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A study on the possible association of dysfunctional uterine bleeding with bacterial vaginosis, mycoplasma, ureaplasma, and Gardnerella vaginalis
  1. B Bhattacharjee1,
  2. A K Ghosh1,
  3. A Murray2,
  4. A E Murray3
  1. 1Department of Genitourinary Medicine, Arrowe Park Hospital, Upton, Wirral, Merseyside, L49 5PE
  2. 2Department of Obstetrics and Gynaecology
  3. 3Department of Medical Microbiology
  1. Dr Bhattacharjee

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Editor,—A number of studies in the recent years have shown that bacterial vaginosis or its associated micro-organisms mycoplasma/ureaplasma may be associated with various obstetric and gynaecological complications such as pelvic inflammatory disease and infertility,1 premature rupture of membranes and preterm labour,2 plasma cell endometritis,3 non-specific urethritis in male partners,4 and in our previous study5 we showed colonisation of the endometrium by mycoplasma and ureaplasma in patients with bacterial vaginosis

The purpose of this study was to see if there is any association between dysfunctional uterine bleeding (DUB) and mycoplasma, ureaplasma, and/or bacterial vaginosis.

Ten patients, all with dysfunctional uterine bleeding admitted for abdominal hysterectomy, were recruited for the study. Patients were between 38 and 48 years (mean age 44) and all except one were parous. Appropriate ethics committee approval and informed consents were taken.

A detailed history was taken, particularly obstetrics and gynaecological, and any history of bacterial vaginosis or troublesome vaginal discharge. A preoperative high vaginal swab for microscopic diagnosis of bacterial vaginosis was taken. At operation, the endometrial cavity was opened by splitting the anterior wall of the uterus and an endometrial swab and biopsy were taken for microbial culture and scanning electron microscopy for mycoplasma, ureaplasma, and Gardnerella vaginalis.

None of the patient had any history of bacterial vaginosis, troublesome vaginal discharge, or any obstetric or gynaecological complications. Microscopic examination of the high vaginal swabs were all normal except one with possible bacterial vaginosis. Microbial culture and scanning electron microscopy showed no mycoplasma, ureaplasma, or Gardnerella vaginalis.

Although there is definite association of colonisation of the endometrium by mycoplasma and ureaplasma in patients with bacterial vaginosis, as we showed in our previous study, this study did not show any association of DUB with bacterial vaginosis, Gardnerella vaginalis, mycoplasma, or ureaplasma. Any significant association of DUB and bacterial vaginosis appears unlikely, as the age group of the majority of patients with DUB, as in this study, is also different from the age group for bacterial vaginosis.