Role of cervical/vaginal cytology in the diagnosis of cervicitis /vaginitis in a rural setup

Abstract

Introduction: Vaginal discharge in the reproductive age group is the most common complaint encountered everyday . Among the cases of symptomatic vaginal discharge Bacterial vaginosis is commonest cause followed by candidiasis and trichomoniasis. Multiple infections can also coexist but these three conditions account for majority of all etiologies of abnormal vaginal discharge.Material and methods: There were 100 women recruited for the study between 20-45 years with the objectives to recognize the cytological and microbiological culture manifestations in vaginitis/cervicitis by correlating the cytological findings with diagnostic culture method to confirm the diagnosis. All the patients with signs and symptoms of vaginitis, who attended the obstetrics and gynecology outpatient department, were subjected to detailed clinical examination and vaginal smearing with a prior consent, a comprehensive history, general examination and gynecological examinations. After that, the papanicolaou test was done on these patients. Three air dried smears for gram stain, giemsa stain, PAS stain and one wet fixed smear for pap stain was prepared along with a wet mount preparation and sent to the department of pathology immediately Results: The most common organism causing vaginitis was gardnerella vaginalis which causes bacterial vaginosis (20%), next common organism detected was E.coli (16%), the least commonly detected organisms in our setup was candida albicans, S. epidermidis, actinomycetes, and trichomonas vaginalis. The culture method determined the organisms and helped in coming to the accurate diagnosis of the cervical smear and hence it was taken as gold standard. Conclusion: It was concluded that women with inflammation on pap test had a significant decrease in the percentage of the negative culture and increase in the percentage of a positive culture.Thus, the role of cervical or vaginal cytology in the diagnosis of cervicitis/ vaginitis should be considered in the normal treatment protocol