Laboratory diagnostic methods in obstetrics and gynecology are an important component of assessing the health status of the female body.

Among their diversity, a simple smear on the flora has stood apart for many decades.

Its other names are: smear on the degree of purity, smear on GN, gynecological smear, bacterioscopy of the discharge of the genitourinary organs, microscopy of the discharge from the urethra, vagina and cervix.

This study allows you to evaluate the composition of the microflora, count the number of leukocytes and epithelial cells, and also diagnose some STDs (gonorrhea, trichomoniasis).

This is a routine, non-invasive, economical and quite informative method, widely used in the work of a gynecologist.

Based on its results, the doctor has the opportunity to determine further tactics for managing the patient and prescribe the appropriate treatment.

When is the analysis performed?

As a rule, a smear on the flora is taken at any initial visit of a woman to a gynecologist.

Also indications for taking a smear and its subsequent microscopy are:

1 Scheduled preventive examinations and medical examinations.
2 Pathological leucorrhea (discharge of the vagina, cervix, urethra), their unpleasant smell, abundant character, discoloration.
3 Preconception preparation in the framework of planning natural and IVF-induced pregnancy.
4 Screening during pregnancy.
5 Unpleasant, painful sensations in the lower abdomen, which a woman does not associate with the menstrual cycle.
6 Painful urination, dysuria, including symptoms of urethritis, cystitis. Urological pathology in women, as a rule, requires consultation and examination by a gynecologist.
7 The end of the course of antibiotics in order to determine the nature of the flora and the possibilities of its restoration.

2. Collection of material for research

Taking a gynecological smear is possible from three points: the urethra (if necessary), the posterolateral fornix of the vagina and the vaginal part of the cervix.

The material for analysis is vaginal discharge, discharge from the cervical canal, discharge from the urethra (according to indications).

Vaginal secretions are multicomponent, they include:

1 Mucus of the cervical canal - is needed for the penetration of spermatozoa into the uterine cavity and above for fertilization. Its density depends on the level of estrogen in the body of a woman; its viscosity can be used to judge the phase of the menstrual cycle.
2 The secret of the glands of the external genital organs.
3 Desquamated epithelium of the vagina.
4 Bacteria (vaginal flora). Normally, the microflora in the smear is represented by a large number of lactic acid bacteria (gram-positive Doderlein rods) and a small amount of conditionally pathogenic flora (most often coccal).

2.1. Preparing for a swab collection

Before taking the material, a woman must meet certain conditions:

1 It is better to take the analysis for 5-7 days. the fence separated is not carried out.
2 Exclude the use of vaginal suppositories, lubricants, douching and sexual intercourse 24 hours before the study.
3 Before taking a smear, you do not need to use flavored intimate hygiene products, it is better to use a toilet of the external genital organs with running water.
4 It is undesirable to take a hot bath on the day of the test.

2.2. Technique for obtaining material

A smear on the flora is taken strictly before the bimanual examination, the woman is on the gynecological chair.
A Cuzco-type bicuspid speculum is inserted into the vagina, the vaginal part of the cervix is exposed (removed).
Focusing on it, the doctor with a special spatula takes material from the posterolateral fornix of the vagina and transfers it to a glass slide, which, after filling the direction, is delivered to the laboratory for microscopic examination.
Analysis from the external opening of the urethra is taken with a bacteriological loop or a Volkmann spoon. If available, it is advisable to take them, slightly pressing on the outer hole from the outside.
Analysis from the surface of the vaginal part of the cervix is taken with an Erb spatula.

3. How to decipher the results?

3.1. normal flora

Recently, special attention has been paid to the normal composition of the vaginal microflora, since it has been proven that it is this factor that determines the reproductive health of a woman, provides local immunity, protection against pathogenic bacteria, and the normal onset and course of pregnancy.

Normally, 95% of the flora in a woman is lactic acid bacteria (otherwise Doderlein sticks, lactobacilli, lactobacilli).

In the course of their vital activity, lactobacilli process glycogen released from epithelial cells, with the formation of lactic acid. It is she who provides the acidic environment of the vaginal contents, which prevents the reproduction of facultative and pathogenic flora.

Every woman has 1-4 types of lactobacilli in her vagina, and their combination is purely individual.

When deciphering the results of the analysis, it is impossible to conduct a detailed analysis of the vaginal microflora, the laboratory assistant evaluates only the ratio of rods and cocci.

The absence of cocci and a large number of gram-positive rod flora (++++) equate to 1 degree of purity of the vagina. This is observed quite rarely, this situation is more typical for control smears after vaginal sanitation or antibiotics.
A small amount of cocci (+, ++) is considered normal and indicates a 2nd degree of purity, but only if rod flora (++, +++) is also found. This is a good smear.
It is considered pathological (+++, ++++) against the background of a decrease in the number of rods (+, ++). This result is called the 3rd degree of purity of the vagina. This situation requires a detailed examination.
A large number of cocci (++++) and the complete absence of gram-positive rods (Gram + rods) in the smear indicate 4 degrees of purity. In this case, the woman needs mandatory treatment.

Table 1 - Normal indicators evaluated when deciphering the results of smear microscopy for flora and GN. Click on the table to view

3.2. Gonococci and Trichomonas (Gn, Tr)

3.7. Yeast-like mushrooms

- single-celled microorganisms of a rounded shape. The vaginal environment is ideal for their growth and development due to the high content of glycogen.

But due to the competing lactobacilli flora, with a normal level of immunity, their active growth is not observed. For the acquisition of pathogenic properties by fungi of the genus Candida, certain conditions are necessary:

1 State of immunosuppression,
2 The presence of endocrine pathology,
3 Malignant neoplasms,
4 Pregnancy, childhood and old age,
5 Therapy with glucocorticosteroids.

Should not be found. In exceptional cases, their single detection is allowed in the material taken from the posterolateral fornix of the vagina, as an integral part of the facultative flora. It is important to take into account the presence / absence of complaints and clinical manifestations.

The detection of spores and mycelium of the fungus in a smear indicates vaginal candidiasis and requires appropriate specific treatment.

Although it is a fairly informative diagnostic method, it is relevant only when comparing the result of microscopy with complaints and clinical manifestations.

The main disadvantage of this research method is the impossibility of identifying a specific pathogen. According to the results of the smear analysis, it is impossible to assess the level and depth of tissue damage.

Therefore, when an inflammatory process is detected in a smear, the doctor may prescribe additional diagnostic methods aimed at identifying the pathogen (PCR, bacteriological examination of the discharge of the urinary organs and determining sensitivity to antibiotics).

Smear - why is it needed?

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Smear is a microscopic examination of cells taken from the wall of an organ. A smear is taken from the walls of the urinary canal in men, as well as from the cervix and vaginal walls in women, from the mucous membrane of the throat, rectum.

smear on flora

A flora smear is an analysis that is automatically taken from all women who visit a gynecologist. This is an inexpensive and uncomplicated study, the results of which can be obtained fairly quickly. The analysis makes it possible to detect some changes in the microflora that should be corrected. For example, during the study of biological material, the presence of leukocytes, erythrocytes, fungi, microbes, as well as dead cells of the mucous membrane can be detected.
For preventive purposes, it is advisable to take this analysis once a year. But if any treatment is being carried out, a swab is taken several times to monitor the progress of the treatment.

Preparation for the delivery of the analysis:

You should not urinate for 2 hours before the test,
For 24 hours, you should not copulate, use vaginal preparations.

Procedure:
Completely painless. Material for research is taken with a special disposable spatula. The woman is at this time in the gynecological chair. If during the taking of the material the patient feels pain, this indicates an inflammatory process. The material is taken from the urethra, cervix and vaginal wall.

Smear analysis

Microscopy
Before examining the material under a microscope, it is stained according to Gram, while different cells acquire a different color, which makes it easier to distinguish them. For example, Gram-positive bacteria staphylococci, streptococci) remain colored even after washing off the paint, since their cell membrane is thicker. Gram-negative microorganisms ( Escherichia coli, gonococcus) are covered with a thin membrane, so after washing off the paint they are not noticeable.

Bacterial culture
The biological material obtained from the patient is sown on special nutrient media and left for 7-15 days at a temperature favorable for the growth of microbes. The duration of cultivation depends on the suspected microorganism. The longest result is obtained when infected with chlamydia - in 15 days. This study allows you to immediately determine the effective antibiotic.

The smear norm for flora. Degree of purity

In the study of biological material in this case, the term " degree of purity”, there are four degrees in total.
At the first degree the state of the microflora is close to ideal, the vast majority of microbes are lactobacilli ( Dederlein sticks), normal acidity, no symptoms of inflammation.

At the second degree a certain number of coccal microorganisms are detected.

At the third degree there are more coccal microorganisms than lactobacilli, and also a lot of leukocytes.

But at the fourth degree there are no lactobacilli at all, the microflora is represented by pathogenic agents, symptoms of inflammation are present, acidity is favorable for the development of microbes.

Norms:
1. The flat epithelium in the smear should be, if not, this indicates atrophy of the genital mucosa. This indicator is affected by the phase of the menstrual cycle
2. Leukocytes - up to 10 units in the field of view in the vagina and up to 30 in the cervical canal
3. Staphylococcus aureus - may be present in small amounts
4. Sticks - healthy microflora
5. Coccus microorganisms - a sign of infection

6. Small sticks ( gardnerella) - indicate the presence of dysbacteriosis or gardnerellosis
7. Key or "atypical" cells - indicate dysbacteriosis
8. Fungus - indicates the presence of candidiasis, in the presence of disputes about the asymptomatic course of the disease
9. The presence of Trichomonas indicates infection.

Most often, when pathogens are found in a smear, additional studies are prescribed, for example, bacterial culture, PCR.

Pap smear during pregnancy

During pregnancy, a smear is usually taken three times: at the first visit to the doctor, at 28-30 weeks, and also a few weeks before delivery. When there are complaints about well-being ( itching, discomfort in the external genitalia), the analysis is taken at any gestation period.
During pregnancy, the microflora of the vagina changes significantly, and conditions favorable for the development of pathogenic microbes and fungi are created in it. In the 3rd trimester, most pregnant women can detect candidiasis.

Tests should not be abandoned, since it is very important to clear the birth canal from infection before childbirth. Otherwise, there is a possibility of infection of the child during childbirth. Sometimes it is possible to infect the fetus even before birth. The presence of pathogenic microbes in the birth canal can complicate the course of childbirth and postpartum recovery.

Smear norms for men

1. Epithelium - up to 5 - 10 in the field of view
2. Leukocytes - 0 - 5 in the field of view
3. Mucus – may be present in moderation
4. gonococcus - no
5. Key cells - no
6. Trichomonas - no

7. candida - no
8. Microflora - coccal microorganisms in single quantities

Throat and nose swab

This analysis is prescribed to patients who often suffer from tonsillitis, runny nose to determine an effective antibiotic and to detect the causative agent of diseases.

The procedure is painless for the patient, although a little uncomfortable for young children.
The material is taken using a special sterile swab on a long stick, separate for the nose and throat. Usually, material is taken from the nose and from the back of the pharynx, tonsils at the same time. After that, each swab is removed into a sterile tube and sent to the laboratory.

After smear

After taking biological material for analysis, some patients experience cramps, pain, and women may experience spotting from the vagina. You shouldn't be afraid.
Acute pain in the urethra in men can be relieved with an anesthetic drug. You should not refrain from urinating. It usually goes away on its own after three days.
Smearing discharge in women after taking a scraping for cytology also passes on its own and does not require any intervention.

smear for oncocytology

A smear for oncocytology makes it possible to detect changes in the structure of the cells of the mucous membrane of the female genital organs. This examination is obligatory for every woman and is carried out twice a year.

Training:

It is advisable to refrain from sexual intercourse for 24 hours,
You should not be tested during courses of drug therapy.

Procedure:
The patient is in a gynecological chair, with the help of a gynecological mirror, the doctor takes a scraping of the tissues of the cervix. Everything is done in a matter of seconds, it does not cause discomfort at all.

Deciphering the results:
The results are assigned one of five classes:
1. healthy cells
2. Inflammatory events are present
3. There is a possibility of malignancy
4. There are a small number of malignant cells
5. Many malignant cells, there is a tumor.

Pap smear

This is practically the same, but the biological material in this analysis is prepared using special dyes. The reliability of the analyzes is approximately the same. In European countries and in the United States of America, this analysis is preferred.

Papanicolaou smear interpretation:
1. Negative - all cells of the biological material are healthy and not modified.
2. Positive – the material contains modified cells ( deformed or enlarged). A positive result does not mean that the woman is already sick

There is one recommendation that doctors repeat year after year, but women with inexplicable obstinacy ignore. At least once a year, every woman needs to visit a gynecologist, even if she is not particularly worried about anything. There are many reasons for such a manifestation of discipline: you need to choose the right contraceptive, check yourself for infection, detect inflammation in a timely manner. In each case, such a visit involves taking smears. What are they for, and what can a specialist find out from them?

Why do you need a pap smear

Pap test or Pap smear is also called a smear for the presence of atypical cells or cytology. This test is ranked first among the total number of preventive tests in gynecology. This test at the microscopic level allows you to evaluate the structure of the cells of the cervix. Thanks to this method, preclinical diagnosis of oncological diseases is carried out.

As an additional method, this method is used in relation to women after thirty years of age in the study for the presence of a malignant type of human papillomavirus. If dysplasia is detected during the Pap test, the patient is given a special study - colposcopy (examine the cervix under a microscope). By the type of epithelium, after using special solutions, preliminary conclusions are made whether there is a pathological focus on the cervix and in which place. But the smear is not performed during menstruation, as well as in case of suspicion of inflammation. Otherwise, the result will be false. The day before the analysis, try to avoid intimacy, do not use tampons or suppositories.

This gynecological smear is taken from the cervical canal, vagina, or urethra. In this way, they try to determine the number of leukocytes, the balance of the vaginal flora, to detect fungal diseases of the vulva and vagina in the genital tract, which are caused by fungi of the genus Candida, Trichomonas and gonococci. When there are too many leukocytes, the presence of a sexually transmitted infection or the onset of an inflammatory process is suggested. In this case, you can not do without additional research.

True, not in all cases, an increased number of leukocytes in a smear becomes a cause for concern. This indicator becomes higher than the norm a few days before the onset of menstruation and immediately after it. It also happens in cases when an ectopia (erosion) appears on the cervix or a woman begins to live sexually. When filaments of mycelium are found in a smear on the flora, this may be a characteristic sign of candidiasis (a disease of the vulva and vagina, which is caused by fungi of the thrush genus). It is important to refrain from intimate contact, do not use spermicidal creams and do not douche the day before the visit to the doctor.

From the genital tract - one of the most common diagnostic methods in obstetrics and gynecology. This study is completely safe for a woman and very informative for a doctor. On the basis of such smears, two analyzes can be performed in women: a study of the microbial flora of the vagina and an indicative cytological diagnosis. We will only talk about the first, because it is he who is mandatory for any woman during pregnancy.

Note. Cytological examination - microscopy of cells and cellular elements with a chain of diagnostics of pathological processes (with the help of this study, changes in the properties of mucosal cells, inflammation and its nature, and also specify which type of microorganisms caused the inflammation). A smear for cytological examination is taken only if necessary (for example, if available). Deeper information is provided not by a smear, but by a biopsy of the mucosa, i.e. taking a small piece of tissue with special tweezers with its subsequent microscopy.

How to take a smear and when to examine the microflora of the vagina

Smears, with the help of which the state of the microflora is determined, are taken from a woman during pregnancy at least three times: during the initial visit to the gynecologist, at a period of 30 weeks at the time of issue and at a period of 36-37 weeks. The need for additional research arises if a pregnant woman complains of itching, burning in the vulva and / or vagina, a change in the amount, color or smell of discharge: such symptoms may be a sign of inflammation.

In order for the result of the study to be reliable, it is necessary to exclude the use of antibacterial drugs 7-10 days before taking a smear. In addition, douching, treatment with vaginal suppositories, etc. should be stopped 24 hours before the analysis.

For research, the doctor takes three smears: from the cervical canal (cervical canal), from the vaginal wall and from the mouth of the paraurethral passages (a separate spatula is used for each of these smears).

Taking a smear is a simple and painless procedure. So that the gynecological mirror is not cold and does not give you discomfort, the doctor can heat it with hot water before manipulation.

The contents of the smears are applied to a glass slide, which is then sent to the laboratory, where the analysis material is stained using a special technique and examined under a microscope. In some situations, doctors not only analyze the smear using a microscope, but also place the resulting material in a nutrient medium in a Petri dish. During reproduction, bacteria form colonies, the appearance of which depends on the type of bacteria. By the way, using this method, the sensitivity of microbes to various antibiotics is also determined.

Bacteria - good neighbors or implacable enemies?

After reviewing the results of the smear study, the doctor can obtain information about the composition of the vaginal microflora, the total number of microbes, the presence and severity of inflammation, and, finally, the state of the vaginal epithelium.

The microflora of the vagina is the microbes that inhabit it. In the vagina of a healthy woman, beneficial microorganisms predominate. Leading among them are lactobacilli, which form a kind of barrier to the spread of pathogenic (pathogenic) microbes. In addition, lactic acid, which is formed during their life, largely determines the acidity (pH) of the vaginal environment. With a sufficient amount of lactobacilli, the acidic environment of the vagina inhibits the growth of pathogenic microbes. Under conditions when lactobacilli die, the acidity of the medium decreases and the number of pathogenic bacteria increases.

Note. The name is derived from the Latin plum lactis - "milk". Lactobacilli break down carbohydrates to form lactic acid.

Bacteria that have disease-causing properties live side by side with useful ones, but these properties do not have the opportunity to manifest themselves until their beneficial neighbors interfere with this. With normal immunity, as a rule, various microorganisms that inhabit the vagina are in a state of truce. When immunity is weakened, favorable conditions are created for expanding the sphere of influence of pathogenic microbes.

Intimate microflora is sensitive to both external and internal changes occurring in a woman's body. The use of antibiotics, hormonal fluctuations, chemotherapy or hormone therapy, radiation therapy, surgical interventions, stressful situations and other factors can have a negative impact on the normal flora of the vagina.

Pregnancy also affects the microflora of the vagina, since during this period the hormonal background and immunity change significantly. These changes reach their peak in the third trimester. Therefore, it is during this period that women are very often concerned about the symptoms of inflammation, which were mentioned above. The most common cause of this condition during pregnancy is the yeast-like fungus Candida albicans, and the disease itself is called candidiasis, candidiasis, or simply thrush. The fungus Candida albicans lives on the skin and mucous membranes of any person, but it is activated only when the immune system is weakened or the bacteria that inhibit its reproduction, including lactobacilli, die. Manifested by signs of inflammation and milky white coating on the mucosa; such a plaque resembles grains of cottage cheese or the remains of dairy food.

Pap smear during pregnancy. Balance control

Why is a microflora smear necessary for every pregnant woman? The fact is that an infectious process that affects the birth canal (cervix, vagina, external genitalia) is fraught with infection of the child during childbirth. The microflora of the mother's vagina has a significant impact on the formation microbiocenosis intestines and skin of the newborn. In addition, in some situations, intrauterine infection of the fetus is possible. Sometimes the altered microflora adversely affects the course of the postpartum period: the recovery process may slow down, the development of infectious complications in a woman is not excluded. A control smear after a course of therapy will help evaluate the effectiveness of the treatment.

Note. Microbiocenosis - a set of microorganisms that inhabit some territory, in particular, the mucous membranes of the oral cavity, intestines, skin, etc.

A decrease in the percentage of lactic acid bacteria and an increase in the number of pathogenic microbes is one of the signs of inflammation. The presence of inflammation is also confirmed by a large number of leukocytes - defender cells that fight for health.

To assess the state of the microflora of the vagina, doctors use the concept of "degree of purity". There are four such levels. The first characterizes the optimal state: lactobacilli predominate in the microbial "landscape", the acidity of the medium is normal, there are no signs of inflammation. At the fourth degree, there are no lactobacilli, many pathogenic microbes, signs of inflammation are pronounced, it turns from an acidic environment into an alkaline one. The second and third degrees are intermediate between the first and fourth.

When choosing a treatment, the doctor will focus on the general condition of the pregnant woman and the results of the examination. Of course, he will choose the method of treatment that in a particular situation will be safer for the fetus.

In situations where there are signs of inflammation, but the cause of it is not clear from the results of conventional smears, doctors may resort to additional research methods, such as PCR smear diagnostics. The PCR method (polymerase chain reaction) is based on a multiple increase in the number of DNA of pathogenic microbes to such an amount that it is possible to determine the type of pathogen even if the smear contained a very small amount of pathogenic bacteria. This analysis requires special equipment, so it can only be done in well-equipped laboratories.

The results of vaginal smears are of great importance during hospitalization in the maternity hospital: if the results are absent or a large number of leukocytes or pathogenic microflora are found in them, and also if the results are obtained more than 40 days ago, the pregnant woman is hospitalized in the II maternity ward, intended for women with infectious diseases and pathology of pregnancy, which is in all maternity hospitals.

Of course, a pregnant woman has every right to refuse to take a vaginal smear: this test, like all others, is voluntary. But practice shows that all future mothers are well aware that the examination is carried out in their interests and determines their health, the outcome of childbirth and the health of the newborn.

Ruslan Karagulyan
Head of Women's Consultation
Khimki Central District Hospital,
obstetrician-gynecologist of the highest category

A smear for flora is a simple and fairly informative analysis that a doctor takes in women and men of all ages both for the purposes of routine diagnostics and in the case of acute or “erased” symptoms.

It allows you to assess the state of the microflora of the urogenital tract, to determine the presence of certain inflammatory diseases, infections, viruses.

Some doctors say that this analysis does not require special preparation, however, this is not so. For the reliability of the results, the patient is recommended do not go to the toilet for 2-3 hours, since urine can wash away all pathogenic bacteria and infections, it will be difficult for your doctor to determine the causes of your pathological condition.

Douching, vaginal suppositories and antibacterial soap also contribute to unreliable indicators. Women it is necessary to take this analysis after the end of menstruation, and besides, all patients should refrain from any sexual intercourse 2 days before taking the biomaterial.

How is the analysis given?

The analysis is most often taken by a doctor when you come to him for a regular appointment at a polyclinic or when you simply go to a paid laboratory where obstetricians and medical staff take biomaterial from you.

The pap smear procedure is completely painless.

Among women a gynecologist, obstetrician or any other medical worker lightly draws a special disposable spatula in the form of a stick at three points - vagina, urethra and cervical canal.

In men the urologist or another doctor inserts a special disposable probe into the urethra, rotates around the axis several times and takes an analysis. It is believed that the study does not cause pain, however, this does not exclude the negligence of the doctor, as well as individual sensitivity or the presence of a particular disease, which can cause discomfort.

Research price

The results of the flora smear are usually ready the next day, as the study is not specific and complex, so you can pick up your tests fairly quickly. smear on flora really considered a fairly simple study that can be done in a regular clinic is free. However, if the deadlines are running out or you simply do not trust the doctors from the clinic, then you don’t have to worry - a swab for the flora is taken in any paid medical laboratory.

Research costs vary. from 440 to 550 rubles and in addition, you can pay separately for the collection of biomaterial by a medical worker. The total will be approximately 900-1000 rubles.

The norm of smear results on flora in women

A smear on flora examines indicators such as leukocytes, epithelium, microflora, infections (trichomoniasis, gonorrhea, candidiasis), mucus and key cells. Let's figure out what it means norm and pathology in this analysis and how to decipher it.

When you receive a form with the results, you usually see such a table, where the following characters are indicated in Latin letters on top: "U", "V", "C", which literally means urethra (urethra), vagina and cervical canal. Often they are written in full like this: "uretra", "vagina", "canalis cervicalis". Normally, the smear analysis indicators for flora in women should look like this:

Indicators	Urethra (normal)	Vagina (normal)	Cervical canal (normal)
Leukocytes	0-5 in p / c	0-10 in p / c	0-15-30 p / s
Epithelium	Moderate or 5-10 in p / s	Moderate or 5-10 in p / s	Moderate or 5-10 in p / s
Slime	Moderate/absent	Moderately	Moderately
	Not found	Not found	Not found
Trichomonas	Not found	Not found	Not found
Yeast fungi (Candida)	Not found	Not found	Not found
Microflora	missing	stick in large quantities or lactobacillus	missing
key cells	missing	missing	missing

Are you testing in a private clinic?

YesNot

Deviations from the norm of any indicators may indicate a pathological process or inflammation, but in order to prescribe treatment to the patient and make a diagnosis, the doctor needs to interpret the results of the study as a whole. A slight excess or underestimation of the indicators can be considered by the doctor as an individual norm, but this is only permissible if there are no patient complaints, otherwise additional tests or a re-examination should be carried out.

Deciphering the results in women

For the urethra, vagina, cervical canal, as mentioned above, there are normal indicators. For the urethra: leukocytes should be in the normal range 0 to 5 in the field of view, epithelium moderate or from 5 to 10 or 15 in the field of view, mucus should be absent, any infections (candidiasis, trichomoniasis, gonorrhea) and bacteria should not be normal.

Increasing performance leukocytes and epithelium in the urethra indicates an inflammatory process or urethritis, urolithiasis, mechanical damage to the urethra with a stone, sand or a foreign object, which requires immediate medical attention. Revealing , Trichomonas and Candida fungi indicates specific urethritis. Increased slime in the analysis is possible due to violation of hygiene rules, improper collection of biomaterial.

For the vagina: leukocytes fine must be 0 to 10 in view. However, during pregnancy leukocytes can increase, and therefore the allowable rate in this case will be from 0 to 20 leukocytes in p / o.

This is not a pathology and does not require any special treatment.

The epithelium must be moderate or 5 to 10 in sight, and mucus in moderate quantity. Infections (Trichomonas, Candida fungi,) normally absent, key cells too, and the microflora should be rod in large or moderate amounts. An increase in the number of leukocytes in a smear indicates an inflammatory process in the vagina, which happens with the following diseases:

colpitis;
vaginitis,
vulvoginitis (especially in girls under 14 years old);
urethritis;
cervicitis (inflammation of the cervix);
oophritis (inflammation of the ovaries);
andexitis (inflammation of the uterine appendages);
sexual infection.

Excess quantity squamous epithelium is also a sign of an inflammatory process. A slight increase in indicators is acceptable at a certain phase of the menstrual cycle, when the hormone estrogen begins to increase. decline the number of epithelial cells occurs in women during the period menopause, as the production of the hormone estrogen begins to decline sharply.

Mucus in large quantities indirectly indicates an inflammatory process or non-compliance with hygiene rules. The microflora of the vagina should be normal rod, which is represented by bifidobacteria and lactobacilli, which protect the body from infection and inflammatory diseases.

At pregnancy lactobacilli increase even more, since during such a period the body's defenses are activated. A decrease in lactobacilli means vaginal dysbiosis (vaginal dysbiosis).

Mixed microflora also quite common in smear results. It happens in girls under the age of 14, as well as in women during menopause, which is considered as a variant of the norm. Otherwise, such flora can mean the following conditions:

ovarian hyperfunction;
inflammatory diseases of the pelvic organs;
venereal diseases;
vaginal dysbiosis;
beginning or end of menstruation.

coccobacillary microflora indicates an imbalance of bacteria in the microflora of the vagina, where pathogenic bacilli and cocci begin to predominate. The presence of such microflora indicates bacterial vaginosis or STIs. coccal flora often occurs with inflammatory diseases of the vagina, urethra, bacterial vaginosis (dysbacteriosis), etc. The usual violation of the microflora of the vagina cannot be any diagnosis.

Key cells, or rather their presence in a smear indicate gardenellosis or vaginal dysbiosis. For the cervical canal: leukocytes should be normal 0 to 15 or 30 in the field of view, epithelium moderate, a microflora, key cells, candida, trichomanads should be absent.

An increase in the number of leukocytes, epithelium indicates an inflammatory process of the pelvic organs, the presence of cancer, genital infections. Revealing fungus candida, trichomanas requires immediate treatment with antibiotics, as they should normally be absent.

The norm in men

In men, a smear on the flora is taken to study the amount leukocytes, epithelium, the presence of cocci, gonocci, trichomanads, mucus, microflora. For diagnosis, only detachable from the urethra (urethra). The results of the analyzes are also usually presented in the form of a table, where one column indicates the parameters studied, and the other - the results obtained. In men, the norm of smear results for flora is presented as follows:

Deviations from the norm are a serious reason to consult an andrologist or urologist, who will accurately diagnose and prescribe treatment. It should again be noted that laboratory reference values must be taken into account, which can be indicated nearby in the right column.

Deciphering the results of men

In the results of a smear on the flora in men, it is normal the number of leukocytes should be from 0 to 5 per field of view, epithelium from 5 to 10 per field of view, cocci are present in a single quantity, mucus in moderation, and Trichomanas, gonococci, fungi are absent.

Deviations from the above norms indicate a pathological process or inflammation. Leukocytes- one of the main indicators that indicate to the doctor the degree of inflammation and pathology of the organs of the urogenital tract. They can be elevated in the following diseases:

specific or nonspecific urethritis;
prostatitis;
urolithiasis disease;
the presence of benign and malignant neoplasms;
stricture (narrowing) of the urethra.

An increase in the epithelium also indicates an inflammatory process or urolithiasis, and the detection of cocci is approximately above 4-5 in the field of view means the presence of acute or chronic non-specific urethritis caused by opportunistic bacteria. Slime in large quantities, it also indirectly indicates inflammation, but with other normal indicators, it can talk about sluggish urethritis, prostatitis.

Presence in analysis gonococci, trichomands, Candida fungi testifies in favor of specific urethritis and, accordingly, diseases of gonorrhea, trichomoniasis, candidiasis. In any case, the doctor must take into account all smear indicators for further diagnosis and treatment.

Analysis Disadvantages

In conclusion, it is worth noting that the main drawback of smear analysis for flora is inability to detect sexually transmitted infections in a patient, but in any case, the doctor should evaluate your condition, symptoms and smear results.

A smear for flora can be called a proven and simple way to study diseases of the urogenital tract, but not the only and not fundamental when making a particular diagnosis.

Often, doctors call this study "outdated", "ineffective" and when they receive patients, they immediately begin to take other, more modern tests, which, in their opinion, show the clinical picture in more detail. This is entirely the decision of the doctor and does not detract from the very specifics of the study. However, a standard swab for flora in any case does not lose its relevance, and its diagnostic value is still quite high and in demand.