REPRODUCTION SYSTEM

GROUP 12th
 Modul 2
a housewife 27 years old, come to public health centre with
leuchorre complaint, one that beginning be felt one week last.
She works as PNS as head of section at Kanwil one of
Department. On sign undiscovered check ferocity.
 Key Word
• housewife 27 years old
• leuchrroe complaint, since one week last
• work as PNS as head of section at Kanwil
• sign undiscovered check ferocity
 Question
1. Anatomy of woman reproduction organ?
2. Histologi of woman reproduction organ?
3. Organ physiology reproduces that in reference to case?
4. Causative whatever factor leuchrroe happening?
5. Whatever disease that have leuchrroe phenomena?
6. Patomekanisme is its happening leuchrroe?
7. Distinctive one arise from causal factor and how to differentiate
physiological leuchrroe and patologis?
8. Any kind risk factor of disease with leuchrroe phenomena and
prevalence and incident of this case?
9. Diagnostic stage of this case?
10. Supporter check on this case?
11. Therapy medikamentosa's and non medikamentosa of this case?
12. Any kind action promotif and preventif of this leuchrroe case?
Ovarium...
Uterus...
Vagina...
Leucorrhoea Pathologies
Cause factor of Leukorea
Vagina of infection or Cervix
 Uterus of tumor
 Psychological of stimulation
 Excess washing of vagina
 trauma
Disease with whitish symptom
• Mushroom:
Candida albicans:
Candidosis Vulvovaginal: leucorrhoea like a milk, clotted, no smell, itchiness
• Bacteria:
Gardnerella vaginalis:
Vaginosis Bacterial: sekret sloppy, smelly, white - gray, itchiness, feeling burned
• Neisseria gonorrhoeae
Gonore: sekret yellow, thick, itchiness, pain when miksi
• Parasite
Trichomonas vaginalis:
Trikomoniasis: sekret yellow – green, frothy, smelly, itchiness, feeling burned
• Carsinoma serviks uterus: sekret malodorous due to infection & nekrosis
• A foreign object with a secondary infection eg, tampon: Toxic shock syndrome
 ETIOLOGY

normal flora vagina

imbalanced

Bacterial growth ↑

vagina secretion

Mechanism of Fluor Albus

 PH G. vaginalis

Amino
Acid

Anaerob germs+
Amin Cells Sel Epitel
facultatif vagina
bacterials Degeneration vagina
Vagina
Release secretion

odor
Patomechanism of Fluor Albus
 Pathology
• Infection • smell
o Bacterium
o Mushroom
• jell the
o Parasite • colour depended cause:
o Virus - Turn yellow the
• Worm
greenness:infection
• Foreign Object
• Hormonal - Brown: blood menstruate
• Cancer - Turn white to jell: mushroom
• Vaginitis Atrofi
 Physiology
• Turn white like cloud • Newborn baby especially until
• Brass of when running dry at age 10 day.
underwear • Premenarche
• Odourless • Moment of before and hereafter
• Is not accompanied by the pain menstruation
in bone, itchy,feel burnted & • Moment or about ovulasi
squeezing.
• Pregnancy
• trouble of body Condition of like
• Psychical Factor
anaemia circumstance,
insuffiency gizi, fatigue, fatness, • Sexual Excitement of at adult
old age > 45 year woman
Diagnostic steps for
‘LEUCHORROE’
Anamnesis
• Age • Relation with menstruation, ovulation,
• Profession and patient status pregnancy
• Quantity of leuchorroe • Iritation : infection, queer substance,
neoplasma
• Colour of leuchorroe
• Pruritus
• Smell of leuchorroe • Contraception
• Incubation period
• Sexual relation with partner
• Medication history
(antibiotic,hormone therapy)
Physical examination
• Abdominal inferior skin inspection (perineum, anus)
• Mons pubis inspection
• eksterna genitalia Inspection and palpation
• Speculum investigation for vagina and serviks
• bimanual pelvis investigation
• inguinal gland palpation
VAGINOSIS BACTERIAL
 Anamnesis :
• vagina smell : stinking as fish smell especially
• quantity of leuchorroe : >> or >>>, homogen
• colour of leuchorroe : white or gray, stuck in vagina’s wall.
• inflamation sign : (-)

 Laboratorium: pH >4,5 (usually 5-5,5)

 Microscopic: clue cell (+), leucocyte (rare)

KANDIDOSIS VULVOVAGINAL
 Anamnesis:
• Hot or iritation in vulva
• Pruritus
• Leuchorroe smell (acid or not smell )
• Leuchorroe quantity : >>, cottage cheeses in vagina’s wall
• Inflamation sign : (+) in vulva or and vagina

 Laboratorium: pH vagina <4,5

 Microscopic: wet preparat with KOH 10% or with gram coloring (blastopora oval
shape, bud cells, pseudohifa)
TRIKOMONIASIS
Anamnesis:
• usually asimptomatic
• >>> vaginal discharge, homogen, wet, foamy
• colour leucorrhoe : white, yellow, purulent
• leuchorroe smell (+)
• dispareunia (+)
• pasca coitus hemorrhage and intermenstrual hemorrhage
• iritation (+)
• pruritus (+)
• Inflamation sign (+)  eritema and edema in vulva with ekskoriasi
• “strawberry servix”
• Laboratorium: pH > 4,5
• Mikroskopik : wet preparat with salt fisiologis liquor , show
up of trichomonas movement, flagel, leukocyte (+) and clue
cell (+)
Medicamentosa
1. Candida albicans
a) Topical
• Nistatin tablet vagina 2 x day until 2 weeks
b) Systemic
• Nistatin tablet 4 x 1 tablet until 2 weeks or
• Ketokonazol oral 2 x 200 mg until 7 days
2. Chlamidia trachomatis
• Metronidazole 600 mg/day 4-7 days
• Tetrasiklin 4 x 500mg until 10-14 days oral
3. Gardnerella vaginalis
• Metronidazole 2 x 500 mg
• Ampisillin 4 x 500 mg oral/day until 7 days
Non-Medicamentosa
• balance diet
• enough to rest
• Use condom
• avoid promiskuitas
• Keep clean the vagina and keep it
• Don’t use a lot of vagina cleaner
 Leukorea as flour
albus

Dilution exit jell from vagina which felt itchy,

heat or hurt some time smell or lost to
Clean vagina whith
cleaner which not Always dry vagina before dressing
bother pH stable at
vagina.

Avoid usage powder at vagina which

target vagina to be fragrance and dry
for long day jeans is not suggest
because is meeting
Usage underwear pore
which sweat absorbed
 Usage dry
underwear

Rinsevagina from front to

back

When mentruation , often change

woman bandage
usage panty liner just
moment need
• DIAGNOSIS DIFERENTIAL
 Vaginosis bacterial Trikomoniasis
Etiology Gardnerella vaginalis of agent. Trikomoniasis vaginalis of
Excess growth of some bacteria agent.
species on vagina and
decrease lactobacillus and
increase anaerob organism.
Incidence Vaginitis causes and the most Sexual infect dissease attack
often at young lady. Coitus of 180 million woman in the world.
pass through spreading.
Symptomp Duh vagina non pruritik with Duh vagina rotten bearded,
rancid bearded. 50 % woman haemorrhage pasca coitus,
asymptomatic. eritema and edema
Diagnose Whiff test +, pH > 4,5, clue pH > 4,5, Excessively leulocyt
cells, white blood cell on the total, Pap smear at woman
discharge. asymptomatic.
Therapy Metronidazol, sefradin, Metronidazol.
 KANDIDOSIS VULVOVAGINALIS
Definition Fungus disease that is acute/subakut in the vagina/vulva & is caused by
kandida
Etiology Candida albicans
Epidemiology • This disease is found throughout the world
• Can attack all ages, both men and women
Clinical • Ithcing in the vulva
Manifestation • leukorea like a milk, clotted, no smell
• Sore vulva & vagina
Supporting • Skin rub with lar.KOH 10% Blastopora or
Examination Pseudohifa
• Lear sediments with Gram & Blastopora
Pseudohifa
Therapy • Avoid or disappear the predisposition factor
• Topical
 Wassalam
Wr. Wb.

Ade Tri Arlini

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