Diseases of the genital tract in children. Signs of a urinary tract infection in children

Diseases of the genital organs in children are very dangerous, as they can flow into chronic inflammatory processes, and further worsen the reproductive function of the patient. According to the statistics of gynecological pathologies, vulvovaginitis of various forms is observed in girls, and in various age periods.

Many inflammatory STIs in children rank first among the whole variety of gynecological diseases, especially for girls from 1 to 8 years old. Long-term sexual infections in children can cause serious diseases that affect the genitourinary and reproductive system in the future.

Diseases of the genital organs in girls

The most common diseases of the genital organs in girls are various inflammations of the external parts of the genital organs and the vagina, in other words, these are various vulvitis and vulvovaginitis. Such diseases develop due to the contact with the mucous membranes of the child of infectious agents such as streptococcus, staphylococcus, E. coli and enterococcus.

The risk of the disease is in girls with metabolic disorders of the body, as well as with frequent childhood infections, bronchitis and diseases of the nasopharynx. Microorganisms that enter the vagina can cause an inflammatory process. This applies to stool microbes that can enter the genitals with insufficient or improper intimate hygiene.

Sometimes pinworms that live in the lower part of the intestine become the cause of vulvovaginitis. These small worms lay their eggs on the skin around the anus and also in the external genitalia. As a result of such actions, the child may feel or if the pinworm pierces the skin. It is on the worms that microorganisms are transferred that cause inflammation of the vulva and the vagina itself.

If the girl has complaints of pain in the genital organs, then after the next washing they should be carefully examined. If pinworms are found, appropriate measures should be taken to remove and remove them. If this is not done on time, then inflammation of the skin and mucous membrane of the genital organs, redness, swelling and unpleasant discharge with a bad odor may appear.

Diseases of the genital organs of boys

To date, diseases of the genital organs of boys are also a common medical problem. So, it is considered one of the most common diseases of the male genital organ, accompanied by inflammation of the foreskin.

With such a disease of the penis in boys, the foreskin usually turns red and swells, as a result of which it often appears. The cause of this disease is an excess of smegma, that is, a lubricant that accumulates in the folds of the foreskin.

Phimosis is a squeezing of the urinary canal due to excess smegma under the foreskin. This disease can cause some diseases of the genitourinary system, which include urinary incontinence, urethritis, cystitis and pyelonephritis.

Cryptorchidism is observed if a child is born with an empty or semi-empty scrotum. This is due to the fact that the testicles did not have time to descend into the scrotum in time before childbirth. The testicles, located in the abdominal cavity, are highly susceptible to thermal effects, and this can lead to further infertility.

Hypospadias is a congenital disorder. In this case, the hole for excretion of urine is located on the back of the penis or at its base. Such an anomaly does not cause pain in the child, but still, one cannot do without surgery.

An inguinal-scrotal hernia occurs if a small hole remains in the peritoneum of the embryo during the transition of the testicles to the scrotum, where part of the intestinal loop can get. An inguinal hernia is accompanied by pain and swelling. In such situations, only surgical intervention will also help.

Dropsy of the testicle occurs due to incomplete closure of the opening between the peritoneum and the scrotum. As a result, fluid can accumulate there, the testicles increase in size, causing the child to experience very painful sensations. Sometimes the disease disappears on its own, but in most cases, doctors prescribe surgery.

In this article:

According to statistics, urinary tract infections in children rank second after viral respiratory diseases. This problem is especially relevant in children under one year old. As a rule, it proceeds without any pronounced symptoms, but can have very serious consequences.

Very often, doctors do not detect urinary tract infections in children in time, as they can disguise themselves as nausea, abdominal pain, vomiting, and even signs of acute respiratory infections.

Due to the peculiarities of the child's body, it spreads quite quickly and can cause inflammation of the kidneys - pyelonephritis. And it is dangerous by the possibility of not restoring their functions in the previous mode after the disease. Further, if you skip the inflammation of the kidney, do not eliminate it in time, there will be kidney failure, and, as a result, the inferiority of the body, that is, disability.

Causes of the disease

The diversity of the microbial flora that causes urinary tract infections in children depends on the sex and age of the child, as well as on the state of his immune system. Among bacterial pathogens, enterobacteria are in the lead, in particular Escherichia coli - in almost 90% of cases, as well as other pathogenic microorganisms.

The incidence of urinary tract infections in children depends on the sex and age of the child. More often this pathology occurs in girls due to the anatomical structure of the organs of the urinary system: proximity to the vagina and intestines, shorter urethra. In girls, the peak incidence occurs at the age of 3-4 years. But in infancy, boys are more likely to get sick, especially under the age of 3 months. The causes of genitourinary infections in children in this case are usually caused by anomalies in the development of the genital organs, as well as the use of diapers and poor hygiene.

The infection can get in the following ways:

1. through the urethra to the bladder and kidneys;
2. from neighboring organs through the lymphatic system;
3. through the blood when it is infected.

Clinical symptoms of the disease

Manifestations and signs of genitourinary infection in children of the disease depend on the age of the child. After two years, the presence of a urinary tract infection may be indicated by:

• painful urination, burning sensation and pain;
• dark color of urine, the presence of blood in it;
• frequent urge to empty the bladder (in this case, urine is excreted in small portions);
• pain in the lower abdomen, suprapubic area, back and lower back;
• high body temperature (above 38 degrees).

Before the age of two years, the presence of a urinary tract infection in children is indicated by one of the following symptoms:

1. Feverish state;
2. Vomiting and diarrhea;
3. Irritability, capriciousness and tearfulness;
4. Changing the color of urine and its sharp, unpleasant odor;
5. Skin blanching and weakness;
6. Lack of appetite and even refusal to eat.

Diagnosis of urinary tract infections

If you suspect that the child has this disease, you should consult a doctor in the next day. If you delay, then there is a risk of inflammation of the kidneys. The fact of the presence of the disease is confirmed by a general urine test. If an infection is detected in the urine in children, it is advisable to take a culture for the pathogen and determine its sensitivity to antibiotics. This is necessary for an adequate, correct choice of prescribing an antimicrobial drug.

Imaging diagnostic methods

These methods include ultrasound and x-rays, they allow the doctor to see the structure of the urinary system and its organs, to detect defects and anomalies in it. These diagnostic methods are not assigned to all children, but only at the age of 3-5 years and with re-infection. Imaging methods include:

• Ultrasound examination of the kidneys. A method that is quite safe for a child, which, using ultrasound rays, displays the state of an organ on a monitor and makes it possible to judge its structure.
• X-ray. It will help to analyze the condition of the organs in the abdominal cavity and behind the peritoneum. Before the procedure, it is advisable to give the child a cleansing enema.
• Cystourethrography. For analysis, a contrast agent is introduced into the bladder using a catheter, through which the rays do not pass. Cystourethrography allows you to see the contours of the bladder and urethra. This takes two pictures. One with a full bladder. The other is directly during urination. The first picture allows you to determine the presence of passive and the second - active reflux, that is, the return of urine into the ureter, which should not normally be. With this procedure, the second phase in children often fails, but even one picture can be very important.

If a sufficiently serious pathology of the urinary tract is suspected in a child, intravenous urography can be performed in a hospital. A contrast agent is injected into a vein, filtered by the kidneys, and the whole process is recorded by a series of x-rays. This method allows a very detailed examination of the structure of the urinary tract and partly of the kidneys. And in order to qualitatively display the function of the kidneys, it is necessary to perform scintigraphy. In this case, not a contrast agent is injected into the vein, but a radioactive isotope.

A rather painful method is cystoscopy, which is indicated only in case of damage to the bladder, the presence of stones, tumors in it, or determining the volume of surgical intervention.

Differential Diagnosis

Bladder infection in children can be similar to other diseases from which it must be distinguished:

1. Vulvovaginitis in girls. With this disease, fever, itching, and changes in the urine are also noted. However, the inflammatory process with it does not affect the genitourinary tract, but affects the vestibule of the vagina and the vagina.
2. Urethritis. Inflammation of the urethra or its irritation with various chemical components that make up soap, shampoo, washing powder. As a rule, it does not require specific treatment and disappears on its own after a few days.
3. Worm invasion. Pinworm infestation will cause itching, irritation, and changes in urine composition. To identify, a scraping of the anal area is taken and it is advisable to repeat it three times.
4. Balanitis. It is manifested by inflammation of the vestibule of the vagina in girls and the foreskin in boys. The doctor will determine the differences during a visual examination.
5. appendicitis. Acute pain in the lower abdomen with inflammation of the appendix can also be mistaken for inflammation of the urinary tract. This is another reason not to delay a visit to the doctor.

Disease classification

In children, urinary tract infections are classified as either primary or recurrent. Recurring are divided into groups:

• Unresolved infection as a result of the selection of non-optimal doses of antibiotics, non-compliance with the established treatment regimen, malsorption syndrome, drug-resistant pathogen.
• Persistence of the pathogen, which will require medical or surgical intervention, as a persistent focus is formed in the urinary tract.
• Reinfection, in which each episode is a new infection.

From a clinical point of view, urinary infection in children is divided into severe and non-severe.

Treatment of urinary tract infections

All measures aimed at treating genitourinary infections in children should be selected individually, depending on age and only by a doctor. Children under 2 years of age, as a rule, are treated inpatiently, as parenteral administration of antibiotics and diffuse therapy are necessary. Bed rest is necessary for severe fever and pain.

To reduce the load on the renal tubules and mucous membranes, frequent feeding of the child is recommended - 5-6 times a day. If impaired renal function is detected, salt and fluid restriction is recommended. In nutrition, preference is given to protein and plant foods, as well as dairy products. From the diet it is necessary to exclude products that irritate the mucous membrane of the urinary tract: canned food, marinades, spices and fried foods. It is also desirable to limit foods with a high content of acids: citrus fruits, tomatoes, pomegranates, kiwi, grapes, sweet peppers, pickled and salted vegetables.

When the pain syndrome is eliminated, it is necessary to drink plenty of fluids to prevent irritation of the mucous membranes of the urinary tract from exposure to urine, remove microorganisms and waste products of toxins.

Antimicrobial drugs are considered the main method of eliminating infection. The antibiotic and optimal, adequate doses are selected taking into account the type of pathogen and its sensitivity, as well as the age of the child. They must be nephrotoxic, the duration of administration is from 7 to 14 days. Sometimes treatment is supplemented with uroantiseptics, and probiotics are recommended to prevent disturbance of the intestinal microflora.

Prevention of urinary tract infections in children

Preventive measures will avoid primary, and in some cases, secondary infection:

1. It is advisable to continue breastfeeding as long as possible, at least 6-7 months. According to doctors, this will protect a child up to two years from the occurrence of urinary tract infections.
2. When introducing complementary foods, give as many vegetables, fruits, and whole grains as possible, which prevent constipation.
3. Try to make food varied, introduce vitamins and minerals into the diet for the normal development of organs and systems.
4. Timely respond to manifestations of capriciousness and tearfulness in infancy, as the child cannot tell about his condition.
5. At any age, it is necessary to ensure that a sufficient amount of water enters the child's body, which will not allow congestion in the kidneys to develop.
6. It is also very important to adhere to the rules of personal hygiene, especially for girls. When bathing, it is advisable to use not soap and shampoo, but special soft gels. It is necessary to wash the genitals daily and also change underwear regularly.
7. If possible, thoroughly wipe the genital area, perineum after changing the diaper.
8. In case of temperature fluctuations of the disease, protect the child from hypothermia.
9. In the first months of life, closely monitor the development of the child. In case of detection of anomalies of the genital organs or abnormal functioning of the urinary tract, consult a doctor.

If cases of infection have already been observed, it is advisable to take herbal remedies for a long time to prevent relapses. These are medicinal preparations, which include herbs with anti-inflammatory and diuretic effects. It is advisable to take them under the supervision of a doctor, as some of them are quite strong biologically active substances. In any case, you should not prescribe them to the child yourself.

After the course of treatment, the doctor must prescribe control tests. Maintenance therapy with antibiotics at the optimal dose and schedule may be needed.

Useful video about urinary tract infections

The content of the article

Inflammatory diseases of the internal genital organs rare in children before puberty. Only during puberty and in adolescents do they acquire practical significance. As a rule, provoking factors are the first sexual contact and the first menstruation.
Inflammatory processes in the uterus in girls are usually localized, which is associated with the phylogenetically determined properties of the uterine epithelium and the biological barriers of the genital organs (girl's membrane, sunken vagina, narrowness of the internal uterine eye, alkaline reaction of the vaginal contents, etc.). The main features of the course of inflammatory processes of the internal genital organs in girls and girls are the latent course of the disease, the absence of severe pain and intoxication, often pronounced inflammatory reactions from the blood (leukocytosis, ESR), normal body temperature.

Endomiometritis in girls and girls

Isolated endomyometritis in young girls almost never occurs. Rarely, endomyometritis is observed in girls who have not lived sexually, since the uterine cavity remains sterile due to the natural barrier of the internal uterine os.
There are practically no nonspecific inflammations of the endometrium before the appearance of the first menstruation. Specific diseases, such as tuberculous endometritis, are found only in extreme cases as the cause of primary amenorrhea. The incidence of gonorrheal endometritis in adolescents has now increased dramatically due to early casual sex. Diagnosis and treatment of endometritis in adolescents and girls are the same as in adult women.

Endocervicitis

Endocervicitis is observed, as a rule, only in adolescent girls who have already had sexual intercourse. The cause of endocervicitis in such cases should be considered to be existing for a long time white from the uterine cavity and its appendages.
The clinical picture, diagnosis and treatment of endocervicitis and cervical erosion in girls are no different from those in adult women.

Erythroplakia of the cervix

Erythroplakia of the cervix - a red spot is limited at the external uterine os of the cervix. Erythroplakia is observed in children and adolescents at certain periods of development. As a rule, the disease is caused by physiological, hormonal stimulation, sex hormones of the girl's body, which leads to the growth of the cervical glandular epithelium.
Ectopic columnar epithelium on the vaginal part of the cervix is ​​found in newborns and adolescent girls. In young children (during the period of hormonal rest), erythroplakia almost never occurs, so it should always be regarded as a pathological process at first and accurate diagnostic methods should be used.
Treatment is carried out with the help of local use of the drug "Solkagin".

adnexitis

Adnexitis (inflammation of the uterine appendages). An ascending infection that spreads to the uterine appendages is almost never observed in infancy and childhood. Often, pain in the area of ​​​​the appendages in girls and girls has a different origin (appendicitis, diseases of the digestive tract, urinary system). Unfortunately, the erroneous diagnosis of adnexitis in girls and girls is now too often established in the presence of endometriosis of the uterine appendages.
In adolescents, adnexitis and other ascending inflammatory processes often develop with sexually transmitted diseases. The close proximity of the appendix and the right fallopian tube predetermines the spread of the inflammatory process in a descending way to the right appendages, sometimes by extension, sometimes through the veins and lymphatic tracts of the so-called baggage connection.
Adhesions and exudate rich in fibrin can lead to dysfunction of the fallopian tube, especially the right one (salpingitis). Inflammation of the peritoneum of the small pelvis, as well as perforation of the appendix, lead to the formation of an appendicular-adnexal "tumor", which causes a clinical picture of unilateral adnexitis in a child. Infertility that occurs over time is often associated with such inflammatory processes that are not diagnosed in a timely manner.
In children, in the pathogenesis of inflammatory diseases of the internal genital organs, the hematogenous route of infection is also important. So, tuberculous salpingitis in 1/3 of cases occurs hematogenously. This disease is more common in girls just before or during puberty.
Inflammatory processes in the ovary ( oophoritis) is often the result of diseases of the fallopian tube, which subsequently spread to the appendages as a whole. Oophoritis associated with mumps occupies a special place. This disease, especially during puberty, can lead to sclerocystic degeneration and ovarian atrophy and is considered the cause of primary or secondary amenorrhea, and later infertility.

Venereal diseases in children alphabetically

Gonorrhea (gonorrhoea), also gonorrhea, is a disease most common in adults, but children can also become infected with it. Illness requires...

Mycoplasmosis in children is not the most common, but unpleasant infection that causes a wide range of diseases of the reproductive and respiratory systems....

Trichomoniasis is a widespread disease of the genitourinary system. It is transmitted mainly through sexual contact, but in some cases it is possible to infect ...

Finding chlamydia in children, parents are often surprised, where did the child get a venereal disease? In fact, chlamydia is transmitted to children ...

Sexual diseases in children are now quite common. Statistical data suggest that infections characteristic of a more mature age are increasingly being diagnosed in infants. Sexually transmitted diseases in children can occur even in utero. If they are not immediately detected, the child may subsequently develop a dangerous pathology. It is important to know the specifics of all violations, identify them in time and immediately contact a specialist, since sexual diseases in children can be very life-threatening. If they are not treated in time, a fatal outcome is quite likely.

Causes and consequences

Sexually transmitted diseases in children occur due to various factors. According to doctors, hereditary pathologies are increasingly observed. But there are also acquired disorders. Therefore, it is important to know how sexually transmitted diseases are transmitted to children. A child can become infected in the following ways:

• when breastfeeding a mother who is sick with HIV, syphilis, various types of hepatitis;
• by direct contact with infected household items or an infected person;
• during the passage of the fetus through the birth canal during childbirth;
• while the embryo is in the womb of an infected mother.

Sexually transmitted diseases in adolescents are no less common than in adult patients. Among the reasons are:

• early onset of sexual activity,
• lack of knowledge about ways to protect against STIs,
• non-compliance with preventive measures and sanitary rules,
• during medical procedures.

Childhood sexually transmitted diseases cause great damage to health. The consequences can be the most deplorable. They affect the formation of deformities, lag in development. At a more mature age, the slightest violations can develop into a serious illness. These can be ectopic pregnancies, and orgastic dysfunctions, and infertility, and disruptions in the menstrual cycle, and oncology.

Sexually transmitted diseases in adolescents may not manifest themselves in the early stages. Subsequently, they can lead to the chronic stage of the disease, cancer, and even death.

Symptoms

Children's sexual diseases may not reveal themselves until a certain period. As soon as the first symptoms appear, you need to make an appointment with a doctor.

Small, at first glance, changes serve as a signal. The main signs of sexually transmitted diseases in children in the genital area:

1. erosion,
2. papillomas,
3. ulcers
4. rash.

Diagnostics and types

Only experienced and qualified venereologists, urologists and gynecologists can identify childhood sexual diseases. That is why it is important to have regular check-ups. Only a doctor is able to determine the pathology and conduct a competent examination. Diagnosis includes a detailed survey of parents, a visual examination of the child. Then, biological material is taken for a general smear analysis for diseases of the genital organs in children. If necessary, the doctor can also take a bacterial culture of the material and take a blood sample. In some cases, ultrasound, X-ray and magnetic resonance examinations are performed. The course of treatment depends on which childhood diseases of the genital organs were identified.

Sexual diseases in children are divided into several types:

1. dropsy is the accumulation of fluid in the vaginal membrane of the testicle in boys;
2. disease of the gonads, manifested in the early onset of secondary sexual characteristics;
3. AIDS, characterized by fever, muscle and bone pain, rashes on the body;
4. vulvitis - an inflammatory process in the vulva region in girls;
5. gonorrhea, which manifests itself in copious purulent discharge of a greenish color;
6. trichomoniasis, characterized by liquid foamy discharge and itching;
7. candidiasis, the main features of which are burning, white curdled discharge;
8. chlamydia in children manifests itself in the form of conjunctivitis and infections in the oral cavity;
9. mycoplasmosis is expressed as itching in the genital area;
10. papillomavirus infection reveals itself in the form of itching and the appearance of genital warts.

Sexually transmitted diseases in children cannot be cured on their own. This can be hazardous to health. Only a knowledgeable doctor is able to recognize the disease and choose the right course of treatment. It takes place with the use of individually selected medications.

Prevention

It is easier, of course, to engage in prevention, and not to treat sexual diseases in children and adolescents. To protect your child from infections, it is enough to follow simple recommendations:

• confidential conversations about how infection occurs and what are the signs of STIs;
• compliance with hygiene rules;
• familiarity with methods of contraception;
• vaccination;
• scheduled examinations by a venereologist.

Sexual diseases in children in most cases can be avoided. The specialists of the clinic will help protect the baby from ailments. They are engaged in comprehensive examinations and the selection of optimal preventive measures. When a pathology is detected, doctors write out a treatment plan. Venereal disease in children is not yet a sentence. You can find a suitable venereologist yourself on our portal. Also call the free referral service, where they will help you find a doctor who knows everything about sexual diseases in children.

This material is posted for informational purposes, is not medical advice and cannot serve as a substitute for consultation with a doctor. For diagnosis and treatment, please contact qualified doctors!

What are they like, how to "lay straws" and what is the treatment?

First of all, they are associated with inflammatory diseases, weakened immunity, insufficient or excessive care for the girl's external genitalia. We will try to understand the causes of painful conditions and give advice on their treatment.

Synechia

Most often, babies up to 2-3 years old have synechia. Synechia (from the Greek word "synecheia" - continuity, connection, adhesion) is called congenital or acquired fusion of the labia minora, less often - the labia minora and labia majora. Most often, fusion occurs over the outlet of the urethra, thereby disrupting the normal outflow of urine. This condition causes discomfort to the child.

Why do synechias occur? There are several reasons for this.

1. Excessive activity in the intimate hygiene of a girl - problems can arise when too active and frequent washing with soap. In babies, the mucous membranes of the genital organs are very thin, and with frequent washing, especially with soap, the protective film is washed off, which can lead to injury and inflammation. During healing, adhesions occur at the site of the inflamed tissues of the labia.
   Of course, this does not mean that synechia occurs due to washing in general and girls do not need to be washed. It’s just enough to wash the baby with soap only after defecation (preferably with a special baby soap with an approximate pH value). The rest of the time, it is enough to wash the girl only with running water without soap, in the direction from the pubis to the anus.
2. Another common reason for the formation of synechia is, and sometimes the presence of synechia directly indicates the need for an examination of the urinary system. Dangerous microbes with urine enter the mucous membranes and cause their inflammation, and at the site of inflammation, fusion of the labia occurs. In this case, it is necessary to consult a doctor, pass a urine test and urine culture.
3. The causes of synechia can be female genital infections- with vulvitis and vulvovaginitis (see below).
4. Synechia can become one of the manifestations allergies, because it affects not only the skin, but also the mucous membranes. From the environment of a baby who has manifestations of allergies (rash, bronchial asthma, allergic rhinitis), it is worth removing all potentially dangerous allergens, cosmetics, diapers and other provoking factors.
5. Complications of pregnancy and childbirth the mother can also be a factor provoking synechia.

How can synechia be recognized or suspected? If the structure of the labia seems suspicious to you, show the child to a pediatric gynecologist - the doctor will dispel your doubts and at the same time tell you what to look for. Follow the process of urinating your daughter - is there any straining, discomfort, is the baby naughty during urination. Crying and unwillingness to sit on the potty can also be a signal.

It is necessary to make it a rule to regularly examine the baby's genitals after hygiene procedures. At the slightest manifestation of redness, rashes, peeling or discharge, you should seek the advice of a doctor. Due to untreated synechia, with the growth of the body, the external and internal genital organs may not form correctly, which may even result in a violation of the reproductive function.

At the appointment, the doctor will carefully examine the baby, if necessary, take smears, cultures of flora for sensitivity to antibiotics in case of detection of infections and analysis for sexual infections - chlamydia, ureaplasma, gonococci, Trichomonas, gardnerella.

If treatment is necessary, then usually before it starts, an examination for enterobiasis is carried out - whether the girl has worms, and allergies are also ruled out. Then the effectiveness of treatment increases.

There are two methods of treatment - conservative and surgical. Many doctors believe that surgery is only possible in extreme cases. In all the rest, it is necessary to apply methods of non-surgical separation of synechiae.

Topical treatment consists of various estrogen creams combined with homeopathic or healing ointments. These preparations are applied in a thin layer on the fusion line twice a day for two weeks, and then for another week or two - 1 time per day. During treatment with cream, you need to make light pressure movements in the area of ​​​​fusion from top to bottom to help the divergence of the labia. Most often, synechias are separated, and after that, ointments with vitamins A and D are prescribed to prevent relapses.

It is believed that the use of disposable diapers does not interfere with treatment, but strict conditions for wearing them must be observed.

If after a month of treatment with estrogen creams there is no separation of the synechiae, it will be necessary to perform a mechanical dissection with a preliminary treatment with 5% lidocaine ointment. After that, treatment with estrogen creams continues for a month so that there is no recurrence.

During this period, proper care is very important for the child. It is recommended to wash the girl in the morning and in the evening and after each bowel movement. In the evenings, you will need sitz baths with a decoction of chamomile, St. John's wort, sage, oak bark or eucalyptus for 5-7 minutes for a week or two. After the baths, it is necessary to wet the genitals with a cotton napkin, apply a gauze napkin with Levomikol ointment to the place where there were synechiae. Then you need to wash the baby, and in the evening lubricate the external genital organs, especially the labia minora, with baby hygienic oils.

It is necessary to monitor the color of the skin in the perineum: the appearance of a bright pink stripe may indicate this recurrence. Synechia tend to relapse up to 6-9 years.

Vulvitis and vulvovaginitis

Inflammation of the labia (vulvitis) and labia with the vagina (vulvovaginitis) is in second place among childhood gynecological diseases. Most often they occur against the background of a decrease in a girl. The main microbes responsible for the development of inflammation are usually streptococci, enterococci, staphylococci and Escherichia coli - that is, the conditionally pathogenic flora of the child.

For the development of inflammation, predisposing factors are needed that reduce the body's resistance - frequent diseases of the throat and nose, childhood infections and other factors. Microorganisms can be introduced with feces with improper washing, dirty hands, other people's clothes, water from open reservoirs. In addition, persistent vulvovaginitis may be a sign of foreign bodies in the vagina.

Unfortunately, even babies can have vulvovaginitis caused by a sexually transmitted infection - trichomonas, chlamydia and others. Most often, pathogens come from the mother - in utero or during childbirth; some of them can be transferred in the household way - through washcloths, shared towels.

Often the causes of vulvovaginitis are pinworms - small worms that cause. As a result of female pinworms crawling into the genital slit or combing the perianal area by the child himself, trauma to the mucosa and inflammation occur.

Why is this disease so dangerous? Vulvovaginitis affects the physical and emotional state of the child, with improper treatment or its absence, it can take a persistent, chronic course, which can threaten the transition to the internal genital organs.

In girls older than 2-3 years, the main cause of vulvitis may be attending a kindergarten or elementary school. The reasons are simple - numerous stresses and a decrease in local immunity, hence the frequent incidence in general and gynecological in particular. All factors create favorable conditions for the suppression of the protection of the vagina and vulva and the reproduction of microbes in them.

Parents should remember that during the period of adaptation to new conditions, the girl needs immunity support and protection from stress. Usually this is maintaining a healthy balance of intestinal microflora, diet and daily routine, the use of multivitamin preparations and tempering procedures. In addition, a significant role in the development of problems in the genital area is played by foci of chronic infection - tonsillitis, adenoids, caries. All these foci need to be treated.

Vulvovaginitis is manifested by swelling of the skin of the external genitalia and their redness, there may be itching, peeling of the skin and discharge of varying intensity and color, with or without odor. When urine comes into contact with the skin, itching and burning are aggravated due to irritation. The girl begins to act up, eat and sleep badly.

To make a diagnosis, you need a doctor's examination. If there is a suspicion of an infection, then also a smear. If necessary, cultures with sensitivity to antibiotics can also be done. In addition, they will conduct a study of perianal scraping to exclude enterobiasis (pinworms), determine the level of glucose in the blood, prescribe a general urine test. If vulvovaginitis recurs, this is a reason to be examined by an ENT specialist, an allergist, a dermatovenereologist in order to exclude foci of chronic infection and allergies.

The approach to the treatment of vulvovaginitis should be individualized. Therapy can be local and general. The complex of local effects includes anti-inflammatory ointments, various antiseptic solutions, baths, strict adherence to personal hygiene measures. If the process recurs, then local antibiotics are prescribed in suppositories, creams, irrigation solutions or tablets. Common remedies include immunostimulants, vitamins, and proper nutrition. In addition, it is worth supporting the treatment by maintaining the intestinal microflora.

In order to prevent the recurrence of the disease, it is necessary to observe preventive measures - often change underwear, bathe the baby daily, wash only in the direction from front to back, without using soap if possible. If a girl wears disposable diapers, you need to change them regularly and not abuse them, wearing them as needed. The girl should have a hotel towel, washcloth, bed linen, which are washed and washed separately from adult things.

Candidiasis (thrush)

This unpleasant disease usually develops in preschool girls and schoolgirls. Thrush is caused by a fungus of the genus Canida, which causes damage to the genital tract. Infection can occur during childbirth, and later - through the household. Candida live on the surface of the skin and mucous membranes and are activated in conditions of reduced immunity - both local and general, and infection can occur even after several months or years from the moment of infection.

Most often, thrush manifests itself in girls from 4 to 8-9 years old. This is explained by the fact that entering a kindergarten or school is a pronounced stress for a child, a new team carries a new active microbial load, which greatly strains the immune system. The rhythm of life is also changing - sleep, daily routine and especially nutrition.

Usually, candidiasis is manifested by severe itching in the genital area, redness and swelling of the labia, scanty white discharge or cheesy deposits on the genitals. You cannot treat candidiasis on your own - this can lead to a chronic infection.

02.01.2012

Paretskaya Alena
pediatrician, member of the Association of Consultants
on breastfeeding, member of the Association IACMAH,
early childhood nutrition specialist
project manager "Children's Doctor"