[Bacterial vaginosis prophylaxis with a vaginal device releasing chlorhexidine. Preliminary study]. / Prevenzione della vaginosi batterica con un nuovo presidio a base di clorexidina: studio preliminare.

AIM: Assessment of clinical, microbiological and subjective postmenstrual data relating to bacterial vaginosis in patients using a vaginal device releasing chlorhexidine. METHODS: Twenty women with vaginosis signs and symptoms before menstruation were randomized to use vaginal tampons releasing chlorhexidine or neutral tampons (placebo). They were reassessed after menstruation. RESULTS: After treatment there was improvement of symptoms referred, but not significant. Itching was particularly reduced after use of chlorhexidine tampon. Vaginal pH was reduced but not significantly in the treated group. Gram stain microscopy showed absence of normal vaginal microflora in all recruited patients. Frequency detection of Doderlein Lactobacilli and clue cells<20% at control time was significantly increased (70%) in patients exposed to the action of chlorhexidine when compared to placebo group (30%). CONCLUSION: Therapy effectiveness is probably due to local anti-inflammatory and antiseptic chlorhexidine properties. Good patient compliance is an additional result in favor of the product. Data collected in this study are a preliminary result.

[Use of transcutaneous electrical stimulation and biofeedback for the treatment of vulvodynia (vulvar vestibular syndrome): result of 3 years of experience]. / Utilizzo dell'elettro-analgesia transcutanea e del biofeedback nel trattamento della vulvodinia: risultati di 3 anni di esperienza.

AIM: The safety, tolerability and efficacy of physical therapy with biofeedback and trans electrical nerve stimulation (TENS) with intravaginal probe for the treatment of vulvar pain and vulvar discomfort in women with vulvodynia, is evalued in the present study. Vulvodinia is a cronic syndrome of unexplained vulvar pain. Patients typically present with a history of intermittent or continuous, localized, vulvar pain, frequently accompanied by sexual dysfunction like entry dispareunia, burning and hiching localized to the vulvar vestibule. METHODS: From January 2005 and June 2007, a total 145 women diagnosed with vulvodynia presented in the ambulatory for the Diagnosis and Treatment of Vulvar Pain and Pelvic Floor Dysfunction, Clinical ''Santa Famiglia'', Rome. Patients were treated with weekly biofeedback (BFB) and transcutaneous electroanalgesia (TENS), in association with functional electrical stimulation (FES) and home-therapy with stretching exercise of pelvic floor. RESULTS: Hundred forty-five women completed both the biofeedback and trans electric nerve stimulation treatment for a total of 10 application, with a improvement of vulvar pain in 75.8% of cases. CONCLUSION: The pelvic floor relaxation with biofeedback and ellectroanalgesia is safe and effective in improvement in vulvar pain and dyspareunia in women with vulvodynia.

[Vulvovaginal candidiasis: a therapeutic approach]. / Vulvovaginiti da candida. Approccio terapeutico.

The vulvovaginal candidiasis represents, after the bacterial vaginosis, the most frequent cause of vaginal affection. It is esteemed that around the 75% of the women of reproductive age suffered from an episode of vulvovaginitis from candida and 40-45% have had more episodes, of which 10-20% in complicated form. The kind of candida more frequently isolated in the vagina of symptomatic women is the Candida albicans: in the 10-20% of the cases the agent is present in absence of symptomatology, and we can almost consider it a saprophytic. On the other hand, always with greater frequency fetterses can be isolated of not albicans Candida, particularly the tropicalis and the glabrata kind, usually resistant to the common therapies. The classification of the vulvovaginal candidiasis proposed by Sobel, and by now universally approved, foresees 2 clinical forms of vulvovaginal candidiasis, the vulvovaginitis from not complicated candida (VVC) and the vulvovaginitis from complicated candida (VVCC): different for pathogenesis, elapsed clinical, symptomatology and frequency. They have to be considered in the substance 2 different nosological entities, and they request a diagnostic approach and a well different therapeutic appointment. In this study we will shortly reassume the principal characteristics of it, detaining us on the most recent acquisitions in theme of therapy. The base medicines of ac. boric, to parity of effectiveness, seem to introduce the most contained cost and the best compliance, and they offer him to a complementary use or, in some cases, alternative to the more you consolidate therapies with azoli.