Effectiveness of Combination of Tibolone and Lactobacilli Plus Lactoferrin in Postmenopausal Women with Vulvar Vestibular Pain: A Preliminary Report.

BACKGROUND: Postmenopausal dyspareunia and vulvar pain are common complaints, affecting about 60% of women within a few years after hormone levels begin to decline (such as estrogen and androgen). Atrophic changes mainly located in the vulvar vestibule and vulnerability to vulvovaginal infections in postmenopause could be predisposing factors to the development of vulvar burning/pain and introital dyspareunia (vestibulodynia secondary to atrophy). Tibolone is the most effective and safe alternative for treating menopausal symptoms. The role of Lactobacilli and lactoferrin shows its effectiveness in the treatment of vaginal microbiota dysbiosis. The aim of the present study was to assess the efficacy of the combination of tibolone and an oral-specific Lactobacilli mixture in combination with bovine lactoferrin as synergistic therapy for the treatment of vestibulodynia related to atrophy. METHODS: In this study, we included 35 postmenopausal women with at least 1 year of amenorrhea, affected by vulvar burning/pain and introital dyspareunia. All participants received treatment with open-label, oral Tibolone 2.5 mg and Lactobacilli mixture (5 × 109 CFU per capsule) in combination with bovine lactoferrin (Respecta®). Each product was taken once daily for 90 days. RESULTS: After 90 d of therapy with TIB+ Respecta®, in 30 women that completed the treatment, there was a statistically significant decrease from the baseline in the mean of the Visual Analog Scale for vulvar burning/pain and a reduction in scores in the pain evaluation test. CONCLUSIONS: This study provides evidence that the combination of TIB+ Respecta® was effective in reducing symptoms related to vestibular pain and hypersensitivity in a postmenopausal setting.

Histopathologic patterns of female genital tuberculosis with clinical correlation: a 10-year (2013-2022) retrospective cross-sectional study.

OBJECTIVE: Underdiagnosis of female genital tuberculosis (FGTB) often leads to infertility. In this study, we aimed to determine the site and histopathologic patterns of FGTB and its correlation with clinical presentation and acid-fast bacilli (AFB) status. METHODS: A retrospective cross-sectional study was conducted on 122 patients with a histopathological diagnosis of FGTB at the Department of Pathology, College of Health Sciences (CHS), Tikur Anbessa Specialized Hospital (TASH), Addis Ababa University (AAU), from January 1, 2013, to August 30, 2022. RESULTS: Female genital tuberculosis was found in 0.94% of the gynecology specimens examined. The most common presentations were menstrual disturbance, abdominopelvic pain, and infertility. Among patients with FGTB, 4.6% exhibited misleading clinical and radiologic findings, leading to suspicion of malignancy and subsequent aggressive surgical management. The endometrium was the most frequently affected organ, followed by the fallopian tube, ovary, cervix, and vulva. In the majority of tuberculous endometritis cases (53.3%), histopathology revealed early-stage granulomas. Acid-fast bacilli were found in a significant proportion (42.6%) of FGTB tissues with TB histopathology. The ovary had the highest rate of AFB detection, followed by the fallopian tube, endometrium, and cervix. CONCLUSION: Female genital tuberculosis should be considered in reproductive-age women presenting with menstrual irregularities, abdominopelvic pain, infertility, or an abdominopelvic mass. The endometrium is commonly affected, displaying early granulomas with low AFB positivity.

Aislamiento de la bacteria Ureaplasma sp. en el tracto reproductivo de vacas lecheras de Costa Rica / Isolation of the bacteria Ureaplasma sp. in the reproductive tract of milking cows in Costa Rica

This is the first report of Ureaplasma sp. from the reproductive tract of Costa Rican cows. Among 204 animals sampled from 11 dairy farms in the country's Central Plateau, the infection rate was 0-71 per cent. Isolation was more frequent in vulvo-vestibular (38.7 per cent) than in cervical swabs (23 per cent). Ureaplasma was correlated with clinical granular vulvitis symptoms

Staphylococcus aureus productores de toxina del sindrome del shock toxico-1 en el tracto genital inferior femenino / Staphylococcus aureus producers of TSST-1 isolated from the female lower genital tract in San Luis, Argentina

Se investigó la presencia de Staphylococcus aureus en el tracto genital inferior de 102 mujeres sanas entre 18 y 48 años de edad en la ciudad de San Luis (Argentina). Se obtuvieron 306 muestras de labios, introito y fondo de saco vaginal. Los materiales, previa coloración de Gram, fueron sembrados en agar sangre, agar salino monitol y en el medio de Baird-Parker. Las cepas se identificaron por producción de coagulasa en tubo, terminucleasa, pigmentación, oxidación-fermentación de glucosa y manitol, hemolisina, fibrinolisina y susceptibilidad a novobiocina. Se ensayó la susceptibilidad a los antibióticos, detección de enterotoxinas y de toxina del sindrome del shock tóxico (TSST-1). En 13,7% de las mujeres se aisló S. aureus: 10,7% en labios, 3,9% en introito y 3,9% en vagina. Algunas cepas fueron halladas en dos o más regiones. Todas las cepas fueron sensibles a cefalotina, clindamicina, eritromicina, gentamicina y cloramfenicol; 21,0% tuvieron sensibilidad intermedia a meticilina, 94,7% fueron resistentes a penicilina, 15,7% a meticilina y 21,0% a tetraciclina. El 15,7% de las cepas produjeron enterotoxinas B y D, respectivamente, 5,2% enterotoxina C, 15,7% TSST-1. Una de las cepas (5,2%) produjo enterotoxina B y TSST-1. El 100% de las cepas produjo hemolisinas. Se identificaron Staphylococcus coagulasa negativos en el 40,1% de las muestras de fondo de saco vaginal correspondiendo 30,3% a S. epidermidis y 9,8% a S, saprophyticus