body as a whole, provoke an increased growth of opportunistic microorganisms and the development of inflammation.
Factors that increase the risk of developing nonspecific vaginitis include:
- acute and chronic diseases of internal organs leading to a decrease in the body’s immune responses (including inflammatory processes in the ovaries, uterus and fallopian tubes);
- sexually transmitted infections (trichomoniasis, chlamydia, mycoplasmosis, ureaplasmosis);
- disorders of the endocrine system (obesity, diabetes mellitus, ovarian hypofunction);
- excessive use of medicines, including long-term courses of antibiotic treatment;
- allergic reactions to hygienic and contraceptive products (tampons, condoms, candles, etc.);
- chemical, mechanical or thermal injuries of the genital mucosa (during medical manipulations: mini-abortion, medical abortion, introduction of intrauterine spirals, douching, etc.);
- anatomical changes of the vagina (decreased tone and lowering of its walls, gaping of the genital slit);
- nutritional disorders and atrophic processes in the vaginal mucosa in vascular disorders and during menopause;
- non-compliance with the rules of personal hygiene.
In childhood, the development of colpitis is promoted by: penetration of infection into the vagina with blood flow (with angina, scarlet fever), allergic reactions of the body, as well as the ingress of foreign objects into the vagina. Usually the inflammation is acute and is associated with infectious diseases of the body as a whole. In old age, a decrease in the hormonal background leads to changes in the mucous membrane of the genitals, it becomes thinner, becomes dry, microtrauma and inflammation occur.
Depending on the pathogen, the severity and severity of the disease, the symptoms of colpitis may vary. Acute nonspecific vaginitis is characterized by:
- discharge in large quantities (mucous, mucopurulent, sometimes bloody) with an unpleasant (sometimes fetid) odor;
- itching and burning caused by the irritating effect of pathological secretions;
- swelling and redness of the mucous membranes of the vagina and external genitalia;
- pain in the lower abdomen and genitals (feeling of bursting, pressure);
- soreness during urination.
In the chronic course of vaginitis, pain is not pronounced, violations of general well-being are usually not observed. Patients note whiteness, burning sensation and itching, ulceration of the mucous membrane of the genitals. With chronic colpitis, there is a sluggish course with intermittent exacerbations.
Colpitis can manifest as vulvovaginitis, in which redness and irritation passes to the external genitals and the inner surface of the thighs and buttocks, often combined with cervicitis, urethritis, pseudoerosion of the cervix.
Due to unpleasant painful sensations, a woman’s sexual activity decreases, the desire for intimacy is suppressed. Also, the swelling and soreness of the vaginal walls makes it impossible to perform an internal examination with the help of mirrors.
If similar symptoms appear, a gynecologist’s consultation is necessary for examination and accurate diagnosis. Treatment of vaginitis at the initial stage is more effective and helps to avoid complications. In severe cases, inflammatory processes can affect the internal genitalia (uterus, appendages) and cause endometritis, cervical erosion, and lead to infertility.
Diagnosis of colpitis
Colpitis can be diagnosed by examining the vagina and cervix with the help of mirrors. In the acute course of vaginitis, the folds of the vaginal mucosa are loose, brightly colored, strongly thickened and edematous, covered with a coating of serous or purulent films. When touching and scraping the plaque, the vaginal walls are damaged and may bleed. In severe cases, erosion of the epithelium of the mucous membrane is observed. In the chronic course of colpitis, mucosal defects are poorly expressed, the discharge is insignificant.
Colposcopy allows you to more accurately see the nature of changes in the walls of the mucous membrane and make an accurate diagnosis. Microscopy of smears from the vagina, cervical canal, urethra also provides important information. With nonspecific vaginitis, a large number of leukocytes are detected in the smear (from 30 to 60 or more at N to 15 in the field of view), a lot of cells of the lowered epithelium, a decrease in the number of lactobacilli, the appearance of extraneous microflora (3 and 4 degrees of purity).
Bacterioscopic examination of smears and bakposev allow identification of microorganisms (gram ownership, type, morphology features). Very often, an association of various bacteria is found with colpitis. Ultrasound examination of the pelvic organs allows to detect concomitant gynecological pathology.
In the treatment of colpitis, modern gynecology effectively applies general and local methods of therapy. Treatment is usually combined and is selected depending on the type of colpitis, the age of the patient, concomitant diseases, etc.
Local treatment consists in the sanitation of the external genitalia and vagina (washing and douching with a decoction of sage, chamomile, chlorophyllipt, a solution of potassium permanganate, zinc sulfate, rivanol, etc.). The introduction of tampons with sea buckthorn oil, antimicrobial vaginal candles and tablets into the vagina is shown. With a persistent, pronounced course of colpitis, local antibiotics are used, taking into account the sensitivity of the pathogen (emulsions, solutions), physiotherapy procedures.
General therapy is aimed at the treatment of concomitant gynecological, metabolic, endocrine diseases, normalization of the hormonal and immune background of the body. During the course of treatment of colpitis, it is recommended to refrain from intimate relationships, examination is also indicated, and if necessary, treatment of another sexual partner. During the treatment of colpitis, a gentle, mainly sour-milk and vegetable diet is prescribed, spicy, salty, smoked dishes that irritate the mucous membranes are excluded from the diet, the use of liquid is limited (to reduce swelling of the mucous membranes).
In the final stage of colpitis treatment, drugs are prescribed that help restore the natural flora of the vagina and increase its protective properties. To control the cure of colpitis, smears are taken on the 4th–5th day of menstruation in women of the reproductive period, in girls and menopausal women – after undergoing a course of treatment. To prevent relapses of the disease, the course of treatment should be repeated after 4-5 months.
Prevention of nonspecific vaginitis (colpitis) is mainly reduced to careful observance of hygiene of the genitals, sexual life, timely treatment of genital and general diseases, exclusion of provoking factors, full rest. A change in the nature of secretions and the menstrual cycle should be the reason for an immediate appeal to a gynecologist. With chronic recurrent vaginitis, it is necessary to conduct PCR diagnostics of sexual infections (chlamydia, mycoplasma, trichomonas, Gardnerella, herpes simplex virus, etc.).
Prevention of vulvovaginitis in girls consists, first of all, in adequate hygienic procedures, general health measures, treatment of foci of chronic infection. As a rule, with proper treatment, colpitis does not pose a serious threat to the patient’s health. However, ignoring colpitis, self-medication and non-compliance with preventive measures can seriously negatively affect a woman’s reproductive health.