Yellow or bloody, smelly vaginal discharge
Introduction
Introduction The so-called vaginal outflow of yellow or bloody smelly secretions is purulent vaginal discharge, yellow or yellowish green, viscous or foamy, smelly, mostly caused by vaginal inflammation. Bloody leucorrhea, mixed with blood in the vaginal discharge. This is an abnormal physiological phenomenon of women.
Cause
Cause
Causes of vaginal outflow of yellow or bloody odorous secretions:
Purulent white with odor, color yellow or yellow-green, due to purulent infection or trichomoniasis; among them, trichomonas vaginitis is the most common, mostly genital itching. Also seen in chronic cervicitis, senile vaginitis, endometritis and other conditions. Bloody leucorrhea, mixed with blood in the vaginal discharge, should be alert to the possibility of malignant tumors such as cervical cancer and endometrial cancer. However, benign lesions such as cervical polyps, cervical erosion, submucosal fibroids, dysfunctional uterine bleeding, urethral meat sputum, and senile vaginitis can also lead to bloody vaginal discharge.
Examine
an examination
Related inspection
Vaginal discharge examination vaginal gynecological routine examination vaginal cleanliness check
Examination and diagnosis of vaginal outflow of yellow or bloody odorous secretions:
Purulent white with odor, color yellow or yellow-green, due to purulent infection or trichomoniasis; so vaginal cleaning examination, vaginal pathogen examination and other means of examination to determine the pathological causes of leucorrhea abnormalities.
Diagnosis
Differential diagnosis
Differential diagnosis of symptoms of vaginal outflow of yellow or bloody odorous secretions:
(A) non-inflammatory leucorrhea: any case of pelvic and uterine congestion can cause cervical gland and endometrial function to secrete excessive secretion of liquid; at the same time, vaginal mucosal exudation also increased. Such as pelvic tumors, uterine flexion, chronic diseases such as heart failure, tuberculosis, diabetes, anemia and other patients and weak women, often more egg-like secretions or white watery vaginal exudate. In addition, due to mental stimulation, vulvovaginal and cervical secretions can continue to increase, the so-called "mental vaginal discharge." Patients often complain of discomfort such as wet and itchy vulva. The vulva of these patients is obviously damp, even acute or subacute eczema, and the surface of the labia minora is grit-like due to the prominent sebaceous glands. If the above-mentioned secretion hyperthyroidism persists for a long time, the cervical mucosa is impregnated with a corrosive alkaline cervical secretion, which can form erosion, reduce vaginal acidity, cause pathogenic bacteria to multiply, and can also be chronic cervicitis, and pathological leucorrhea.
(B) inflammatory vaginal discharge: vaginal discharge of genital tract disease contains a number of different white blood cells, but more purulent, but the leucorrhea of different pathogens also have different traits.
1. Bacterial vaginosis: The patient stated that the white scent has a fishy smell, the odor is increased during sexual intercourse, and the leucorrhea is a gray or grayish yellow thin liquid, which is homogeneous and often evenly attached to the anterior or vaginal mucosa of the vagina. The surface does not gather in the back. If a small amount of 10% potassium hydroxide solution is added to the leucorrhea specimen, the smell of amine (fishy smell) can be emitted. Microscopic observation: less white blood cells, lack of inflammatory response, and the discovery of clue cells can diagnose bacterial vaginosis.
2. Trichomonas vaginitis: The leucorrhea produced by it is yellow or yellow-green thin pus, sometimes foamy. In addition to the general infrared ray, the vaginal wall often sees spotted or bayberry-like hemorrhagic spots in the cervix and vaginal wall. Taking the vaginal secretion test can confirm that the trichomonas infection rarely exceeds the external cervix, so the neck of the general case has no purulent fluid suppository.
3. Fungal vaginitis: The vaginal discharge is white thick paste or curd, the vaginal wall is generally red, and some areas are covered with white throat-like membrane. Wipe off the white film to see the rough red erosion surface, mostly caused by mold infection caused by vaginitis, taking secretion tests can also be confirmed.
4. senile vaginitis: although there are not many vaginal discharges, but the vaginal wall is generally red, there are more serious burning and itching and other discomfort, severe cases have pus-like irritating vaginal discharge, vaginal burning and tenderness, epithelial shedding Spots, mostly senile vaginitis. If the infection is serious, the secretions are stinky and easy to be diagnosed as malignant tumors should be further examined.
5. Gonorrhea vaginitis: a thick yellow purulent liquid appears in the neck tube, which overflows into the vagina and causes vaginitis. There is no erythema on the vaginal wall. Such as extrusion of the urethra of the paraurethral glands or vestibular glands, often with purulent fluid overflow, mostly caused by gonococcal infection.
6. Chronic cervicitis or cervical erosion: vaginal discharge is mostly mucopurulent, because the increase in cervical secretions often makes patients think that leucorrhea is too much to see a doctor. Thus, about 25% of women complaining of excessive vaginal discharge have cervicitis. At present, only Chlamydia trachomatis and Mycoplasma hominis are known to be the direct cause of common cervicitis, but many patients have not found any microorganisms. Therefore, its cause remains to be studied.
(3) Foreign body irritating vaginal discharge: placement of pessary, vaginal tampon, vaginal diaphragm retention or postpartum vaginal surgery in the vagina will leave the gauze cotton ball in the vagina, or the young girl will put a variety of foreign objects such as pencil head, rubber block, etc. If the vagina is not taken out for a long time, it can cause odorous vaginal discharge.
In addition, there are often purulent and odorous leucorrhea after total hysterectomy or vaginal surgery, which is caused by suture foreign body stimulation and necrosis of the ligation stump. This vaginal discharge often requires the suture ligature and the necrotic tissue to fall off, and the wound will disappear after it has completely healed.
(D) cancerous leucorrhea: bloody watery malignant leucorrhea more common in the late stage of uterine body cancer. The odor of cervical cancer drainage is more special, and the amount is often caused by the vagina vagina. Older women repeatedly expel the stench of pus should think of the possibility of uterine empyema. Tubal cancer often leaves a clear yellow-red liquid, intermittently leaking out of the vagina. Purulent white with odor, color yellow or yellow-green, due to purulent infection or trichomoniasis; so vaginal cleaning examination, vaginal pathogen examination and other means of examination to determine the pathological causes of leucorrhea abnormalities.
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