Does yellow leucorrhea and vulvar itching require hospital examination?

After discovering the symptoms of yellow leucorrhea and vulvar itching, many women will treat themselves at home, mostly using vaginal washes for flushing, which may make the disease worse. So, do patients with yellow leucorrhea and vulvar itching need to be examined in the hospital? According to the doctor's advice, patients should go to the hospital for formal examinations after discovering the symptoms of yellow leucorrhea and vulvar itching. During the examination, the patient needs to do many items. Let's learn about it together.

To check whether the leucorrhea is normal, you need to observe the amount, color, texture and smell. Normal leucorrhea should be milky white or colorless and transparent, with a slight fishy smell or no smell. The amount and texture of leucorrhea are affected by the levels of estrogen and progesterone in the body, and the amount, texture and consistency change periodically with the menstrual cycle. Patients can do the following examinations to diagnose the disease:

1. Physical Examination

Proceed from outside to inside. First, visually inspect the vulva, urethra, paraurethral glands and Bartholin's glands. Then, use a vaginal speculum to observe the vaginal wall and cervix.

(I) Visual examination of the vulva

See helps to identify vaginitis. Erythema and small collar fissures around the vulva and anus may be caused by candidiasis, and vulvar edema may be caused by trichomoniasis. The vulva of patients with Trichomonas vaginitis or cervicitis is often contaminated with a large amount of purulent vaginal discharge, while in bacterial vaginosis, only accumulated vaginal discharge is seen at the vaginal opening.

(ii) Appearance of vaginal discharge

Various pathological vaginal discharges have different specific characteristics that can provide diagnostic clues.

(III) Cervical secretions

The cervix has a clear fluid-like discharge before ovulation, which becomes thicker during the luteal phase.

2. Laboratory Examination

(I) pH determination

The use of paper strips to measure the state of vaginal discharge has certain value in diagnosis. The pH value of normal vaginal discharge is ≤4.5, while the pH value of discharge caused by Trichomonas and bacterial vaginosis increases.

(ii) Odor of amines

All patients with excessive vaginal discharge should be tested for the presence of glue odor. First put a drop of 100% KOH solution on the glass slide and mix the leucorrhea with it. The leucorrhea of ​​bacterial vaginosis may emit a fishy odor, which is caused by the volatilization of amine in the discharge through alkalization. This situation occasionally occurs in cases of leucorrhea caused by trichomoniasis. Normal leucorrhea and Candida leucorrhea do not have this amine smell.

(III) Microbial culture

(IV) Bacterial vaginosis (BV) testing

There are two methodologies for BV detection reagents. The improved amine test overcomes the shortcomings of the traditional amine test, which is low in sensitivity and highly subjective. Neuraminidase, also known as neuraminidase, has a close correlation with BV activity in the vaginal environment and has a high compliance rate with the Amsel method. A lot of work has been done on the research and development of related reagents at home and abroad, and products are already used in clinical testing.

3. Equipment Inspection

Observe the leucorrhea under a microscope. Guided by the clues of the appearance of the discharge, it is easier to get a correct diagnosis through microscopic observation. Mix a small amount of vaginal discharge with normal saline on a slide to disperse the vaginal epithelial cells, and observe lactobacilli, white blood cells, Trichomonas and clue cells under a high-power microscope (400x). Use 10% KOH solution to mix a larger amount of leucorrhea on another slide and observe Candida under a 100x microscope.

When patients have yellow leucorrhea and vulvar itching, the main examination they need to undergo is a gynecological examination, after which the disease can be diagnosed. Patients currently have yellow leucorrhea and vulvar itching mostly due to vaginitis, but which type of vaginitis it is can only be confirmed after further examination. Therefore, patients with yellow leucorrhea and vulvar itching must be examined, otherwise the disease will be misdiagnosed and treatment errors will be caused.