Purulent Discharge From The Vagina : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Purulent Discharge From The Vagina
• Gynecological Infections
• Pathologies Of The Uterus And Appendages
• Bartholinitis
• Rare Causes
• Diagnostics
• Treatment
• Help Before Diagnosis
• Conservative Therapy
• Surgery

Purulent discharge from the vagina is the appearance of thick yellow-green pus from the patient's genitals. The symptom is combined with pain in the perineum and lower abdomen, fever, discomfort during intercourse. Greenish discharge with a putrid odor is characteristic of genital infections, severe inflammatory processes of the genital organs. To verify the cause of purulent leucorrhoea, an examination is carried out in the mirrors, ultrasound, bacteriological analysis of the discharge. Drugs are used after the establishment of the etiological factor of purulent leucorrhoea.

Causes of purulent discharge from the vagina

Gynecological infections

With gonorrhea, thick yellow or green pus with an unpleasant putrid odor is discharged from the vagina. The amount of purulent leucorrhea may increase after sexual intercourse. Yellow-green discharge from the vagina is accompanied by pain in the perineum radiating to the sacrum and coccyx. With the upward spread of the infection to the overlying genital organs, abundant purulent creamy discharge with a characteristic odor is observed, sometimes streaks of blood are visible in them. Other infectious pathologies (mycoplasmosis, ureaplasmosis) can occur with scanty greenish whites.

Pathologies of the uterus and appendages

Purulent vaginal discharge is characteristic of severe lesions of the uterus and its appendages - pyometra, pyosalpinx. Women note a constant outflow from the vagina of thick pus with a fetid odor, in which fragments of necrotic tissue or blood are found. The symptom is accompanied by severe pain in the lower abdomen, fever, urination and defecation disorders. Inflammatory causes of the disorder are endometritis (including postpartum) and endocervicitis, in which scanty purulent discharge is observed.

Bartholinitis

When the Bartholin gland (bartholinitis) is affected, patients are concerned about the periodic outflow of yellow or greenish pus from the vagina with a specific odor. In the posterior third of the labia majora, a woman palpates a seal, with pressure on it, suppuration intensifies. Throbbing pain in the perineum is possible, aggravated during walking. The lack of timely treatment and other unfavorable causes provoke the formation of an abscess of the Bartholin gland, with spontaneous opening of which there is abundant purulent discharge with a pungent odor.

Rare Causes

• Staphylococcal infections of the genital tract : bacterial vaginitis, cervicitis.
• Enterovaginal fistulas.
• Furuncles and carbuncles of the skin of the perineum .

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Diagnostics

Purulent discharge from the vagina with an unpleasant odor is a serious reason for contacting an obstetrician-gynecologist in order to find out the causes of suppuration. Examination of patients involves a physical and instrumental examination of the genitals, various laboratory methods aimed at clarifying the etiological factor. The following have the greatest diagnostic value:

• Gynecological examination . To obtain a complete picture of the disease, examination of patients with purulent leucorrhoea is carried out without prior preparation and the toilet of the external genital organs. When viewed in mirrors on the walls of the vagina, accumulations of thick pus can be found, hyperemia and swelling of the mucosa are typical.
• Ultrasound . Ultrasound of the pelvic organs allows you to find out the causes associated with purulent discharge from the vagina. During standard or transvaginal sonography, the condition of the genital organs is assessed, the accumulation of hypoechoic fluid in the uterine cavity is detected, and signs of an inflammatory process are detected.
• Endoscopic methods . To establish the cause of scanty purulent discharge with streaks of blood, colposcopy is necessary for a targeted examination of the cervix and cervical canal. The method helps to identify erosive changes, areas of tissue atypia.
• bacteriological method . In order to identify the causative agent of a gynecological infection, microscopy of a smear from the vagina after staining is performed, then the secretions are sown on nutrient media. Modern methods - ELISA, RSK, PCR - are designed for rapid diagnosis of the cause of suppuration.

To identify laboratory signs of inflammation, a general and biochemical blood test is done. Serological reactions help to confirm the etiological factor of vaginal leucorrhoea with a sharp putrid odor. To exclude lesions of other pelvic organs, CT or MRI of the pelvic cavity is used. Diagnostic laparoscopy is prescribed if it is impossible to establish the causes that provoked purulent discharge using other methods.

The study of a vaginal smear is carried out in order to identify the causative agent of the infection

Treatment

Help before diagnosis

The outflow of pus from the vagina is a symptom of serious disorders of the reproductive system, in which it is necessary to seek medical help as soon as possible. Self-medication can lead to the spread of the process to other pelvic organs or the peritoneum. Until the reasons for which purulent fetid discharges appeared, it is acceptable to take analgesics to reduce pain. With high febrile fever, antipyretics are used.

Conservative therapy

Medical tactics depend on the prevalence of purulent inflammation, the etiological factor of the disease and the presence of concomitant pathology in the patient. In the acute period, physiotherapy methods are not used, after the main manifestations subside, drug therapy is supplemented with UHF, electrophoresis, UVI. Local treatment includes instillations of antiseptic solutions (miramistin, chlorhexidine) into the vagina. For sexually transmitted infections, medications are prescribed to both sexual partners. Of the drugs most often shown:

• Antibiotics . They are selected taking into account the causative agent of infection and its antibiotic sensitivity. If severe purulent processes are found in the uterus and appendages, a combination of 2-3 drugs with a wide spectrum of action is necessary.
• Detox solutions . Diseases, combined with suppuration, are characterized by severe intoxication of the body. To eliminate intoxication, glucose-salt agents are used for parenteral administration.
• Immunomodulators . Medicines increase the overall reactivity of the body, stimulate local immunity, and speed up the healing process. In chronic gonorrhea, a gonococcal vaccine is used for the purpose of immunostimulation.

Surgery

Purulent vaginal discharge with a noticeable putrid odor, due to the accumulation of pus in the uterus, is an indication for the evacuation of the contents, sanitation and drainage. With an abscess of the Bartholin gland, it is surgically incised with washing with antibiotic solutions. In most cases, it is possible to confine ourselves to organ-preserving operations, with diffuse purulent fusion of tissues, they resort to supravaginal amputation of the uterus, tubectomy or adnexectomy.