When is bacterial vaginosis not bacterial vaginosis?--a case of cervical carcinoma presenting as recurrent vaginal anaerobic infection.

Hudson, M; Tidy, JA; McCulloch, Tom; Rogstad, K E

doi:10.1136/sti.73.4.306

Cited by 5 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, BV is associated with profound changes in the physicochemical and immunological environment of the vaginal niche. It has been suggested that an elevated vaginal pH, as present in BV, may arrest squamous metaplasia in the post-pubertal cervix and prolong the period in which the transformation zone is vulnerable to agents promoting dysplasia such as HPV [46] . Da Silva et al described an increased frequency of BV and Chlamydia trachomatis in pregnant women with HPV infection [47] .…”

Section: Discussionmentioning

confidence: 99%

“…These carcinogenic compounds are capable of forming DNA adducts and consequently mutagenic events [50] . Previous investigations suggest that local accumulation of nitrosamines during episodes of BV may induce cell transformation of the cervical epithelium, in concert with other oncogenic agents like HPV infection [10] , [38] , [46] , [49] , [51] , [52] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis

et al. 2012

View full text Add to dashboard Cite

ObjectiveBacterial vaginosis (BV), the most common vaginal disorder among women of reproductive age, has been suggested as co-factor in the development of cervical cancer. Previous studies examining the relationship between BV and cervical intra-epithelial neoplasia (CIN) provided inconsistent and conflicting results. The aim of this study is to clarify the association between these two conditions.MethodsA systematic review and meta-analysis were conducted to summarize published literature on the association between BV and cervical pre-cancerous lesions. An extensive search of electronic databases Medline (Pubmed) and Web of Science was performed. The key words ‘bacterial vaginosis’ and ‘bacterial infections and vaginitis’ were used in combination with ‘cervical intraepithelial neoplasia’, ‘squamous intraepithelial lesions’, ‘cervical lesions’, ‘cervical dysplasia’, and ‘cervical screening’. Eligible studies required a clear description of diagnostic methods used for detecting both BV and cervical pre-cancerous lesions. Publications were included if they either reported odds ratios (OR) and corresponding 95% confidence intervals (CI) representing the magnitude of association between these two conditions, or presented data that allowed calculation of the OR.ResultsOut of 329 articles, 17 cross-sectional and 2 incidence studies were selected. In addition, two studies conducted in The Netherlands, using the national KOPAC system, were retained. After testing for heterogeneity and publication bias, meta-analysis and meta-regression were performed, using a random effects model. Although heterogeneity among studies was high (χ2 = 164.7, p<0.01, I2 = 88.5), a positive association between BV and cervical pre-cancerous lesions was found, with an overall estimated odds ratio of 1.51 (95% CI, 1.24–1.83). Meta-regression analysis could not detect a significant difference between studies based on BV diagnosis, CIN diagnosis or study population.ConclusionsAlthough most studies were cross-sectional and heterogeneity was high, this meta-analysis confirms a connection between BV and CIN.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis

et al. 2012

View full text Add to dashboard Cite

show abstract

“…The literature records several anecdotal treatments for recurrent BV, such as avoiding use of a vaginal sponge for contraceptive purposes (78), use of oral clindamycin (40, 41, 79, 80), supplement of hydrogen peroxide (81–83), lactobacillus recolonization with yogurt or capsules (84), or vaccination with lyophilized Lactobacillus acidophilus (85). Treatment failure is sometimes ascribed to nontreated partners (86), Netherton's syndrome, (87), or carcinoma of the cervix (88). Repeated treatments of the type commonly applied to severe candida infections – albeit not well founded through controlled trials – find some support in published recommendations by Wilson and Alfonsi et al (74, 89) that involve suppression with metronidazole vaginal gel for 10 days followed by twice weekly administration for 6 months or initial treatment with clindamycin vaginal cream followed by metronidazole vaginal gel after the next two menstruations.…”

Section: Recurrent Bvmentioning

confidence: 99%

Bacterial vaginosis – a disturbed bacterial flora and treatment enigma

Larsson

Forsum

2005

APMIS

View full text Add to dashboard Cite

The syndrome bacterial vaginosis (BV) is characterized by a disturbed vaginal microflora in which the normally occurring lactobacilli yield quantitatively to an overgrowth of mainly anaerobic bacteria. As BV is a possible cause of obstetrics complications and gynaecological disease--as well as a nuisance to the affected women--there is a strong impetus to find a cure. In BV treatment studies, the diagnosis criteria for diagnosis of BV vary considerably and different methods are used for cure evaluation. The design of study protocols varies and there is no consensus respecting a suitable time for follow-up visits. For the purpose of this review, available data were recalculated for 4-week post treatment cure rates. For oral metronidazole the 4-week cure rate was found not to exceed 60-70%. Treatment regimens with topical clindamycin or topical metronidazole have the same cure rates. It can thus be said that no sound scientific basis exists for recommending any particular treatment. There is no evidence of beneficial effects on BV engendered by partner treatment, or by addition of probiotics or buffered gel. Long-term follow-up (longer than 4 weeks) shows a relapse rate of 70%. With a primary cure rate of 60-70%, and a similar relapse rate documented in the reviewed literature, clinicians simply do not have adequate data for determining treatment or designing clinical studies. This is unfortunate since--apart from the obvious patient benefits--clinical studies can often serve as a guide for more basic studies in the quest for underlying disease mechanisms. In the case of BV there is still a need for continued basic studies on the vaginal flora, local immunity to the flora and host-parasite interactions as an aid when designing informative clinical studies.

show abstract

“…Cervical intraepithelial neoplasia (CIN) has a multifactorial aetiology, it is associated with sexual activity, and can lead to carcinoma of the cervix, the most powerful cause being oncogenic human papillomavirus infection. Any association between bacterial vaginosis and CIN is suggested to be caused by nitrosamines produced by the abnormal vaginal microflora 69,70 . A retrospective study 71 of 300 patients at a UK genitourinary medicine clinic found significantly more bacterial vaginosis in women with CIN, but other studies have failed to confirm these findings 72–75 .…”

Section: Conditions and Complications Associated With Bacterial Vagimentioning

confidence: 99%

Bacterial vaginosis: a public health review

Morris¹,

Nicoll²,

Simms³

et al. 2001

BJOG

124

View full text Add to dashboard Cite

When is bacterial vaginosis not bacterial vaginosis?--a case of cervical carcinoma presenting as recurrent vaginal anaerobic infection.

Cited by 5 publications

References 8 publications

Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis

Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis

Bacterial vaginosis – a disturbed bacterial flora and treatment enigma

Bacterial vaginosis: a public health review

Contact Info

Product

Resources

About