Monday, September 24, 2012

Ask Us Anything: What Can I Do About Chronic Yeast Infections?

"I have been experiencing chronic vaginal yeast infections for about 2 years. Treatment with Diflucan provided only partial symptomatic relief. Treating with over-the-counter miconazole and clotrimazole vaginal creams controls the problem within 3 days, only to have it return in about 2 weeks.

I often wear a 'light days' sani-pad for mild stress incontinece and had been scheduled for pelvic prolapse repair using mesh until I read your article. Could the vagina being exposed to urine cause this problem? What can I do?"

Dr. Ali Ghomi Responds:

Persistent or recurrent vaginal yeast infection can be a challenging problem to resolve. Patients, such as yourself, feel usually frustrated having to make multiple visits to the doctor's office and take frequent medications.

It would be ideal to address the underlying problem and the cause of the yeast infection if one can be identified.

Based on the history provided, I suspect urinary incontinence has a significant role to play in the development of the yeast infection. The incontinence would have to be addressed. Otherwise, the constant moisture in the external genitalia would make one very susceptible to recurrent yeast infection.

With chronic use of anti-fungal medications, the yeast organisms might develop drug resistance and would not respond as before to medical therapy.

Although there has been huge controversy, and I might add rightly so, regarding transvaginal mesh repair, this should not prevent one from undergoing appropriate anti-incontinence and prolapse surgery.

Prolapse surgery can be performed without having to use transvaginal mesh. The mesh used to address incontinence, the so-called sling procedures, is very safe and considered the preferred way to treat incontinence worldwide.

— Dr. Ali Ghomi

Dr. Ghomi is the Director of Minimally Invasive Gynecologic Surgery and Chair of The Robotic Surgical Committee at Sisters of Charity Hospital. He is the only physician in Western New York who performs Sacrocolpopexy Prolapse surgery using the da Vinci® robot. Sacrocolpopexy is a proven “gold standard” procedure worldwide to repair severe pelvic prolapse. Click here to learn more about Catholic Health's OB/GYN services.

Dr. Ghomi sees patients at the M. Steven Piver, M.D. Center for Women’s Health & Wellness in Buffalo.

If you have a question about your health, click here to ask our experts.

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