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The author studied the distribution of T. vaginalis in the reproductive tract of woman. The preliminary results indicate that the parasite may be confined to some segments of the system mostly to the paraurethral glands or to the urethra without invading the vagina, even for several weeks' time. Further observations are concerned with the behaviour of T. vaginalis in particular segments of the tract both prior and after oral and intravaginal treatment with the following drugs: Flagyl, Aminitrozol, Devaginol and the recent Polish preparation Chelivag. The observations were made in 50 women, the results being evaluated by culture method. The preliminary evaluation of the results obtained suggest that the estimation of the drugs in question should involve topographic examinations (urethra, paraurethral glands, vagina and the canal of the uterine cervix), since the drugs often proved to be effective in the vagina, while they failed to act in the paraurethral glands and the urethra. This finding is likely to be the result of uneven penetration of the drug used into all segments of the uro-genital tract in women. This might account for unexplained recurrences of T. vaginalis in the vagina as late as after second or third follow-up examination. The existence of drug-resistant strains in particular segments of the uro-genital system is open to discussion.
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Studies on the presence of T. vaginalis were performed in 387 women with particular reference to the distribution of T. vaginalis in the uro-genital tract. The samples were collected from the urethra [c], paraurethral glands [g], vagina [p] external orifice and canal of the uterine cervix [uk]. In 118 women, the uterus was excised, in 100 of them along with adnexa. In the operation room, the material was take in turn from each dissected oviduct and uterine corpus, as well as from the canal of the uterine cervix (non-dissected) without exceeding the external orifice. The diagnostic specimen from all above given portions of the reproductive organ was collected by means of sterile wet swabs and then placed on the Johnson-Trussel medium, as modified by Stępkowski. Parallely, the examinations were concerned with direct preparations in 0.9% NaCl, intravitally, and with stained sections. Among the total number of 387 women, 167 of them showed trichomonadosis as follows: c-3-1.7%; g-5-3.2%; p-3-1.7%; k-o-0%; c, g, p, uk-22-13.1%; c, g, p-115-68.8%; c, g-5-3.2%; c, p-1-0.6%; g, p–12-7.7%. The results of the topographic studies show that T. vaginalis may be confined to particular segments of the female reproductive system. The focal invasion confined to the urethra, paraurethral glands or vagina is not common, since -according to the tabular data-it occurs only in 1.7-3.2% of cases. On the other hand, the highest incidence was found for the simultaneous multifocal invasion, i.e. 68.8% in c, g, p and 13.1% in c, g, p, uk. Out of 32 operated patients, in whom trichomonadosis was demonstrated before the intervention, only one showed the presence of T. vaginalis in the corpus and canal of the uterine cervix. In the remaining patients affected by trichomonadosis and in 80 women operated upon without any evidence of trichomonadosis in the preoperative period, no T. vaginalis was encountered in the excised uterus and adnexa.
During 5 years cycle a prophylactic gynaecological, cytological and parasitological examinations of 1918 women were performed. 12.8% of women were infected with T. vaginalis. Decreasing percentage of infections was observed: from 9.92% in 1984 to 2.2% in 1988. In the I° of Papanicolaou cervical smears T. vaginalis has been found in 1.60% of cases, in the II°-in 5.2%, in the III°- in 14.29%, and in the IV°-in 22.22% of cases. In women with normal cervix uteri T. vaginalis have been found in 5.01% of cases, and in women with hypertrophical cervix and partially epidermised ectopy with ovula Nabothi in 15.28% of cases.
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