Routine intimate hygiene care has a major contribution in maintaining overall urogenital and perineal health in women. However, Filipino women continue to experience a major surge in vulvar and vaginal symptoms across all age groups, in a context of major changes in lifestyles and risk factors impacting their genital health. Personal beliefs, preferences, apprehensions to discuss intimate topics with health care practitioners (HCPs), availability of cleansing products in the market, and their affordability prevent many women from discussing the role of intimate hygiene care with their HCPs. Communication difficulties and lack of robust evidence, supporting optimal hygiene recommendations are some of the challenges experienced by HCPs. Through this review, the authors discuss the following factors: (i) Differing physiological needs and pathological effects that result from changing dynamics of microflora in the vulvar, perineal, and vaginal region across all age groups of women, (ii) Importance of focusing on perianal and perineal hygiene, and bowel habits, to improve the quality of vulvar hygiene and genital health, (iii) Designing approaches for HCPs to maintain genital health in the light of intimate hygiene, (iv) Recommending improvements in HCP-patient communications to help HCPs dispel the misconceptions pertaining to intimate hygiene practices, and (v) Highlighting the antimicrobial efficacy of feminine hygiene cleansers that preserve the natural microbiome and help maintain the vaginal pH within the normal range. These strategies can fill the knowledge gaps among HCPs, women, and their caregivers’ perspectives and help achieve optimal intimate hygiene.

Objective: To explore the characteristics and correlations of vaginal flora in women with cervical lesions. Methods: A total of 132 women, including 41 women diagnosed with normal cervical (NC), 39 patients with low-grade cervical intraepithelial neoplasia (CIN 1), 37 patients with high-grade cervical intraepithelial neoplasia (CIN 2/3) and 15 patients with cervical squamous cell carcinoma (SCC), who came from the gynecological clinic of Second Hospital of Shanxi Medical University during January 2018 to June 2018, were enrolled in this study according to the inclusive and exclusive criteria strictly. The vaginal flora was detected by 16S rDNA sequencing technology. Co-occurrence network analysis was used to investigate the Spearman correlations between different genera of bacteria. Results: The dominant bacteria in NC, CIN 1 and CIN 2/3 groups were Lactobacillus [constituent ratios 79.4% (1 869 598/2 354 098), 63.6% (1 536 466/2 415 100) and 58.3% (1 342 896/2 301 536), respectively], while Peptophilus [20.4% (246 072/1 205 154) ] was the dominant bacteria in SCC group. With the aggravation of cervical lesions, the diversity of vaginal flora gradually increased (Shannon index: F=6.39, P=0.001; Simpson index: F=3.95, P=0.012). During the cervical lesion progress, the ratio of Lactobacillus gradually decreased, the ratio of other anaerobes such as Peptophilus, Sneathia, Prevotella and etc. gradually increased, and the differential bacteria (LDA score >3.5) gradually evolved from Lactobacillus to other anaerobes. The top 10 relative abundance bacteria, spearman correlation coefficient>0.4 and P<0.05 were selected. Co-occurrence network analysis showed that Prevotella, Peptophilus, Porphyrinomonas, Anaerococcus, Sneathia, Atopobium, Gardnerella and Streptococcus were positively correlated in different stages of cervical lesions, while Lactobacillus was negatively correlated with the above anaerobes. It was found that the relationship between vaginal floras in CIN 1 group was the most complex and only Peptophilus was significantly negatively correlated with Lactobacillus in SCC group. Conclusions: The increased diversity and changed correlations between vaginal floras are closely related to cervical lesions. Peptophilus is of great significance in the diagnosis, prediction and early warning of cervical carcinogenesis.
Female ; Humans ; Vagina/microbiology* ; Uterine Cervical Neoplasms/genetics* ; Uterine Cervical Dysplasia ; Cervix Uteri ; Lactobacillus/genetics* ; Papillomavirus Infections

In recent years, many studies have found that vaginal microbiota is closely related to female reproductive tract diseases. However, traditional microbial culture technology has the defects of long culture cycle and most microorganisms cannot be cultured. The development of metagenomics technique has broken the limitations of culture technology, and has been gradually applied to the study of vaginal microorganisms with the characteristics of high throughput, short time, identification of microbial population structure and gene function. It also provides technical support for elucidating the relationship between vaginal microbiota and female reproductive tract diseases. This article mainly introduces the metagenomics techniques and their applications in prevention, screening and diagnosis of common female reproductive tract diseases, and discusses their promising development and limitations to be overcome.
Female ; Humans ; Microbiota/genetics* ; Vagina ; Metagenomics/methods*

Primary endometrioid adenocarcinoma of the rectovaginal septum is rare. Its pathogenesis is not clear and there is no standard treatment. One patient with endometrioid adenocarcinoma of the rectovaginal septum arising from deep infiltrative endometriosis was admitted to Qingdao Municipal Hospital. The patient presented with incessant menstruation and abdominal distension. She had bilateral ovarian endometriotic cystectomy 6 years ago. Imaging findings suggested a pelvic mass which might invade the rectovaginal septum. Pathological results of primary surgery confirmed endometrioid carcinoma of the pelvic mass arising from the rectovaginal septum. Then she had a comprehensive staged surgery. Postoperative chemotherapy was given 6 times. No recurrence or metastasis was found during the 2-year follow-up. The possibility of deep infiltrating endometriosis and its malignant transformation should be considered in the differential diagnosis of a new extragonadal pelvic lesion in a patient with a history of endometriosis, which would avoid misdiagnosis and missed diagnosis.
Female ; Humans ; Carcinoma, Endometrioid/surgery* ; Endometriosis/surgery* ; Rectum ; Vagina ; Cystectomy

The vaginal microbiota is a complex and dynamic environment that plays an important role in the healthy reproduction of women. The mechanism of unexplained infertility is not yet clear, and the imbalance and low stability of vaginal microbiota may be related to unexplained infertility. Taking probiotic composite preparations to restore normal vaginal microbiota may be a safe and natural method for treating unexplained infertility. This article reviews the probiotic composite preparations used in the treatment of unexplained infertility both domestically and internationally, including the isolation site of the bacterial species, the use method of the composite preparation, the course of treatment, and the final therapeutic effect, aiming to provide a basis for the clinical application of probiotic composite preparations in the treatment of unexplained infertility.
Female ; Humans ; Infertility, Female/microbiology* ; Vagina/microbiology* ; Microbiota

The vaginal microbiota is a complex and dynamic environment that plays an important role in the healthy reproduction of women. The mechanism of unexplained infertility is not yet clear, and the imbalance and low stability of vaginal microbiota may be related to unexplained infertility. Taking probiotic composite preparations to restore normal vaginal microbiota may be a safe and natural method for treating unexplained infertility. This article reviews the probiotic composite preparations used in the treatment of unexplained infertility both domestically and internationally, including the isolation site of the bacterial species, the use method of the composite preparation, the course of treatment, and the final therapeutic effect, aiming to provide a basis for the clinical application of probiotic composite preparations in the treatment of unexplained infertility.
Female ; Humans ; Infertility, Female/microbiology* ; Vagina/microbiology* ; Microbiota

BACKGROUND: A Japanese woman in her early twenties had committed suicide, jumped from a 25-meter high bridge into a lake. She had been suffering from severe dysmenorrhea and general fatigue monthly. RESULTS: A forensic autopsy revealed indications of a bicorporeal uterus, obstructed hemi-vagina, and ipsilateral renal agenesis, which lead to a diagnosis of obstructed hemi-vagina and ipsilateral renal anomaly (OHVIRA) syndrome. On the right side of the uterus, an enclosed cavity composed of black clots was observed. Histological findings suggested that her endometrium was in the early proliferative phase, implying that she was in the menstrual phase just before her death. She may have been suffering from severe lower abdominal pain from the increased pressure of the closed uterus cavity. CONCLUSIONS This case indicates that dysmenorrhea from undiagnosed OHVIRA syndrome can possibly lead to a suicide attempt. In Japan, because suicide was the leading cause of death for people aged 15 to 39 in 2019, preventive measures for suicide should be promoted. The present case also suggests that intervention for dysmenorrhea may prevent this in adolescent woman.
Adult ; Causality ; Dysmenorrhea/etiology* ; Female ; Humans ; Kidney ; Syndrome ; Vagina ; Young Adult

Female ; Humans ; Hysterectomy ; Laparoscopy ; Natural Orifice Endoscopic Surgery ; Singapore ; Vagina/surgery*

Rectovaginal fistula (RVF) is an abnormal connection between the rectum and the vagina. At present, the principle method for RVF is surgery. With a variety of surgical methods, clinicians still lack a generally recognized consensus on RVF. Therefore, based on latest evidence from literature and expert experience, the Clinical Guidelines Committee of Chinese Medical Doctor Association Anorectal Branch organized domestic experts in anorectal surgery and gynecology to discuss the etiology, classification, diagnosis, treatment and special types of rectovaginal fistula of RVF, through questionnaires and expert seminars. "Chinese experts consensus on the diagnosis and treatment of rectovaginal fistula (2022 edition)" was produced in order to deepen the understanding of RVF, and to provide a standardized treatment for RVF in order to reduce the failure rate of surgery.
Female ; Humans ; Rectovaginal Fistula/surgery* ; Consensus ; East Asian People ; Rectum/surgery* ; Vagina/surgery*

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), or Herlyn–Werner–Wunderlich syndrome, is a rare Müllerian duct anomaly that is characterized by a triad of uterus didelphys, unilateral obstructed vagina, and ipsilateral renal agenesis. Patients with this anomaly usually present after menarche with abdominal pain or a pelvic mass which worsens over some time. Herein, presented is a case of a 12‑year‑old nulligravid with cyclic pelvic pain and palpable pelvic mass after her menarche. A series of diagnostic tests were done which were compatible with the diagnosis of OHVIRA with an associated finding of ectopic ureteral insertion into the obstructed hemivagina and nonfunctional urinary bladder. The patient underwent diagnostic hysteroscopy, cystoscopy, and full resection of the longitudinal vaginal septum as well as drainage of hematocolpos, which are the main treatment of the patient with OHVIRA.
Ureterocele ; Humans ; Femalec ; Uterine Anomalies ; Vagina ; Uterus