Evaluation of role of cytology and its pitfall in cytodiagnosis of vaginal discharge

Abstract

Aim and Objectives: The present study was carried out with an objective 1) To find out the causes of discharge per vaginum, 2) To know the incidence of various causes of vaginal discharge, 3) To evaluate the role of cytology and its pitfall in cytodiagnosis of vaginal discharge, and 4) It can act as a screening procedure for cervical malignanacies.

Methods: Total 150 cases of leucorrhoea were studied using pH determination, wet mount, KOH mount, amine test, Gram staining and papanicolaou staining methods, during a period of one year.

Results: Using all above methods we were able to detect non-specific vaginitis [70 (46.66%)], trichomonas vaginitis [22 (14.66%)], senile vaginitis [11 (7.33%)], candida vaginitis [15 (10.0%)] and gonococcal vaginitis [1 (0.66%)] while 24 (16.0%) cases were without any specific pathology. We found 2 (1.33%) cases suggestive of cervical erosion and 5 (3.33%) cases suggestive of squamous malignancies as a cause of discharge per vaginum. Out of 70 cases of non-specific vaginitis, 50 were suggestive of bacterial vaginosis. In diagnosing bacterial vaginosis, all these methods have adequate sensitivity and specificity and can alert pathologist to look for clue cells in pap stained smears. Pap stained smears were found to be 96.28% sensitive and 95.13% specific in diagnosing bacterial vaginosis while in diagnosing vaginal mycosis it was 47.12% sensitive and 100% specific as compared to cultures. KOH mount was 94.33% sensitive with 100% specificity in comparison to cultures.

Conclusion: If these simple, rapid, inexpensive methods undertaken prior to pap stained screening are more useful in reaching appropriate diagnosis in patients presenting with discharge per vaginum.