RISK FACTORS ASSOCIATED WITH THE PRESENCE OF VAGINAL WINDS IN WOMEN FROM A CHILEAN HOSPITAL
CASTRO, K. CEBALLOS, N. CANARIO, C. MANRIQUEZ;
Departamento de Obstetricia y Ginecologia, Univ. de Concepcion, Concepcion, Chile.
Introduction: Vaginal winds or garrulitas vulvae is defined as the expulsion of air from the vagina. The mechanism that produces this symptom is unknown, but it has been associated with a defective perineum, where there would be a passage way through the introit that would let air accumulate in the apex. Then, if there were any alterations in the vaginal area, the air would be expulsed, producing a particular noise that is similar to that of anal flatuses. This has been associated with both sexual and physical activity. Radiological studies have reported that 11% of healthy women who have done a CT of abdomen and pelvis show presence of air in the vagina; however, this is not necessarily related to the symptom. The only study of its prevalence on the general population found this symptom in 12.8% of women, without differences between sexually active women and those who were not. Also, only 3.4% of them had mild to severe troubles due to this symptom. Another study reported a rate of 69%; however, the studied population consisted of urogynecological patients. This study determined that there were no differences due to prolapse, which refutes the notion that a wide urogenital hiatus is linked to flatuses. There are no studies on this topic in our country.
Objective: To determine the risk factors and symptoms associated with vaginal winds in women attended in the pelvic floor unit of a public hospital in Chile.
Methods: A retrospective, observational cross-sectional study. Data was obtained from the database with the patients who are attended in the pelvic floor unit of the hospital. Two study groups were randomized: one with 113 patients who had the symptom and the other with 127 women who did not have it (control group). Patients with prolapse and urinary incontinence were included, while patients with other diagnoses or younger than 18 years old were excluded. Data was analyzed through absolute and relative frequency, and with bivariate analysis and chi-square test. P<0.05 was considered statistically significant.
Results: Average age was 54.16 (25-80). Average number of births was 3.61 (0-9). 87.6% of women with vaginal winds had stress urinary incontinence, while 78% of women from the control group had it (p<0.049). 62.5% of women with vaginal winds had the feeling of incomplete bladder emptying, vs 45.2% of the control group (p<0.008). Dyspareunia was found in 50% of women with garrulitas and 27.6% of the control group (p<0.0001). 52.7% of women with vaginal winds felt that their vagina was loose, while 31.2% of the control group had the same feeling (p<0.001). 57.1% of women with vaginal winds and 32.5% of the control group suffered from coital incontinence (p<0.001). Finally, there was no significant difference among women with a record of forceps, episiotomy, or macrosomia.
Conclusions: Vaginal winds is quite frequent in women who are attended in urogynecology centers. Although the pathophysiology of this symptom is unknown, it is clearly associated with a defective pelvic floor. In this study, we demonstrated that it comes with other symptoms and is probably associated with several of them. Therefore, it could be considered as a severe pelvic floor dysfunction symptom and a more symptomatic diseases. More studies are necessary, and not only to determine its cause, but also to understand how it affects quality of life and how we can treat it.