The effect of vaginal douching on Pap-Smear

Yıl 2022, Cilt: 15 Sayı: 3, 603 - 609, 01.07.2022

Berfin Gök , Soner Gök , Selda Demircan Sezer , Ayhan Atıgan

https://doi.org/10.31362/patd.1090608

Öz

Objective: Vaginal douching damages vaginal flora and ecosystem. The disruption of the equilibrium of vaginal flora composition leads to many outcomes having a negative effect on women and newborn health.
Materials and methods: 105 patients who applied vaginal douche were included in this study. All women taken of Pap smear test and the patients were informed in writing about the reasons why they must leave their vaginal douching habits, and a second Pap smear appointment day not earlier than 30 days were given. After taken of patients first Pap smears, none of them took an infection treatment. Pap smear results taken before and after vaginal douche have been compared.
Results: It was seen in the detailed comparison of Pap smear outcomes that the rate of patients with violent inflammation decreased from 11.4% to 1.9%. The decrease in violent inflammation was found statistically significant (p=0.006). When the patients with infection were compared regardless of any discrimination of slightly or violent; the rate of the cases with typical infection findings was seen to decrease from 48.5% to 31.4% and found statistically significant (p=0.01).
Conclusions: Vaginal flora is a very complex and dynamic component and is under the influence of many factors. Vaginal douching damages vaginal flora structure and balance, and adversely affects women’s health in a wide range from a simple vaginal infection to cervical neoplasia.

Anahtar Kelimeler

Pap smear, vaginal douche, vaginal flora

Vajinal duşun Pap-smear üzerine etkisi

Öz

Amaç: Vajinal duş, vajinal floraya ve ekosisteme zarar verir. Vajinal flora dengesinin bozulması, kadın ve yenidoğan sağlığı üzerinde olumsuz etki yapan birçok nedene yol açmaktadır.
Materyal ve metod: Çalışmaya vajinal duş uygulayan 105 hasta dahil edildi. Tüm kadınlardan Pap smear testi alındı. Hastalara neden vajinal duş alışkanlıklarını bırakmaları gerektiğine dair yazılı bilgi verildi. 30 günden önce olmamak üzere ikinci bir Pap smear testi için randevu günü verildi. Hastaların ilk Pap smearleri alındıktan sonra hiçbirine enfeksiyon tedavisi verilmedi. Vajinal duştan önce ve sonra alınan pap smear sonuçları karşılaştırıldı.
Bulgular: Pap smear sonuçlarının detaylı karşılaştırmasında şiddetli inflamasyonu olan hasta oranının %11,4'ten %1,9'a düştüğü görüldü. Şiddetli inflamasyondaki azalma istatistiksel olarak anlamlı bulundu (p=0,006). Hafif veya şiddetli ayrımına bakılmaksızın enfeksiyonlu hastalar karşılaştırıldığında; tipik enfeksiyon bulgusu olan olguların oranının %48,5'ten %31,4'e düştüğü görüldü ve istatistiksel olarak anlamlı bulundu (p=0,01).
Sonuçlar: Vajinal flora; bir çok faktörün etkisi altında olan, çok karmaşık ve dinamik bir bileşendir. Vajinal duş, vajinal flora yapısına ve dengesine zarar verir. Basit bir vajinal enfeksiyondan servikal neoplaziye kadar geniş bir yelpazede kadın sağlığını olumsuz etkiler.

Anahtar Kelimeler

Pap smear, vajinal duş, vajinal flora

Kaynakça

• Sevil S, Sena K, Alaattin U, Halime A, Gul P, Nazli Y. Vaginal douching among married Turkish women and relation to quality of life. Indian J Tradit Know 2016;15(4):611-8.
• Martino JL, Youngpairoj S, Vermund SH. Vaginal douching: Personal practices and public policies. J Womens Health 2004;13(9):1048-65.
• Alcaide ML, Chisembele M, Mumbi M, Malupande E, Jones D. Examining Targets for HIV Prevention: Intravaginal Practices in Urban Lusaka, Zambia. Aids Patient Care St 2014;28(3):121-7.
• Christopher EE, Nyebuk ED, E EA. Vaginal douching behavior among young adult women and the perceived adverse health effects. Journal of Public Health and Epidemiology 2014;6(5):182-91.
• Annang L, Grimley DM, Hook EW. Vaginal douche practices among black women at risk: Exploring douching prevalence, reasons for douching, and sexually transmitted disease infection. Sex Transm Dis 2006;33(4):215-9.
• Branch F, Woodruff TJ, Mitro SD, Zota AR. Vaginal douching and racial/ethnic disparities in phthalates exposures among reproductive-aged women: National Health and Nutrition Examination Survey 2001-2004. Environ Health-Glob 2015;14.
• McCarthy FNA, Nii-Trebi NI, Musah BO, Asmah RH. Intravaginal practices and lactobacilli colonization among women in Accra, Ghana. Bmc Womens Health 2015;15.
• Li JR, McCormick J, Bocking A, Reid G. Importance of Vaginal Microbes in Reproductive Health. Reprod Sci 2012;19(3):235-42.
• Zapata HJ, Quagliarello VJ. The Microbiota and Microbiome in Aging: Potential Implications in Health and Age-Related Diseases. J Am Geriatr Soc 2015;63(4):776-81.
• Herbst-Kralovetz MM, Pyles RB, Ratner AJ, Sycuro LK, Mitchell C. New Systems for Studying Intercellular Interactions in Bacterial Vaginosis. J Infect Dis 2016;214:S6-S13.
• Fettweis JM, Brooks JP, Serrano MG, et al. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiol-Sgm 2014;160:2272-82.
• Mendling W. Vaginal Microbiota. Adv Exp Med Biol 2016;902:83-93.
• Reid G. Is bacterial vaginosis a disease? Appl Microbiol Biot 2018;102(2):553-8.
• Martin DH, Marrazzo JM. The Vaginal Microbiome: Current Understanding and Future Directions. J Infect Dis 2016;214:S36-S41.
• Afolabi BB, Moses OE, Oduyebo OO. Bacterial Vaginosis and Pregnancy Outcome in Lagos, Nigeria. Open Forum Infect Di 2016;3(1).
• Bui TC, Thai TN, Tran LTH, Shete SS, Ramondetta LM, Basen-Engquist KM. Association Between Vaginal Douching and Genital Human Papillomavirus Infection Among Women in the United States. J Infect Dis 2016;214(9):1370-5.
• Bui TC, Tran LTH, Ross MW, Markham CM. Douching practices among female sex workers in Phnom Penh, Cambodia. Int J Std Aids 2015;26(4):238-42.
• Attieh E, Maalouf S, Roumieh D, Abdayem P, AbiTayeh G, Kesrouani A. Feminine hygiene practices among female patients and nurses in Lebanon. Reprod Health 2016;13.
• Srinivasan S, Fredricks DN. The human vaginal bacterial biota and bacterial vaginosis. Interdiscip Perspect Infect Dis 2008;2008:750479.
• McClelland RS, Lingappa JR, Srinivasan S, et al. Evaluation of the association between the concentrations of key vaginal bacteria and the increased risk of HIV acquisition in African women from five cohorts: a nested case-control study. Lancet Infect Dis 2018;18(5):554-64.
• Yaman HE, Aygun M, Tosun H. Traditional genital hygiene practices in Turkey. Indian J Tradit Know 2016;15(2):214-8.
• Ziba FA, Yakong VN, Asore RA, Frederickson K, Flynch M. Douching practices among women in the Bolgatanga municipality of the upper east region of Ghana. Bmc Womens Health 2019;19.
• Mckee MD, Baquero M, Anderson M, Alvarez A, Karasz A. Vaginal Douching Among Latinas: Practices and Meaning. Matern Child Hlth J 2009;13(1):98-106.
• Brown JM, Poirot E, Hess KL, Brown S, Vertucci M, Hezareh M. Motivations for Intravaginal Product Use among a Cohort of Women in Los Angeles. Plos One 2016;11(3).
• Brotman RM, Klebanoff MA, Nansel TR, et al. A longitudinal study of vaginal douching and bacterial vaginosis - A marginal structural modeling analysis. Am J Epidemiol 2008;168(2):188-96.
• Africa CWJ, Nel J, Stemmet M. Anaerobes and Bacterial Vaginosis in Pregnancy: Virulence Factors Contributing to Vaginal Colonisation. Int J Env Res Pub He 2014;11(7):6979-7000.
• Bautista CT, Wurapa E, Sateren WB, Morris S, Hollingsworth B, Sanchez JL. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Military Med Res 2016;3.
• Muzny CA, Schwebke JR. Pathogenesis of Bacterial Vaginosis: Discussion of Current Hypotheses. J Infect Dis 2016;214:S1-S5.
• Moscicki AB, Ma YF, Farhat S, et al. Redetection of Cervical Human Papillomavirus Type 16 (HPV16) in Women With a History of HPV16. J Infect Dis 2013;208(3):403-12.
• Dickson EL, Vogel RI, Bliss RL, Downs LS. Multiple-Type Human Papillomavirus (HPV) Infections A Cross-Sectional Analysis of the Prevalence of Specific Types in 309,000 Women Referred for HPV Testing at the Time of Cervical Cytology. Int J Gynecol Cancer 2013;23(7):1295-302.
• Oh JE, Kim BC, Chang DH, et al. Dysbiosis-induced IL-33 contributes to impaired antiviral immunity in the genital mucosa. P Natl Acad Sci USA 2016;113(6):E762-E71.
• Bayigga L, Kateete DP, Anderson DJ, Sekikubo M, Nakanjako D. Diversity of vaginal microbiota in sub-Saharan Africa and its effects on HIV transmission and prevention. Am J Obstet Gynecol 2019;220(2):155-66.