Smear on infection. Special examination of girls and adolescents at the gynecologist How taking a smear in girls

Dear Tatyana!

The gynecologist is inspected by the girls who have never who who have never joined sex, somewhat different in contrast to women who already live in sexual life. We are talking about the finger-rectal examination of the small pelvis organs on the gynecological chair. It is carried out with the consent of the patient if there are any complaints. If patients undergoing a medical examination, there are no questions for a doctor, an inspection may not be conducted. A visit to the gynecologist can limit the conversation and fill your medical card. The gynecologist will ask questions about the date of the last menstruation, the stability of the menstrual cycles and the nature of menstruation. This information helps to make a map of your female health.

Federal Law No. 323-FZ dated 21.11.2011 (editors of 04.26.2016) gives you the right to refuse any medical intervention, including inspection on the gynecological chair, if you do not want it. But you have to be afraid, in fact, there is nothing. Even if the doctor's consultation plan includes a finger-rectal inspection, it is quite fast and painless, albeit an unpleasant procedure. Mirror you do not need for this. This device is designed for vaginal inspection when it is also necessary to gain access to the zev of the cervix.

However, if you need to pass the cytological smear to the dispensarization, you still have to get a gynecological set in the pharmacy, because it includes a special spoon for the smear of the smear, a disposable napkin, which can be sought to the gynecological chair, and disposable gloves for a doctor.

Inspection of virgins on the gynecological chair

The gynecologist may ask you to lie on the gynecological chair for inspecting the development of outdoor genital organs. Also palpable stomach. If the inspection suggests a finger-rectal examination, then the gynecologist, put on disposable rubber gloves, introduces a finger into the anal hole, and the other hand will simultaneously press on the stomach. Thus, the specialist will be able to feel the bodies of the small pelvis and understand whether their location and the amount of the adopted standards correspond.

Virgin Moshak Take Procedure

The capture of cytological smear from the vagina in virgins is carried out in the same way as in women living in sex. However, in this case, the gynecological mirror is not used. The unit for the capture of the secret is introduced into the vagina through the holes in the virgin spheres.

Perhaps it sounds scary for you, but in fact it is an absolutely painless procedure. According to the indications, sowing from the rectum or urethra can also be examined. The smear for analysis takes even the smallest girls. The manipulation of the gynecologist is absolutely safe for you, because damage to the virgin splava is excluded.

Such a study will give an opportunity to a gynecologist to eliminate or detect inflammatory processes from you, draw conclusions about the composition of the vagina microflora, and will also provide information on the presence or absence of diseases of such diseases such as thrush or gardnerellosis. The development of these diseases is due to active breeding Conditional pathogenic organisms that live in the body of any woman, including virgins.

Sincerely, Ksenia.

The smear microscopy in a woman is a study of biomaterial (discharged, neighboring) using a microscope under an increase with a pre-painting material. Microscopic examination is an important part of the diagnosis of urinary infections, as it is possible to estimate the presence or absence inflammatory process In the urinary organs, the degree of its severity and reliably determine a number of pathogens of the STD.

Taking a smear on infections in women is carried out in a manipulation office on a gynecological chair or a medical couch. A gynecological mirror (disposable plastic or sterile metallic) is introduced into the patient's vagina (disposable plastic or sterile metallic) and the material (discharge) is taken from all alleged foci of infection with a disposable sensing.

Usually, the smear in women take out of three points - from the outer opening of urethra, vagina and cervix. A disposable spatula is a plastic wand with an extended end, which, making strokes, a gynecologist evenly distributes the material taken on a special clean object glass, assigning adhesive notes from different sites:

Microscopic examination of the smear from the cervical canal and separated from the vagina in women is necessary method In screening and diagnosis of infectious inflammatory diseases of the genital tract (cervicitis, vaginitis). It allows you to estimate the degree of inflammatory process (leukocyte) and microflora state, as well as identify elements of mushrooms of the genus Candida, trichomonas, intracellular gram-negative diplococci.

Virgin Mail Take

Girls - virgins of smear take the same way as women living in sex life. The main difference between the take-off of a girl in a girl who does not live sexual life - the gynecological mirror is not used, the taking of material for smear from the vagina is carried out through a hole in the virgin peg. Perhaps according to the testimony of the britter to research and from the urethra. The applying procedure for the virgin of the virgin by the doctor of our clinic is absolutely painless, damage to the splava is excluded. In the same way take the smear and in the smallest patients.

Indications for surcharge in women

• Study of flora with preventive inspections, clinical examination, pregnancy, before carrying out gynecological operations;
• Comprehensive diagnostics reasons pathological discharge from the vagina, symptoms of vaginitis, cervicitis;
• Diagnosis of bacterial vaginosis;
• Control of the curability of vaginite, cervicitis, vaginosis.

After passing the smear

After taking the smear, the resulting material is dried and sent to the microscopy of the smear into the medical laboratory. Then the so-called painting of smears of special dyes is produced, and then a microscopic study of torn smears under the microscope. Different parts of cells and bacteria are painted in different colorsIt allows you to estimate the composition of the secretions from the urethra, vagina and cervix. With a properly embarrassed smear, the paintings of these smears differ from each other in their cellular composition and the conditions of existence for pathogenic and non-pathogenic microorganisms.

The urogenital smear is painless to take a procedure for a healthy woman who can only cause light discomfort. The accompanying taking of the smear of pain indicates violations that can occur at various inflammatory diseases, or as a result of genital infections. The stronger the pain while taking pain, the stronger the tissue is damaged.

It should be noted that a couple of spouses (sexual partners) after visiting the gynecologist and the urologist and putting the smears on the flora later always compares its results. In principle, these strokes cannot be exactly the same. Man and woman are completely two different organism with individual features and immunity. The conditions for microorganisms in the urethra of the man and the vagina of the woman are completely different. The difference in conditions contribute to various manifestations clinical picture infections.

The smear in women (on the flora, PCR, on Bakposposev with the selection of antibiotics) surrenders in our clinic daily, from 10-00.

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Do you take a smear from virgins or to visit the gynecologist and take tests at all? The question is quite interesting and painful.

With women who live sex life, everything is clear. They may have certain infections, and questions about contraception or pregnancy planning arise. However, those who have never lived in sex, sometimes you have to attend the main female doctor.

The smear of "girls" is taken with the passage of the climbing. Usually this 2 smear - One on the flora (purity of the vagina), and the second - on atypical cells from the cervix. Regarding the need to take these two analyzes, the doctors lead disputes.

Why take a smear on the flora, if a woman does not impose complaints? And why study the cellular composition of its neck, if one cannot be an oncogenic type of HPV (human papilloma virus), because it is transmitted only in sexual path. And the cause of the cervical cancer was several years ago. Conduct gynecological examinations of virgins through the vagina doctors do not like at all. And most of them do not have a suitable toolkit:

• children's sterile gynecological mirrors;
• urethroscope (for vaginososcopy, i.e., the optical inspection of the walls of the vagina; in general, the urethroscope is used to inspect the urethra, but its diameter is ideal for vaginal research in the presence of a virgin splava).

The use of these gynecological tools allows their patient in essence to preserve virginity (hymen). Some doctors for taking smears from the cervix, if there are no children's gynecological mirrors (lifts) use nasal mirrors - these are devices that manipulate ENT doctors to inspect the nasal strokes.

The fact is that getting to the cervix without some extension of the vagina, difficult. And when expanding, the doctor himself can see the neck of the uterus, inspect it, diagnose ectopia (erosion) and take the smear precisely from suspicious to atypius the site - the so-called. The neat introduction of the mirror in the vagina and the taking from there Marak-imprints will not lead to the loss of virginity, because there are even hygienic tampons that women can use with a holistic hymen.

Are all these gynecological manipulations painful? Subjectively. However, abroad doctors gynecologists are often used when examining and taking scraps from virgins local anesthesia - Lidocaine spray or even make short-term general anesthesia . But without it it is easy to do if the doctor has a necessary toolkit, an experienced and neat gynecologist at hand.

What are the reasons for the study of the surface cells of the cervix in women who do not live sex life? These are usually the need to appoint oral contraceptives (hormonal contraceptive tablets). After all, these drugs are not only protected from unwanted pregnancy, but also used to reduce menstrual blood loss, and with other medical purposes. But when cervical cancer, they are categorically impossible to take them. The doctor can only say about the gynecological health of the patient, if he holds an inspection on the chair and takes tests from her.

In this video, the doctor shows the future physicians of various gynecological instruments and explains their appointment.

Gynecological research. An important selection of the patient's position seems. It is customary to distinguish between two main provisions in the gynecological study of children: the first - when a girl or a teenager lies horizontally on his back, the legs are bent only in knee joints or stretched; the second - when a girl or a teenager lies horizontally on his back, hips are given to the stomach and supported by any of medical personnel. At the same time, the vagina is shortened, and the cervix becomes more accessible to research and procedures. Do not use the leg holders in children. For them, the gynecological chair KGD-1 is produced. Before the examination, it is necessary to empty the intestines and bladder.

Special, in contrast to the general examination at the gynecologist, is carried out in the following order: the inspection of the abdomen and external genitalia, including the virgin splava. Estimated appearance Virgin Plevy (ring-shaped, semi-lipped, baked, llude; in the form of a membrane without a hole, with one hole or with a multitude of holes; virgin glue in the form of obsol, cone, "spiral", etc.), shape, size and location Himensal hole (holes), as well as its thickness, elasticity, extensibility. It is difficult to distinguish the praying form of the splava with natural recesses from the supervision due to the injury leading to defloration.

In the latter case, they additionally find the scarsing deformation of the sections of the virgin splava, its excessive stretchability, hyperpigmentation of covers near the entrance to the vagina, the presence of signs of inflammation.

Following this, you can take strokes for bacterioscopic and bacteriological research from the anticipation of the vagina, urethra, parauretral moves, output of large vestibular glands and from the rectum. If necessary, a smear is taken from the vaginal secretions for cytological research.

To take frauds, you can use various tools: special children's glass catheters, pipettes, capillary tubes, graincattered probes, spoons various shapes And finally, wooden chopsticks with a tight wool. The method of obtaining a smear can also vary: from touching the mucous membrane to light scraping. It is allowed to obtain secretions with a pipette with a pear or a brown syringe. The obtained sections are applied to the slide. Skin glasses with strokes are marked accordingly. Dried and fixed strokes can be maintained for a very long time; However, non-fixed strokes are preserved well.

Bimanual vaginal-abdominal research in children, as a rule, does not apply, but is replaced by a straight-turn-bournoyenency.

When examining girls of more junior (up to 6 years), the age of a short study should be made with a little finger and only in extremely index finger. In exceptional cases, a combined recycling vaginal research (When suspected of a tumor of the vagina or cervix, as well as upon receipt of fuzzy data as a result of a rectal study). In these cases, the vaginal research is carried out very carefully, one finger, be sure to consent parents and in the presence of a third party.

In the gynecological clinic of LPMI, when visiting girls, practically vague examination is not used, and successfully replace it with a rectal-abdominal study, complementing the inspection of the vagina and the vaginal part of the cervix with the help of special children's mirrors. In children under 4 years old, often bimanual (straight-bonded-wall) study is carried out under inhalation anesthesiathat promotes good muscle relaxation front abdominal wall And crotch.

Additional types of special research. The study of the vagina in children is made using the endoscopy method.

Vaginoscopy. The inspection of the vagina and the vaginal part of the cervix with the help of various lighting systems is indicated by the term "vaginoscopy".

In the first stages, attempts to use for vaginopia of ear and nasal mirrors were made. However, the use of their widespread dissemination did not receive. In the future, a urethroscope was used to be successfully applied. The most widely distribution was obtained by a dry observation urethroscope of the type of urethroscope Valentine, which makes it possible relatively easy to examine the deep departments of the vagina and the vaginal part of the cervix. Children's mirrors with fastening illuminators are equally widespread and without that: when the reflector is the light source.

Recently, children's mirrors equipped with modern illuminators have become very successfully used for the production of vaginoscopy in children. It must be emphasized that any endoscopic instrument should be used with great care, since inept and careless manipulation can lead to the traumatization of Genitia Girls.

Sounding. This method is used often to study the vagina in children. In some cases, it is advisable to apply a combined straight-turn and vaginal study using a probe. Such a combined study gives nice resultsFor example, in cases where you need to detect and remove a foreign body from the vagina.

Trial puncture. In children, the test puncture has to be resorted not in the area of \u200b\u200bthe rear axle of the vagina, as is done in adult women, and in the field of hynatresium (with the atresia of virgin splava or atresia vagina). In such situations, the trial puncture is made in suspected the presence of hematocolpos or to establish the presence or absence of a vagina cavity.

Colpocytological research. In children, colpocytological research is quite widely used for judgment about the hormonal function of the ovaries and in the presence of indications for conducting an oncocytological or endocrinocytological research. For the last strokes are taken from lateral arch (for oncocytological - from the outer uterine zoom and the rear axle).

MAZA Taking Technique. The ideal area from which the material for smear is taken during the endocrinocytological research is a lateral arch of the vagina at the place of transition to the front wall. The smear takes without forcing with the help of half a wooden spatula (among senior girls), a children's probe, a cotton tight tampon on a wooden stick, a wasteless spoon of folkman, a pipette. It is dried and after coloring one of the polychrome methods is studied in a light microscope. In a number of institutions, it is preferred to paint acridine orange strokes (1:40,000) for luminescent microscopation.

If there is no possibility to take stars from the vagina (colpit, the atresia of the virgin splava, a small hole), then they can be prepared from the centrifuger morning urine; You can also take a smear from the inner surface of the cheek.

Age dynamics of the colpocytological picture. In the first week of life, intermediate cells predominate, surface cells make up about 10%. In the future, from the 7th day of life and up to 7-8 years of age, only basal and parabazl cells are observed, which indicates the low proliferative activity of the vaginal epithelium caused by low estrogen saturation. In the preumbaten period (from 8-9 years), intermediate cells appear, and the surface cells can already be 50%.

In the pubertal period, the proportion of highly differentiated cells of the wall of the vagina is gradually increasing; according to phases menstrual cycle You can detect signs of increasing estrogenic influence due to progesterone.

With violation of hormone products, disorder menstrual function, deviations in the process of puberty Colpocytologically, the research method bears greater diagnostic information. When deviating from the norm, colpocytological patterns may be the most diverse.

Measure basal temperature . The girls of puberty often have to measure the basal temperature, which in the ovulatory cycle rises in the second (progesterone) phase by 0.4-0.6 ° C. Minor (less than 0.4 °) Increased basal temperature indicates the inferiority of the yellow body. The monotonous curve indicates the absence of two-phase, i.e., the absence of ovulation, and the greater the temperature curve approaches the 37-degree mark, the more likely it indicates a low estrogen saturation.

Taking aspirate. Per last years Increasingly and more often, the capture of aspirate from the uterine cavity for cytological research is practiced. By virtue of the mild cervical canal in girls, the fence of aspirate from the uterine cavity is made by Brown syringe without expanding the cervical canal.

Methods of functional diagnostics. Measuring basal temperature and colpocytological studies have received widespread in children. They are mainly used for judgment on the nature of the menstrual cycle (one or two-phase cycle).

Diagnostic scraping of the uterine oral mucosa. This type of intervention (girls) should be made only in exceptional cases. We should never forget that the scattering of the uterine cavity mucous membrane can cause severe neurotrophic injury to this organ, so in children and adolescents it should be applied only if there are very serious testimony (the inability of stopping conservative methods juvenile bleeding, threatening life; suspicion of the malignant process, etc.).

Trupture. Trial curvature as a diagnostic method is shown in suspected malignant ovarian tumor.

X-ray study. Of particular importance in children has a radiographic study. Along with clinical and laboratory, it is advisable to conduct various radiological studies to identify (or exceptions) of a number pathological conditions genital organs. Often apply (with diagnostic purposes) the following radiological methods For the study of children: gas x-impeller, hysterography, vaginography, radiography of adrenal glands under the conditions of the pneummatroperitoneum.

Due to the fact that X-ray research in children has a number of features, a description of these methods is described in more detail.

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Bags for infections in women are one of the most common diagnostic methods in gynecology. This analysis is completely safe and painless for the patient and is very informative for a gynecologist. On its basis, two main tests can be carried out: the study of microbial flora and determining the degree of purity of the vagina.

What smears take a gynecologist

For primary inspection Women in a consultation or a paid clinic exist several common methods laboratory research The material obtained. Usually at the reception or during a profression, these are three types of smears for sex infections:

1. bacteriological sowing
2. PCR diagnostics and
3. microscopy (so-called "smear on the flora").

In this material we will look at last method laboratory diagnostics. A simple "smear on infection", which most often passes women and girls at the reception and inspection of the gynecologist for initial diagnosis. Also below separately focus on the question, whether the smear of virgins are taken and if so, as.

You can hand over the smear on infections from the following seats:

How to prepare

• 1-2 days before a visit to the doctor for passing analyzes to refrain from sex contacts;
• Before passing a smear to sex infections, it is recommended not to urinate for 2 hours.
• On the eve of the analysis, it is recommended to conduct a provocation. The easiest and most reliable method is the alimentary provocation (alcohol, salty, sharp).
• If there is such an opportunity, girls are desirable to pass the smear on the STD before or after menstruation

How is the smear on infections

Taking a smear on infections is carried out by a doctor in the viewing office on the gynecological chair. In the vagina, a gynecologist introduces a special medical instrument, the so-called. "Mirror" and takes the material (discharge) from all alleged foci of infection with a disposable spatula - Probe. A disposable probe is a plastic wand with an extended end, which, making strokes, a gynecologist evenly distributes the material taken by a special clean object glass.

The minimum fence is carried out of three points - from the outer opening of the urethra, vagina and cervix.

Taking a smear of virgins

Taking a smear of a girl or a girl - a virgin gynecologist is carried out in the same way as in women living in sex. The main difference in the fence of the material in girls who do not live in sexual life is not used, the gynecological mirror is not used, the collection of excretions for smear on infections from the vagina is carried out through the hole in the virgin spray. Perhaps a fence from the urethra or rectum. The mapping procedure in the virgin in our doctor is absolutely painless, damage to the virgin splava is excluded. In the same way, this analysis is taken from the smallest patients.

A good result of the smear on infection (i.e. their non-peculiar) cannot be considered absolutely reliable, especially if there are certain complaints. This is explained by a number of objective moments affecting his result. In situations where signs of inflammation are obvious, but the reason for its results of ordinary smears is not clear, gynecologists can resort to additional methods - PCR diagnostics, Bakposposev.

Why the results of the smear on infections are not enough to accurate diagnostics of the STD:

• Viral, chlamydial, mycoplasma and ureaplasmen infections are practically not defined in the urogenital smear on infection. Viruses, chlamydia, Mycoplasma ureaplasma are very small microorganisms, which are difficult to notice under a microscope with a conventional smear analysis. For the diagnosis of these infections, there are other, more informative methods (PCR smear, IFA diagnostics).
• The detected fungus in a smear on infections is a faithful symptom of thrush. But candidiasis can be a concomitant disease that has developed against the background of a more serious sexual infection (STIs).
• Increased leukocytes for microscopy smear on infections may be a consequence of erroneous diagnostics, with random hit in the smear when taking pus. Leukocytosis will prevent the doctor to "see" the causative agent of the STD.
• In many cases, the vaginal smear on infection allows to identify infection, but not "nature" (pathogen) of this infection and, not less important, it is not possible to find out the sensitivity of these pathogens to certain antibiotics. This problem can be solved by bacteriological sowing.

Tag in gynecologist

If you need a specialist help, we invite you to visit our center. At the initial consultation, the doctor defines the range of issues requiring decisions, according to the testimony, conducts the necessary research and is individual plan Treatment. In addition to the generally accepted methods of therapy of gynecological diseases (drug, medicinal, etc.), additional, tested, and many years of practice are used, effective methods conservative treatment.

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