In order to identify various microflora and indirect signs of the inflammatory process of the urogenital zone in women, a gynecological smear is performed. This procedure is performed by a gynecologist and involves taking biological material from the urethra, vagina and cervix (in virgins, only the first two samples).
For reliability, 24-48 hours before the analysis, sexual intercourse, the use of drugs, suppositories and other local remedies are excluded, and douching cannot be done. It is better to consult a doctor a few days in advance, especially if the procedure is being carried out for the first time.
A sample from each anatomical area is marked with a special symbol (U - urethra, V - vagina, C - cervix) and sent to the laboratory, where the contents are examined under a microscope. The result includes the following indicators:
Leukocytes - with an increase of more than 10 in the field of view, they are a nonspecific sign of inflammation;
Squamous epithelium - normally no more than 5-10 cells are found, all that is higher indicates an inflammatory process, if less - mucosal atrophy;
Mucus - a small amount must be present, changes are interpreted similarly to squamous epithelium;
Lactobacilli are representatives of normal flora (Doderlein sticks), the content of which decreases against the background of the growth of pathogenic microbes;
Key cells are desquamated epithelial scales covered with gardnerella bacteria. No more than 2-3 such complexes are considered the norm, otherwise they talk about bacterial vaginosis;
Yeast-like fungi are also present under normal conditions, but their active growth indicates thrush (candidiasis).
The diagnosis of "bacterial vaginosis" is established upon detection of such pathogens as:
Leptotrix;
Mobiluncus;
Trichomonas;
Gonococci.
The conditionally pathogenic microflora includes E. coli, enterococcus, streptococcus, staphylococcus. Their individual representatives can be determined under normal conditions, while a large number indicates an infectious pathology of the urogenital zone.
Based on the results obtained, a conclusion is made on the degree of purity, the presence of inflammation and its nature (infectious, non-infectious, microbial pathogens), the state of the mucous membrane. Also, this study can serve as an indication for conducting clarifying diagnostic measures:
Sowing flora on a nutrient medium;
Determination of the sensitivity of grown colonies to antibacterial drugs;
Measurement of the acidity of the vaginal environment;
Performing PCR to detect hidden infections, including STIs.
The study is indicated for all women during the annual preventive examination, as well as in the case of complaints (itching, burning, pathological discharge, unpleasant odor). The lack of timely diagnosis and treatment is fraught with the development of serious complications in the form of infertility, generalization of infection, and the occurrence of benign and precancerous formations.
