Gn smear: what is it, interpretation of the results

The most common method for diagnosing gonorrhea is a Gn smear.

Most often, the disease is practically asymptomatic, although in some cases there may be a burning sensation when urinating, a violation of the frequency of trips to the toilet, and the presence of whitish or yellowish discharge from the genitals.

In rare cases, gonorrhea may present with a sore throat and fever. In addition to a smear directly for gonorrhea, it is possible to conduct a more comprehensive study (smear for flora), which can reveal the presence of other pathogenic bacteria.

Indications for taking a vaginal smear

This test is prescribed only after examination by a gynecologist. A woman’s complaints about menstrual irregularities or the occurrence of pain in the lower abdomen, as well as the condition of the female genital organs, the presence of redness, itching or nonspecific discharge are taken into account. You also need to know that a smear on vaginal flora is mandatory after long-term use of antibiotics. This is done for preventive purposes in order to diagnose the occurrence of candidiasis in time. Interpretation of smears for flora should be done exclusively by a doctor. Doing this on your own, much less prescribing any medications based on the results of the analysis, is strictly not recommended. This can contribute to further disruption of the balance of normal microflora and the development of inflammatory processes.

Should you be afraid of pain?

Taking a smear from healthy men is not accompanied by pain, only a feeling of slight discomfort is possible. But if the canal walls are inflamed, which may be caused by urethritis or sexually transmitted diseases, the procedure causes discomfort.

The discomfort is associated with the fact that the walls of the canal are irritated in the acute phase of the disease, and the impact of a foreign object further increases this irritation.

However, you need to understand that for pathologies of the genitourinary system in men, it is impossible to choose the right therapy without a smear. Therefore, you will have to be patient, especially since an experienced doctor performs the manipulation in just a few seconds.

In private clinics, local anesthesia is offered before the procedure. A special gel is used for anesthesia, which does not affect the analysis results.

After the procedure, it is possible to experience burning and itching in the urethra, as well as pain during emptying of the bladder. Often men, fearing a recurrence of such symptoms, sharply limit fluid intake.

This is fundamentally wrong - concentrated urine irritates the mucous membranes even more. Sufficient intake of water, herbal teas with chamomile, calendula, cranberry or lingonberry juice helps speed up healing.

Severe pain can be relieved by taking a painkiller; a warm sitz bath can also help with this.

After taking a smear, it is not advisable for men to drink alcohol for 2-3 days or eat too spicy, fatty and smoked foods. If all recommendations are followed, unpleasant symptoms disappear within 2-3 days.

POPULAR WITH READERS: How to diagnose prostatitis in men

How to prepare for a vaginal smear test?

If a woman systematically notices the appearance of pain in the lower abdomen, itching, discharge with an unpleasant odor from the vagina, then she needs to consult a gynecologist and take a smear for flora. Where to take this test is not important; it is much more important to prepare for it correctly. For two days, several conditions must be observed to guarantee more reliable results.

First of all, it is necessary to abstain from sexual intercourse. It is also prohibited to use various vaginal tablets and suppositories. You cannot do any douching or even take a bath. The vaginal smear is not taken during menstruation. On the day of visiting the gynecologist, you need to wash yourself only with water, without using detergents, including gels. Do not urinate several hours before the test.

What is gonorrhea?

Gonorrhea is an infectious disease that is sexually transmitted. In common parlance, gonorrhea is known as gonorrhea.

The disease is caused by gonococci - round bacteria that cause inflammation of the mucous membranes of the genitourinary system, throat and other organs.

Most often, gonorrhea is transmitted from person to person during sex, including anal and oral. It is extremely rare that infection occurs through household items: towel, underwear, washcloth, etc.

The risk of contracting gonorrhea is much higher in women, since the anatomical structure of the genitourinary system allows gonococci to immediately enter a favorable environment.

On average, the probability of contracting gonorrhea through sexual contact with a carrier of bacteria is 35–40% in men and up to 85% in women.

Gonorrhea can be transmitted from mother to child, especially during natural childbirth, so when planning pregnancy, women are strongly advised to undergo examination and undergo the necessary tests.

Gonorrhea begins to appear approximately 3 to 6 days after infection. Characteristic symptoms are discharge from the genitals, itching, burning, and a tickling sensation.

In some cases, the disease is accompanied by a frequent urge to urinate and pain in the urethra.

If the infection occurs during oral sex, then signs of inflammation in the throat appear: redness, increased volume of the tonsils, pain, ulcerative lesions.

In about half of cases, gonorrhea occurs without symptoms or signs of the disease appear only in later stages.

Gonorrhea is divided into acute and chronic. Gonorrhea is considered acute if the disease manifested itself within the first two months from the moment of infection, that is, any symptoms appeared, and doctors managed to make a diagnosis in time.

READ Bacterial culture from the cervical canal - why is it needed?

Gonorrhea is considered chronic if it was asymptomatic in the first months or if it was not detected for any reason.

The chronic course of the disease is especially dangerous if it spreads to nearby internal organs. In men, gonorrhea can spread to the testicle and epididymis.

In this case, the testicle becomes inflamed, increases in size, and causes severe pain. The consequences of such inflammation depend on timely treatment and the body’s defenses: in the best case, everything will go away in a month, in the worst case, necrosis of the appendage will occur.

Gonorrhea can spread to the penis, in some cases causing necrosis of the foreskin. In women, gonorrhea, without proper treatment, affects the lining of the uterus and often causes infertility.

Video:

Gonorrhea can also spread to the bladder. If you do not consult a doctor in time, the disease gradually penetrates deep into the organs, affecting the kidneys and ureters. In some cases, the lymph nodes become inflamed, increased swelling and rashes appear.

Gonorrhea is treated mainly with antibiotics in combination with immunostimulating drugs.

It is absolutely forbidden to take antibiotics on your own, even if you are confident in the diagnosis and are familiar with the medications.

Gonococci may turn out to be insensitive to certain antibacterial therapy, and as a result of illiterate treatment, acquire additional resistance to antibiotics or degenerate into a new strain.

Vaginal flora smear

If you need to find out about the quantitative and qualitative composition of the normal vaginal microflora, then you need to take a smear. This is how the presence of pathogenic, that is, pathogenic, bacteria and fungi on the mucous membranes of the female genital organs is determined. You can also find out about the percentage of microbial groups and its shift in one direction or another. This is very important, since it is in the imbalance that the main reason for changes in the pH of the vaginal environment lies. Normally it is acidic, but if disturbed it can become alkaline, and this is a high risk of developing infection. In addition, a complete picture of the number of opportunistic microorganisms can be given by a smear on the flora. The normal condition of the vaginal mucosa, of course, requires their presence. But there should be very few of them. In a healthy woman, a flora analysis reveals 95% of lactobacilli. The remaining 5% are opportunistic cocci and bacilli. Disruption of this balance can cause emotional stress, depression, physical fatigue, acute inflammation and pregnancy. The development of the disease will be indicated by foreign microflora and an alkaline or slightly acidic vaginal environment.

Smear for hidden sexually transmitted and urogenital infections

Many diseases, especially sexually transmitted diseases, can manifest themselves only in the final stages, so only a smear on the flora can help detect them. The norm of this analysis completely excludes the presence of pathogenic bacteria. In addition, many diseases give a similar clinical picture. To correctly prescribe treatment, it is necessary to identify the pathogen. A vaginal smear for hidden infections can give accurate results, even if the number of pathogens is low. This analysis has a number of advantages. Firstly, it accurately shows the species identity of the pathogen down to the strain. Secondly, this analysis is done very quickly and painlessly. Thirdly, a smear on hidden pathogenic flora can reveal viruses, and not antibodies to them.

This research method is sometimes the only one for detecting infectious diseases with a latent course. Thanks to this, many sexually transmitted diseases can be diagnosed in the early stages of development, which allows for the most effective treatment.

Interpretation of smears for flora should be carried out by a doctor. If there are any doubts about the accuracy of the analysis, a repeat examination is scheduled. It is advisable to take smears in one medical institution. This will make it easier to track the reasons for different indicators in the results. It is also better not to change the doctor. Sexually transmitted diseases are treated with quite serious medications, so if you have already started a course of antibiotics, then complete it to the end. The causative agents of sexually transmitted infections are most often invasive, so it is easy for them to hide their presence in the body. After completing the course of taking the drugs, you will need to undergo a re-examination; the resulting transcript of smears for flora will show whether the treatment was effective.

Designations on analysis forms

Having received the result of the analysis in their hands, many cannot resist and appease their curiosity, and try to decipher it themselves.
But, as a rule, instead of a clear answer, they see a lot of unfamiliar abbreviations and letters. So what do they mean? So, in order for the decoding of flora smears to be at least a little clearer, you must first understand these abbreviations. Firstly, the places from which the analysis was taken are lettered: v - vagina, c - cervical canal and u - urethra. These symbols will appear opposite numbers that indicate what was found on the mucous membranes in these areas of the body. The letter L indicates white blood cells. They will be found both normally and in pathologies, but the difference will be visible in their quantity.

The abbreviation “Ep” means epithelium, in some cases it may be written “Pl.” Ep" (squamous epithelium). The causative agents of gonorrhea and trichomoniasis will be indicated by the letters “Gn” and “Trich”, respectively. In addition, the analysis can detect mucus, which is used to determine the pH of the vaginal environment. A woman will have a mixed flora in the smear. These are both rods and cocci. Their number can be indicated by numbers or pluses “+”. Well, if some type of microorganism is not detected, then the abbreviation “abs” is written. Depending on the amount of a particular microbe, they put a certain number “+”. There are 4 categories in total. The minimum amount of pathogen is indicated by one “+”, the maximum, respectively, “++++”.

What is coccal flora?

All bacteria are divided according to shape into three large groups: spherical, rod-shaped and convoluted. All of them can normally be found in the vaginal microflora. But spherical bacteria, that is, cocci, include causative agents of inflammatory diseases. These are diplococci, streptococci and staphylococci. To determine their quantitative content, a smear is taken on the flora. The norm of analysis allows for their presence. But these must be single bacteria. The risk of developing an inflammatory disease caused by opportunistic coccal flora increases with a decrease in the body's protective immune forces.

Normal indicators

A smear examination for flora in laboratory conditions is carried out using a light or electron microscope by Gram staining the smear. Infectious pathogens have an individual response to color. This allows you to determine the quantitative level of leukocytes, erythrocytes, epithelial cells, the presence of microflora, mucus and secretions. Reliable assessment of analysis parameters guarantees an accurate diagnosis. Men can rest assured if the smear has the following criteria, which are normal:

There should be five to ten epithelium.
Leukocytes – no more than five.
Cocci (staphylococci, enterococci, streptococci) – single.
Mucus – moderate amount.
Gonococci and Trichomonas are absent.

Deviation of indicators from the norm is not a reason to despair. This is a timely call to contact a urologist. The doctor may prescribe an additional examination, and if an inflammatory process is detected, treatment. Infections of the genitourinary system, which are the cause of poor analysis, can be successfully cured.

Under no circumstances should you self-medicate.

Vaginal flora smear during pregnancy

Each woman has an individual vaginal microflora.
Its formation is influenced by the state of immunity and previous urogenital and sexually transmitted infections. Normally, women have 95% of lactobacilli, which form an acidic pH environment in the vagina. The opportunistic coccobacillary flora in the smear occupies the remaining 5%; it does not cause disease, but lives quite “peacefully” in the body. But under certain conditions, the pH of the environment may change, and then the risk of developing an infection increases. Flora can change for various reasons. This includes decreased immunity, long-term use of antibiotics, acute inflammatory diseases, and pregnancy. When fertilization occurs, the hormonal levels in a woman’s body change dramatically. Estrogens practically cease to be produced, but the level of progesterone increases significantly. This, of course, helps preserve and support the developing fetus, but can upset the balance of the environment. To prevent a pregnant woman from developing such unpleasant diseases as gardnerellosis, vaginosis and candidiasis, a flora smear is prescribed. The results of this analysis indicate the “purity” of the birth canal. The causative agents of these infections loosen the walls of the vagina. This increases the likelihood of mucosal ruptures during labor.

What should not be included in a vaginal smear test?

In order for a woman to feel confident, her body must have the correct balance of microorganisms. Otherwise, she will constantly experience discomfort, which will certainly affect her life. A smear on the flora is taken from women if there are complaints of itching, burning, pain in the lower abdomen, or discharge with an unpleasant odor. All these are symptoms of inflammatory diseases. So, what microorganisms should not be present in a smear normally? When receiving the test result, you must make sure that the following infectious agents are absent:

- Gardnerellas. This is a pathogenic rod flora in a smear. In a healthy woman, these microbes can be detected, but only in small quantities. When immunity decreases, they begin to actively multiply, and bacterial vaginosis develops. The presence of a large number of gardnerella may also indicate vaginal dysbiosis.

- Candida. This opportunistic fungus is normally present on the genital mucosa in almost all women. It can exist quite “peacefully” in our body, without showing its presence. But as soon as the reaction of the environment changes to slightly acidic or alkaline, candida begins to multiply. As a result, the disease develops: candidiasis, or, popularly, thrush. It is not difficult to diagnose this pathology; it is enough to take a smear. In the active form of the disease, fungal threads are found, in the latent form - spores. As a rule, candida increases in number when hormonal levels are disrupted and the body's immune forces decrease.

Opportunistic cocci in a smear

Of course, these are not all microorganisms, the presence of which on a woman’s vaginal mucosa should at least alert the doctor.
The coccobacillary flora in the smear deserves special attention. These are primarily pathogenic diplococci, streptococci and staphylococci. They can be detected in a smear extracellularly. Only the causative agents of the sexually transmitted disease gonorrhea parasitize inside the cells of the body. So, what microorganisms should not be present in a smear of a healthy woman? Firstly, it is gonococcus - a gram-negative spherical bacterium. It belongs to diplococci. The causative agents of gonorrhea are intracellular parasites; they quickly die in the environment in the fresh air. In the latent form of the disease, it can be difficult to detect them. But only identifying the infection in the early stages guarantees quick and successful treatment. Otherwise, the disease becomes chronic.

In addition to gonococcus, a woman should not have Staphylococcus aureus in her smear. But, as statistics show, about 20% of the world's population are carriers of this pathogen of purulent-inflammatory diseases. These are both men and women.

In addition, streptococcus may be found on the vaginal mucosa. This spherical gram-positive bacterium lives in the large intestine and upper respiratory tract. But when it gets into the vagina, it behaves not so harmlessly. If streptococcus is detected in large quantities in a pregnant woman, it can cause miscarriage, premature birth and fetal death. That’s why a timely smear analysis of the flora is so important. Deciphering it can help prevent a number of pathological complications. The presence of enterococcus in the smear may indicate an inflammatory process in the genitourinary system. These bacteria are part of the normal intestinal microflora. But in some cases they penetrate neighboring systems and cause inflammation. Most often these are the ureter, bladder and female internal genital organs.

Flora smear in men

A bacteriological smear from the urethra in men is taken for flora in order to identify hidden infections. This analysis helps to detect pathogenic microflora that causes inflammatory diseases. Using a smear from the urethra, diseases such as urethritis and prostatitis can be diagnosed. But more often it is used to identify pathogens of sexually transmitted infections. For this purpose, a smear of flora is also taken from the urethra. Leukocytes detected as a result of the analysis are direct evidence indicating the inflammatory process that accompanies gonorrhea, chlamydia, trichomoniasis, and ureaplasmosis. Of course, based only on the results of a bacteriological smear, a final diagnosis cannot be made. Therefore, additional microbiological tests are often prescribed, including PCR diagnostics. This is the only way to accurately identify developing sexually transmitted diseases in the early stages.

Analysis transcript

A general smear is ready on average after 3 days. The form indicates the number of detected cocci, epithelial cells, mucous inclusions, leukocytes and atypical cells if detected.

It is considered normal if the following is found in the discharge:

Within 5-10 epithelial cells. A larger amount of epithelium indicates an inflammatory process. Detection of transitional epithelial cells in a smear occurs with prostatitis.
4-5 leukocytes per field of view. A deviation above normal is a clear sign of inflammation of the urethra.
Moderate amount of mucus. Exceeding this indicator is a laboratory sign of an inflammatory reaction.

A normal smear should not contain yeast-like fungi, gardnerella and other pathogens of infectious diseases. A small number of diplococci is acceptable.

Analysis of the contents of the urethra for hidden infections (PCR method) takes about 2 days. Normally, there should be no pathogenic microorganisms.

If they are identified, the study may take a little longer, since it is necessary to establish their quantitative relationship.

An accurate determination of the number of microorganisms that cause sexually transmitted infections allows us to determine whether the acute or chronic phase of the disease is developing. Based on this, medications are selected.

How is a smear taken from the urethra in men?

A smear on the flora in men is taken from the urethra.
This procedure is carried out using a special probe, which is inserted to a depth of 3 centimeters. Of course, collecting material in this way causes unpleasant painful sensations. There is often slight discomfort and a burning sensation in the area of the glans penis after the analysis. But after a few hours it completely disappears. In some cases, before taking a smear, the doctor may insist on massaging the prostate gland or urethra. This is not necessary for everyone, but only for those patients who experience an exacerbation of the inflammatory process. But, regardless of the man’s condition, the purity of the flora smear largely depends on the preparation for the analysis. You must abstain from sexual intercourse for two days before taking material for research. Genital hygiene should be carried out the night before the test. There is no need to wash your penis in the morning on the day of taking a smear. Before inserting the probe, it is advisable not to urinate for at least two hours.

Preparation for the procedure

As a rule, any procedure must be carefully prepared and taken seriously:

Mandatory hygiene procedures. It is advisable to perform genital hygiene immediately before bed, but not before visiting a specialist. The use of hygiene products significantly distorts the obtained test result. If a man experiences heavy discharge from the genital organ, then genital hygiene is performed immediately before a visit to the urologist, but it is strictly forbidden to use alkali-containing detergents.
If a procedure is prescribed - taking a smear, then strictly abstain from intimate life for two days;
A week in advance, or better yet 10 days in advance, stop using medications prescribed by your doctor. This is especially true for medicines related to antibiotics. Taking medications can significantly distort the picture of the analysis results obtained;
For a clear picture, a smear is performed only when the bladder is full. Therefore, two hours before the procedure, you should not urinate;
Stop drinking alcoholic beverages in advance.

Interpretation of smear results in men

If a man has complaints of burning, pain and discharge from the urethra, he needs to see a doctor and take a smear for flora. In case of inflammation, the leukocyte norm will be exceeded several times. These cells of the immune system are a direct indicator of the development of pathology. In men, the presence of leukocytes in the urethra is allowed, but only in very small quantities. Normally, this indicator should range from 0 to 5. If several times more of these cells are found, then there is reason to suspect urethritis or prostatitis.

Another indicator that will be present as a result of the analysis is epithelial cells. They line the inner surface of the urethra and are therefore always present in the smear. Their norm is from 5 to 10. If the number of epithelial cells is increased, this indicates the development of an infectious disease. Mucus in small quantities is always found in the urethra. Its increase also indicates inflammation. Of course, when performing a smear on the microflora, attention is always paid to the presence of opportunistic cocci. Under certain conditions, the disease can be caused by streptococci, enterococci and staphylococci. If a large number of them are detected, this indicates bacterial urethritis. A separate group includes gonococci. These are exclusively pathogenic microbes. They cause sexually transmitted diseases such as gonorrhea. Normally they shouldn't be there.

Types of analysis

After collection, the contents from the urethra are sent for 2 types of research:

The first is a general smear, the purpose of which is to determine the microflora. Shows the quantitative content of bacteria, leukocytes, intracellular and fungal microorganisms. The general smear often does not show the type of specific bacterium, since when examining a slide under a microscope, they all look approximately the same. A probe is used to collect the contents, it is inserted into the urethra and then the contents are applied to a glass slide and stained, thus obtaining a smear.
The second is a study for hidden infections, performed using the PCR method. When carrying out a polymerase chain reaction, even the smallest amount of DNA of infectious agents in the test material is detected. PCR is divided into qualitative and quantitative analysis. In the first option, only the general result of the smear is written on the form - positive if infectious microorganisms are detected and negative if they are absent. Quantitative analysis shows the type of microorganism and its quantity in the smear.

POPULAR WITH READERS: What is a PSA test and why is it performed?

A smear culture is also carried out to determine sensitivity to antibiotics, which allows you to select the most effective antibiotic therapy.

Flora smear from the nose and throat

A nasal and throat swab is a standard procedure when infectious diseases such as diphtheria and whooping cough are suspected.
Analysis from the mucous membrane of the back of the throat is also taken for sore throat. This is necessary in order to determine the sensitivity of the infectious agent to the antibiotic. The result of a bacteriological smear can help to make a final diagnosis and determine not only the nature of the disease, but also establish the latent carriage of a pathogenic microorganism. This is important for providing timely effective treatment and preventing further spread of airborne infection among the population. All medical workers must regularly take a throat and nasal swab. This is done to identify bacteria carriers of such opportunistic microorganisms as Staphylococcus aureus. For healthy people, this microbe does not pose a threat, but for “severe” patients and newborns it is extremely dangerous. Identification of carriers of Staphylococcus aureus is especially important among doctors and other medical workers who are directly involved in their work with young children. This primarily concerns the staff of maternity hospitals and perinatal centers. Staphylococcus aureus is spread by airborne droplets. Infection occurs during talking, sneezing or coughing. When suspended with aerosol droplets, the pathogen can remain in the air for some time.

Staphylococcal infection can manifest itself in different ways. In young children, pustular lesions of the skin and mucous membranes are most often detected. Based on the analysis, it is possible to identify not only staphylococci; opportunistic pneumococci and streptococci are also detected. In addition, this research method is relevant for determining diphtheria bacilli in a smear on the flora. This analysis, unfortunately, is not quick, but it allows you to determine not only the type of pathogen, but also its strain.

Indications for taking a smear

A smear is taken during a routine examination without any signs of the presence of infection (to exclude its latent forms). The analysis is required in preparation for conception (natural or IVF) or sperm donation. There are also obvious indications:

Discharge from the urethra (read about prostatorrhea in men), redness of the glans, itching;
Pain, burning when urinating;
The partner has an STD.

A smear is prescribed if prostatitis is suspected (difficulty urinating, nagging or sharp pain in the groin, deterioration of erection). Read more about the first symptoms of prostatitis.

Have you ever experienced any of the symptoms listed above?