Frimley Health NHS Foundation Trust
Clinical Guideline: Vaginal DischargeSite: FPH-85725267336Discharge: Colour, consistency, odour, onset, amount, ass. Irritation, bleedingGynae: Pelvic pain, smear history, contraception (ocp), recent pregnancySexual history: New partner. Symptomatic partner00Discharge: Colour, consistency, odour, onset, amount, ass. Irritation, bleedingGynae: Pelvic pain, smear history, contraception (ocp), recent pregnancySexual history: New partner. Symptomatic partner-127028575History00History-38100269240General Information00General Information-85725204470Rarely due to a significant cause.Exclude ca cervix or endometrium (watery blood stained discharge from cervical canal in post-menopausal women)Avoid antibiotics: can lead to persistent and resistant infection00Rarely due to a significant cause.Exclude ca cervix or endometrium (watery blood stained discharge from cervical canal in post-menopausal women)Avoid antibiotics: can lead to persistent and resistant infection-857255033645Ectopy: Stop OCP if applicable, consider cautery if symptoms warrantBacterial vaginosis (BV): Oral metronidazoleAntifungal treatment: CandidiasisTry antiseptic therapy (specific products not commercially available) e.g. dilute betadine douche,(Live yoghurt may be beneficial)00Ectopy: Stop OCP if applicable, consider cautery if symptoms warrantBacterial vaginosis (BV): Oral metronidazoleAntifungal treatment: CandidiasisTry antiseptic therapy (specific products not commercially available) e.g. dilute betadine douche,(Live yoghurt may be beneficial)-381004794250Advice and Treatment00Advice and Treatment-857253490595Consider referral if:Suspicious cervix: TWREctopy: For cautery if symptoms persist after stopping OCP?PID: Associated pelvic pain and tenderness (emergency referral for suspected acute PID)Undiagnosed or persistent discharge: Refer GUM00Consider referral if:Suspicious cervix: TWREctopy: For cautery if symptoms persist after stopping OCP?PID: Associated pelvic pain and tenderness (emergency referral for suspected acute PID)Undiagnosed or persistent discharge: Refer GUM-857253195320Referral Guidelines – red flag signs00Referral Guidelines – red flag signs-857252490470High vaginal + endocervical and/or high vaginal swab (inc. chlamydia +/- gonorrhoea)FBC, and CRP/ESR if PID is suspected00High vaginal + endocervical and/or high vaginal swab (inc. chlamydia +/- gonorrhoea)FBC, and CRP/ESR if PID is suspected-381002195195Investigation00Investigation-857251052195Abdomen: Tenderness, massVulva: vulvitisSpeculum: Discharge watery, malodourous (BV), thick, white (candida)Local inflammation of vagina or cervix. Cervical ectropion +/- purulent dischargeBimanual: cervical excitation tenderness00Abdomen: Tenderness, massVulva: vulvitisSpeculum: Discharge watery, malodourous (BV), thick, white (candida)Local inflammation of vagina or cervix. Cervical ectropion +/- purulent dischargeBimanual: cervical excitation tenderness-38735812800Examination00Examination ................
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