Cytological smear

Fast and early diagnosis of women's diseases has become possible thanks to cytological tests. A cytological smear is an analysis of a sample of cells from the cervix and cervical canal.  The test is conducted to detect early forms of cancer, assess the hormonal background of the female body, and find abnormalities in the bacterial flora of the female genital tract.

When cytological tests are prescribed?

All women over the age of 21 are recommended to visit a clinic every year to get a cytology, even if there are no gynecological complaints. The test will either confirm that everything is fine or detect a pathological process and allow for timely treatment of the disease. Without risk and serious consequences.

The smear is prescribed to diagnose asymptomatic genital cancers and to assess other risks to women's health:

• papillomavirus infection, a common cause of cervical cancer;

• sexually transmitted infections (STIs);

• hormonal background, its correspondence to the period and the age of the woman;

• the dynamics of diseases and disorders for which females use oral contraceptives.

A gynecologist may recommend a pap smear for pregnant women. 

Symptoms 

In addition to the preventive purpose, we recommend that you visit the clinic to get a pap smear test in case of any pathology of the female reproductive system.

Signs that are a reason to visit the clinic for a cytological examination:

• itching and discomfort in the lower abdomen;

• papillomas appear on the skin (a sign of infection with papillomaviruses);

• the monthly cycle is not regular;

• bleeding after menopause or in the period between menstrual periods;

• vaginal discharge (white) of any nature;

• heavy, prolonged, painful menstruation.

What material is taken for cytology

A sample of biomaterial for a Pap smear in gynecology is a small fragment of cells from the genital tract. Depending on the type of cytological test is taken from different parts of the genital organs:

• area of the cervix;

• cervical canal.

The test is taken by a doctor, the procedure is not painful and takes only a few minutes.

How to prepare for a cytological test

The test is very sensitive, which is why its results can be affected by various factors. For example, you should not have a Pap test if you have taken antibiotics vaginally or had gynecological procedures the day before.

However, there is nothing complicated to prepare for the Pap test:

• refuse to have sex 48 hours before the test;

• do not use vaginal suppositories for a day;

• do not use vaginal douches two days before the visit to the clinic.

It is better to schedule a visit starting from the fifth day after your period or in the middle of your period. In the morning, before visiting the clinic, perform a gentle toilet of the external genitalia with warm water.

How a Pap smear test is performed

The procedure is performed in a gynecological chair. First, the doctor examines the woman using a vaginal speculum to see the changed areas of the cervical mucosa and vaginal epithelium.

There are two methods of cytological diagnosis:

• PAP test (Papanicolaou's test, tumor diagnosis). A wooden or plastic spatula is used. Under the control of a speculum, the doctor scrapes a little tissue from the suspicious area of the epithelium.

• Liquid cytology using a special endobrush. It is inserted into the cervical canal  and made 1-2 turns around the axis. The biomaterial clings to the brush pile.

After the test is taken, the sample is transferred to the laboratory, where it is transferred to a glass slide, stained, fixed and examined under a microscope.

Evaluation of Pap smear results

In the referral to the laboratory, the gynecologist indicates where the material was taken from. This is important because a cervical smear under a microscope will differ from a sample from the cervical canal or vaginal cavity.

If the cells are not typical of the area from which they were taken or have abnormalities in structure, this is noted in the report.

The typical classification of a Pap smear includes four gradations:

• normal.

• STI pathogens are detected.

• inflammatory or hormonal cellular reactions are detected.

• atypical cells are detected, which is a dangerously malignant process.

The gynecologist at LuxMedic Clinic performs a Pap smear test without pain and discomfort, the manipulations are performed correctly and with the highest level of professionalism.

The analysis in the clinic's laboratory is performed for 3-4 days, and the Pap smear test results are passed on to the gynecologist. Based on the Pap test results, if they are normal, the doctor gives preventive advice for the future. If the cytological smear indicates pathology, the Universum clinic specialist draws up an individual treatment plan. Depending on the diagnosis, medications, local medical procedures or surgery are used.

Sources

1. J.Ernest Ayre, “Selective cytology smear for diagnosis of cancer”, American Journal of Obstetrics and Gynecology, Volume 53, Issue 4, Pages 609-617, ISSN 0002-9378.
2. Committee Opinion No. 483: Primary and Preventive Care: Periodic Assessments. Obstetrics & Gynecology: April 2011 - Volume 117 - Issue 4 - p 1008-1015. doi: 10.1097/AOG.0b013e318219226e.
3. Faghih, Nafiseh et al. “Effective High Grade Cervical Intraepithelial Neoplasia Case Finding in Low Resource Settings.” Medical journal of the Islamic Republic of Iran vol. 36 33. 11 Apr. 2022, doi:10.47176/mjiri.36.33.
4. Nicole Liddon, Sanjana Pampati, Richard Dunville, Greta Kilmer, Riley J Steiner; “Annual STI Testing Among Sexually Active Adolescents”. Pediatrics May 2022; 149 (5): e2021051893. 10.1542/peds.2021-051893.