Flora smear: interpretation of analysis results, normal indicators and pathology. Detailed explanation of smear analysis for flora in women Analysis of discharge from the genitourinary organs is normal

Microscopic or bacterioscopic examination is the study of biomaterial (discharge, scraping) from the genital organs using a light microscope. IN modern medicine now widely used combined use light microscopy and digital photography, which is obtained on digital microscopes and is analyzed using computer programs, which leads to a significant increase in research efficiency. You can also undergo a microscopic examination at our medical center.

Microscopic examination of discharge from the genitourinary organs is one of the main methods for diagnosing genitourinary infections, since its results indicate the absence or presence of an inflammatory process in the genitourinary organs and the degree of its development. With its help, a number of infectious agents are determined with reliable accuracy.

When is microscopic examination used?

A microscopic examination is prescribed when symptoms of sexually transmitted infections appear, for example TORCH infections, STDs. For the most part, these are vaginal and urethral discharge. It is also used to study prostate secretions to diagnose prostatitis, count spermograms, and study urine sediment during prostatitis. general analysis and a cyto-morphological study using Papanicolaou is carried out. One of the options for microscopic examination is dark field examination.

The object of bacterioscopic examination can be discharge and scrapings from erosions and ulcers of the mucous membrane of the genital organs, rectum, as well as the conjunctiva of the eye and the posterior wall of the pharynx.

Material collection

To obtain a high-quality smear, men are advised to refrain from urinating for several hours. Women should avoid douching. The material is collected from the places where the lesion is concentrated using special instruments, for example, a Volkmann spoon. To collect material, you can also use glass slides or a bacteriological loop. Most often, material is collected from the vagina, urethra, rectum, cervical canal, sometimes from the mucous membrane of the conjunctiva of the eye or the back wall of the pharynx.

It is very important that the collection of biomaterial for laboratory research was carried out correctly. The sample must contain infectious agents, otherwise no matter how accurate the diagnostic methods are, the result will be negative. This applies more to women. A number of infections, such as chlamydial and gonococcal, most often choose the ecclesiastical canal for their localization and may simply be absent from the vagina.

In men, such localization may be in the prostate gland, epididymis, but pathogens will not be detected in the urethra.

How is microscopic examination performed?

After collection, the material is immediately delivered to the laboratory, where, depending on the objectives of the study, it is stained using special dyes and analyzed under various microscope magnifications.

To determine whether an inflammatory process is occurring in the patient’s body, the discharged material is carefully studied. Diseases are indicated by the presence of leukocytes, fibrin, mucus, and Gram staining; if microorganisms are found, then the degree of contamination is determined. Additional examination for gonorrhea is required if the study reveals gram-negative diplococci, which have an intracellular location.

If protozoa (Trichomonas), fungal blastospores or mycelium are detected in the smear, then this is reason to believe that they will be found in the test material.

Microscopic examination of a smear allows one to identify beneficial and pathogenic microflora in a woman’s genital tract. Therefore, it is considered a very informative diagnostic method that reveals various diseases in gynecology from inflammatory processes to malignant formations of the genitourinary system.

Typically, the gynecologist prescribes one of three smear examinations to patients: microscopic, bacteriological or cytological. What each gynecological smear means and what test results can be obtained will be described below.

Microscopic analysis of a smear for microflora

Microscopy involves taking a smear from three areas: the vagina itself (V), the cervical canal (C) and the urinary canal (U). In some cases, a smear is taken from the rectum (R). How is content collected for research? The mucus is collected with a spatula or spatula. This is done carefully so as not to damage the mucous membrane in the marked areas. Before this, the doctor inserts a special mirror into the vagina, through which he sees the vaginal surfaces and the cervix. The mucus taken is distributed onto a glass slide and sent for study.

Smear bacterioscopy involves staining the material with a dye, drying it, and identifying the species under a microscope. In this case, not only the species of microorganisms (bacteria, fungi, etc.) is assessed, but also the quantitative indicators of each species. The results of the analysis are reflected on a paper form.

Interpretation of individual microscopy indicators

The transcript of the smear contains the following information:

1. Epithelium. Its presence is the norm up to 15 units. in sight. Examination of the vagina reveals squamous epithelium, smear from the cervical canal - columnar epithelium. Epithelial values ​​exceeding normal values ​​indicate inflammation in the organ. Interpretation of the parameter is possible only in conjunction with other analysis data.
2. Leukocytes. For the vagina, the norm is about 5 units. in sight. For the vagina - 10 units. For the cervix - 30 units. in sight. Some white blood cell content is necessary for the organ to support and protect against adverse conditions. Exceeding the indicator means the presence of inflammation (colpitis, cervicitis or urethritis). The laboratory mark “covering the field of view” means that the inflammation is at the peak of its development, that is, in an acute form.
3. Bacteria. In women of childbearing age, gram-positive rods with lactobacilli are normally found in the vagina. The content of microorganisms in the cervical canal is lower than in the vagina. Normally, there should be no microflora present in the urination channel. A variety of pathogenic microorganisms explain the development of vaginal dysbiosis or inflammation.
4. Trichomonas, gonococcus and key cells in healthy women are not shown by normal smears. If there are any, then we are talking about the existence of trichomoniasis, gonorrhea or gardnerellosis, respectively.

Preparation for smear microscopy. Following the basics of preparation for a smear test will help you obtain the most reliable test results. These are the rules:

1. Eliminate antibiotics approximately 14 days before the smear test.
2. Do not use local contraceptives, antibacterial and antiseptic drugs approximately 3 days before the test.
3. The day before the smear, you should not be sexually active.
4. Three hours before visiting the gynecologist, you should not wash your face or douche.

Taking a smear is considered a painless and safe procedure, which is recommended for all women to perform once every six months.

Cytomorphological analysis of smear

This type of female smear has other names - a smear for cytology or for atypical cells; Pap testing. The purpose of this analysis is to detect atypical cells, indicating development pathological condition in the cervix (dysplasia or malignancy). Pap test allows you to diagnose papilloma viral infection, which is directly related to dysplasia and cancer. Material for analysis is collected from the surface of the uterine cervix bordering the vagina, as well as from the cervical canal. The material applied to the glass is sent for study. According to the results of the study, smears are divided into 5 types:

The first is that the composition of the cells of the material (cytogram) has no features. In other words, the cervix is ​​in perfect order. Second, the composition of cells characterizes inflammation or dysplasia mild degree. Having seen a similar result, the doctor prescribes treatment for inflammation and subsequent Pap test. Third, the cells show signs of mild or severe dysplasia. For such tests, the doctor usually recommends additional examination in the form of colposcopy, biopsy of cervical tissue and histological examination of the collected material.

Type 4 - characterizes a precancerous condition of the genital tract in women, suspected of cancer. With this test result, the patient receives a referral for examination and subsequent treatment to a gynecological oncologist. Type 5 is a malignant tumor or cancerous tumor. The woman receives further examination and specific treatment in an oncology clinic. Similar to the situation with a smear for microflora, the accuracy of cytology is determined by the literacy of the woman’s preparation for collecting the material.

A smear for cytology is prescribed in the middle of the menstrual cycle - on the 5th day of menstruation (not earlier) and 5 days before the next menstruation (and no later). There is no need to use it for one day before collecting the contents. medical drugs and local contraception. Sexual rest is also indicated 24 hours before visiting a gynecologist. For healthy women, it is recommended to undergo a Pap test once a year; for those with abnormalities, the frequency is prescribed by a gynecologist.

Bacteriological analysis of smears for urogenital infections

Bacteriological research involves inoculating material on a special nutrient medium to identify the composition of the flora of the genitourinary tract. As a result of this analysis, the presence and quantitative indicators of normal flora, as well as pathogenic and opportunistic flora, are studied. At the same time as bacterial culture, the degree of tolerance of microorganisms to a particular antibiotic is studied, and an antibiogram is compiled on the basis of this.

Fungi from the genus Candida, in the form of spores or mycelium, are often found in the vaginal environment. Fungal spores indicate the carriage of candida (microorganisms found in all healthy women). But mycelium is considered a sign of active infection, the culprit of which is fungi (thrush or candidiasis).

In addition to beneficial lactobacilli (10*9 CFU) and bifidobacteria (10*7 CFU), urogenital contents may include microorganisms such as Candida fungi (10*4 CFU), Escherichia coli (10*4), Gardnerella (10*5), mycoplasma (10*3), staphylococci (10*4), enterococci (10*5), peptostreptococci (10*4), streptococci (10*5), etc. Exceeding the normal values ​​of these values ​​may be evidence of the development of inflammation in the genital tract or bacterial vaginosis disease.

In some situations, the bacteriological culture form may contain an indication of the level of growth of colony-forming microorganisms. The first two levels of growth correspond to a condition in which a woman acts as an asymptomatic carrier of a particular type of microorganism; the last two levels of growth signal that the detected type of bacteria occupies a key position in relation to the disease (or inflammatory process) diagnosed in the patient.

The collection of material for bacterial culture is carried out in the same way as in the case of a smear on the flora. The main requirement when preparing for an analysis is to stop taking antibiotics a couple of weeks before it. The delivery/collection of material for research is planned for any date menstrual cycle. Culture is not included in the routine tests. To prescribe it, appropriate indications are required - identified bacterial vaginosis or inflammation.

Each of the three microflora tests, starting with microscopic examination, has its own purposes and is sometimes necessary to confirm a particular disease.

Urological analysis is necessary to identify women's diseases, a urethral smear in women is part of a clinical trial. For complete research and ruling accurate diagnosis, the doctor takes a scraping from the cervical canal and a smear from the vagina. The cervical canal is located in the cervix and connects the uterus to the vagina. This is a simple and quick procedure, sometimes painful. The study of a smear is a bacteriological examination of the collected material.

Why is the research being conducted?

To diagnose genitourinary diseases, a general clinical examination of discharge from the urethra is necessary. Thanks to the flora analysis, it is possible to detect an infectious or sexually transmitted disease in a woman. It is necessary to undergo an analysis of discharge from the genitourinary organs, discomfort during urination, pain in the urethra and vagina. Often, microscopy of urethral discharge is performed as a warning against the disease. The results of the analysis help to choose the most appropriate treatment. The analysis is important when planning to conceive a child, in which case taking material from the urethra is a necessity for both the woman and the man.

Why does it hurt when taking a smear from the urethra in women?

The process of taking a smear is short-term, but most often painful. This happens because the organ is inflamed and damaged in the presence of a disease. Any mechanical intervention causes discomfort. Those who have undergone such an analysis note that after taking a smear, it hurts them to write and the amount increases. This is not dangerous, but indicates pathological processes that require immediate specialist intervention. If after a urethral smear you feel the need to drink more water to increase the urge to urinate. If you go to the toilet more often, the pain after the test will go away faster. After taking a scraping from the cervix, the lower abdomen hurts and blood is released. For healthy people, the procedure is painless and it is not painful for them to urinate after the procedure.

Preparation

For the smear analysis to be reliable, the procedure requires certain preparation. 7 days before the analysis, stop taking external and internal medicines. It takes a week after menstruation to take material from the urethra. Sexual contacts and alcoholic drinks are prohibited 24 hours before the test. It is necessary to wash the genitals 3 hours before visiting the doctor so as not to change the microflora. Before taking the material, you must refrain from visiting the toilet. It is best to hand over the sowing tank in the morning.

How to take a smear, what is the technique?

A smear is taken from the urethra in women using 2 methods. The first method can be painful and involves collecting epithelial cells that will be sent for analysis. A special tool is used for this. It is inserted into the urethra a few centimeters. The applicator is slightly pressed against the wall of the urethral canal and removed slowly by rotating it. The second method does not cause severe discomfort and can only be used if there is obvious discharge from the urethra. To do this, a woman inserts a finger into the vagina, then presses on its front wall. A special instrument is used to collect discharge from the urethra for smear examination. Standards for urethral smear analysis.

• Epithelial cells - up to 10.
• In the urinary canal there are up to 5 leukocytes, in the vagina - up to 10, in the cervix - up to 15.
• Red blood cells - up to 2 units.
• There is no yeast in the urethra and cervix, and a small amount in the vagina.
• Mucus in the cervix and vagina is moderate, and absent in the urethra.

The analysis is popular due to its low cost, which is combined with fairly high efficiency and the ability to quickly obtain results. But what does a smear from the urogenital tract mean??

Urogenital smear: the essence of the analysis

A healthy mucous membrane of the genitourinary tract provides normal discharge mucus and special secretion. It is also a substrate on which opportunistic bacteria live.

Microorganisms received this name because if the immune system is impaired, they can pose a danger to the body. Also, on the surface of the mucous membranes, old cells that can no longer function normally are constantly being replaced with new ones.

Naturally, even if healthy person take a urogenital smear for flora; sterility cannot be expected. In varying quantities, you will be able to see dead epithelial cells, bacteria, leukocytes, and mucus.

But what will the analysis show if a person is sick?

If the mucous membrane of the urogenital tract is infected with any pathogenic microflora (for example, gonococci or chlamydia), the body will respond to this with an inflammatory reaction.

The process of death of mucous membrane cells during this period will proceed faster. Mucus will be released into more, possible appearance of purulent or bloody discharge. The number of leukocytes will also increase, and lymphocytes will arrive at the site of inflammation to fight the infection.

The results of a microscopic examination of a urogenital smear in a sick person will be radically different from those in a healthy person. After evaluating the analysis, the doctor will be able to determine which bacterium caused the inflammatory reaction and how badly the mucous membrane is damaged.

Indications for urogenital smear

Analysis of a urogenital smear will give the doctor an idea of ​​the pathological processes that occur in genitourinary system men or women.

The procedure should be performed in the following cases:

• there are complaints about the appearance of abnormal or abnormal vagina (blood, pus, too much or of unusual consistency);
• in stock pain syndrome or any discomfort in the genitourinary tract;
• there are problems with potency or libido;
• a person was forced to take systemic antibiotics for a long time, which could affect the composition of the natural microflora of the genitourinary tract;
• planning pregnancy or its occurrence.

The study is carried out not only according to indications, but also during medical examination for preventive purposes.

Urogenital smear: preparation rules

Proper preparation for a urogenital smear is the key to reliable results. If neglected nearby simple rules, the analysis will most likely have to be taken again.

• 24 hours before the study, refrain from visiting saunas, baths, showers;
• before taking a urogenital smear, you should not drink alcohol;
• limit sexual contact at least 3-4 days before the procedure;
• Before taking the test, do not use intimate hygiene products (it is also recommended to avoid the most simple means for body care in the material collection area);
• The last trip to the toilet should be at least 2-2.5 hours before the test, since you cannot empty your bladder immediately before the procedure;
• it is necessary to stop taking systemic antibiotics at least 10 days before the day of the test;
• It is recommended to take a urogenital smear in women 4-5 days after menstruation.

Taking a urogenital smear in men is easier than in women, since there is no need to focus on cycles. Representatives of the stronger sex will have to adhere to the same rules.