Üreme Sistemi Enfeksiyonları ve Cinsel Yolla Bulaşan Enfeksiyonlar
Özet
Genital sistemi etkileyen enfeksiyonlar üreme sistemi enfeksiyonları olarak ifade edilmektedir. Kadınların birçoğu üreme sistemi enfeksiyonlarını hayatları boyunca sıklıkla yaşamaktadır. Bu enfeksiyonlara yol açan faktörler arasında vajinal duş, tampon kullanımı, yetersiz genital hijyen, çok eşlilik, sistemik hastalıklar, beslenme bozuklukları ve yanlış bilgi ve uygulamalar yer almaktadır. Üreme sistemi enfeksiyonları belirgin semptomlarla ortaya çıkabildiği gibi hiçbir belirti göstermeyebilir. Kadınların birçoğunda görülen en yaygın belirtiler vajinal akıntı, kaşıntı ve yanma hissidir. Bu enfeksiyonlar kadın yaşamını tehdit etmese de fiziksel, emosyonel, sosyokültürel ve ekonomik sorunlara yol açmaktadır. Üreme sistemi enfeksiyonları içerisinde önemli bir yeri olan Cinsel Yolla Bulaşan Enfeksiyonlar (CYBE) ise kadın sağlığını tehdit eden küresel bir sorundur. Çoğunlukla korunmasız vajinal, anal ya da oral cinsel ilişki yoluyla bulaşan bu enfeksiyonların çoğu başlangıçta asemptomatiktir. Kadınların birçoğu şikâyetleri başladığında hemen sağlık kuruluşuna başvururken, bazıları bu semptomları normal kabul ederek tedavi arayışına girmemektedir. Diğer taraftan bu enfeksiyonlar korku, utanma, sosyal izolasyon ve suçluluk hissi gibi psikososyal sorunlara neden olmaktadır. Bu durum tanı ve tedavi sürecini geciktirmektedir. İhmal edilen ve uzun süre tedavi edilmeyen CYBE ise enfeksiyonun başkalarına bulaşmasına ve kadını hayatı boyunca etkileyebilecek ciddi komplikasyonlara yol açmaktadır. Hemşireler üreme sistemi enfeksiyonları ve CYBE’den korunma ile doğru tanı ve tedavinin sürdürülmesinde kritik öneme sahip sağlık profesyonelleridir. Bu doğrultuda hemşireler kadınların sağlık sorunlarını ve gereksinimlerini kapsamlı şekilde değerlendirmeli ve bu enfeksiyonlara yol açabilecek yanlış uygulamalar, doğru hijyen alışkanlıkları ve güvenli cinsel davranışlar konularında kadınları bilgilendirmelidir. Ayrıca yargılayıcı olmayan bir tutumla kadınları soru sormaya teşvik etmeli ve bakımlarıyla ilgili uygun ve yeterli bilgi vermelidir.
Referanslar
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Referanslar
Greenbaum S, Greenbaum G, Moran-Gilad J, Weintraub AY. Ecological dynamics of the vaginal microbiome in relation to health and disease. Am J Obstet Gynecol 2019;220(4):324-35. doi: 10.1016/j.ajog.2018.11.1089
Morgan HS. Primary care management of women with persistent vaginal discharge. Nurse Pract 2016;41(12):1-6. doi: 10.1097/01.NPR.0000508174.26163.7f
Aldunate M, Srbinovski D, Hearps AC, Latham CF, Ramsland PA, Gugasyan R, et al. Antimicrobial and immune modulatory effects of lactic acid and short chain fatty acids produced by vaginal microbiota associated with eubiosis and bacterial vaginosis. Front Physiol 2015;6(164):1-23.doi: 10.3389/fphys.2015.00164
Lin YP, Chen WC, Cheng CM, Shen CJ. Vaginal pH value for clinical diagnosis and treatment of common vaginitis. Diagnostics 2021;11(11):1996. doi: 10.3390/diagnostics11111996
Powell AM, Nyirjesy P. New perspectives on the normal vagina and noninfectious causes of discharge. Clin Obstet Gynecol 2015;58(3):453-63. doi: 10.1097/GRF.0000000000000124
Parma M, Vanni VS, Bertini M, Candiani M. Probiotics in the prevention of recurrences of bacterial vaginosis. Altern Ther Health Med 2014;20 (Supp. 1):52-7.
Rao VL, Mahmood T. Vaginal discharge. Obstetrics, Gynaecology & Reproductive Medicine 2020;30(1):11-8. doi: 10.1016/j.ogrm.2019.10.004
Allen M. Identifying acute cervicitis in an era of less-frequent routine gynecologic examinations. JAAPA 2018;31(2):50-3. doi: 10.1097/01.JAA.0000530277.12517.69
Abd EL-Menim SO, Moursi HA, Sarhan AEM. Effect of educational program on vulvitis prevention among nursing students. Am J Nurs 2018;7(6):254-67. doi:10.11648/j.ajns.20180706.19
Agana MG, Ryali B, Patel DR. Vulvovaginitis in adolescents. Pediat Med 2019;2(53):1-7. doi: 10.21037/pm.2019.09.04
Stricker T. Vulvovaginitis. Paediatr Child Health 2010;20(3):143-5. doi: 10.1016/j.paed.2009.10.002
Itriyeva K. Evaluation of vulvovaginitis in the adolescent patient. Curr Probl Pediatr Adolesc Health Care 2020;50(7):100836. doi: 10.1016/j.cppeds.2020.100836
Paladine HL, Desai UA. Vaginitis: diagnosis and treatment. Am Fam Physician 2018;97(5):321-9.
Abou Chacra L, Fenollar F, Diop K. Bacterial vaginosis: What do we currently know? Front Cell Infect Microbiol 2022;11:1-15. doi:10.3389/fcimb.2021.672429
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. Mil Med Res 2016;3:1-10. doi: 10.1186/s40779-016-0074-5
Coudray MS, Madhivanan P. Bacterial vaginosis - A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol 2020;245:143-8. doi: 10.1016/j.ejogrb.2019.12.035
WHO. Bacterial vaginosis: World Health Organization; 2023 [Available from: https://www.who.int/news-room/fact-sheets/detail/bacterial-vaginosis.
CDC. Sexually Transmitted Infections Treatment Guidelines, 2021. Centers for Disease Control and Prevention 2021 [Available from: https://www.cdc.gov/std/treatment-guidelines/hpv.htm.
San Juan Galán J, Poliquin V, Gerstein AC. Insights and advances in recurrent vulvovaginal candidiasis. PLoS Pathog 2023;19(11):e1011684. doi: 10.1371/journal.ppat.1011684
Denning DW, Kneale M, Sobel JD, Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: A systematic review. Lancet Infect Dis 2018;18(11):e339-e47. doi: 10.1016/S1473-3099(18)30103-8
Malak A, Kurç MA, Gülen D, Kaya AD, Taşdemir N, Varol G. Vulvovajinal kandidiyazis: Risk faktörleri ve infeksiyon etkenlerinin dağılımı. Sağlık Bilimlerinde Değer 2024;14(1):66-70. doi: 10.33631/sabd.1359836
Frobenius W, Bogdan C. Diagnostic value of vaginal discharge, wet mount and vaginal Ph-an update on the basics of gynecologic infectiology. Geburtshilfe Frauenheilkd 2015;75(04):355-66. doi: 10.1055/s-0035-1545909
WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021- Accountability for the global health sector strategies 2016–2021: actions for impact. World Health Organization 2021 [Available from: https://iris.who.int/bitstream/handle/10665/341412/9789240027077-eng.pdf.
Beyhan YE. A systematic review of trichomonas vaginalis in Turkey from 2002 to 2020. Acta Trop 2021;221:105995. doi: 10.1016/j.actatropica.2021.105995
Lewis FM, Spicknall IH, Flagg EW, Papp JR, Kreisel KM. Incidence and prevalence of trichomonas vaginalis infection among persons aged 15 to 59 years: United States, 2018. Sex Transm Dis 2021;48(4):232-7. doi: 10.1097/OLQ.0000000000001383
Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016. Bull World Health Organ 2019;97(8):548.
WHO. Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. World Health Organization 2022 [Available from: https://www.who.int/publications/i/item/9789240052390.
Reichman O, Sobel J. Desquamative inflammatory vaginitis. Best Pract Res Clin Obstet Gynaecol 2014;28(7):1042-50. doi: 10.1016/j.bpobgyn.2014.07.003
Smagulova AA, Kamaliyeva AK, Sagdatbek NS. Bacterial vaginosis and desquamative inflammatory vaginitis: Choice of an effective therapy method. Science & Healthcare 2022;24(4):216-23. doi: 10.34689/SH.2022.24.4.026
Ortiz-de la Tabla V, Gutiérrez F. Cervicitis: etiología, diagnóstico y tratamiento. Enferm Infecc Microbiol Clin 2019;37(10):661-7. doi: 10.1016/j.eimc.2018.12.004
Taylor SN, Lensing S, Schwebke J, Lillis R, Mena LA, Nelson AL, et al. Prevalence and treatment outcome of cervicitis of unknown etiology. Sex Transm Dis 2013;40(5):1-17. doi: 10.1097/OLQ.0b013e31828bfcb1
Bansal S, Bhargava A, Verma P, Khunger N, Panchal P, Joshi N. Etiology of cervicitis: Are there new agents in play? Indian J Sex Transm Dis AIDS 2022;43(2):174-8. doi: 10.4103/ijstd.ijstd_75_21
Ford GW, Decker CF. Pelvic inflammatory disease. Dis Mon 2016;62(8):301-5. doi: 10.1016/j.disamonth.2016.03.015
Garcia MR, Leslie SW, Wray AA. Sexually transmitted infections. StatPearls; 2023 [Available from: https://www.ncbi.nlm.nih.gov/books/NBK560808/.
Jennings LK, Krywko DM. Pelvic inflammatory disease. StatPearls; 2018 [Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/.
Kreisel KM, Llata E, Haderxhanaj L, Pearson WS, Tao G, Wiesenfeld HC, et al. The burden of and trends in pelvic inflammatory disease in the United States, 2006-2016. J Infect Dis 2021;224(Supplement 2):S103-S12. doi: 10.1093/infdis/jiaa771
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