Infections of the Female Lower Genital Tract

Abstract

Infekcije donjeg dijela genitalnog trakta žene i simptomi koje one izazivaju (pojačani iscjedak, svrbež i žarenje ili peckanje) spadaju u najčešće ginekološke probleme i najčešći su razlozi posjeta ginekologu. U infekcije donjeg dijela genitalnog trakta žene ubrajamo cervicitis, vaginitis ili colpitis i vulvitis. Najvažnije infekcije cerviksa danas su klamidijski cervicitis kao ishodišna točka zdjelične upalne bolesti s mogućom posljedičnom neplodnošću te infekcija onkogenim tipovima HPV-a kao nedvojbenim etiološkim čimbenikom karcinoma cerviksa. Ove su infekcije zbog svog izrazitog značenja obrađene u zasebnim poglavljima, a u ovom su radu opisane infekcije rodnice i stidnice koje zajedničkim imenom opisujemo kao vulvovaginitis. Tri najčešće su: infekcija kandidom albikans, trihomonasom vaginalis (TV) i gardnerelom vaginalis (GV). Ove se infekcije mogu dobiti spolnim kontaktom, ali ne nužno. Candida albicans je uvjetno patogena i u 20–25% žena bez simptoma nađe se u rodnici kao saprofi t. Umnoži se i uzrokuje upalu u slučajevima slabosti obrambenog sustava rodnice, odnosno povišenja pH rodnice. Porast pH rodnice je nuždan preduvjet i za infekciju TV-om i GV-om.Infections of the female lower genital tract and the related symptoms (increased discharge, itching, burning) belong to the most common gynecological problems, and they are the most frequent reason to visit a gynecologist. Lower genital tract infections include cervicitis, vaginitis or colpitis, and vulvitis. Nowadays, the most important cervical infections are chlamydial cervicitis, as the primary reason for pelvic infl ammatory disease with possible infertility, and infection with oncogenic types of HPV, being an undoubted ethiologic factor for cervical carcinoma. Due to their importance, these infections are elaborated in separate chapters. This article describes vaginal and vulval infections, i.e. vulvovaginitis. The three most common are Candida albicans, Trichomonas vaginalis (TV) and Gardnerella vaginalis (GV) infections. These infections can be sexually transmitted, but not necessarily. Candida albicans may be pathogen and can be found as saprophyte in the vagina of about 20-25% women without any symptoms. It multiplies and causes infl ammation in the case of the impaired vaginal immune system or increased pH. An increase in vaginal pH is also a prerequisite for TV and GV infections

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