A survey of women begin with the collection of family history. Rigorous questioning, detailed knowledge of the beginning and the first sign of illness, the nature of the complaints prior to treatment determine the correct diagnosis. Itching of the external genitalia say 26% of patients, burning - 28%, dyspareunia - 23%. Dizuricheskie disorder is observed in only 15% of women, pain in the vagina or perineum in 21%. Complaints about these 97% of women had already repeatedly addressed to a gynecologist or urologist, mycology, endocrinologist, neurologist. At the same time 95% of them exhibited nonspecific vaginitis diagnosis, 75% of women previously repeatedly and unsuccessfully treated for suspected vaginitis, often used in a variety of topical antibiotics as well as orally or parenteral.
An objective examination is necessary to pay attention to the condition of the vulva, the external opening of the urethra, the mucous membrane of the vagina, cervix, the character of discharge. Vaginal discharge in bacterial vaginosis is usually abundant, homogeneous, white, with a sharp unpleasant smell "stale fish" . Depending on the nature of the discharge duration of the illness varies. At the beginning of the disease leucorrhoea liquid consistency, white or grayish tint. With long-term bacterial vaginosis (2 years) allocation zheltovatozelenovatoy color, more dense, reminiscent of curdled mass, frothy, viscous and sticky, evenly distributed along the walls of the vagina. Number whiter varies from moderate to heavy, but the average volume of 20 ml per day (approximately 10 times higher than normal). feature of bacterial vaginosis - the absence of signs of inflammation (swelling, redness) of the vaginal walls .
Mucosa with bacterial vaginosis normal pink color . In rare cases, elderly women (in menopause) show a small reddish spots. PH measurement is carried out using indicator strips with a scale interval not greater than 0.2 at the time of inspection. For bacterial vaginosis is characterized by a shift to the alkaline side (average 6.0). Simultaneously raise the reaction with 10% KOH solution. When mixed vaginal discharge and a few drops of alkali increases or creates a characteristic odor of "rotten fish" - a positive aminotest. Colposcopic picture of bacterial vaginosis characterizes the absence of diffuse or focal hyperemia, petechial hemorrhages, edema and infiltration of the mucosa of the vagina. In 39% of patients exhibit abnormal vaginal part of cervix (cervicitis, ectropion, a simple erosion, deformation scars, etc.).
GOALS OF TREATMENT
3 days to permanent bacterial vaginosis relief The principal goal of therapy is to allow vaginal symptoms. All women with symptoms of bacterial vaginosis should be treated. The use of metronidazole in bacterial vaginosis significantly reduces the incidence of PID after the abortion. Thus, it is necessary treatment of bacterial vaginosis (accompanied by symptoms or asymptomatic bacterial vaginosis) prior to surgical abortion.