Tuesday, July 28, 2015

Pathology of the Genital sexuality and reproduction (1) | Pathologies and health.

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Diseases and conditions


  • Male reproductive system
  • Penis inflammation
  • Malformations of the penis
  • Penile cancer
  • Epididymitis
  • Testicular retention
  • Testicular torsion
  • Hydrocele
  • Varicocele
  • Testicular tumours
  • Prostatitis
  • Prostate hypertrophy
  • Prostate cancer
  • Prostate stones
  • General information and inflammatory diseases
  • Leukoplakia of vulva
  • Vaginitis
  • Vaginal lesions

MALE REPRODUCTIVE SYSTEM

What is the male reproductive system?

The male reproductive system is formed mainly from these organs: testis and epididymis, contained in the scrotum, vas deferens, prostate, seminal vesicles, urethra and penis.

What is the function of the penis?

in The urine output);
b) the emission of semen containing sperm.

What is the structure of the penis?

The penis consists mainly of three tubular bodies (corpora cavernosa), made up of erectile tissue.
Two of these are located in the back-side of the penis, while the third, located in the ventral part, is crossed by the urethra, which carries urine and semen. When the three structures, of spongy tissue, fill with blood, they become turgid giving rise to erection.
In relaxed state, the end of the penis, called the Glans, is covered by a fold of skin, the foreskin.

PENIS INFLAMMATION

What are inflammatory processes that can affect the penis?

Inflammatory processes affecting the penis are essentially Balanitis (inflammation of the Glans) and posthitis (inflammation of the foreskin). Almost always these two processes are associated.

What are determined?

By germs resulting from poor sanitation, local irritation caused by medicines, from sexual intercourse infectious.

How to manifest?

With redness and possibly superficial erosions.

How to treat?

With antiseptic solutions.

MALFORMATIONS OF THE PENIS

What can suffer malformations in the penis?

The penis can be home to anatomical abnormalities related to the outlet of the urethra (hypospadias and epispadias).
Two other malformations are phimosis and parafimo you, that concerning relations between the foreskin and the glans.

PENILE CANCER

Are common cancers of the penis?

No, their impact is modest. The most frightening cancer is cancer of the penis.

Where is usually localized cancer of the penis?

In the area of the Glans, which takes on the appearance of a nodular mass or a deep ulceration.

At what age is more frequently?

In adulthood and old age. Rarely affects young people.

How is?

Making a collection of tissue and by microscopic examination.

With what other disease can be confused with cancer of the penis?

With an injury, for example a venereal Chancre.

There is relationship between cancer of the penis and sexual activity?

No.

How is it treated?

The best treatment is amputation of part or all of the penis, along with removal of the lymph glands in the groin where the lymphatic vessels of the penis.

In the case of penile amputation, as is urination?

To enable this function is left a stump on site.

Penile cancer can be transmitted through intercourse?

No.

What is the scrotum or scrotal bag?

It is a muscular bag, semielastica, covered with membrane and located under the penis. Is divided by a septum in two lodges, each of which contains a testicle with his the epididymis and the vas deferens.

As a testicle and what is its function?

The testis is composed of many tiny tubules, glandular called seminiferous tubules: it is here that produce sperm. The testicle also contains interstitial cells responsible for production of the male sex hormone, testosterone. Testicular function is to produce semen and then transported along the vas deferens through the spermatic cord, up to the seminal vesicles.
From vesicles, the sperm is ejaculated during intercourse.

Treatment of traumatic injury of the testis?

Most injuries, although extremely painful, are not serious and usually heal spontaneously. If the testicle was seriously crushed or damaged, you must remove it.

A testicle injury can cause infertility?

A seriously injured testicle may lose the ability to transmit sperm, but if the other testicle is normal, you will not have infertility.

Injuries are very common in both testicles?

No. Injuries to both testicles are unusual.

EPIDIDYMITIS

What is the epididymis?

Is an organ, immediately adjacent to the testicle and linked to it, consisting of countless canaliculi containing the sperm produced in the testicles.

Are common infections of the epididymis (into epididymitis)?

Yes. In the past, when the gonorroiche infection control was poor, were numerous cases of these infections. Today, the antibiotic therapy has much reduced the incidence of into epididymitis.

In addition to gonorrhea, what are the other causes of infection of the epididymis?

Into epididymitis sometimes occur after a prostate operation, or have the complication of a cistoscopico examination. They are also often a consequence of vigorous Prostate Massage, they do get off by force the infected material from the prostate itself along the vas deferens that connects epididymis.

How can I prevent epididymitis?

During the talks, the best system of prevention is to tie and cut the vas deferens (the tube that connects the epididymis to the seminal vesicles) before carrying out this operation on the prostate.
Medical syndromes, such as prostatitis, the massage should be performed with extreme delicacy and the patient should urinate after treatment.

What are the harmful effects of epididymitis?

In addition to be very painful, with swelling, fever and extreme tenderness, testicular epididymitis is often followed by sterility, if both parties are affected.

As untreated acute epididymitis?

The therapy consists of bed rest, plenty of liquids in the Administration, in the application of ice on the affected part and administration of antibiotics.

How long is the acute phase?

Five to seven days, the swelling may persist for several weeks.

It is sometimes necessary to resort to surgery?

Yes, when you have an abscess formation that requires a drainage of pus.

Acute epididymitis can sometimes become chronic?

Yes. There are cases when the infection recedes and seemingly reappears from time to time.

What is the treatment for chronic or recurrent epididymitis?

Surgical excision of the epididymis, often in day hospital.

Epididymitis can be caused by tuberculosis?

Yes, there is a tuberculous epididymitis.

TESTICULAR RETENTION

What is a testis considered?

During development of the embryo the testicles are located in the abdominal cavity; as the embryo grows, the testes descend and, at the time of birth, reached the scrotal bags.
In case of missing or incomplete you have the so-called retention of testicles (cryptorchidism), which can occur for one or both testicles.

If one of the testicles at birth is considered, this malformation will be permanent?

Not necessarily, there are testicles descend during the first year of life or even during adolescence.

You can find a medical therapy, cause the testicle descent into scrotal bag?

Yes; hormones injections facilitate sometimes testicular development, causing the descent into the scrotal bag.

Testicular retention is often associated with cases of inguinal hernia?

Yes.

What is the best time to trade?

The work must be carried out within three years of age. Wait over 5 years can result in the inability of the testis to produce sperm throughout their lives. If maintained for a long time at the temperature of the abdominal cavity (37°), germ cells eventually atrophy.

And surgery is necessary in any case?

No, if the testicle drops further to hormone therapy.

Operations for cases of testicular retention are serious?

No, no more serious than a hernia operation.

What is the period of hospitalisation required for such actions?

Five to seven days.

How is the procedure?

Methods for practicing such intervention (orchiopessi) are varied. Typically practicing in the groin incision length varying from seven to twelve centimeters, then expose the testis and spermatic cord through the wound. The cord is stretched severing all excess fibrous tissue and any adhesions around it. The testicle is then sent down into the scrotal SAC which is anchored in its place with silk sutures.
The orchiopessi can be accomplished even with laparoscopic surgical techniques.

The Undescended Testicles are functioning normally, once you get down in the normal position?

Not always, because sometimes the Undescended Testicles are tiny and ipofunzionanti.
However, even if they cannot produce sperm, fertilizing them continue to secrete the male hormone, thus maintaining the masculine characteristics of the individual.

You will get good results with these operations?

Yes, in most cases.


TESTICULAR TORSION

What is a testicular torsion?

In children and young adults, it is possible that the testis undergoes a rotation within the scrotal cavity, causing torsion of the spermatic cord. This usually depends on the absence of normal means testis fixation to the scrotum wall.

What are the symptoms of a testicular torsion?

Sharp sudden pain, tenderness, swelling pressure in the testicle region and along the cord and testis to lift or in the inguinal Canal.
The pain increases while lifting your scrotum (This differentiates from a twist epididymitis) and may result from nausea and vomiting. When you check the twisting interrupts the blood supply to the testicle and if not treated promptly, there is danger that arises a gangrene.

What is therapy?

Immediate surgery to straighten the cord. To save the testicle, the work must be carried out within six to eight hours from the onset of
twist. If you currently operate the gangrene has already arisen, the testicle must be removed.

Testicular torsion is serious?

It is serious because it can lead to the loss of a testicle, but not life-threatening. Normally you need a shelter for a few days in the hospital.

HYDROCELE

What is a Hydrocele?

A collection of liquid, clear, color within the serous SAC surrounding the testis. Sometimes occurs also in the spermatic cord.

What does it depend?

The cause is unknown.

The presence of a Hydrocele testis damage?

No.

How do we cure it?

In infants the Hydrocele tends to disappear spontaneously, in older children and adults we recommend surgery.

What is the surgical therapy for Hydrocele?

Through a small incision in the groin, it removes all or part of the sack of Hydrocele; If partial excision, turns the remnants and suture behind the testis.

These are serious operations?

No. Are considered minor surgery, executables in day hospital.

What gives the surgical therapy?

Healing.

There is a non-surgical therapy for Hydrocele?

Yes. You can remove the fluid that is inside the bag through a needle and then inject a solution that causes sclerosis of the walls of the bag itself.
This therapy does not give results as good as surgery and sometimes gives rise to infection.
Cases of hernia and Hydrocele's are often associated with? Yes, and in this case it is necessary to correct them both surgically.

VARICOCELE

What is a varicocele?

A varicocele is a varicose of veins accompanying the spermatic cord; in particular, internal spermatic vein.

What is causing the varicocele?

It is thought to be a congenital malformation. In 90% of cases occurs on the left side, because only this way the spermatic vein you enter into the Renal vein forming a right angle, which promotes blood stagnation.

How is it diagnosed?

Rubbing the spermatic cord, the doctor warns him to feel like a "bag of worms".

What causes disorders varicocele?

It is usually asymptomatic, although it may cause a feeling of tension and a vague sense of unease to the scrotum.

How do we cure it?

In most cases you do not need any treatment. If the varicocele reaches considerable dimensions, then surgical intervention, with the removal of some of the dilated veins.

Are serious interventions for varicocele?

No. You run through preference an incision in the groin. You can also affect the scrotum, but would more likely an atrophy of the testis. Sometimes you can also employ the technique of spermatic vein embolization.

Medical treatment exists for cases of varicocele?

Yes. You can wear a Jockstrap is adequate to support the scrotum.

Varicocele affects fertility and sexual potency?

The varicocele has no influence on sexual potency, while dan can damage the testicle up to prevent the formation of sperm. To cause infertility, however, must be very serious.

TESTICULAR TUMOURS

What is the incidence of tumours of the testis?

Are the majority of malignant neoplasms of male under 30 years.

These tumors occur more frequently in the testes and abnormal development in those considered?

Yes.

When they appear most frequently?

Under 30 years, or after 60 years.

Testicular tumors are all malignant?

No, but malignant forms are more frequent than benign. Today, however, it is possible to treat them successfully in a high percentage of cases.

How do I find the presence of a tumor of the testis?

By the appearance of a slow and painless enlargement of the structure.

What is their cause?

You do not know.

What is the treatment for these tumors?

Proceed to surgical excision just made the diagnosis and radical proceedings where both neoplasia malignant nature; This also involves the excision of inguinal lymph glands. Sometimes i remove abdominal lymph nodes up to the level of the kidneys.

Röntgenterapia is useful to treat tumors of the testis?

Yes. After surgery is often used to radiation therapy to destroy remaining cancer cells and prevent the spread of the tumor.

It is useful to medical therapy (chemotherapy)?

Yes. There are very effective medications to destroy some testicular malignant tumors and their metastases.

Where is located the prostate and what is its function?

It is located near and around the outlet of the urinary bladder and the initial section of the urethra. Is the size of a chestnut and its main function is to secrete a liquid (prostate juice) which is an important constituent of that seminal fluid.

What are the main diseases affecting the prostate?

in) infections (prostatitis);
b) enlargement of the gland associated with the aging process (benign prostatic adenoma hypertrophy);
c) cancer.

How is a prostate exam?

in) due to its proximity to the rectum, the doctor may examine the conditions of the gland with a digital scan of the rectum;
b) you can get more information with cystoscopy.

Which path usually follows the infection to reach the prostate gland?

at) dates directly from outside, along the urethra;
b) less often is caused by bacteria that come to the gland from the blood stream.

PROSTATITIS

What are the bacteria more easily cause infection of the prostate gland?

Gonococcus, pathogen of gonorrhea, and other bacteria such as staphylococci, streptococci and Escherichia coli. An important role is now attributed to infection from this infection Chlamydia trachomatis and ureaplasma.

What are the symptoms of prostate infection?

Fever, pain in the sacral region, frequent urination, pain during defecation, urine infected with blood.

What are the recommended treatments for prostate infections?

The recommended treatments for prostate infections are as follows:
bed rest);
b) administration of appropriate antibiotics;
c) abundant fluid administration;
d) Elimination of alcohol and spicy foods;
and administration of sedatives) to relieve tension and pain;
f) abstinence from sexual relations;
g) hot sitz baths.

You have to resort to surgery to prostate infections?

Generally no, unless it forms an abscess. In such a case can become essential the need of his incision.

What is Chronic prostatitis?

A persistent inflammation and light manifested with pains in the regio ne sacral, impaired urination and sexual intercourse and sometimes a morning secretion from the penis.

Is curable?

In most cases, Yes, although the most persistent and chronic infections tend to reappear from time to time.

How do we cure it?

in) With antibiotics;
b) with periodic gentle Prostate Massage;
c) with hot baths;
d) with rectal Diathermy.

PROSTATE HYPERTROPHY

What is BPH?

An alteration for which gland parts undergo a slow enlarged over the years. This type of hypertrophy is never malignant.

It is natural that in all men, with age, there is an enlarged prostate?

Yes. Starting from 40-45 years, in almost all men will have an enlarged prostate slow.

Prostate enlargement gives rise to troublesome symptoms in all people?

No. Most men continue to live without experiencing difficulties.
It must be remembered that this phenomenon accompanies normal aging process.

How can you tell if prostate enlargement requires medical supervision?

According to normal urinary function disorders.

Because prostate enlargement impedes urination?

A prostate that expands compresses the urethra to the bladder outlet.

What could be the possible consequence of an enlarged prostate?

Can cause a sudden inability to pass urine, known as acute retention of urine.

There is a relationship between the frequency of sexual activity and prostate hypertrophy?

No.

It is necessary that all men subject to prostate hypertrophy undergo surgery?

No. Only one man out of four manifested any symptoms; of these, only one out of four will have to undergo surgery.

There are medical treatments that give satisfactory results for the treatment of this disorder?

Yes, there are drugs, some of which are antagonists of male hormones (anti-androgens; one of the newest is finestaride), and others of a different nature (falitici), which can reduce noise caused by prostatic hypertrophy. If hypertrophy is associated with an infection, the latter control may reduce symptoms.

What are the common symptoms?

a) frequent urination during the day;
b) need to urinate many times during the night;
c) difficulty in initiating the urinary flow;
d) decrease the size and strength of the urine stream;
and drip) before and after urination;
f) burning sensation during urination;
g) any inability to urinate (acute retention);
h) presence of blood in the urine.
The symptoms will be much more pronounced the greater the gland hypertrophy and subsequent urethral obstruction.

What are the effects of prostate hypertrophy on the bladder and kidneys?

Because the main function of the bladder is to expel urine, it is clear that the obstacle represented by the enlarged prostate bladder requires more effort to drain the urine. It follows that the bladder wall becomes thicker, more muscular and heavier. Eventually, the bladder cannot empty completely at each urination. The amount of this residual urine continues to increase and ends up creating abnormal pressure on ureters, toward the kidneys. The expansion will add a ureters of renal function failure and this reflects the general health of the patient. Leaving him progress without being taken care of, this process can lead to a total kidney failure, resulting in uremia and death.

What are the damage that one incomplete emptying of the bladder causes the patient?

It follows a stagnation of urine, leading to infection, which can extend to the ureter and kidney. Is likely to end in the bladder will form calculations following the prolonged stagnation of urine. The work and increased pressure on the bladder can cause local swelling, called diverticula. These are bag-shaped protrusions in the bladder wall, which may contain stagnant urine and within them you can also the formation of stones.

What are the interventions which occurs in cases of prostate hypertrophy?

Prostate hypertrophy we resort to the following actions to destroy excess prostate tissue:
surgical removal) by Transurethral endoscopic (TUR-P) generally in spinal anesthesia;
b) endoscopic Transurethral elettrovaporizzazione of prostate tissue, by means of
an electrocautery;
c) TULIP method (Transuretral Laser-Induced Prostatectomy) who uses in ane stesia regionale a Transurethral ultrasound probe equipped with laser, which induce coagulative necrosis of tissue;
d) method, which causes the ambulatory electro-coagulation of prostate tissue through a needle through a catheter inserted frames into the urethra and connected to a generator of electric current;
) and transurethral microwave thermotherapy Necrotizing prostatic tissue using hyperthermia caused by microwaves;
f) or transrectal ultrasound: extracorporeal prostatic tissue is necrotizzato using an applicator of ultrasound in ultrasound assistance;
suprapubic Prostatectomy g): for such intervention is practised an incision along the midline of the abdomen and bladder opens. Through the bladder is open removes the prostate, in one or two stages. Then in the bladder for a few days, you place a rubber tube (catheter); When this is removed, the normal urinary flow flowing through the urethra as it did prior to surgery (figs. 7 and 8);
h) retropubic Prostatectomy: in this posting the incision is made in the lower abdomen, directly above the prostate, which is removed without opening the urinary bladder.

On what bases the choice of the procedure?

in prostate size);
b) on presence or absence of infection or stones in the bladder;
c) on presence or absence of bladder diverticula;
d) about the condition of renal function;
and health) General of the patient.

What is the process to be preferred?

For every action there are well-defined indications, which depend on each individual case.

What is a prostate operation in "two steps"?

In some cases, because of poor general health of the patient or of insufficient kidney function, infection, calculations or associated diseases, such as heart conditions or high blood pressure – is too dangerous to remove the gland directly; You then need a preliminary urine drainage period; is this the first phase (cistotomia) of the prostate operation.
The operation is to open surgery for bladder
allow drainage through the abdominal wall.
After a reasonable amount of time, when renal function is back to normal, the infection has disappeared and were taken off any present calculations in the bladder, the surgeon removes the prostate by inserting your finger into the bladder and by pulling out the gland. This is the second phase of the operation.

How much time should elapse between the two phases of the operation?

From one week to indefinitely, depending on the improvement of the general condition of the patient.

Performing a radical prostatectomy remove the whole prostate?

Actually, no. Usually you leave a border of glandular tissue.

What is cistotomia?

It is the first phase of a prostate operation in two stages, with which, through an abdominal incision, you insert a rubber tube into the bladder.

It may sometimes be necessary to resort to emergency surgery to operate the prostate?

No. Even in the situation more dramatic, when complete blockage occurs at passing urine, no need for emergency surgery. We resort to the emptying of the bladder with a suprapubic puncture leaving in place a drain that allows the discharge of urine formed later and only later the prostate is removed.

Prostate operations are serious?

Yes, but thanks to current knowledge, the use of better surgical techniques and the aid of antibiotics, the vast majority of patients who undergo Prostate Surgery can expect definitely safe and complete healing.

After surgery, the prostate is bloat again causing acute retention of urine?

Sometimes, after a Transurethral resection through the cystoscope, the prostatic tissue from growing back and cause obstruction.

Sex life affected by surgery?

The most serious possible consequence is retrograde ejaculation, i.e. the emission of semen into the bladder instead of the urethra, resulting in inability to conceive naturally.

PROSTATE CANCER

What is the incidence of prostate cancer?

It is generally accepted that about 10-20% of men over the age of fifty years is suffering from prostate cancer, and it becomes more common with advancing age, so much so that nearly all those who reach the ninety years have prostate tissue that could be called malignant.
The process is slow, so these men usually die because of some other disease.

At what age is more likely to be manifested prostate cancer?

From sixty to eighty years.

All cases of cancer are characterized by symptoms?

No. It turned out that in many individuals the tumor may remain dormant indefinitely, without ever causing symptoms or metastasis. (U.s. Statistics speak of two out of three cases of prostate cancer detected at autopsy on dead from other causes that they didn't give any symptom or discomfort.)

What are the symptoms?

Unfortunately, as mentioned, the initial cancer symptoms are few, although there are, and manifest themselves only when the disease is already at an advanced stage. The only system for early detection of prostate cancer is to examine the gland at regular intervals. Men who have passed fifty years should undergo digital rectal examination annually, which allows palpation of the prostate.

How can you diagnose prostate cancer?

a rectal examination), prostate cancer is very irregular and a benign hypertrophy;
b) assay of PSA (Prostate Specific Antigen) measures the amount of a specific antigen produced by prostate cells. His rise shows – although not with absolute certainty – the likely presence of a tumor or prostatic hypertrophy. Another marker to be assayed in plasma, cancer is suspected, the enzyme is PAP (prostatic acid phosphatase);
transrectal ultrasonography c) defines the structure and size of any suspected areas;
d), aspirate needle inserted through the rectum or perineum, allows the removal of a tissue sample on which you run the microscopic examination; This makes it possible to identify with certainty the nature of cells.

You can apply a medical therapy to treat prostate cancer?

Yes. You can get some symptomatic relief by administering drugs, nonsteroidal antiandrogens that are blocking the stimulatory effect of natural hormones on the prostate. You can also bind drugs competitive with the male hormone testosterone that inhibit the testicular secretion. In some cases, tumor growth is delayed by suppression of male hormone secretion due to antagonistic action of these hormones.

Benign prostate hypertrophy can degenerate into cancer?

Rarely. There is no evidence of the transition from adenoma tumour.

How long does the effectiveness of female sex hormones in delaying the progression of malignant process?

Although this form of therapy does not lead to healing, can reverse the cancer education and extend the life of many years.

Radiation therapy is a useful treatment?

Yes, especially in the early stages and in cases without metastasis, this therapy produces nearly the same results of surgery. Lately it has successfully used a new type of three-dimensional Conformal radiotherapy, called.
Computerized process you send high-energy rays that follow with absolute accuracy the boundaries of the target, so as not to damage the surrounding tissue. This method therefore allows the preservation of the gland and cancels or reduces the risk of incontinence and impotence that follows surgery.

There are radioactive materials useful for the treatment of prostate cancer?

Yes. In some cases, promising results were obtained by injecting radioactive iodine directly in the gland. This type of treatment is useful for very small tumors (less than 5 cm in diameter).

What is the surgical therapy for prostate cancer?

In early cases), treatment consists of removal of the entire gland (radical prostatectomy);
b) in more advanced cases, you also remove the testicles.

The surgical removal of the prostate gland cause impotence?

The municipality no prostatectomy, while radical surgery usually makes you impotent.
Recently, however, came into use for radical prostatectomy a new surgical technique, called "Nerve Sparing", sparing the nerves erigentes, and maintains sexual potency.

The interventions on the prostate can cause inability to control urination (incontinence)?

Largely breaks down on surgery prostate is often followed by temporary loss of control. In most cases, however, this results in a period of time that can vary from several weeks to a few months.

Loss of control over urination after a prostatectomy for benign hypertrophy municipality?

Very rarely, and only for a few weeks.

How long does it stay in the hospital?

For operations in a single step, from twelve to fourteen days. For two-stage operation, three to four weeks.

We recommend the assistance of specialized nurses after prostate surgery?

Yes. For a period of three or four days.

Using blood transfusions during surgery?

Yes, although today for this type of operation hemorrhage cases are much less frequent than before.

What is the duration of convalescence after a prostate operation?

Four to five weeks.

Prostate hypertrophy may occur again after excision?

Only in very rare cases, when the gland has been removed completely, you can verify a regrowth of glandular tissue; in that case we shall take a new one, to remove the tissues regrown.

PROSTATE STONES

You can stone formation in the prostate?

Yes, it is not unusual to find, especially in glands in which there are bacterial infections in place for several years.

What is therapy for prostate stones?

It operates only in cases where symptoms similar to those caused by hypertrophy.

What type of anesthesia is used usually for a prostate operation?

Depends on the patient's general condition. In some cases we use lumbar anesthesia; in others, for inhalation narcosis.

It is normal practice to isolate the vas deferens which starts from the testicle to Prostatectomy?

Yes, this is done as a precautionary measure to prevent inflammation of the epididymis, adjacent to the testis.

After a prostate operation, how does urination?

Urine Drainage takes place by means of a rubber catheter into the urethra.

How long usually before the function of urination is normalize?

A period of time between eight and ten days.

GENERAL INFORMATION AND INFLAMMATORY DISEASES

What is your vulva?

Is the region surrounding access to the vagina and is formed from clitoris, from large and small lips, from the external orifice of the urethra, the Bartholin glands, from the vestibule of vagina and hymen.

What is the clitoris and what is its function?

Is a small cylindrical structure, located at the top of the vagina, where the lips of the vulva. The clitoris is a focal point of orgasm and has an important part in sexual relations. Its fabric is very similar to that of the male penis.

What is the hymen?

Is a fold of mucous membrane that lines the inner surface of the vagina.
It closes, in part or completely, the vaginal orifice and tears, but not necessarily, at first intercourse.

The structure of the hymen can vary?

Yes. In most girls the hymen has perforations that allow the release of menstrual flow. In rare cases where these perforations are absent and should affect the hymen surgically.

What is a imenotomia?

Surgical incision of Hymen to stretch the vaginal orifice.

When do you run?

a) in the case of imperforate hymen;
b) in cases where an annular hymen, thickened or rigid, makes it difficult or impossible sexual intercourse.

The imenotomia is an invasive surgery?

No. Is a very simple operation that is performed in the hospital through a slight anaesthesia.

It is always necessary to resort to imenotomia in case of difficult relations?

No, the most painful intercourse is due to vaginal spasms, caused by tension and fear of sexual intercourse. With proper sex education can overcome many fears and thus control the spasm.

When you can have sex, after a imenotomia?

After three or four weeks.

Why arise painful intercourse in women who have had normal relations?

a) painful intercourse (dyspareunia), when after many years of married life, is often due to an emotional problem;
b) more rarely the cause of painful intercourse is of organic nature, such as an inflammation of the vagina and the pelvic organs.

What are the Bartholin glands?

Two structures are ovoid, located at the side wall of the vestibule of the vagina, at the lower end of the lips, one on each side: via a narrow excretory duct flow into the vaginal vestibule.

What is their function?

Secrete a mucous substance which acts as a lubricant to the inner surface of the lips of the vagina.

What is a Bartholin's cyst?

Is a formation which occurs due to a glandular duct obstruction.
Its size varies from that of a pea to that of a plum.

What are the usual symptoms of a Bartholin's cyst?

in walking or Pain) during intercourse;
b) swelling of the lips of the vulva.

What is the treatment for Bartholin's cyst?

Surgical excision or incision of cysts, with construction of a new orifice (marsupialization).

Hospitalization is required for this type of operation?

Yes, three to five days.

What is a Bartholin's gland abscess?

A gland infection caused by bacteria, with pockets of purulent material.

How do you treat the abscess?

in) with antibiotics, warm compresses and analgesics to relieve pain;
b) in more severe cases, you need to hack and drain the abscess, or create a new permanent orifice by a marsupialization.

You need hospitalisation for the incision and drainage of a Bartholin gland abscess?

Yes. The surgery is performed under general anesthesia and requires a shelter for a few days. In some cases the incision and drainage are performed on an outpatient basis, under local anesthesia.

There are other forms of therapy for the Bartholin gland abscess?

Yes. After incision and drainage is sometimes practice electrocautery with which he destroys the inner membrane of the abscess. In certain cases you can also use the laser.

What is Vulvitis?

Is an inflammation or infection of the vulva. Very often is associated with a vaginal infection (vaginitis).

LEUKOPLAKIA OF VULVA

What is the Leukoplakia of vulva?

It is a whitish and Pearly stain forming on vulvar mucosa.

What are the causes of Leukoplakia of vulva?

You do not know the exact cause, but is thought to be linked to a decrease in the secretion of ovarian hormone.

Who is more susceptible to Leukoplakia?

Women who have reached menopause.

Leukoplakia of vulva is a common disease?

No, it is relatively rare.

How does it occur?

The most prominent symptom is a sensation of itching. The scratching often leads to a secondary infection by bacteria.

Leukoplakia is a precancerous disease?

In the long run, Yes. The process is still very slow and takes years. It therefore has all the time to remove the Leukoplakia. In any case, if a Leukoplakia, it is always advisable to perform a biopsy to ascertain that there are no atypical cells.

How do I delete the Leukoplakia?

Surgically removing it when.

Leukoplakia can resolve spontaneously?

No; Leukoplakia cannot resolve spontaneously. There is not a medical treatment, unless it is to fight infection and itching that often are associated with Leukoplakia.

Cancer of the vulva can arise even in the absence of Leukoplakia?

Yes.

You can prevent cancer of the vulva, Leukoplakia when there?

In the absence of Leukoplakia prevention is virtually impossible. However being an outer region, you can notice very early onset of the slightest alteration locally. In this case, turning immediately to your doctor, you have the option, if it were an initial cancer, to effectively remedy.

What is therapy for vulvar cancer?

The vulvectomy, which consists of surgical excision of all structures of the vulva.

You can heal a vulvar cancer?

Yes, if the shape is starting. In 70% of cases the survival is more than 5 years.

How to diagnose a case of cancer of the vulva?

By: biopsy you surgically removes a piece of tissue and subjected to microscopic examination.

What is the incidence of vulvar cancer?

It is estimated that vulvar cancer accounts for 4% of all cancers that affect the female organs.

Who is more likely to contract cancer of the vulva?

Women between sixty and seventy years.

Vulvectomy is the grave?

Yes, but in almost all cases is exceeded.

What is the vagina?

Is a muscle-membranous, with a length of eight to ten centimetres, which extends from the orifice of the vagina and the cervix. It is lined by a mucous membrane that forms several folds and is very elastic.

What are its functions?

in) is the feminine form of copulation;
b) is the receptacle for the male sperm;
c) is conducted from which comes the menstrual flow;
d) is the conduit through which passes the newborn at birth (birth canal).

Women should do regular vaginal irrigations?

No, only external washing: the real running irrigation prescription only and in the event of illness.

Because irrigation are not recommended as hygienic practice?

Because they can carry the germs present in the vulvar area; because it can irritate a healthy vaginal mucosa, because they diminish the normal acidity of the vagina.

The acidity of the vagina is useful?

Yes, because it opposes the development of pathogenic micro-organisms and thus protects the vaginal mucosa from infection.

Irrigation can be done in the case of vaginal discharge?

Only if they are prescribed by a gynecologist.

Irrigation can be done after sexual intercourse and at the end of menstruation?

No, just an accurate external cleaning.

The healthy vagina contains bacteria?

Yes, but it's beneficial bacteria, which maintain the correct level of acidity in the vagina without causing any disease. For this we recommend simply washing the external irrigation.

What are the main problems that may affect the vagina?

a) Inflammation (vaginitis);
b) growths.

VAGINITIS

What caused the vaginitis

bacteria) such as Staphylococcus, Streptococcus, gonococcus;
b) from parasites such as Trichomonas;
c) by fungi such as Candida;
d) from deterioration due to age (vaginitis senile);
s) antibiotic treatment made previously, that destroying the vaginal bacteria useful favoured the settling of microorganisms (particularly parasites and fungi).

There are conditions that favour the onset of vaginitis?

Yes, those that decrease vaginal acidity; This allows microorganisms to grow. These conditions are:
menstruation);
b) pregnancy and childbirth;
c) repeated watering.

There are non-infectious vaginitis?

Yes; are related to the use of deodorants, rubbers, synthetic fiber underwear, tampons, tight jeans, all conditions that can cause inflammation.

What is the most severe form of vaginitis?

sexual transmission.)

What are the symptoms of vaginitis?

The symptoms of vaginitis by parasites, bacteria and fungi are:
itching of the vulva);
b) vaginal discharge;
c) painful sexual intercourse;
d) frequent and painful urination;
and) swelling of the external genitalia.

What are the symptoms of senile vaginitis?

Itching and vaginal discharge, but very poor. Sometimes even painful sexual intercourse and, rarely, bleeding.

Which you perform analysis to determine the type of vaginitis?

You perform a vaginal swab, i.e. with a swab is taken a small amount of vaginal discharge and subjected to microscopic examination and culture. This shows up if the infection is caused by Candida, Trichomonas or bacteria.

What is the treatment for cases of vaginitis?

a) fungal infections are treated with various medications administered success antifungals, either orally with both local applications into the vagina;
b bacterial vaginitis) is treated with antibiotics administered orally or applied topically;
c) senile vaginitis treated with local application of female hormones.

Treating fungal vaginitis with administration of oral medication gives good results?

Yes, excellent. In most cases, treatment continued for a period of ten days, leads to healing.

Vaginitis has tendency to recur?

Yes. Many types of vaginitis have this tendency.

What time is greater than this danger?

Immediately before or after a menstrual period, and during the last months of pregnancy.
This suggests that hormonal changes are a very important part in fostering the vaginitis.

Vaginal infections can be transmitted to humans?

Yes, especially those by Trichomonas and Candida (Besides, of course, gonorrhea). Even in vaginitis by parasites and fungi infection transmitted to humans during sexual intercourse, but in most cases without causing any trouble. Precisely this fact is dangerous, because the man, thinking healthy, reinfetta his partner during sexual intercourse later. It is therefore necessary, in the case of vaginitis or fungal parasites, treat the sick partner.

As you perform the treatment in sick partner?

With specific products, orally. No local treatment instead.
It is also advisable, during the period (about 10 days), abstain from sex or use condoms.

VAGINAL LESIONS

From what can be affected neoformations vagina?

Ernie bodies) (cystocele and rectocele);
b) polyps and generally benign tumors (fibroids).

How to treat benign Neoplasms of the vagina?

All forms mentioned can be cured with a simple surgical excision.

What is a cystocele?

Is an extroversion of bladder wall, which due to the proximity goes into the vagina. There are various degrees of cystocele, by a slight bump up to a lowering total; in the latter case, almost all of the bladder protrudes through the vaginal orifice.

What is a rectocele?

Is a hernia of the rectal wall into the vagina. Also in this case the size of the hernia can vary considerably.

What are caused cystocele and rectocele?

The same type of injury that causes prolapse (see below, uterus), namely the relaxation of ligaments support following childbirth.

What is the frequency of cases of cystocele, rectocele and prolapse?

Events are fairly common. The incidence is higher in women who had more children and those who have spent forty years. In both cases, the supporting ligaments to weaken and begin to grow and promote the ptosis of viscera.

Cystocele, rectocele and prolapse tend to occur at the same time?

Yes, in many cases. The cases are possible without prolapse, cystocele or rectocele and vice versa.

How can you tell the cystocele?

The most common symptoms are frequent urination, urine loss coughing sneezing, laughing or making physical effort. You can also experience a swelling sensation in the vagina.

What are the symptoms of rectocele?

A feeling of pressure in the vagina and rectum, with difficulty to empty your bowel.

Cases of cystocele, rectocele and prolapse can lead to cancer?

No.

How to care for cystocele and rectocele?

With a plastic surgery to fix and tighten muscles and tissues are released, or to remove excess tissue.

Vaginal plastic surgery is bad?

No, but requires the care of an experienced gynecologist who knows the anatomy and the functions in the region.

What is the period of hospitalization necessary for vaginal plastic?

From one week to ten days.

Interventions for cystocele, rectocele and prolapse give satisfactory results?

Yes. There is healing in almost all cases.

You can correct cases of cystocele, rectocele and prolapse with medical therapy?

No, but you can get temporary relief with the use of intravaginal rings.
With these tools you don't get though healing.

When is surgery necessary?

When the symptoms, as mentioned above, are sufficient to interfere with normal life, or when the functions of the bladder or bowel are damaged.

What are the odds of recurrence after surgical therapy?

The chances of recurrence are below 5%.

Scars remain visible after a vaginal plastic surgery?

No.

What type of anesthesia is used for these interventions?

General anaesthesia or spinal anaesthesia.

How long these interventions require?

Two to four hours.

After these interventions requires a continuous nursing care?

Usually no, though, for a few days, is a big help.

The operations are very painful vagina?

No.

When the patient after surgery on the vagina, it can leave the bed?

Can leave the bed the next day.

Special precautions necessary post-operative care?

It is often necessary to insert a catheter into the bladder for urination.

Vaginal plastic interventions lead to unintended consequences?

Sometimes, for a week or two, there may be some difficulty in urination.
Interventions for rectocele can cause some difficulty in defecation for the same time period. However, these are temporary complications disappear spontaneously.

After these interventions must remove the stitches?

No. The stitches you absorb and should therefore not be removed.

Are common blood leaks after working on the vagina?

Yes. For a couple of weeks there may be a slight colored loss appearing irregularly.

Vaginal plastic interventions hamper intercourse?

No. Reports can be resumed once the tissues have healed. This usually takes four to five weeks.

You can still conceive after surgery for cystocele or rectocele?

Yes, but the delivery may take as caesarean surgery may have influenced expansion and extension capacity of the structures concerned.
In addition, vaginal delivery can cause a recurrence of cystocele or rectocele.

When should undergo plastic surgery?

When you are no longer of childbearing potential, i.e. after menopause.

After a vaginal plastic you can:

showering bathing leave home tend to drive the car home to resume sexual relations resume work after 1 day after 4 weeks after 1 week after 2 weeks after 2 weeks after 4-5 weeks after 4 weeks

What is the cervix?

The cervix, or neck of the uterus, is the portion of the uterus that you insert into the vagina.
Is a small, compact, muscular body crossed by a channel (cervical canal), which extends from the vagina up inside the body of the uterus.
The cervix is the only part of the uterus visible during an exam.

What is its function?

in) protects the cavity of the uterus from invasion by bacteria or foreign matter;
b) allows the sperm to penetrate into the cavity of the uterus;
c) protects the embryo during pregnancy;
d) dilates during labor to allow the passage of the baby.

How do I perform an examination of the cervix?

By means of a special tool, called speculum, which is inserted into the vagina.
Today it is often used speculoscopio, a speculum with a luminescent capsule that allows a precise examination.

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