Nystatin-Neomycin-Polymyxin B Combination:Efficacy and Tolerance as 1st-Line Local Treatment of Infectious Vaginitis

Objective: To evaluate the efficacy and tolerance of a local treatment combining two antibacterials and one antifungal in patients with a clinical presentation suggesting infectious vaginitis. Patients and methods: 169 patients presenting with clinical criteria for vaginitis were included in an open, multicenter trial. Vaginal samples were taken for microbiological analyses and a triple-combination product of nystatin, neomycin and polymyxin B was then started as local treatment, without waiting for the test results. The treatment was continued with the usual dosage (1 vaginal capsule at bedtime for 12 days) for vaginal infections in the scope of the combination product with approved labeling. A second vaginal sample was performed at the end of the treatment. The main efficacy criterion was the clinical success rate (cure or improvement of the clinical signs and symptoms) according to the investigator.Results: 93 patients were included in the efficacy population. Non-exclusively fungal vaginitis (strictly bacterial or bacterial + fungal) represented 31.2% of the cases. The clinical success rate was 97.8% according to the investigator and 95.7% according to the patients. The microbiological success rate was 81.3%, with no differences between etiologies (Candida spp., bacteria or both). The combination product was well-tolerated, despite the local inflammation before treatment. Discussion and conclusion: Given the etiological diversity of vaginitis, this trial supports the efficacy of a triple-combination product (nystatin, neomycin, polymyxin B) as a first-line local treatment of Candida, bacterial or mixed vaginitis.

Importance of Lactic Acid in Maintaining Vaginal Health: A Review of Vaginitis and Vaginosis Etiopathogenic Bases and a Proposal for a New Treatment

The most frequent cause of visits to the gynecologist in the western world is vaginal discomfort (vaginitis and vaginosis) whose origin lies in the uncontrolled proliferation of bacteria, such as haemophilus vaginalis or Candida-type fungi, normally considered as saprophytes. Such uncontrolled development of saprophytes is caused by some types of aggression against?Doderlein bacilli and/or by a significant decrease in the amount of lactic acid (use of broad-spectrum antibiotics, douches with aggressive products, etc.). Consequently, as the vagina creates a progressively alkalinized and increasingly inadequate environment for the lactobacilli activity, a more favorable environment for the growth of saprophytes is created. The more alkaline the medium becomes, the lower the production of lactic acid. Therefore a vicious circle is created, resulting in the bacillus acidophilus near the lack of metabolism and the disappearance of lactic acid, hydrogen peroxide and bacteriocins. All of the above make it possible for saprophytic bacteria to proliferate and become pathogenic. So far, all vaginitis and vaginosis treatments have solely been focused on attacking the disproportionately developed bacteria but have not addressed the restoration of a vaginal acidic environment, i.e. the environment allowing the proliferation of lactic acid-producing bacillus acidophilus. This explains the high rate of relapse occurring after the treatment of these vaginal profiles. In this paper we propose a new treatment focused on the use of lactic acid to prevent recurrence after a vaginitis or vaginosis treatment.

SilTech: A New Approach to Treat Aerobic Vaginitis

Background: The aerobic vaginitis (AV) is characterized by increased levels of aerobic bacteria, vaginal inflammation and depressed levels of lactobacilli. Objective: The purpose of this study was to investigate the therapeutic efficacy of SilTechTM vaginal softgel capsules, containing new microcrystals of silver monovalent ions, for aerobic vaginitis (AV). Methods: This prospective study enrolled 32 women diagnosed with AV. All recruited women were treated with SilTechTM vaginal softgel capsules once daily for 7 days (one course). Therapeutic efficacy was evaluated based on clinical and microscopic criteria, and cure rates were calculated. Women who were improved (but not cured) received a second course of therapy. Patients classified with clinical and microscopic failure were treated using other strategies. Results: After one course of therapy, 59.2% (19/32) of women were cured, 19.0% (6/32) were improved (but not cured) and 21.8% (7/32) failed to respond to the therapy. After two courses of therapy, clinical improvement was achieved in additional two women. The therapy was very well tolerated, and during the entire study no drop out related to the SylTechTM vaginal capsules treatment was observed;only two patients (6.2%) experienced a mild transient burning after application. Conclusion: SylTechTM vaginal capsules is an effective therapeutic option for patients with AV, and most women with AV were cured with one course of therapy.

Occurrence and Clinical Characteristics of Vaginitis among Women of Reproductive Age in Lagos, Nigeria

Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.

Topical Treatment of Infectious Vaginitis:Effects of Antibiotic,Antifungal and Antiseptic Drugs on the Growth of Normal Vaginal Lactobacillus Strains

Objectives: The balance of the vaginal ecosystem depends on lactobacilli whose biofilm protectsagainst microorganisms that are not normally present or are subdominant in vaginal flora. Vaginal?infection treatments should eliminate pathogens while preserving the?Lactobacillus?flora to prevent relapse or recurrence. The objective of this study was to determine the sensitivity of lactobacilli to antiseptics, antibiotics and antifungal agents used, alone or in combination, in the topical treatment of infectious vaginitis. Materials and Methods: The minimum inhibitory concentration (MIC) of 15 active ingredients and the minimum inhibitory dilution (MID) of 17 pharmaceuticals products were determined for three main?Lactobacillus?strains (L. crispatus,?L. gasseri?and?L. jensenii). Results: The MICs of the antibiotics and antifungal agents were above their critical concentrations in the three strains, contrary to the antiseptics. According to their MID, some pharmaceutical products, especially combinations, inhibit the growth of one or more strains at concentrations that can be found in the vaginal mucosa after application at the usual dosage. Conclusions: Certain topical anti-infective drugs may interfere with the growth of lactobacilli, worsening the vaginal flora imbalance. Maintaining vaginal flora balance should be a selection criterion when choosing an anti-infective therapy.

Clinical Observation on Treatment of 50 Patients with Candidal Vaginitis by Chinese Herbal Medicine Combined with Canesten

From January 2001 to January 2002, 50 patients of candidal vaginitis were treated by Kushen powder (KSP,苦参散) combined with Canesten as the treatment group, and controlled by a control group including another 50 patients treated with Canesten alone. The therapeutic results were satisfactory and reported as follows.

Oral Low-Molecular Weight Hyaluronic Acid in the Treatment of Atrophic Vaginitis

The aim of this study was to evaluate the effectiveness of low molecular weight hyaluronic acid oral tablets for the treatment of atrophic vaginitis. 12 women with atrophic vaginitis were recruited for this double blind, placebo-controlled study. Patients were randomized to receive either low molecular weight hyaluronic acid (HA) oral tablets or placebo for three months. Vaginal biopsies were taken at baseline and after three months of treatment, and vaginal epithelium was analysed using light microscopy. The evaluation of symptoms was self-assessed by the patients. Biopsies from HA group showed an epithelium thicker than in placebo group. The lamina propria from the HA group also showed a denser appearance compared to placebo group. Morphometric analysis showed significant differences between HA and baseline in the number of epithelial layers and in the thickness. The evaluation of symptoms also showed an effective improvement in the patients treated with HA, compared to baseline and to placebo group. In conclusion, oral administration of HA tablets improved the vaginal epithelium, decreasing atrophy. This can be an ideal option for patients with atrophic vaginitis who do not want to or can not take estrogen and show low compliance toward vaginal administration.

Vaginitis in Intrauterine Contraceptive Device Users

Objectives: This study aimed to assess clinical, microbial changes in IUD users and other contraceptive methods in referent to urban health centers in Hamadan city, Iran. Methods: Detailed history and gynecological examination were conducted on women (IUD users, n = 100) or other contraceptive methods (controls, n = 160) in the health centers. Results: Frequencies of the different vaginal pathogens, high indices of infection by bacterial vaginosis (12.0%) candida albicance (7.0%) and low indices of trichomoniasis (5.0%) were found in present study, but none of them in both groups was significant. Menorrhagia was more frequent among women with IUD than that among women without IUD (P < 0.05). A trend of erosion cervix and dysmenorrhea being more frequent among women with IUD was also found (P < 0.05). Conclusions: IUD is the safety in general;however, an increase occurred in the frequency of vaginitis.

Therapeutical effect of marine lysozyme suppository on bacterial vaginitis caused by S. aureus and E. coli

Aim To research therapeutical effect of marine lysozyme suppository on bacterial vaginitis caused by S. aureus and E. coll. Methods Lysozyme obtained from concha ostreae which were used to preparate marine lyso- zyme suppository. The identification and test of suppository was in line with the standards stated in Chinese pharma- coperia（2010 edition）. After determined its quality control, we studied its therapeutical effect on bacterial vaginitis which caused by S. aureus and E. coli, by vaginitis model in rats infection of S. aureus bacteria and E. coli. Results The preparation technology of marine lysozyme suppository was simple, convenient and clinically effective. The marine lysozyme suppository was delivered by dose 0.5, 0.25, 0. 125 g ~ kg-1, the cure rates of S. aureus infec- tion were 80% , 50% and 30% , respectively, the cure rates of E. coli infection were 90% , 60% and 30% re- spectively, the cure rates of mixed infection were 92.9% , 82. 1% and 92.9% respectively. Marine lysozyme sup- pository had an outstanding therapeutical effect on bacterial vaginitis which caused by S. aureus and E. coll. Con- clusion The preparative process of marine lysozyme suppository was practicable, and it had a good therapeutic effect on bacterial vaginitis caused by S. aureus and E. coll.

A Case of Senile Vaginitis Treated by Acupuncture

The article records details of the treatment process and efect of an elderly patient with senile vaginitis,where needling,a method of Chinese Traditional Medicine(TCM)method,was applied mainly,combined with oral administration of western medicine.It then analyses this disease from prospective of TCM.In the end,it concludes that no matter traditional needling method or traditional needling method combined with moxibustion,it has achieved a satisfied treatment effect while applying needling on chosen acupuncture points,so it is worthy being further popularized.

VES:阴道炎症(vaginitis)辅助诊断专家系统设计与实现

阐述基于规则诊断推理技术的阴道炎症辅助专家系统的设计与实现。针对阴道炎症医疗诊断的特点,讨论该系统在建立过程采用的关键技术,描述系统的结构框架、知识表示、推理方法和实现技术。整合数据库技术,人工智能技术及阴道炎症医疗诊断技术,为实现阴道炎症智能诊断系统提供有价值的探讨。

Study of Harmful Vaginal Practices of Women in the Municipality of Ouagadougou, Burkina Faso

Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the different vaginal practices of women using non-pharmaceutical products. Methodology: This was a cross-sectional study with descriptive and analytical purposes that took place from January 15 to April 23, 2023, in the four largest markets in the municipality of Ouagadougou. This was performed using the data collection sheet in the KoboCollect application. Epi info 7.2.5.0. software was used for data analysis. For the analysis of associated factors, a p-value Results: In total, 977 women were surveyed. Among them, 43.19% underwent vaginal procedures using non-pharmaceutical products. The female practitioners were 34.34 ± 7.44 years old. The products used included plants, mineral substances, ointments, tablets, and solutions. Among the practicing women, 40.99% were looking for vaginal tightening. The main purpose was to maintain their partners (45.97%). Three-point thirty-two percent (3.32%) of the women who underwent vaginal procedures had reported adverse events. Conclusion: Raising awareness of the consequences of vaginal practices and encouraging women to go to a health center for any gynecological problem could significantly reduce the prevalence of vaginal practices.

Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.

Risk Factors Associated with Unsuccessful Vaginal Birth after One Cesarean (VBAC-1) in Puerto Rico

Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.

Effects of β-Glucan Supplementation on Repairing of Phenol-Induced Vaginal Mucosal Epithelium Damage in Rats

Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.

Spontaneous Paravesical and Broad Ligament Hematoma after Vaginal Delivery Had Uterine Artery Embolization after Evacuating the Hematoma

Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.

A Clinical Study to Assess the Effectiveness of Oral Combination Kit Therapy in Syndromic Management of Abnormal Vaginal Discharge (FEMINE Study) in Kinshasa, Democratic Republic of Congo

Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS® combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS® combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.

Study on Vaginitis Among Intrauterine Contraceptive Device Users in Ibadan,South-western Nigeria

Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.