HPV Medical Studies - Risks

Klebanoff MA, Hillier SL, Nugent RP, MacPherson CA, Hauth JC, Carey JC, Harper M, Wapner RJ, Trout W, Moawad A, Leveno KJ, Miodovnik M, Sibai BM, Vandorsten JP, Dombrowski MP, O'Sullivan MJ, Varner M, Langer O; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

OBJECTIVE: It is stated commonly that the earlier in pregnancy bacterial vaginosis is diagnosed, the greater is the increase in risk of preterm birth compared with women without bacterial vaginosis. However, this contention is based on small numbers of women. STUDY DESIGN: In this analysis of 12,937 women who were screened for bacterial vaginosis as part of a previously conducted clinical trial, the odds ratio of preterm birth (<7 weeks of gestation) for asymptomatic bacterial vaginosis-positive versus bacterial vaginosis-negative women was evaluated among women who were screened from 8 to 22 weeks of gestation. RESULTS: The odds ratio of preterm birth among bacterial vaginosis-positive versus bacterial vaginosis-negative women ranged from 1.1 to 1.6 and did not vary significantly according to the gestational age at which bacterial vaginosis was screened. The odds ratio for preterm birth did not vary significantly by gestational age at diagnosis when bacterial vaginosis was subdivided into Gram stain score 7 to 8 or 9 to 10. CONCLUSION: Although bacterial vaginosis was associated with an increased risk of preterm birth, the gestational age at which bacterial vaginosis was screened for and diagnosed did not influence the increase.

J Reprod Med. 2005 Jan;50(1):49-52.

Childhood nocturnal enuresis in vulvar vestibulitis syndrome.

Greenstein A, Sarig J, Chen J, Matzkin H, Lessing JB, Abramov L. Department of Urology, Sex Therapy Clinic and Uro-gynecologic Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

OBJECTIVE: To define correlations between vulvar vestibulitis syndrome (VVS) and childhood nocturnal enuresis and the effect of biofeedback therapy. STUDY DESIGN: Of 104 women diagnosed with VVS, 54 (30 with primary vulvar vestibulitis syndrome [PVVS] and 24 with secondary vulvar vestibulitis syndrome [SVVS], mean age 24.5 years) chose Glazer biofeedback therapy. Information on lower urinary tract symptoms was recorded at the initial and final visits. RESULTS: Eight of the 30 women with PVVS (26.6%) had a history of childhood enuresis as compared to none of the women with SVVS (p < 0.01). The 8 women developed lower urinary tract symptoms following biofeedback treatment. None of the women with SVVS had urinary symptoms before or following biofeedback therapy. The high, unstable baseline muscle tone revealed by the Glazer technique to be present in all VVS patients underwent substantial reduction and stabilization at the end of biofeedback therapy. CONCLUSION: Childhood nocturnal enuresis is apparently common among women with PVVS. New urinary symptoms may develop following biofeedback therapy for PVVS.

Am J Obstet Gynecol. 2005 Jan;192(1):213-8.

The vaginal inflammatory milieu and the risk of early premature preterm rupture of membranes.

Simhan HN, Caritis SN, Krohn MA, Hillier SL. Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

OBJECTIVE: The purpose of this study was to determine the association of vaginal pH > or =5.0 and vaginal neutrophils >5 per oil field with preterm rupture of membranes (PPROM). STUDY DESIGN: This was a secondary analysis of the Vaginal Infections and Prematurity cohort, and was comprised of 12,734 evaluable women enrolled between 23 and 26 weeks' gestation. Women were tested for sexually transmitted infections and vaginal pH. Gram-stained smears were used for the detection of neutrophils. RESULTS: In this analysis, 5751 (41.3%) women had neutrophils >5 per oil field, and 2500 (18.0%) had pH > or =5.0. Both elevated pH and neutrophils were present in 1149 women (8.3%). The concomitant presence of both neutrophils and elevated pH was significantly associated with PPROM at 24 to 32 weeks. CONCLUSION: Elevated vaginal pH and neutrophils are most strongly associated with early third-trimester PPROM, reflecting the importance of infection and/or inflammation in the pathogenesis of this condition.

Publication Types:
• Evaluation Studies

Gynakol Geburtshilfliche Rundsch. 2005 Jan;45(1):5-13.

Vulvovaginal diseases: differentiation between treatable infections and other causes

HPV Medical Studies - Article in German

Disorders of the vulvar area are quite frequent. Only part of inflammatory diseases are caused by an infection. The number of possible pathogens is limited. Noninfectious inflammatory dermatoses and allergies also occur in the vulvar area and should gain much more attention. While most infections are curable, some dermatoses are curable too, but most can only partly be improved. The importance of skin care is still underestimated. The early diagnosis and treatment of inflammatory disorders of the vulva save patients much unnecessary pain and also prevent vulvar carcinoma or excessively mutilating interventions.

HPV Medical Studies - Genital Infections Risks Links

Genital Infections - Learn about the danger associated with STDs.

Infections and Safer Sex - A good article on general sexual health.