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1.
J Low Genit Tract Dis ; 25(2): 172-180, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33631782

RESUMO

OBJECTIVES: The aims of the study were to assess the available literature concerning the indications, performance, technique, and classification of wet mount microscopy (WMM) and to establish evidence-based recommendations. METHODS: Literature review from the main scientific databases was performed by the ad hoc "Vaginitis and Microbiome Committee" of the International Society for the Study of Vulvovaginal Disease. The document was approved by the executive council and membership of the International Society for the Study of Vulvovaginal Disease. RESULTS: Available data are limited and usually of low level of evidence. Nevertheless, it shows that WMM is capable of reducing misdiagnosis, overtreatment, and undertreatment of vaginal conditions. It has an excellent performance for the diagnosis of bacterial vaginosis and variable performance for trichomoniasis and candidiasis. It is the gold standard for aerobic vaginitis/desquamative inflammatory vaginitis. Currently, there is no recommendation to use WMM in the screening of asymptomatic women.The use of phase contrast is recommended to improve performance and reproducibility. Sampling location, devices, and technique have an impact on the results.Available scoring and classification scores have significant limitations. CONCLUSIONS: Wet mount microscopy is a point-of-care, inexpensive, and fast technique that, with practice, can be mastered by office clinicians. It should be considered a basic skill in the curricula of gynecology and obstetrics residencies. Recommendations are provided on sampling, reading, and scoring.


Assuntos
Microscopia/métodos , Manejo de Espécimes/métodos , Doenças Vaginais/diagnóstico , Doenças da Vulva/diagnóstico , Feminino , Humanos , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade , Sociedades Médicas , Vaginite por Trichomonas/diagnóstico , Doenças Vaginais/microbiologia , Vaginose Bacteriana/diagnóstico , Doenças da Vulva/microbiologia
3.
J Low Genit Tract Dis ; 22(4): 415-434, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29994815

RESUMO

Female genital cosmetic surgeries (FGCSs) and procedures are increasingly being advertised as common, simple, and complication-free, capable of not only improving aesthetic appearance but also increasing self-esteem and sexual pleasure.Guidelines for physicians and clear, scientifically correct information for patients must be made available, to minimize the number of ineffective or deleterious procedures.The International Society for the Study of Vulvovaginal Disease positions/recommendations regarding FGCS are as follows:1. There is a wide variation regarding genital normalcy; providers must be able to explain this to women.2. There are no data supporting FGCS including, G-spot augmentation, hymenoplasty, vulvar and perianal bleaching/whitening, vaginal tightening procedures, and other procedures aimed at increasing sexual function.3. Women should not be offered FGCS before the age of 18 years.4. Women undergoing FGCS should be evaluated by a provider with expertise in vulvovaginal diseases, including attention to their psychological, social, and sexual context. Evaluation by an experienced mental health provider should be considered when the motivation for seeking surgery and/or expectations are not clear or realistic.5. Female genital cosmetic surgery is not exempt from complications.6. Informed consent must always be obtained.7. Surgeons performing FGCS should refrain from solicitous advertising or promoting procedures without scientific basis, including on Web sites.8. Surgeons should not perform surgery that they do not agree with and explain their rationale/position when pressured by patients.9. The genital surgeon must be adequately trained in performing FGCS including knowledge of the anatomy, physiology and pathophysiology of the vulva, vagina and adjacent organs.


Assuntos
Guias de Prática Clínica como Assunto , Cirurgia Plástica/métodos , Doenças da Vulva/patologia , Doenças da Vulva/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Sociedades Científicas , Adulto Jovem
6.
J Low Genit Tract Dis ; 15(3): 219-23, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21716050

RESUMO

OBJECTIVE: This study aimed to compare cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate (DMPA) and oral contraceptives (OCs) referred for colposcopy and to determine whether there were differences in the occurrence of false-positive cytologic finding between the 2 contraceptive groups. MATERIALS AND METHODS: Retrospective cohort of 1,569 premenopausal women using either DMPA or OC who were evaluated for abnormal cervical cytologic findings. Cytologic and histologic data were collected in conjunction with routine gynecologic examinations or follow-up colposcopic evaluations. χ2 tests were used to determine differences in cervical cytologic and histologic findings and the proportion of false-positive results across contraceptive groups. Nominal logistic regression was used to evaluate the association between contraceptive use, cervical, and histologic abnormalities while controlling or age and smoking status. RESULTS: The mean age of all participants was 23.5 years, with no significant difference between OC (n = 1194) and DMPA (n = 375) users. Although there were no differences in the proportion of false-positive cytologic results (21.8% overall), DMPA users were more likely to smoke (p < .001), have atypical glandular cell (AGC) on referral cytology (p < .001), and have histologic confirmation of cervical intraepithelial neoplasia 2, 3 (p = .004). Users of DMPA remained more likely to have AGC cytology after considering smoking status; however, cervical intraepithelial neoplasia 2, 3 was found to be associated with smoking status and not use of DMPA. CONCLUSIONS: We found no difference in the proportion of false-positive cytologic results between DMPA and OC users referred for evaluation of abnormal cytology. Users of DMPA were more likely to have AGC, which necessitates a more comprehensive evaluation.


Assuntos
Colo do Útero/patologia , Colposcopia/normas , Anticoncepcionais Femininos/efeitos adversos , Acetato de Medroxiprogesterona/efeitos adversos , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Adolescente , Adulto , Anticoncepcionais Orais/efeitos adversos , Preparações de Ação Retardada , Reações Falso-Positivas , Feminino , Humanos , Iowa/epidemiologia , Modelos Logísticos , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia , Adulto Jovem , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/etiologia
7.
Curr Infect Dis Rep ; 12(6): 479-83, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21308558

RESUMO

Desquamative inflammatory vaginitis (DIV) is a rare chronic clinical syndrome of unknown etiology characterized by profuse purulent vaginal discharge, diffuse exudative vaginitis, epithelial cell exfoliation, and pain. A diagnosis of DIV is often missed by even experienced practitioners owing to its rarity and its clinical and laboratory presentation similar to other inflammatory vulvovaginal disorders. Although DIV is difficult to treat and often requires long-term therapy for maintenance, successful therapy has been reported with topical steroids and clindamycin.

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