Vaginitis dan Bartolinitis

BY
TETTI SOLEHATI, SKP.M.KEP
I. Vaginitis
 A. What is vaginitis?

 Vaginitis is a name for swelling, itching,

burning or infection in the vagina that can
be caused by several different germs. The
most common kinds of vaginitis are
bacterial vaginosis (BV) and yeast, a
fungus. Sometimes trichomoniasis (trich,
pronounced "trick") is called vaginitis too.
Trichomoniasis is caused by a parasitic
protozoa called Trichomonas vaginalis.
 B.How common is it?

Vaginitis is very common. If you are

like most women, you will have some
kind of vaginitis at least once in your
life.
 C. How is it transmitted?
 The healthy vagina has a balance
of many different kinds of
bacteria. "Good" bacteria help
keep the vagina a little-bit acidic.
This keeps "Bad" bacteria from
growing too fast. A healthy
vagina makes a mucus-like
discharge that may look clear or
a little milky, depending on the
time of a woman's monthly
cycle.
When the balance between the
"Good" bacteria and the "Bad"
bacteria is upset, "Bad" bacteria
grow too fast and cause infections.
Discharge may have a funny color or
a bad smell. Sometimes these "Bad"
bacteria and other germs that cause
vaginitis can be spread through sex.
Other things that can upset the
balance of the vagina are:
 Other things that can upset the balance of
the vagina are:
 antibiotics (medicines)
 pregnancy
 douching
 damp underwear
 tight pants
 poor diet
 vaginal products (sprays, lubricants, birth
control devices)
 D. Symptoms

The signs or symptoms of vaginitis

are different, depending on the germ
that you have. Signs or symptoms
of:
 bacterial vaginosis
 yeast
 trichomoniasis
 Keluhan gynekologi yang paling
sering sedikitnya terdapat 4 tipe
infeksi vaginitis, yaitu :
• Kandida
• Trikhomonas
• Vaginosis bakterial
• Gonokokal (pada anak-anak)
 E. Testing/Diagnosis

If you have symptoms of

vaginitis, see your health care
provider for a correct diagnosis.
To help your provider find out
what you have:
 Schedule the exam when you're
not having your monthly period.
 Don't douche 24 hours before your
exam.
 Don't use vaginal sprays 24 hours
before your exam.
 If you have sex less than 24 hours
before the exam, use condoms
 Pemeriksaan :
• Genitalia eksterna mungkin normal
atau mengalami inflamasi
• Ph vagina harus diperoleh
• Lakukan uji bau KOH dan pemeriksaan
mikroskopos
 Periksa adakah bau amin ( BV)
 Observasi adanya hifa
 F. Treatment

The treatment will depend on which

germ is causing the infection.
 Treatment for bacterial vaginosis

 Treatment for yeast

 Treatment for trichomoniasis

1. Vaginitis kandida (pruritus
vulva dan vagina, 90%
infeksi ragi pada wanita)
•Obat-obat antifungus lokal :
obat-obat imidazol
• Pengobatan oral : 150 mg
fluconazole tunggal dosis
• Infeksi rekuren sering terjadi :
 Nilai status HIV dan penapisan
untuk DM
 Pengobatan vaginal diperpanjang
s.d 2-3 minggu
 Obati pasangan laki-laki
 Pengobatan supresi :

•100mg ketoconazole setiap hari

•Pengobatan vaginal dengan
imidazole atau asam borat masing
masing 2 x seminggu atau setiap
hari selama 5 hari satu kali
perbulan.
2. Vaginitis trikomonas ( haluaran
kuning, bau, pruritis vulva);
• Metronidazole 2 gr dosis tunggal
• 95 % angka kesembuhan
• Beberapa meningkatkan resistensi
terhadap Metronidazole
• Hindari obat ini selama 20 minggu
pertama kehamilan
3. vaginosis bakterial (pertumbuhan
bakteri aerob dan anaerob
berlebihan, bau amina seperti ikan)
• Metronidazole :
 dosis tunggal 2g atau 0,75 gel

metronidazole
 Cream clindamycin 2%
 G. What does it mean for health?

These infections are usually treated with a

prescription from your health care
provider. With trichomoniasis, if your
partner does not receive treatment as
well, re-infection can occur.
Having BV has been associated with an
increased risk in developing pelvic
inflammatory disease (PID), which is a
serious infection of the uterus and
fallopian tubes.
 BV and trichomoniasis increase a
woman's risk of getting HIV if she is
exposed to a partner with HIV.
Having trichomoniasis or BV may
also increase the chance that an
HIV-infected woman passes HIV to
her partner(s).
 Having BV or trichomoniasis while pregnant
may put a woman at increased risk for some
complications of pregnancy, including
potentially having a baby born early or with
low birth weight.
 Treatment of BV might help reduce the risk
of these complications. Having a yeast
infection during pregnancy does not
typically pose any risk to the baby or the
pregnancy.
 H. Reduce your risk

 Wash your vaginal area every day.

Use mild soap. Rinse well and pat
dry.
 Wipe your vagina and anus from
front to back.
 Don't douche, this can upset the
natural balance of the vagina.
 Take antibiotics only when needed.
Antibiotics can kill "good" bacteria.
 Limit the number of your sex
partners. Always use condoms
with a new partner or with
multiple partners.
 Wear cotton or cotton-lined
underpants.
 Don't wear tight pants and don't
wear panty hose in hot weather.
 See your health care provider if
you have any unusual discharge
or smell.
II. Bartolinitis
 Merupakan infeksi akut
 Sering disebabkan oleh :
•Nisseria gonorrhoeae
•Clamydia trachomatis
 Obstruksi duktus bisa
menyebabkan pembentukan
abses
 Pengobatan :
•insisi dan drainage
selama 3-6 minggu
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