Non-cancerous diseases of the vagina

The vagina is rarely the site of primary disease. It is more often affected secondary due to the metastatic spread of tumors or infection from adjacent structures. Non-cancerous diseases of the vagina include congenital anomalies of the vagina and inflammation of the vagina (vaginitis).

Congenital anomalies
Congenital anomalies include vaginal aplasia, vaginal septum (vagina septa), double vagina (vagina duplex) or congenital ductal Gartner's duct (ductus longitudinalis Gartneri - arising on the basis of the present persistent embryonic Wolf's duct).

Inflammation of the vagina (vaginitis, colpitis)
Inflammation of the vagina is a relatively common process. It is characterized by the formation of a whitish mucus vaginal discharge (leukorrhea) caused by bacteria, fungi or parasites. Many of these organisms can, by their action, cause the resulting blockage of the mouth of the glands in the transformation zone and thus form small cysts (Nabothi ovules) lined with mucus-forming epithelium. The situation results in an inflammatory infiltration of the transformation zone with other consequences such as a disruption of the balance of the pH environment and a change in the composition of the natural microflora of the vagina.

Inflammation of the cervix (cervicitis)
Cervical inflammation is a very common problem for women. It is associated with mucopurulent to purulent vaginal discharge. Inflammation of the cervix is ​​divided into infectious and non-infectious. During a cytological examination, it is not easy to distinguish these types, because bacteria are always present in the vagina. In the microbial picture of the vagina we find original bacteria and partly vaginal aerobes, anaerobes, streptococci, staphylococci, enterococci and E. coli. In addition, the bacterium Chlamydia trachomatis (diagnosed in up to 40% of cases), Ureaplasma urealyticum, Trichomonas vaginalis, Candida yeast, Neisserii gonorrhoeae, possibly the HSV-2 virus and one or more types of HPV. Many of these organisms are sexually transmitted (STD).

Morfology
Nespecifické záněty děložního čípku mohou být akutní či chronické. Gonokoková infekce způsobuje akutní specifický zánět. Jiné relativně neobvyklé akutní nespecifické záněty, které postihují ženy po porodu, jsou vyvolány stafylokoky nebo streptokoky. Chronické formy zánětu jsou způsobeny nespecifickými bakteriemi, stav označujeme jako tzv. nespecifická cervicitida. Specifické formy zánětu jsou způsobeny specifickými agens, jako např. HSV-2 s typickými herpetickými ulcerativními lézemi, a změny vyvolané Chlamydií trachomatis. Chronická cervicitida není jednotně definovaná, ale vykazuje chronické známky zánětu a epiteliální regeneraci u většiny fertilních žen. Cervikální epitel může být hyperplastický nebo vykazuje reaktivní změny. Tyto změny se vyskytují jednak v dlaždicovém, jednak v cylindrickém epitelu, který může podstoupit dlaždicovou metaplázii a přechod v dlaždicobuněčný epitel.

Clinical picture
Differentiation of microorganisms present in the effluent must be always carried out as accurately as possible. If it is a severe inflammation, reactive changes may resemble carcinomatous lesions, which must be differentiated by colposcopy.

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