Vaginal Infections / UTIs (Urinary Tract Infections)
Common symptoms such as itching, burning, discharge, and redness often indicate an inflammation in the vaginal area. Similar symptoms can also accompany a sudden, painful urge to urinate, indicative of a urinary tract infection (UTI).
Vaginal Inflammations (Colpitis)
The vagina is naturally inhabited by various bacteria, with the most crucial being the "Döderlein bacteria" or acid-producing bacteria. They maintain a naturally acidic pH in the vagina, forming the physiological and protective vaginal flora. Therefore, the vagina doesn't require specific cleaning; it is a "self-cleaning organ." Disturbances in this flora can lead to various symptoms, with the most common infections being:
Candida Fungal Infections (usually Candida albicans):
Characterized by a typical discharge that is crumbly and white (resembling cottage cheese).
Often accompanied by redness and itching (pruritus).
Gardnerella (Bacterial Vaginosis):
Typically presents with a whitish-yellowish creamy discharge and a distinctive fishy odor. Itching and burning are less common.
Trichomonads:
Single-celled organisms (flagellates) causing a massively inflammatory and greenish discharge.
Streptococcal Colpitis:
Often results in a highly inflammatory and painful discharge.
Vaginal Herpes:
Can be asymptomatic in the cervical area but often presents with classic, small, and painful ulcers in Vulvar Herpes.
Frequently accompanied by swollen lymph nodes in the groin.
Chlamydia, Ureaplasma, and Mycoplasma; Gonorrhea (Clap):
Can cause purulent discharge but may also be entirely asymptomatic without complaints.
Most infections, especially those caused by fungi and Gardnerella, respond well to conventional medications. The challenge lies in the frequent recurrence of these infections. Approximately 40-50% of women experience at least one or two yeast infections per year, often triggered by antibiotic therapy, which disrupts the natural Döderlein flora and the acidic environment in the vagina.
Chlamydia and gonococci can ascend to the uterus, passing through the fallopian tubes into the abdominal cavity. This can lead to a painful condition known as salpingitis, causing intense lower abdominal pain resembling appendicitis (peritonitis).
The challenge lies in the chronically recurring infections, often requiring patience from both the patient and the treating physician.
Urinary Tract Infections (UTIs)
Due to the shortness of the urethra, women are particularly prone to bladder infections. These infections often exhibit classic symptoms such as frequent urges to urinate, passing small amounts of urine, and a burning, stabbing pain, often with a slight tinge of blood. UTIs are usually easily treated with antibiotics.
However, asymptomatic UTIs can also occur, where bacteria in the urine cause no symptoms. These are generally not in need of treatment unless found in pregnant women.
Similar to fungal infections, the challenge here is the frequent recurrence of infections, often triggered by sexual intercourse. This can be emotionally distressing, requiring specific treatment and guidance.
As with vaginal infections, a simple bladder infection can ascend to the kidneys, causing extremely painful kidney infections and, in severe cases, urosepsis. Therefore, early treatment of UTIs is crucial, and in the case of recurring infections, abnormalities in the bladder and kidneys should be ruled out.
For bladder infections, the motto is to use as much antibiotic as necessary and as little as possible. Proper identification of the causative bacterium is crucial to prevent antibiotic resistance. The most common bacterium is E. coli.
The investigation of recurring UTIs is done through a urine culture (Uricult), which cultivates the urine to determine the causing bacterium along with a specific antibiotic sensitivity test. With more than four to five infections per year, anatomical anomalies in the bladder and kidneys should be ruled out.
