Piocolpos: causes, symptoms, diagnosis, treatment

The causes of pyokolpos - violation of natural outflow from the vagina and infection of its contents as a result of congenital anomalies or acquired strictures.

The greatest number of diagnostic and treatment errors occurs in patients with malformations of the genital organs, in particular when infection of the contents of the additional closed vagina.

Symptoms of pyokolpos

Incomplete doubling of the uterus with the presence of an additional closed vagina is accompanied by a one-sided delay in menstrual blood. A characteristic sign of the disease is the presence of persistent algomenorrhea. Distinctive features of the disease are the following symptoms of pyocolpos:

• pains appear soon after menarche, associated with menstruation, intensified on the 3-4th day of menstruation and continue for 3-5 days after it;
• pain is often spastic;
• a stable one-sided localization of pain is characteristic. With the long-term existence of hematocolpos, the contents become infected, which is accompanied by a temperature reaction, an increase in pains that take a "pulling", pulsating character.

Diagnostics of pyokolpos

When palpation from the side and below the uterus, a fixed "tumor-like" one-sided formation is defined. The study of the correct diagnosis helps the study of the urinary system: in 100% of cases of congenital vaginal flora, aplasia of the kidney on the side of the closed vagina is detected. When puncturing the formation of a tar or purulent fluid containing elements of blood and leukocytes.

Differential diagnosis

This contingent of patients accounts for the greatest number of medical errors. Typical diagnoses, concerning which erroneous abdominal procedures are carried out, are:

• tubo-ovarian abscess;
• suppurative endometrioid cyst;
• suppurated parovarial cyst.

Treatment of pyokolpos

The most correct in the timely diagnosis should be considered conservative surgical treatment, consisting in dissection of the wall of the additional closed vagina and creating a communication between it and the functioning vagina.

To do this, an oval incision is made over the lower pole of formation along the lateral wall of the vagina in the upper third of the vagina over the protruding, usually thinned and having a bluish tinge of the mucosa. In doubtful cases, you should puncture the formation and open the closed vagina "on the needle." The incision should be sufficient, and the newly formed hole should be free to pass the finger. After emptying the closed vagina, the latter is washed with an antiseptic solution. The edges of the vaginal mucosa are lined with separate vikril sutures, preventing its contraction.

Patients are recommended active mode - early getting up (in the first day), daily syringing. All patients are further recommended abdominal delivery.

In advanced cases (pyometra and pyosalpinx), as well as in the presence of organic pathology, radical treatment is performed - abdominal and extirpation of the uterus with a closed vagina.

Prevention of pyokolpos

At present, there are no effective preventive measures, excluding the hygiene of pregnant women (excluding the impact of harmful exogenous factors, especially in the 6-17 weeks, when it is possible to form this developmental disability).

Significantly more often, pyocolpos occurs when infection occurs with accumulated menstrual blood in developmental anomalies accompanied by a complete delay in the outflow of menstrual blood (atemia of the hymen, periendinal septum, transverse vagina, aplasia of part or all of the vagina in the functioning uterus).

[1], [2], [3], [4]