Gynecology from diapers

Gynecological diseases are by no means uncommon in childhood. And their untimely treatment can lead to quite serious consequences.

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Inflammatory diseases of the female genital organs most often occur in girls of preschool age. These include vulvitis and vulvovaginitis.

Vulvitis is an inflammation of the female external genitalia. Vulvovaginitis is an inflammation of the external genitalia and vaginal mucosa (often develops against the background of vulvitis). As a consequence of these inflammatory diseases, synechia (gluing) of the labia minora may subsequently occur.

The most common cause is a bacterial infection (staphylococci, streptococci, E. coli, Candida fungi, etc.). Less commonly, the inflammatory process can be caused by infections such as chlamydia, mycoplasma, ureaplasma, etc. (in cases of transmission of the disease from an infected mother to a child during childbirth).

Also, these diseases can be allergic in nature, for example, with diathesis (in some cases, vulvovaginitis is the only manifestation of diathesis). Vulvovaginitis is also caused by helminthic infestations. This occurs when worms (usually pinworms - small worms that parasitize the lower intestine) crawl into the vagina. And another reason for the development of vulvovaginitis is the presence of a foreign body in the vagina. This used to happen more often, now it happens less often. But, nevertheless, about four to five patients a year come to our department with foreign bodies in the vagina. Girls' pen caps, pen refills, and small parts of toys are removed...

In addition, factors such as decreased immunity, failure to comply with personal hygiene rules, and wearing tight underwear can contribute to the development of inflammatory diseases.

Firstly, it should be noted that vulvitis and vulvovaginitis can be both acute and chronic. In the acute form of the disease, swelling of the genital organs, pain, itching and burning are noted, which intensify with urination and washing, and frequent urination. Purulent discharge and enlarged inguinal lymph nodes may be observed. On examination, the mucous membrane is red.

Chronic forms of inflammatory diseases are characterized by itching and burning in the genital area, slight redness of the mucous membrane. In addition to the examination, the gynecologist must take tests - smears, culture for pathogenic flora with determination of sensitivity to antibiotics, tests for urogenital infections.

For vulvovaginitis, vaginoscopy (examination of the vagina using a vaginoscope, a special optical device) is also necessary. It is worth saying that vaginoscopy and further manipulations are carried out under anesthesia. Treatment tactics depend on the cause that provoked the disease. If the inflammatory process was caused by an infectious factor, then antibacterial therapy is prescribed. For extensive, serious inflammation, an antibiotic is prescribed intramuscularly. If the disease is in a mild stage, local treatment (antibacterial ointments) may be sufficient.

In addition, patients are given baths with a decoction of herbal preparations that have an antiseptic effect (chamomile, string, calendula, etc.). Chamomile solution can also be used to cleanse the external genitalia.

If the cause of the disease is worms, then first of all, a course of anthelmintic therapy should be carried out. Sometimes the presence of worms in the vagina is difficult to diagnose. And in cases where a girl has developed chronic vulvovaginitis and synechiae, a course of anthelmintic therapy is also prescribed.

If the disease is a consequence of an allergic reaction, then antihistamines and a diet that excludes food allergens are prescribed.

If the inflammatory process was caused by a foreign body, then, of course, it is necessary to remove it and sanitize the vagina.

Against the background of inflammatory diseases of the genital organs, synechiae of the labia minora may develop, i.e. they stick together. Adhesion may be complete or incomplete depending on at what stage it was diagnosed. The separation of synechiae is a very painful process and must be carried out under anesthesia in a hospital setting. When girls come to us who have already had their synechiae separated several times in the clinic, it’s even difficult to administer anesthesia to them - they are so afraid. After the disconnection procedure, special treatment is carried out, swabs are taken, and subsequent treatment is prescribed. The child spends five to seven days in the hospital, after which we give recommendations to the mother and the attending physician at the clinic.

It would not be superfluous to show the girl to a gynecologist when she is one year old, so that the doctor can make sure that the process of development of the genital organs is proceeding normally. Then, as a rule, an examination by a gynecologist is scheduled before entering a preschool institution, as well as before school. In cases where no alarming symptoms or complaints are observed from the child, this is enough. In other situations, you should consult a doctor as the need arises.

All those that have already been mentioned above: the child’s complaints of pain and burning, in particular when urinating. In addition, if parents notice stains on their underwear indicating the appearance of discharge, or that the girl is bothered by itching in the genital area, this is also a reason to immediately consult a doctor.

You should always remember that a girl is a future mother . Although the formation of the genital organs occurs at five weeks of pregnancy, their further development and final formation occurs after the birth of the child. And any deviation from the norm, if not treated in time, can lead to serious consequences, which in the future will interfere with a full sexual life, pregnancy, and childbirth. Inflammatory diseases of the genital organs started in childhood can subsequently provoke menstrual irregularities, endometritis, inflammation of the fallopian tubes, ovaries, and even infertility.

Exclusively observing the rules of personal hygiene . The girl needs to be washed regularly, and this needs to be done correctly - from front to back, so that discharge from the rectum does not fall on the genitals. Make sure she washes her hands thoroughly after each visit to the toilet. Change your underwear every day and iron it on both sides. In addition, underwear should not be tight or made from synthetic fabrics.

And, of course, as she grows up, you need to teach the girl basic hygiene rules and explain how important this is. Parents should always remember that the health of their child largely depends on themselves.

Obstetrician-gynecologist (head of department), gynecological department No. 2
Salamakha Anna Vladislavovna.