Perineal itching

Introduction The narrow perineum refers only to the soft tissue between the anus and the external genitalia. The generalized perineum refers to the entire soft tissue of the lower pelvis below the pot. Itching may be caused by vaginitis.

Cause

Itching may be caused by vaginitis. In normal women of childbearing age, vaginal epithelial cells proliferate under the action of endocrine hormones, and the surface cells are rich in glycogen, which is very beneficial to the growth of lactic acid bacteria, which accounts for more than 90% of the vagina. This large amount of lactobacilli inhibits the growth of other pathogenic bacteria. A normal ecological balance is formed in the vagina. When the level of estrogen in the human body decreases, the vaginal epithelium shrinks and the cell glycogen decreases, which is not conducive to the growth of lactobacilli. Excessive use of antibiotics or excessive flushing of the vagina with alkaline fluids inhibits the growth of lactobacilli. Sexual disorder, frequent sexual intercourse (since semen pH 7.2-7.8), etc. cause pathogenic anaerobic bacteria and Gardnerella to multiply, causing vaginal microbial ecological imbalance. Reduced facultative lactic acid bacteria. Eventually lead to bacterial vaginosis. Due to the decarboxylase produced by anaerobic bacteria, Gatner bacteria can be stimulated to produce certain amino acids, produce volatile amines, release unpleasant fishy odor, amines increase pH, inhibit lactobacilli reproduction, and stick The vaginal epidermal cells with bacteria are detached, causing an increase in vaginal secretions, which leads to the disease. Due to the disorder of the flora, vaginal inflammation is not obvious, and the leukocytes in the secretions are reduced. Therefore, bacterial vaginosis is more appropriate than vaginitis.

an examination

Related inspection

Vaginal secretion examination colposcopy

Clinical manifestations: The typical clinical symptoms of this disease are markedly increased vaginal abnormal secretions, which are thin homogeneous or thin paste, grayish white, grayish yellow or milky yellow with special fishy smell. Since alkaline prostatic fluid can cause the release of amines, it is manifested as an increase in odor after sexual intercourse or after sexual intercourse. The vaginal pH value increases during menstruation, so the odor can be aggravated during menstruation or menstruation. The patient's vulva has discomfort, including varying degrees of genital itching, generally no obvious time, but itching is more obvious in rest and mood. There are still varying degrees of external burning sensation, and some patients have sexual pain. Very few patients have lower abdominal pain, difficulty in sexual intercourse and abnormal urination. The vaginal mucosa epithelium has no obvious hyperemia at the time of onset. This disease can often be combined with other vaginal sexually transmitted diseases, so its clinical manifestations may be affected by comorbidities. For example, when combined with gonococcal infection, vaginal discharge can be characterized by obvious purulent traits, and urinary tract irritation such as dysuria and dysuria may occur. When trichomoniasis is infected, foamy vaginal secretions may occur, and itching is aggravated. It is very itchy. When combined with Candida infection, vaginal secretions can appear as curd or bean curd.

diagnosis:

First, the vaginal secretions are grayish white, very viscous, even like batter, uniform, but not purulent secretions, the amount is uncertain.

Second, the secretion of amines is particularly high, so it is a fishy smell. During sexual intercourse or after activities, the odor is aggravated by the release of amines. The secretion of amines can also be released after adding 10% potassium hydroxide to the secretions.

Third, the pH value in the vaginal secretions increased, the PH range of 5.0-5.5, and the normal person is 4.5-4.7.

4. The clue cells can be detected in the wet smear of vaginal secretions.

Among the above four criteria, more than three can be diagnosed, and the fourth is the necessary diagnostic criteria.

Differential diagnosis

Anal perineal area is damp and unclean: old incontinence or anal incontinence refers to defecation and deflation that are not controlled at least twice or more per day. It is a kind of clinical symptom with various pathophysiological basis caused by various reasons. The incidence rate of the elderly is about 1%. The elderly inpatients are more common than the average female. Fecal incontinence is common in elderly people with mild fecal incontinence and is often not reported by patients and doctors. Physical examination showed that the perineal perineal area was wet and unclean. Perineal ulcer: The genital ulcer refers to the loss or exfoliation of the normal epithelium of the skin mucosa in the anus and genital area. It is a complex and diverse cause of genital ulcers, so it usually represents a variety of diseases including various skin diseases and sexually transmitted diseases. .

Clinical manifestations: The typical clinical symptoms of this disease are markedly increased vaginal abnormal secretions, which are thin homogeneous or thin paste, grayish white, grayish yellow or milky yellow with special fishy smell. Since alkaline prostatic fluid can cause the release of amines, it is manifested as an increase in odor after sexual intercourse or after sexual intercourse. The vaginal pH value increases during menstruation, so the odor can be aggravated during menstruation or menstruation. The patient's vulva has discomfort, including varying degrees of genital itching, generally no obvious time, but itching is more obvious in rest and mood. There are still varying degrees of external burning sensation, and some patients have sexual pain. Very few patients have lower abdominal pain, difficulty in sexual intercourse and abnormal urination. The vaginal mucosa epithelium showed no obvious hyperemia at the time of onset. This disease can often be combined with other vaginal sexually transmitted diseases, so its clinical manifestations may be affected by comorbidities. For example, when combined with gonococcal infection, vaginal discharge can be characterized by obvious purulent traits, and urinary tract irritation such as dysuria and dysuria can occur; when trichomoniasis is infected, foamy vaginal discharge can occur, and itching is intensified. It is very itchy. When combined with Candida infection, vaginal secretions may appear as curd or bean curd.

diagnosis:

First, the vaginal secretions are grayish white, very viscous, even like batter, uniform, but not purulent secretions, the amount is uncertain.

Second, the secretion of amines is particularly high, so it is a fishy smell. During sexual intercourse or after activities, the odor is aggravated by the release of amines. The secretion of amines can also be released after adding 10% potassium hydroxide to the secretions.

Third, the pH value in the vaginal secretions increased, the PH range of 5.0-5.5, and the normal person is 4.5-4.7.

4. The clue cells can be detected in the wet smear of vaginal secretions.

Among the above four criteria, more than three can be diagnosed, and the fourth is the necessary diagnostic criteria.

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