Abstract

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; how- ever, 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 asso- ciated 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 inconti- nence 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 statisti- cally 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 wom- en with vaginal winds and 32.5% of the control group suffered from coital incontinence (p<0.001). Finally, there was no sig- nificant 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 patho- physiology of this symptom is unknown, it is clearly associ- ated with a defective pelvic floor. In this study, we demon- strated that it comes with other symptoms and is probably associated with several of them. Therefore, it could be consid- ered 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.