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Undergone Vaginal Hysterectomy. Had Severe Vaginitis And Have Tried Terazol And Flagstatin. Having Severe Burning And Pain. Treatment?
Question: i am about 9 weeks post surgery ...vaginal hysterectomy ...I have had severe vaginitis and have tried terazol( cannot use over the counter stuff) and flagstatin ..I had a post op vag infection which I was given Flagyl for 7 days. I am having severe burning and pain ..I have have several bouts of vaginitis before surgery , but never this bad!!!
Brief Answer:
Antifungal treatment might be necessary
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
As you have mentioned, you have had vaginitis before your surgery and they were mild infections treated with terazol (terconazole - antifungal) and flagystatin (metronidazole and nystatin - antibiotic and antifungal).
Presently, the vaginitis which has appeared 9 weeks after surgery is causing severe discomfort, burning and pain.
It may be important to note that vaginal hysterectomy is a surgical wound in the region. Like any surgical wound, it heals by primary closure and scar formation, but in this case it is more internally located.
I understand that when you had the post op vaginal infection, you were given Flagyl (metronidazole) only (for a week), you might not have been given any antifungal treatment (please correct me if I am wrong), following which you could now have severe fungal infection.
Please keep the area absolutely dry and wear cotton inner clothes which are not too tight. Please take lots of water and use wash room frequently to avoid any urinary tract infection.
You could approach your doctor stating that you have had fungal vaginitis infection and take antifungal treatment for that. Also get your partner treated with antifungals.
Hope your query is answered.
Do write back if you have any doubts.
Dr. A. Rao Kavoor
Antifungal treatment might be necessary
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
As you have mentioned, you have had vaginitis before your surgery and they were mild infections treated with terazol (terconazole - antifungal) and flagystatin (metronidazole and nystatin - antibiotic and antifungal).
Presently, the vaginitis which has appeared 9 weeks after surgery is causing severe discomfort, burning and pain.
It may be important to note that vaginal hysterectomy is a surgical wound in the region. Like any surgical wound, it heals by primary closure and scar formation, but in this case it is more internally located.
I understand that when you had the post op vaginal infection, you were given Flagyl (metronidazole) only (for a week), you might not have been given any antifungal treatment (please correct me if I am wrong), following which you could now have severe fungal infection.
Please keep the area absolutely dry and wear cotton inner clothes which are not too tight. Please take lots of water and use wash room frequently to avoid any urinary tract infection.
You could approach your doctor stating that you have had fungal vaginitis infection and take antifungal treatment for that. Also get your partner treated with antifungals.
Hope your query is answered.
Do write back if you have any doubts.
Dr. A. Rao Kavoor
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes I have currently been using ta tar axial and flagstatin .. Although it gives me some relief after a few days I have severe burning ... Bad enough to not be able to do much .. Not really ant discharge .. Watery at best my gynaecologist did say I have a yeast infection .. What do you know about boric acid treatment. Sorry I meant tarazol anti fungal ..
Brief Answer:
Boric acid promising treatment for vaginitis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I have done literature research on Boric acid treatment for vaginitis and would like to share the information as below.
Research 1 (2003)
The boric acid regimen, 600 mg daily for 2 to 3 weeks, achieved clinical and mycologic success in 47 of 73 symptomatic women (64%) in Detroit and 27 of 38 symptomatic women (71%) in Beer XXXXXXX No advantage was observed in extending therapy for 14 to 21 days. Topical flucytosine cream administered nightly for 14 days was associated with a successful outcome in 27 of 30 of women (90%) whose condition had failed to respond to boric acid and azole therapy. Local side effects were uncommon with both regimens.
Research 2 (2007)
Diabetic women with C. glabrata show higher mycological cure with boric acid vaginal suppositories given for 14 days in comparison with single-dose oral 150-mg fluconazole.
Research 3 (2011)
Findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.
Hence we can conclude that boric acid therapy is promising in patients with recurrent vaginitis.
Hope your query is answered.
Dr A. Rao Kavoor
Boric acid promising treatment for vaginitis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I have done literature research on Boric acid treatment for vaginitis and would like to share the information as below.
Research 1 (2003)
The boric acid regimen, 600 mg daily for 2 to 3 weeks, achieved clinical and mycologic success in 47 of 73 symptomatic women (64%) in Detroit and 27 of 38 symptomatic women (71%) in Beer XXXXXXX No advantage was observed in extending therapy for 14 to 21 days. Topical flucytosine cream administered nightly for 14 days was associated with a successful outcome in 27 of 30 of women (90%) whose condition had failed to respond to boric acid and azole therapy. Local side effects were uncommon with both regimens.
Research 2 (2007)
Diabetic women with C. glabrata show higher mycological cure with boric acid vaginal suppositories given for 14 days in comparison with single-dose oral 150-mg fluconazole.
Research 3 (2011)
Findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.
Hence we can conclude that boric acid therapy is promising in patients with recurrent vaginitis.
Hope your query is answered.
Dr A. Rao Kavoor
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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