A systematic review of the effect of daily panty liner use on the vulvovaginal environment

Background

Whether panty liners predispose to vulvovaginitis is unclear.

Objectives

To clarify the effects of the use of panty liners on the female genital tract.

Search strategy

Several electronic databases (including PubMed and Embase) were searched to identify studies published in English before May 3, 2012.

Selection criteria

Case–control studies, randomized controlled trials, and cohort studies comparing young women who did and did not use panty liners in the intermenstrual period were included.

Data collection and analysis

The quality of the studies was assessed using the Newcastle–Ottawa Scale or the Jadad Scale. Data from suitable studies were extracted for analysis.

Main results

Five articles met the inclusion criteria. Four studies—all of which included only healthy women—found no significant clinical implications arising from the use of panty liners. The fifth study was of women with recurrent candidiasis and showed that use of panty liners was associated with new candidiasis episodes.

Conclusions

The intermenstrual use of panty liners does not seem to have a negative effect on the vulvovaginal area.     

反复发作的幼女外阴阴道炎病因与治疗方法探讨

目的探讨反复发作的幼女外阴阴道炎的病因与治疗方法。方法对中山大学附属第二医院近15年收治的51例年龄在10岁以下反复发作的幼女外阴阴道炎患儿的临床资料进行回顾分析。结果51例患儿中,28例为非特异性外阴阴道炎（55％）,14例为后天性直肠阴道瘘（27％）,5例为外阴溃疡及疖肿（10％）,3例为阴道异物（6％）,1例为小阴唇粘连（2％）。对其中的21例患儿行阴道分泌物病原体检测、培养,17例找到病原体,阳性率达81％,菌谱包括大肠埃希菌5例,金黄色葡萄球菌、微需氧链球菌各3例、其他菌11例。非特异性外阴阴道炎、外阴溃疡及疖肿患儿经外用洗剂、抗生素软膏,或联合全身应用抗生素,均获得治愈;后天性直肠阴道瘘患儿行瘘管切除、瘘修补术后治愈;阴道异物者取出异物后阴道炎获得治愈;小阴唇粘连者行小阴唇粘连分离术。结论非特异性外阴阴道炎是反复发作的幼女外阴阴道炎的常见类型,其主要病原菌为大肠埃希菌;针对反复发作的幼女外阴阴道炎病因的局部及全身治疗效果显著。     

Clinical and Microbiological Findings of Vulvovaginitis in Prepubertal Girls

Study ObjectiveTo evaluate genital microbiological findings in prepubertal girls with vulvovaginitis and in healthy controls.DesignProspective case-control study.SettingPediatric Outpatient unit of the Department of Pediatrics of the Hospital of the Lithuanian University of Health Sciences Kauno Klinikos from November 2014 to May 2017.ParticipantsFifty-two prepubertal girls aged 1-9 years diagnosed with vulvovaginitis, and 42 age-matched healthy controls.Interventions and Main Outcome MeasuresSamples for microbiological culture were collected using sterile cotton swabs from the introitus and the lower third of the vagina from all study participants. Microbiological findings were analyzed according to bacteria type and intensity of growth.ResultsMost of the vaginal microbiological swab results were positive for bacterial growth: 47 (90.4%) and 34 (80.9%) were similar in the study and control groups, respectively (P = .24). Sixteen (30.8%) and 9 (21.4%) of the microbiological traits results in the case and control groups, respectively, were regarded as potential causative agents (P = .27). Streptococcus pyogenes was the most frequent pathogen in the study group (P = .03); all other microorganisms detected as either a pure or dominant growth in the control group, were considered opportunistic.ConclusionsVaginal bacterial culture results were positive in prepubertal girls with vulvovaginitis and in healthy controls. Nonspecific vulvovaginitis without a dominant/isolated pathogen was seen to be more common than vulvovaginitis with a potential causative agent. Clinical symptoms were more frequent among girls when the potential infectious agent was identified.     

Bovine necrotic vulvovaginitis associated with Porphyromonas levii

An outbreak of bovine necrotic vulvovaginitis associated with Porphyromonas levii, an emerging animal and human pathogen, affected 32 cows on a dairy farm in the northeast of Israel. Five animals had to be culled. This report appears to be the first that associates P. levii with bovine necrotic vulvovagnitis.     

Vulvo-vaginitis in Prepubertal Girls: New Ways of Administering Old Drugs

Study ObjectiveTo evaluate the effectiveness and safety of local vs systemic antibiotic treatment in the management of recurrent vulvovaginitis in children.DesignRandomized treatment and follow-up of 90 cases of persistent vulvovaginitis.SettingThe Department of Medicine and Health Sciences, Institute of Gynecology and Obstetrics, University of Molise, Italy.MethodsBetween January 2009 and December 2012, 90 prepubertal girls (Tanner Stage I) aged 6–12 years, with recurrent discharge not responding to common hygienic measures and not suspected of being sexually abused, were treated, 45 patients with oral antibiotic treatment (group 1) and 45 patients with a local antibiotic treatment (group 2). Vaginal cultures were prepared before treatment and follow-ups were made after 3 months.ResultsBacterial pathogens were isolated in vaginal secretions of 84/90 (93%) girls. There were 6 girls receiving antibiotic treatment who had persistent discharge and repetitive isolations of Escherichia coli. Administration type was selected at random. Symptoms and signs were resolved in all girls, but we observed 1 recurrence (2.22%) in group 2 vs 6 recurrences (13.33%) in group 1 (P = .049). In group 1 we observed 3 cases (6.67%) of gastro-intestinal side effects vs no cases in group 2 (P = .079).ConclusionTopical medication based on netilmicin, associated with Benzalkonium-Chloride, showed a clinical and microbiological effectiveness in first-line treatment of bacterial vulvovaginitis in children, comparable to conventional drugs; so local treatment may be a good alternative to systemic treatment decreasing the use of oral antibiotics in young people and related risks of bacterial resistances.     

霉克霜与制霉菌素栓治疗霉菌性外阴阴道炎临床对比研究

目的 探讨一种治疗霉菌性外阴阴道炎的更有效的外用药物疗法。方法 对58例患霉菌性外阴阴道炎患者采用霉克霜治疗,并对56例同期患者给予制霉菌素栓及达克宁产霜治疗。结果 霉克霜组在疗效、自觉症状消火时间及复发率方面均优于制霉菌索栓组,其差异有显著性(P<0.01)。结论 霉克霜是治疗霉菌性外阴阴道炎最有效的外用药之一,起效快、疗效高、副作用小、复发率低,值得推广应用。     

Der Einfluß von Antiandrogenen auf die Entstehung von vaginalen Candidosen:* The Influence of Antiandrogens on the Development of Vaginal Candidosis

Zusammenfassung: Bei Behandlung mit Cyproteronacetat-haltigen Kontrazeptiva führte bei 11 von 61 Probanden mit androgenbedingten Hauterscheinungen zum Auftreten einer Candida-Vulvovaginitis. Summary: In 11 out of 61 patients suffering from androgen-dependent dermatosis the treatment with cyproteron-acetat-containing contraceptives led to the development of candidal Vulvovaginitis.     

34例复发性念珠菌外阴阴道炎的分析

目的：探讨复发性念珠菌外阴阴道炎（PVVC）反复发作的诱因,寻找合理治疗的方法及预防措施。方法：对34例RVVC患者常规做真菌学和滴虫检查、宫颈炎检查,询问既往史、七项不良个人生活卫生习惯史,既往复发时的治疗情况。结果：与RVVC直接的诱因（糖尿病、口服避孕药、 妊娠13例（38．2％）,与个人不良生活卫生习惯的有关因素21例（61．8％）P＜0．05。宫颈轻度糜烂7例,宫颈中度糜烂15例,宫颈重度糜烂12例（无一例宫颈光滑者）。共34例RVVC患者既往共治疗81次,短期治疗77次（95．1％）,长期治疗4次（4．9％）P＜0．001。结论：个人不良生活卫生习惯之因素在RVVC中是不可低估的原因之一,一旦发生VVC或是RVVC都应合理用药,长期巩固治疗,同时积极治疗宫颈糜烂, 降低复发,提高卫生保健意识。     

Vulvovaginitis due to Candida glabrata. An emerging problem

A review is presented of the emerging problem of resistant and chronic vaginitis due to Candida glabrata. Although accurate numbers are lacking, several investigators report encountering increased numbers of women with vaginitis due to C. glabrata. Possible reasons for this apparent increase are discussed. Risk factors and clinical manifestations of symptomatic C. glabrata vaginitis differ from those of C. albicans, C. glabrata being less susceptible to fungistatic azole agents is more difficult to eradicate. Successful management of chronic C. glabrata vaginitis constitutes a major challenge with currently available therapeutic agents.