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Vaginal Irrigation (Douche)

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By Paul Martin, BSN, R.N.

Vaginal douching, the act of cleansing the vagina with water or solutions, is a widespread practice among women worldwide. While often seen as promoting hygiene and odor control, it’s associated with various health risks. Research consistently indicates that douching disrupts the natural balance of vaginal bacteria, necessary for fighting off infections and maintaining vaginal health, thereby increasing the likelihood of conditions like bacterial vaginosis and yeast infections.

Table of Contents

What is Vaginal Irrigation or Vaginal Douching?

Vaginal irrigation (douche), also known as douching involves the gentle washing of the vagina using a fluid either plain or medicated under low pressure to facilitate cleansing of the vaginal tract. Most of the vaginal douches available in stores are packaged mixes containing water combined with ingredients such as vinegar, baking soda, or iodine. These mixtures are typically packaged in bottles or bags for easy use.

Common Reasons for Vaginal Douching

  • Mechanical cleansing of the vaginal tract and the cervix as in leukorrhea.
  • Removal of foul odor that may be present in the vagina.
  • Cleanse and irrigate the cervix after cauterization to reduce the swelling and promote healing.
  • Pre-operative procedure on most patients having the type of gynecologic surgery.
  • Reduce or prevent transmission of vaginal organisms from mother to child during delivery, including HIV.

Risk of Vaginal Douching

The following are the health problems linked to vaginal douching:

  • Vaginal Dryness. Douching has the potential to eliminate or modify the natural mucus present on the vaginal walls.
  • Bacterial vaginosis. Douching can lead to an overgrowth of harmful bacteria, increasing the risk of developing bacterial vaginosis, a common vaginal infection characterized by an imbalance in vaginal flora.
  • Ectopic pregnancy, miscarriage, and Infertility. Douching can cause pathogenic bacteria to ascend into the upper reproductive tract, resulting in inflammatory scarring, which is identified as the primary cause of ectopic pregnancy, early miscarriage, and infertility.
  • Yeast infections. Yeast infections thrive in less acidic environments, and douching can exacerbate this condition. Douching can facilitate the ascent of harmful bacteria further into the reproductive system. This is particularly concerning as infections like chlamydia or gonorrhea can remain asymptomatic in women.
  • Pelvic inflammatory disease (PID). Douching is linked to a higher risk of pelvic inflammatory disease (PID) in women, which can result in persistent pelvic pain and elevate the likelihood of ectopic pregnancy and infertility.

Equipment used during Vaginal Irrigation

  • Douche kit or apparatus
  • Solution for douching (e.g., water mixed with vinegar, baking soda, iodine)
  • Tubing or nozzle for administering the solution
  • Sterile gloves
  • Bath blanket
  • Disposable bed protector
  • Towels or disposable pads
  • Lubricant (if required)
  • Waste disposal container

Preparing the Patient

  1. Explain to the patient the nature and necessity of the treatment. Explaining vaginal douching ensures patients understand its purpose and benefits, aiding in informed decisions about their health. This clarity helps patients grasp its importance and any associated risks.
  2. Let the patient void first before giving the douche. Patients may be advised to empty their bladder before undergoing vaginal douching to ensure comfort and ease during the procedure.

Procedure

1. Bring all materials and equipment to the bedside.
Proper preparation ensures the availability of all required items and promotes patient comfort during the procedure.

2. Wash hands and maintain sterility.
Maintaining hand hygiene and equipment sterility reduces the risk of infection and promotes safe practice.

3. Screen the bed. Replace the top sheet with a bath blanket and Slip the bed protector under the patient’s buttocks.
This enhances absorption and protects bedding from potential leakage. It also ensures the patient’s comfort and promotes easier cleanup post-procedure.

4. Instruct the patient to assume a comfortable position, such as lying on their back with knees bent and feet flat on the bed.
Comfortable positioning enhances patient cooperation and relaxation, facilitating a smoother procedure.

5. Position and drape the patient.
Offering appropriate privacy and assistance aims to instill a sense of comfort and confidence in the patient throughout the procedure.

6. Insert the Applicator or Bulb Syringe tip gently into the vaginal opening until it is comfortably positioned.
Proper insertion of the applicator or syringe allows for effective delivery of the cleansing solution into the vaginal canal.

7. Administer the prepared solution by slowly and gently squeezing the bulb syringe or applicator to release the cleansing solution into the vagina.
Gradual administration of the solution helps prevent discomfort and allows for thorough cleansing of the vaginal area.

8. After administering the solution, instruct the patient to remain in position and allow the solution to drain from the vagina.
Allowing the solution to drain helps remove debris and bacteria from the vaginal canal, promoting cleanliness and hygiene.

9. Dispose of the used douche kit components or bulb syringe appropriately.
Proper disposal of equipment and external cleansing helps prevent contamination and maintains hygiene.

10. Provide the patient with any necessary post-procedure instructions, such as avoiding intercourse or certain activities for a specified period.
Patient education promotes understanding of proper post-procedure care and encourages adherence to recommended guidelines for vaginal health.

11. Record details of the vaginal irrigation procedure in the patient’s medical record, including the type of solution used, patient positioning, and any observed complications or adverse reactions.
Documentation ensures accurate tracking of patient care and provides valuable information for future reference and follow-up assessments.

12. Monitor for any signs of irritation, discomfort, or abnormal discharge following vaginal irrigation/douching.
Prompt identification of adverse reactions allows for timely intervention and management to prevent complications.

Source and References

  • Asiya, Umar & Adikwu, Pamela & Obeagu, Emmanuel. (2024). Impact of Vaginal Douching on Women’s Health; Benefits and Potential Health Risk. 5. 20-29.
  • Jenny L. Martino, Sten H. Vermund, Vaginal Douching: Evidence for Risks or Benefits to Women’s Health, Epidemiologic Reviews, Volume 24, Issue 2, December 2002, Pages 109–124,
  • Martino, J. L. (2002). Vaginal Douching: Evidence for Risks or Benefits to Women’s Health. Epidemiologic Reviews, 24(2), 109–124.
  • Berman, A., Frandsen, G., & Snyder, S. (2015). Kozier and Erb’s Fundamentals of Nursing.
Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.

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