Leukocytes in a smear: normal and abnormal. Leukocytes in the urethra

Cytological studies show the overall picture of a woman’s health. With their help, inflammatory processes in the body are detected. Every time during a standard examination by a gynecologist, a woman is taken.

Thanks to this simple procedure, the doctor will be able to promptly identify the causative agent of infection, which may not manifest itself for a long time. Therefore, it is very important for a woman to visit a gynecologist on time and get tested. An increase in leukocytes in a smear indicates inflammatory processes that need to be treated.

White cells are a kind of defenders that accumulate at the site of inflammation to fight infection. If a large number of leukocytes are observed, it means that there is a pathogen in this place. Typically, a smear is taken from several places to get a complete picture of your health.A test can also be prescribed after other examinations that are not related to the sexual sphere, but have reason to believe that there is trouble in the reproductive system.

A flora smear is taken if the patient complains of itching, discharge and pain in the genital area.

It is mandatory to take a smear during pregnancy.This analysis helps to collect many indicators - infectious agents, hormonal abnormalities. An increase in leukocytes indicates an ongoing inflammatory process.

Preparing for the procedure and taking a smear

Preparation for taking a smear includes abstaining from sexual intercourse for at least two days. It is not recommended to douche, insert any suppositories, or use vaginal contraceptives. Immediately before going to the gynecologist, it is not recommended to shower with gels, foams or other perfumes and cosmetics. Genital hygiene is carried out using soap. Also, you should not carry out deep cleaning of the reproductive system.

A smear cannot be taken during the menstrual cycle, or two days before and after it. In this case, the indicators may be false. If you do not follow the rules for preparing for a smear collection, the results may be incorrect and you will have to take a second test.

A smear is taken from several places in the reproductive system - the cervix (C), urethra (U) and vagina (V).

Z The sampling is carried out with a disposable sterile spatula. Smears are applied to three different glasses, each of which is signed, indicating the place from which the smear was taken. The study is carried out under a microscope in the laboratory.

In addition to the quantitative indicators of white bodies, the presence of gonococci, trichomonas, candida, key cells and other flora is detected. Pap smear results provide an overall picture of your health and may indicate the need for additional testing.

When examining a smear under a microscope, there should be no more than 15 white bodies in the field of view of the laboratory technician.The smear should show a value of 15, from the urethra - 5 and from the vagina - 10.

In case of a significant increase in indicators, the doctor determines the cause of the inflammatory process. It is worth understanding that an increase in white cells is not a disease, but only an indicator of the inflammatory process. To identify the causative agent of the infection, the doctor may prescribe other examinations and tests.

An increase in white blood cells can be triggered by a vigorous sex life and frequent changes of partners. In this case, this indicator is considered normal and is not a sign of an inflammatory process. The increase in performance in this case is small.More often, a deviation from the norm indicates infection of the reproductive system; the woman complains of poor health.

To identify pathogens and make a diagnosis, additional examinations may be prescribed:

Enzyme immunoassay and direct immunofluorescence are performed
Polymerase chain reaction test
Blood tests
Taking tissues -
Examination by other specialists, including consultation with a physician, may be required

Additional examinations are necessary to identify the cause of inflammatory processes. One standard smear is usually not enough. It gives only a general picture of the health of the reproductive system.

Causes of increased leukocytes in a smear

There are many reasons for an increase in the number of white blood cells. Among them, there are also physiological reasons - pregnancy or premenstrual condition. Basically, deviations from the norm are caused by the following infectious diseases ():

Gonorrhea
Syphilis
Chlamydia
Mycoplasmosis
Tuberculosis of the genital organs
Granuloma inguinale

The cause of the deviation is viral infections - papillomaviruses, herpes, cytomegaloviruses. There are protozoal and fungal infections - trichomoniasis, candidiasis and actinomycetes. A strong increase in white cells may also indicate cancer.

In addition to PPIs, the cause of deviations from the norm can be diseases such as dysbiosis, colpitis, cevitis, endometritis, adnexitis, etc. As a rule, all these diseases have pronounced symptoms, but some pathogens can remain dormant and wait for the body’s immunity to fail. In this case, nothing bothers the woman.

Deviation from the norm can be caused by hormonal imbalance - pregnancy, menopause, puberty of a girl, miscarriage or abortion, as well as endocrine diseases.

Often the indicators are overestimated due to a decrease in local immunity. A woman constantly washes herself deeply, thereby disturbing the healthy microflora of the vagina. Leads a promiscuous sex life and does not take care of personal hygiene.

The cause may also be self-medication, uncontrolled use of antibiotics and douching. A deviation from the norm may be an allergic reaction to various vaginal creams, lubricants or contraceptives that are inserted into the vagina before sexual intercourse.

Useful video - Smears in gynecology:

Hypothermia or, conversely, overheating can also cause infection. Doctors often pay attention to mechanical damage caused by constant wearing of thongs. Such underwear can provoke inflammation of the reproductive system.

Accurate diagnosis of the disease is possible with additional tests. The doctor will determine the cause of the inflammation and prescribe treatment.

Symptoms and treatment

An increase as such does not have any symptoms. Signs of disease refer to infection, not test results. Symptoms of an infectious disease include:

Drawing or dull pain in the lower abdomen.
Discomfort during sexual intercourse.
with an unpleasant odor. They can be scanty, medium or abundant.
Burning and itching.
Swelling and redness of tissues, which causes severe discomfort.
Irregular menstrual cycles.

It is worth remembering that some pathogens do not manifest themselves in any way and the woman does not exhibit alarming symptoms. Therefore, it is so important to undergo a scheduled examination by a gynecologist in a timely manner.

There is no single treatment for an elevated white blood cell count, since the deviation can be caused by various pathogens - viruses, fungi, bacteria, or a combination of several types of pathogens.

Therefore, treatment is prescribed individually depending on the type of infection and the patient’s condition.

Treatment may include taking not one, but several different drugs due to several pathogens. Only a doctor can prescribe a complete, comprehensive treatment. Self-medication in such cases is contraindicated. This can lead to disastrous consequences.A timely visit to the gynecologist, taking tests and following the doctor’s instructions will reduce the risk of serious diseases that can lead to infertility or oncology. Take care of your health and do not ignore regular visits to the gynecologist.

A smear (bacterioscopy) is a type of analysis in which the composition of secretions from the mucous membranes of the vagina, cervix and urethra is studied. Taking a smear is a quick and painless procedure. The resulting secretions are examined for the presence of leukocytes in the laboratory using a microscope.

A detailed description of the norms for smear results in women can be found in a special table. Depending on the day of the menstrual cycle, age and health status of the woman, the normal indicators will differ.

Only a gynecologist or urologist can refer you for analysis.

The main reasons for taking a smear are:

vaginal discharge with an atypical color, smell and consistency;
burning, stinging and itching in the vagina;
painful sensations when urinating;
irritation and redness of the skin on the genitals;
taking antibiotics for 10 days or longer;
pregnancy planning;
suspicion of sexually transmitted infection.

Women who have regular sex life are recommended to undergo preventive tests once a year. The vaginal microflora is an ideal environment for the development of inflammatory processes, and regular examination will help to detect and promptly treat the disease if it appears.

Preparing for analysis

Collecting discharge is similar to a routine examination by a gynecologist. For this you need a spatula and a gynecological speculum. A spatula is a thin plastic stick, one end of which is slightly widened. The doctor inserts it into the vagina and runs the tip of the spatula along the cervix with a gentle sweeping motion. He applies the secretions taken in this way onto a special piece of glass.

From the vagina, discharge is collected on a gauze swab, and a smear from the urethra is taken using a bacteriological loop. Women can find out whether the number of leukocytes in a smear is normal using a special results table, posted on the Internet, or ask your gynecologist. To get correct results, you need to prepare for the tests.

A smear test is not taken during menstruation. It is advisable to take tests 2-3 days before or after the end of your period, and not in the middle of the cycle. This will allow you to get more accurate results.

You also cannot:

have sexual intercourse 2 days before the test;
use suppositories, lubricant and cream 1 day before the test;
douche 1 day before the test;
wash yourself before use using detergents;
visit the toilet 3 hours before the test.

What tests can detect an elevated white blood cell count?

3 types of analysis can detect an increased number of leukocytes.

On the composition of microflora

If a genitourinary infection is suspected, the gynecologist prescribes an analysis of the composition of the microflora. It includes epithelial cells and opportunistic bacteria - pathogens. Normally, bacteria are absent or present in an amount of 1-2 units.

For the degree of purity

Vaginal cleanliness is a relative concept.

Depending on the quantity and composition of microflora, there are 4 degrees of purity:

Complete absence of pathogenic flora and leukocytes;
Normal number of leukocytes and insignificant presence of microflora;
The level of leukocytes is elevated, pathogenic bacteria are present, repeated tests are required to clarify the diagnosis;
All indicators are elevated, bifidobacteria that can normalize the condition of the vagina are absent, the patient requires emergency treatment.

Oncocytology

Oncocytological examination allows early detection of precancerous cells in the epithelium of the cervix and vagina. Doctors strongly recommend that all women, upon reaching 18 years of age, regardless of health status and lifestyle, undergo an oncocytology test once a year.

Decoding the analysis results

Tests can detect bacteria and leukocytes in a smear. The norm in women (the table of normal indicators is given below) varies depending on the place where the analysis was taken, age and sexual activity.

When receiving test results to check the norm of leukocytes in a smear in women, it is important to familiarize yourself with the table of normal indicators.

The following may be found in the discharge:

Lactobacilli. Their presence in the vagina is normal. A small number of lactobacilli is a symptom of bacterial vaginosis;
Gonococci. Normally absent, they cause gonorrhea;
Cocci. Can be gram-positive and gram-negative; gram-positive: staphylococcus, streptococcus and enterococcus should be present in the vagina, but their increased number indicates calpitis;
Yeast. They are constantly present in the vagina in small quantities; the rate increases with the development of candidiasis;
"Key" cells. They are formed as a result of the connection of squamous epithelial cells and gardnerella, their presence means the development of gardnerellosis or vaginosis;
Leptothrix. The bacterium that causes candidiasis is normally absent;
Trichomonas. Normally absent, causes chlamydia;
Escherichia coli. The presence in a single number is acceptable; the accumulation of E. coli bacteria often indicates neglect of personal hygiene;
Flat epithelium. Low values indicate atrophy of the epithelial layer, high values indicate the presence of inflammation.

The norm of leukocytes in a smear in women

Ideally, there should be no leukocytes, but such indicators are extremely rare. Even girls who are not sexually active can have viruses and bacteria in their smear.

Table

The table shows the norms for the diagnostic results of leukocytes.

Diagnostic criterion	Normal indicators
Diagnostic criterion	Vagina (V)	Cervix (C)	Urethra (U)
White blood cell count	0-10	0-15	0-5
White blood cell count after 50 years	0-12	0-20	0-7

Normal before menstruation

In healthy women, the number of white blood cells does not increase before menstruation. Only 1% of patients are characterized by an increase in leukocyte levels by 2-3 units. During menopause, the rate within normal limits can increase to 20 units.

Normal after menstruation

Normally, the number of leukocytes in a smear in women should not change significantly after menstruation. A table with normal indicators is an open source of information; it can be found on the Internet and the results can be compared. Significant an increase in the level of leukocytes may be associated with non-compliance with personal hygiene rules.

If a girl washes herself irregularly and uses low-quality tampons, bacteria will actively multiply in the vagina and cause inflammation.

Normal during pregnancy

During pregnancy, a woman's immune system is under great strain, and an increase in the level of leukocytes to 20 units is considered normal. If the indicators are higher, it is necessary to urgently undergo treatment. Any inflammation in the body is dangerous for a child, and diseases of the reproductive system are especially dangerous.

Normal after childbirth

During childbirth, a woman loses a lot of blood. This is a serious shake-up for the body, for which it prepares in advance. A few days before giving birth, white blood cells accumulate in the uterine area and An elevated level of white blood cells within 4-5 days after birth is normal. If after 5 days the leukocyte level has not decreased, this indicates the presence of postpartum complications.

Causes of increased leukocytes

An increased level of leukocytes is observed in various diseases of the genitourinary system, some of which require drug treatment or surgical intervention. The slightest manifestation of characteristic symptoms is a reason to consult a gynecologist.

Urogenital infection

Urogenital infections are called cystitis and urethritis - inflammation of the walls of the bladder and urethra.

They are manifested by frequent urges, sharp pain when urinating, and fever. The causes of the disease are hypothermia and neglect of hygiene rules.

About 80% of women suffer from cystitis at least once in their lives; without proper treatment, it becomes chronic and can cause more serious diseases.

Thrush

Vaginal candidiasis or thrush is a disease in which vaginal discharge acquires a specific structure - it becomes compacted, similar to cottage cheese. They have an unpleasant sour smell. If the discharge is not washed off from the external genitalia in time, it causes itching and redness. Candida fungi are always present in the vaginal microflora. Candidiasis develops when the number of Candida fungi increases by 3-4 times.

A smear for leukocytes will allow you not only to see the causative agent of the fungus, but also to determine its type and reaction to medications.

Allergic vulvitis

In allergic vulvitis, inflammation occurs as a result of the action of an allergen. Most often, they are caused by poor-quality linen and unsuitable hygiene products.

Vulvitis can be hidden, but its active manifestations include:
redness and swelling;
pain;
rash;

purulent discharge.

Allergic vulvitis is primarily a disease of the external genital organs. But without proper treatment, the inflammation can spread to the vagina. To find out whether vulvitis has provoked internal inflammation, an analysis is performed to determine the number of leukocytes.

Trichomoniasis The causative agent of trichomoniasis is Trichomonas vaginalis. This is a viral disease that most often develops in parallel with other infections: gonorrhea and chlamydia.

The disease is manifested by pain and redness of the genital organs. Atypical discharge often appears: foamy, green or yellow. Trichomoniasis disrupts the composition of the vaginal microflora, which leads to inflammation and an increase in the number of leukocytes by 2-5 times.

Hidden infections

Normal levels of leukocytes can be easily found on the Internet using the appropriate query in the form of a table. In women, hidden infections can increase the rate of leukocytes in a smear tenfold, so it is important to know these standards and be able to independently decipher the results. This will allow the patient to take a more competent approach to treatment and follow the doctor’s recommendations.

Hidden infections are asymptomatic and a smear is the only way to identify them. With its help, the type of infectious agent and its quantity in the microflora are determined. Sometimes the disease is caused by pathogens of different types, and the treatment process requires a combination of several drugs.

Vaginitis

Vaginitis is a disease in which the vaginal mucosa is negatively affected and reacts to it with inflammation. It can be caused by hormonal imbalances, taking antibiotics that affect the composition of the vaginal microflora, or infection with a virus from a partner. With vaginitis, symptoms appear chaotically, and often women do not pay attention to them.

Like any inflammation, vaginitis is dangerous due to complications. A smear will help to accurately determine the presence of infection and the specific pathogen.

Gonorrhea

Gonorrhea most often affects young women between the ages of 20 and 35. This is an infectious disease transmitted through sexual contact. Infection is possible even through oral sex, since gonorrhea affects all mucous membranes of the body.

The first symptoms of gonorrhea are pain in the lower abdomen and yellowish vaginal discharge. But recent data shows that More and more women are experiencing asymptomatic gonorrhea. It affects internal organs and can cause infertility. In this case, only a general smear and further tests to clarify the diagnosis can detect gonorrhea.

Erosion

According to statistics, erosion occurs in more than 50% of women. This is a small red area on the cervix that appears as a result of hormonal imbalance. To diagnose erosion, you will need not only to take a smear for leukocytes, but also to undergo video colposcopy - a study using a miniature camera. Erosion can be successfully treated, but without treatment it can develop into cancer.

Herpes

The herpes virus is ubiquitous and affects about 90% of people. But most of them are carriers - they do not get sick themselves, but transmit the virus to their sexual partners. The herpes virus is transmitted not only through sexual contact, but also through kissing, using shared personal hygiene products and utensils.

Herpes manifests itself as a rash and redness: Small blisters filled with fluid appear on the external genitalia. With herpes, the level of white blood cells decreases, and this can be revealed by a general blood test. A smear for leukocytes must be taken to clarify the diagnosis.

Oncology

The main symptom of cancer is pain and bloody discharge from the vagina. But they are also a symptom of many other diseases, and a smear is necessary to make a correct diagnosis.

Drug treatment

Most women without chronic diseases can quickly achieve the norm of leukocytes in the smear indicated in the table. A course of antibiotics can cure almost any genitourinary infection. Only in particularly difficult cases does long-term treatment, consisting of several courses, be required.

To treat elevated white blood cell levels, use:

Antiseptics. They are used to disinfect the vagina and external genitalia. The solution is injected into the vagina and washed. Popular antiseptics: Miramistin and Chlorhexidine;
Antibiotics. They are prescribed to suppress pathogenic microflora. But, since the antibiotic also destroys beneficial microflora, it should be used carefully and in short courses. These antibiotics include: Furagin, Palin, Azithromycin;
Aminoglycosides(antibiotics prescribed only in hospital settings). These are enhanced action antibiotics. They can only be used under the constant supervision of specialists, since they have a long list of contraindications and can cause severe allergic reactions;
Immunomodulators. They are used as an adjunct that improves the performance of antibiotics. Universal immunomodulator – “Vitaferon”. It does not cause allergic reactions and promotes the rapid restoration of beneficial microorganisms;
Preparations for the prevention of dysbacteriosis. These are immune-supporting drugs that prevent antibiotics from changing the composition of the vaginal microflora too much. Most often, experts recommend Laktovit.

ethnoscience

Traditional methods of treatment cannot be a complete replacement for medications, but are often used as an adjuvant.

A decrease in the level of leukocytes is facilitated by:

Douching. To douche, you will need a tampon: a sterile bandage rolled into a tight roll. Using a tampon, the treatment solution is injected into the vagina. You can use a decoction of chamomile or calendula as a solution. Pour 200 ml of boiling water over a tablespoon of finely chopped dry herb, cover with a lid and leave until it cools completely. Strain the finished broth. Before inserting into the vagina, it is advisable to warm the broth to a comfortable warm temperature in order to avoid unpleasant sensations;
Baths. A medicinal bath is useful as a disease prevention, and during the treatment process it is used as a stimulant. To prepare a bath you will need 20 g of dry laurel leaves. They need to be poured with a glass of boiling water, strained and diluted with 10 liters of water. The water will cool down quickly, but you cannot top it up. This will disrupt the concentration of the decoction, so this bath should be taken no longer than 10 minutes;
Decoctions for oral administration. A woman can obtain the normal level of leukocytes in a smear corresponding to the one indicated in the table using herbal decoctions. A decoction of St. John's wort has proven itself well. Pour boiling water over 1 teaspoon of dry herb and leave covered for 15 minutes. The prepared decoction is taken 3 times a day. The duration of the course of treatment is 10 days, if necessary, repeated after a break of 1 week.

Many diseases of the female genital organs are asymptomatic, and regular testing for leukocyte levels is the only way to detect them at an early stage. Gynecologists recommend undergoing a full examination at least once a year, and in the presence of chronic diseases - 2 times a year.

Video on the topic: the norm of leukocytes in a smear in women

The norm of leukocytes in a smear in women according to the generally accepted table:

Rules for taking and interpreting smear analysis in women:

Flora smear- a test often prescribed by gynecologists. What does it show and what misconceptions exist about it?

This analysis can be called “general”. This is a primary diagnosis that allows the doctor to confirm or refute the presence of an inflammatory process in the vagina, urethra, cervical canal, as well as draw certain conclusions regarding possible menopause or menopausal changes in the patient.

What exactly is the name of the analysis:

microscopic (bacterioscopic) examination of a Gram-stained smear - this is the official name;
genital smear;
bacterioscopy;
microscopy.

Used to diagnose infectious and inflammatory processes. Bacterioscopy allows you to detect bacteria in a woman’s genital organs: protozoan microorganisms - gonococci, which cause gonorrhea, Trichomonas - the causative agent of trichomoniasis. Also, a specialist will see under a microscope some bacteria, fungi (Candida), key cells (a sign of bacterial vaginosis). The type of microorganism is determined by its shape, size, and whether it is stained with a dye or not, that is, whether it is gram-positive or gram-negative.

In addition, in a smear from each point (taken from the vagina, urethra, cervical canal), the number of leukocytes in the field of view is counted. The more there are, the more pronounced the inflammatory process. The amount of epithelium and mucus is assessed. it is especially high in women of reproductive age during the period of ovulation - in the middle of the menstrual cycle.

Microscopic examination of the discharge of the female genital organs is an opportunity to quickly assess whether a woman is gynecologically healthy or not and make one of four diagnoses:

vaginal candidiasis (thrush);
bacterial vaginosis (formerly called gardnerellosis);
gonorrhea;
trichomoniasis.

If there are no clear signs of one of these diseases, but the smear is bad, an in-depth study of the material is carried out - bacterial culture is performed.

Reasons for performing culture in gynecology

If the smear contains a moderate or large number of leukocytes, but the causative agent of the infection is not known. Since with microscopy there is a lower limit for the detection of microorganisms: 10 to 4 - 10 to 5 degrees.
If a microbe is identified, to determine its sensitivity to antibiotics.
If there are signs of a fungal infection. To accurately determine the type of fungi and prescribe an effective antimycotic drug.
Some types of fungi, for example, Candida albicans (a diploid fungus), are very dangerous for expectant mothers and can cause infection and premature rupture of the membranes.

Other types of Candida fungi do not need to be treated if there are no pathological symptoms.

If key cells are found (signs of bacterial vaginosis), but besides them, other microbes are also present. For identification.

What are the differences between bacterial culture, flora smear and degree of vaginal cleanliness?

In the research method. With a general smear, the material applied to the glass is stained with special dyes and examined under a microscope. And when a bacteriological (bacteriological, cultural, microbiological) study is done, it is first “sown” on a nutrient medium. And then, after a few days, they look under a microscope to see what colonies of microorganisms have grown.

That is, if we are talking about a rapid analysis, you will only be given a conclusion about the number of leukocytes, epithelium and mucus. Sowing is not urgent

Also, with microscopy, you can quickly determine the degree of purity from the vagina. Here the doctor only assesses the relationship between normal, opportunistic and pathogenic microflora.

Classic assessment of vaginal cleanliness.

Updated table

Degrees	Signs
I	Dederlein rods, squamous epithelium.
II	Non-pyogenic bacteria. Leukocytes are normal. Diagnosis: non-purulent bacterial colpitis.
III	Pyogenic (staphylococci, streptococci, Pseudomonas aeruginosa, gonococci, etc.) microorganisms. High white blood cell count. Purulent bacterial colpitis.
IV	Gonorrhea (gonococci detected).
V	Trichomoniasis (Trichomonas detected).
VI	Vaginal candidiasis (fungi detected).

What doctors don't see with microscopy

Pregnancy. To determine it, a smear is not needed and it does not matter what result it shows. It is necessary to take a blood test for hCG, undergo a gynecological examination by a doctor, or do an ultrasound of the uterus. It is possible to detect human chorionic gonadotropin in urine, but not in genital discharge!
Cancer of the uterus and cervix. To diagnose malignant degeneration of the endometrium, histological material is needed, and in large quantities. And they take it directly from the uterus.
CC and other pathologies (erosion, leukoplakia, atypical cells, etc.) are diagnosed based on the results of a cytological examination. This analysis is taken directly from the cervix, from the transformation zone, using a certain method with Papanicolaou staining (hence the name of the analysis - PAP test). It is also called oncocytology.
Does not show infections (STDs) such as:
- herpes;
- chlamydia (chlamydia);
- mycoplasmas (mycoplasmosis);
- ureaplasma (ureaplasmosis);

The first four infections are diagnosed using the PCR method. And it is impossible to determine the presence of the immunodeficiency virus from a smear with high accuracy. You need to take a blood test.

How to prepare for the test and when it is needed

The doctor takes a smear from the patient on the gynecological chair (regardless of whether she is pregnant or not) using a special brush or a sterile Volkmann spoon. It doesn't hurt at all and is very fast.

It is technically possible to achieve a good, even perfect smear if you sanitize the vagina with chlorhexidine or miramistin, for example. But what's the point?

To get a reliable smear result, 48 hours before taking it you cannot:

douche;
have sex;
use any vaginal hygiene products, intimate deodorants, or medications unless they have been prescribed by a doctor;
do an ultrasound using a vaginal probe;
undergo colposcopy.
3 hours before visiting a gynecologist or laboratory, you should not urinate.

You need to take smears outside of menstrual bleeding. Even if there is just a “daub” on the last day of menstruation, it is better to postpone the study, since the result will probably be bad - a large number of leukocytes will be detected.

There are no prohibitions regarding drinking alcohol.

Is it possible to take a smear while taking antibiotics or immediately after treatment? It is not advisable to do this within 10 days after using topical drugs (vaginal) and one month after taking antibacterial agents orally.

Microscopic examination is prescribed:

as planned when visiting a gynecologist;
upon admission to the gynecological hospital;
before IVF;
during pregnancy (especially if smears are often bad);
if there are complaints: unusual discharge, itching, pelvic pain, etc.

Decoding the results: what is considered normal and what is pathology in the microflora

To begin with, we present to your attention a table that displays the indicators of the so-called first degree of purity. There is no mention of the urethra (although material is taken from there too), since we are talking about gynecological diseases. The inflammatory process in the urethra is treated by a urologist.

Index	Vagina	Cervical canal
Leukocytes	0-10 in field of view	0-30 in sight
Epithelium	depending on the phase of men. cycle
Slime	moderately
Trichomonas	No
Gonococci	No
Key cells	No
Candida	No
Microflora	gram-positive rods	absent

Epithelium - the number of epithelial cells is not counted, since this has no diagnostic value. But too scanty an amount of epithelium indicates an atrophic type of smear - this happens in women during menopause.

Leukocytes - counted in the “field of view”:

no more than 10 - a small amount;
10-15 - moderate amount;
30-50 is a large number, the woman notices pathological symptoms, and the doctor, upon examination, diagnoses an inflammatory process in the vagina and (or) cervix.

Mucus (mucus strands)- should be present normally, but a large amount occurs during inflammation. There should be no mucus in the urethra.

Rod flora or gr lactomorphotypes- the norm, this is the protection of the vagina from germs.

Trichomonas, gonococci and key cells in a healthy woman there should not be any in the cervix and vagina. Candida is also normally absent. At least in a significant amount, which is detected when analyzing the flora.

The usefulness of the smear is not great. But if a woman is admitted to the hospital, then right there, during the initial examination on the chair, they take a fresh one.

Results are usually valid for 7-14 days. Therefore, if you need to take it before surgery, do it 3 days before entering the hospital. The last of the prescribed tests.

What is found in bacterial culture

A gynecologist can best decipher the result of a cultural study. But you yourself, if you read the information below, will roughly understand your analysis.

The number of microorganisms can be expressed by “crosses”:

“+” – small amount;
“++” – moderate amount;
“+++” – large quantity;
“++++” – abundant flora.

But more often the number of microflora representatives is expressed in degrees. For example: Klebsiella: 10 to the 4th power. By the way, this is one of the representatives of enterobacteria. Gram-negative rod, aerobic microorganism. One of the most dangerous pathogens, although it is only opportunistic. This is because Klebsiella is resistant (immune) to most antibacterial agents.

Below we describe other common terms that appear in research results or you may hear from your doctor.

Soor is candidiasis, or in other words, thrush. It is treated with antimycotic (antifungal) drugs.

Blastospores and pseudomycelium of yeast-like fungi- candidiasis or other fungal disease, usually treated in the same way as thrush.

Diphtheroids are opportunistic microorganisms; according to scientific research, in most women about 10% of the microflora consists of them, as well as streptococci, staphylococci, E. coli, and gardnerella. If the flora is disturbed, their number increases.

Mixed flora is a variant of the norm, if there are no symptoms of the disease, only leukocytes or a strong increase in them (40-60-100). 15-20 is the norm, especially during pregnancy.

Enterococcus- representatives of intestinal microflora, which sometimes enter the vagina. Gram-positive cocci. We are talking about Enterococcus faecalis. There is also enterococcus coli - E. coli. Usually cause unpleasant symptoms at concentrations above 10 to the 4th power.

Pseudomonas aeruginosa- gram-negative bacterium. Often affects people with low immunity. It has good resistance to antibiotics, which makes the treatment process difficult.

Polymorphic rod- a common representative of the vaginal biocenosis. If the number of leukocytes is normal and there are no complaints, its presence should not be alarming.

Red blood cells - may be present in small quantities in the smear, especially if it was taken during an inflammatory process or when there was slight bleeding.

Coccus or coccobacillary flora- usually occurs with an infectious process in the vagina or cervix. If a woman has complaints, antibacterial treatment is required - vaginal sanitation.

Diplococci are a type of bacteria (cocci). In small quantities they are not harmful. With the exception of gonococci - the causative agents of gonorrhea. She is always treated.

And in conclusion, here are the common abbreviations that are written on test results forms:

L – leukocytes;
Ep – epithelium;
Pl. ep. - flat epithelium;
Gn (gn) – gonococcus, the causative agent of gonorrhea;
Trich is a trichomonas, the causative agent of trichomoniasis.

In this article, we will find out what the norm of leukocytes in a woman’s smear should be.

Leukocyte level in smear

A smear to determine microflora is one of the main and most effective methods for the comprehensive diagnosis of various diseases of the female genitourinary system.

For workers in certain manufacturing industries, as well as pregnant women, this smear is mandatory.

Carrying out this laboratory analysis makes it possible to identify quite serious diseases in a woman in the early stages of development, and at the same time, timely prescribe and carry out the necessary drug treatment.

Normally, in an adult, healthy woman, the level of leukocytes in a smear should not exceed 14-15 units in the field of view. A slight increase in leukocytes may occur before and during the menstrual cycle, when the figure can reach 18-20 units.

In a pregnant woman, the total content of leukocytes in a smear is significantly higher than normal, and can be more than 16-22 units in the field of view (this is normal).

With a significant increase in the level of leukocytes above normal, this may be the cause of the development of some kind of acute or chronic inflammatory process in the woman’s genitourinary system, which requires an additional, comprehensive examination of the body.

As a rule, in older women, the total content of leukocytes in the smear may be very low or completely absent, as gradual atrophy of the vaginal tissue occurs.

The level of leukocytes in a smear in women can periodically fluctuate, which can primarily be influenced by hormonal changes, age, general state of immunity, the presence of bad habits (smoking, alcoholism), the menstrual cycle, taking medications, stressful situations, therefore, when assessing the main results smear, it is necessary to take into account these influencing factors.

Main indications for a flora smear

prolonged painful sensations in the lower abdomen (periodic, constant, cramping) for 3-5 days or more;
copious vaginal discharge, which may be caused by acute inflammatory processes (endometritis, colpitis, urethritis, etc.) requiring complex antibacterial treatment;
infertility (carried out as an additional diagnostic method to determine the microflora of a woman’s vagina, the presence of an infection in which may be the cause of infertility);
preventive examinations (recommended annually);
frequent vaginal itching and burning in the female genital area;
pregnancy planning.

How to properly prepare for a smear test?

1-2 days before the analysis, it is necessary to completely exclude any douching of the internal cavity of the vagina;
it is temporarily recommended to limit possible sexual contacts;
it is advisable not to empty the bladder 1.5-2 hours before the laboratory test;
you should temporarily limit the intake of various vaginal medications (suppositories, tablets, ointments);
Before performing a smear, it is strictly contraindicated to wash the genitals with various hygiene products (it is allowed to wash only with a small amount of warm water).

Elevated leukocytes in the smear

The most common causes of elevated white blood cell levels in a smear are:

acute or chronic endometritis (inflammatory process affecting the uterine mucosa);
urethritis - inflammation of the mucous membrane of the urethra;
genitourinary infection (syphilis, genital herpes, gonorrhea);
vulvovaginitis (inflammation of the mucous membrane of the vagina and vulva);
adnexitis - inflammatory process of the uterine appendages;
colpitis is an acute or chronic inflammatory process that affects the mucous membrane of the vaginal walls;
intestinal or vaginal dysbiosis;
the presence of an oncological (malignant) neoplasm (tumor) in the woman’s genital organs.

Every woman under 45-50 years of age is recommended at least 1 r. take a gynecological smear per year for flora, and for older women it is advisable to undergo this examination at least 1-2 times. per year, since today the total number of serious diseases of the female genitourinary system is increasing.

The delicate balance system in a woman’s reproductive system can malfunction in the presence of an inflammatory process caused by exposure to a variety of pathogens.

An increase in the level in the sample becomes an indicator of the presence of the disease. Detection of an excess number of white cells becomes the basis for conducting an in-depth study in order to identify the source of the disease and prescribe targeted treatment.

Flora smear is an effective diagnostic tool for assessing the nature of inflammation of the genitourinary canal

Typically, a smear is taken from a woman at each visit to the gynecologist, both during a routine examination and in case of complaints of strange discharge, dryness, burning, itching, irritation and pain during sexual intercourse.

In some cases, infections have no external manifestations and can only be detected by a smear test.

An example of such a “secretive” disease is chlamydia, which is asymptomatic and is often discovered completely by accident.The basis for prescribing a smear, in addition to the presence of complaints, is the discovery during another type of examination of grounds for suspecting the presence of problems in the woman’s sexual sphere, as well as pregnancy.A flora smear reveals many indicators; it demonstrates not only the number of white cells, but also possible infection with various microorganisms, and also indicates the state of the woman’s hormonal status.

The analysis involves taking a smear from different places - the urethra, and, in some cases, from the rectum and oropharynx.

It is taken using a special disposable spatula, and samples are individually applied to special glasses. The samples are then marked in order to know exactly from which zone the material was taken for analysis.

The finished slides are sent for microscopic examination, which is performed by an experienced laboratory technician. It counts the amount and also identifies the possible presence of pathogenic microflora.

A smear is a fairly simple and quick test that can quite accurately determine the presence or absence of an inflammatory process and indicate the existing source of infection.

When conducting an analysis, the following indicators are checked:

Leukocytes
Flat epithelium
Gonococci
Trichomonas, etc.

If performed, and the leukocytes are elevated, this means that the specialist counted more than 15 cells in the field of view in the sample from the cervix, 5 in scrapings from the urethra, and 10 from the vagina. Usually this is evidence of an inflammatory process in the woman’s genital organs, and the higher the test values, the more intense the inflammation.

Causes of increased leukocyte levels

The main reason for indicators significantly exceeding the norm is the presence of an inflammatory process in the genitourinary organs.

There may be several diseases that cause such symptoms:

Vaginal and/or intestinal dysbiosis
Colpitis is an inflammatory process that develops in the vaginal mucosa
Cevicitis - inflammation localized in the cervical canal
Endometritis - inflammation of the uterine mucosa
Adnexitis - inflammation of the ovaries, fallopian tubes
- a process affecting the urethra
Oncological lesions of the genitourinary organs

If a smear on the flora shows that leukocytes are elevated and the numbers are very high, this is a reason to sound the alarm and immediately seek an in-depth study and prescribe the necessary treatment.

Useful video - Cervical smear in women.

In some cases, leukocytes are present in the sample, but the pathogen is not detected. This may be due to the fact that the process has just begun, as well as due to severe stress of a psychological or physiological nature. The most unpleasant option is an increase in indicators provoked by intestinal dysbiosis, since this condition is often extremely difficult to treat and the level of white cells in the smear does not decrease even with intensive drug exposure.

Sometimes even intense sexual activity can be the cause of a stable increase in the number of leukocytes. In a fairly common number of reported cases, leukocytosis slightly above the normal level is detected as a variation in the woman’s usual condition and does not turn out to be an indicator of the disease.

Signs of the disease

In most cases, inflammation of the genitourinary area manifests itself quite violently. You can note the presence of pain of varying degrees of intensity, scanty, abundant or foamy discharge, with an unpleasant odor, and a color that differs sharply from normal daily discharge.

Often inflammation is accompanied by itching, severe discomfort, swelling, and redness. Such manifestations bother a woman, make her nervous, interfere with normal sexual life, affect behavior, and affect the quality and duration of sleep.

It should be noted that all these signs indicate an infection, and not an increase in leukocytes - the appearance of these cells is one of the symptoms of the inflammatory process.Some diseases cause no symptoms. The woman feels healthy, everything is also fine externally - no pain, no itching or discharge.

Only a timely smear can reveal the presence of a hidden disease and allow the correct treatment to begin, preventing the development of a dangerous disease.

When this is done - leukocytes are elevated, and other analysis data cannot give an accurate determination of the cause of the disease, the doctor must send the patient for an in-depth examination to finally determine the exact cause of the appearance of these cells in the sample.

Treatment method

Since changes in the smear are associated with various reasons, the treatment itself is always specialized. This means that the appearance above normal in a smear is just an indicator of trouble, and not the disease itself, so the main goal of treatment is to cope with the pathogens that caused the inflammation. Since they can be different (bacteria, viruses, fungi, as well as various combinations of these pathogens), specific treatment will be prescribed.

Most often, leukocytosis is caused by bacterial vaginosis, which can be successfully treated with a course of appropriate antibiotics. Other diseases will require precise selection of drugs, and if several types of infection are combined at once, then the use of a whole range of drugs.

With candidiasis, you need to fight a fungal infection, and chlamydia, gardnerellosis and many other diseases are caused by protozoan microorganisms. They are also treated with specific drugs. The large number of pathogens that can cause changes in smear parameters suggests that there is simply no single universal medicine to combat them; each cause requires a “personal” drug.

It is extremely important to complete the entire course of treatment prescribed by your doctor, without skipping medications or arbitrarily reducing the dose and duration of therapy.

If you stop treatment after symptoms disappear, the infection can simply be “healed.” It will not go anywhere, it will “sleep” in the body until the next convenient opportunity. As soon as something happens and the immune system decreases and cannot resist the onslaught of infection, the disease will return at the most inopportune moment.

It is especially risky if this inopportune moment turns out to be. Some infectious diseases, especially, can have an extremely negative impact on development or even cause involuntary termination of pregnancy. Treatment of such infections in a pregnant woman is very difficult, since medications can have a detrimental effect on the fetus and the gestation process.It is much wiser to diligently complete treatment and save yourself from the risk of recurrence of the disease.