Cervical canal. Smear as a diagnostic method: norms for women and men, preparation for analysis, results
Smear from cervical canal allows you to get an idea of the microflora and prescribe appropriate treatment. A cytological smear is taken in 2 ways:
- sowing;
- microscopy.
A study that allows you to identify oncological diseases is carried out 24 hours after douching. It is recommended that women undergo a cervical smear every year. Use of oral contraception, the development of pathology or ailments of the reproductive system requires conducting a study once every 6 months.
The cervical canal plays important role during pregnancy and childbirth. Its average length is 3-4 cm. The main functions of the organ in question include:
- protection against infection;
- conception.
The vagina is home to germs and fungi. The uterine cavity is sterile. Special cells are responsible for the production of mucus. The level of female sex hormones has a direct effect on the properties of mucus. At the end and at the beginning of menstruation, mucus is characterized by an acidic (viscous) environment. It blocks the cervical canal. Microbes, entering an acidic environment, die, and sperm lose their mobility and ability to fertilize. At maximum level estrogen mucus becomes liquid alkaline environment. In the middle of the menstrual cycle, sperm and eggs begin new life. Progesterone is produced after conception.
The vagina is lined with epithelium, which is renewed, matures and rejected. A new population of cells occurs every 4-5 days. The composition of cells depends on the following factors:
- menstrual cycle;
- menstruation phase.
Medical indications
Cervical cytology is performed during a routine gynecological examination of the patient. For this you will need a spatula. The material is taken from various parts of the corresponding channel. A smear from the cervix is applied to a plate and sent to the laboratory. If the procedure is performed correctly, then the patient does not feel pain.
The consequences of this process include discomfort that may appear in the vaginal area during the day.
A cervical smear is performed to identify pathology of the cervix.
The examination is carried out in the middle of menstruation. Before taking a smear for cytology, you must follow your doctor's recommendations. Before the study (2-3 days before), it is recommended to abstain from sex, vaginal products, contraceptives and douching. During this period, you cannot visit a gynecologist and perform a colposcopy. In this case, the cytology smear will be reliable.
- rash;
- unpleasant odor;
- discharge.
In this case, you will need to be cured. Vaginal cleanliness should be grade 1. If necessary, the patient takes a smear for flora. Especially representatives of the fair sex who are active should undergo such an analysis. sex life. You cannot take a smear for cytology and flora from a gynecological speculum. A special brush is used for this. If there is ectopia and other changes on the cervix, material is taken from these areas. Pregnant women should undergo a smear for microscopic cytology, as opposed to an examination of the cervical canal, 2 times within 9 months.
Diagnosis and treatment
Deciphering the analysis is part of the gynecologist's specialization. When examining the collected material, doctors pay special attention to atypical cells. Their moderate amount symbolizes the development of the inflammatory process. Therefore, a smear for cytology is taken at a time when the number of leukocytes does not exceed the permissible value.
The normal smear provides for the absence of atypical cells. Otherwise, the gynecologist makes a diagnosis of “Dysplasia” of the 1st, 2nd or 3rd degree. Malignant cells are observed during the development of cervical cancer. If a specialist has identified grade 1 dysplasia, then the patient must undergo a full examination. With the development of dysplasia of the 2nd and 3rd degrees, colposcopy, biopsy and conization are performed. The latter procedure involves removing the affected area of the cervix using a scalpel or radio knife. Stage 3 dysplasia refers to cancer, the treatment of which is the specialty of a gynecological oncologist. The patient is admitted to an oncology clinic.
Diagnosis and treatment of diseases of the cervical canal involves the use of curettage. The procedure for curettage of the canal is carried out for therapeutic purposes in the following cases:
- hyperplasia;
- polyps;
- bleeding of the uterus;
- removal of fibroids.
The resulting material is sent to the laboratory. Curettage is prescribed by a gynecologist in cases where this technique is the only way to diagnose and treat the female genital organs.
Planned curettage of the cervical canal is prescribed a few days before the start of the menstrual cycle. In this case, the operation coincides with the physiological period of rejection of the uterine epithelium. Intravenous anesthesia is used to perform diagnostic curettage.
After the operation (for 2-3 weeks), the patient must maintain hygiene, avoiding hypothermia and excluding severe physical activity. You are not allowed to visit the solarium or gym during this period. Swimming in the pool, sea and bath is contraindicated. Showering is allowed. Similar rules must be followed in the postoperative period, since the genital tract has not healed. Upon completion of the course of treatment, a repeat cytology smear is prescribed.
An alternative method to curettage is hysteroscopy. To perform this, you will need a hysteroscope. With its help, a specialist examines the uterus. Diseases of the female genital organs occur for the following reasons:
- infection;
- hormonal disbalance;
- tumor.
Regular visits to the gynecologist will help to promptly identify any pathological change.
Medical tests and studies play a big role in diagnosis various diseases. Many diseases do not produce any symptoms, and only laboratory examination of cells under a microscope can reveal infection or the presence pathological changes in tissues. That is why all women aged 19 to 65 years old must be seen by a gynecologist for analysis.
How is a cervical smear taken?
One of the simplest, but no less important gynecological tests is a smear from the cervical canal. It is performed for every woman reproductive age, who came for a preventive appointment with a gynecologist during a routine examination on the chair. A smear is a scraping from the cervical canal, which is then sent for cytological examination to the laboratory. The latter is usually done using one of two methods: examining biological material under a microscope or do bacteriological culture. Cytology of a smear from the cervical canal makes it possible to judge the state of the microflora, and also helps to identify inflammatory processes and even oncological changes in the cervix.
A cytological smear from the cervical canal is not painful or scary at all. The doctor simply carefully takes the scraping with a special spatula, and then transfers it to a clean glass slide. This process takes literally a few seconds. The analysis is the basis for the prevention of many female diseases, so you need to prepare for it: at least a day before going to the doctor, sexual intercourse, douching, the use of vaginal suppositories, pills, etc. are not recommended, otherwise the analysis will be uninformative. In addition, a cervical smear test should not be performed during menstruation.
Deciphering a smear from the cervical canal
In the table below you see the indicators by which the doctor interprets this analysis. This is the presence or absence of leukocytes, gonococci, trichomonas, yeast fungi and other norms in a smear from the cervical canal. The Latin letters V, C and U stand for the vagina, cervix and urethra, respectively (those tissues where certain microorganisms were or were not found).
The following facts indicate a deviation from the norm:
- a large number of leukocytes, mucus or epithelium (inflammation);
- lack of epithelium (lack of estrogen hormone);
- presence of gram-negative rods ();
- gonococci();
- trichomonas (trichomoniasis);
- chlamydia (chlamydia);
- yeast fungi (candidiasis);
- key cells (vaginal candidiasis).
There is also a Papanicolaou reading option - it helps identify cervical pathologies, including precancerous conditions. There are 5 stages:
In more than 20% of cases, the results of this cytological study are false. This happens when outdated methods are imperfect. Therefore, if you doubt the reliability of the result of a smear from the cervical canal, you can retake it or ask your doctor about colposcopy - a detailed examination of the cervix, which provides expanded information about possible pathologies, which are not noticeable during normal inspection.
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Bolotova Irina Gennadievna
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Ryasova E.K.
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Eremin D.S.
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Kravtsova E.V.
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Moisov Adonis Alexandrovich
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Vereshchagina Natalya Sergeevna
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Normatova Dilfuza Yashinovna
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Armashova Olesya Yurievna
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Voitashevskaya N.V.
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Alasheeva Margarita Nikolaevna
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Shiukashvili Marina Borisovna
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Khalitov Ranil Ravilievich
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Minosyants Anna Arminakovna
Specialization: Ultrasound Doctor
Work experience: 22 years
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Graduated from the State Medical University of Turkmenistan (TSMU)
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"Ultrasound diagnostics" Russian Scientific Center of X-ray Radiology
Movsisyan Arthur Grishaevich
Specialization: Ultrasound Doctor
Work experience: 31 years
Higher education
Diploma in General Medicine, Yerevan State Medical Institute
- Internship in the specialty "Ultrasound Diagnostics", Central Order of Lenin Institute for Advanced Training of Physicians
"Radiation diagnostics", Moscow Medical Academy named after I.M. Sechenov
"Radiation diagnostics", Russian Medical Academy of Postgraduate Education
"Radiation diagnostics", Kuban State Medical University
Additionally:
Proficient in basic methods of ultrasound diagnostics, including ultrasound of the abdominal cavity, retroperitoneal space, ultrasound of the prostate gland, ultrasound thyroid gland, Ultrasound of the mammary glands, Ultrasound of the pelvic organs, transvaginal examination, ultrasound internal organs, Ultrasound of joints, Ultrasound of lymph nodes
Zashlyakhin Andrey Rafailovich
Specialization: Neurologist
Work experience: 33 years
Education: Chisinau Medical Institute 2016 - Kuban State Medical University, Krasnodar (Professional retraining, Coloproctologist)
2017 - Outpatient coloproctology (Russian School of Colorectal Surgery, Coloproctologist)
Outpatient appointment Diagnosis of diseases Prescription of treatment
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Lipatova Veronika Evgenievna
Specialization: Therapist-cardiologist
Work experience: 22 years
Higher education
from 1987 - 1993 Russian State Medical University (General Medicine)
Internship: from 1993 - 1994 (therapy) medical unit No. 1 (City Clinical Hospital No. 12)
Certificate of specialist in oncology since 2001.
Doctor's Certificate functional diagnostics since 2003
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Lenev Oleg Glebovich
Specialization: Neurologist, neurosurgeon
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Bolotova Irina Gennadievna
Specialization: General practitioner, cardiologist/CMN
Work experience: 30 years
Odintsovo Central District Hospital - intern doctor, local doctor. Main Military Clinical Hospital named after Burden - coordinator of the cardiology department, head. endocrinology office of the advisory center. Medical Center of the Bank of Russia - head of the VIP patient therapy department. Polyclinic of the Main Directorate of the Bank of Russia in Moscow.
Education:
Diploma in general medicine from PSU - 1987.
Postgraduate studies at RUDN - defense of a dissertation for the degree of Candidate of Medical Sciences in 2001.
Certificate courses in therapy - the last one in 2014, cardiology, endocrinology.
Area of professional interests:
Conducts diagnostics and treatment of diseases of the cardiovascular, respiratory, endocrine, digestive systems. Selection of therapy for patients with concomitant pathology.
Scientific activity:
Management of patients in hospital and outpatient settings. Performs an initial comprehensive examination to determine risk factors for the development of chronic diseases and draw up an individual plan for their correction. Uses modern diagnostic methods with interpretation of all types of laboratory, radiation and functional examination methods.
Kokina Olga Nikolaevana
Specialization: Endocrinologist
Work experience: 7 years
Education: 2002-2008 – Volgograd State Medical University (VolSMU), Faculty of Medicine.
2009 – an advanced course in clinical endocrinology at the workplace in the department of therapy and pathology of metabolism of the Federal State Institution Scientific Center under the program “Organization and conduct of training schools for patients with obesity.”
2010 - an advanced course in clinical endocrinology in the workplace at the department of the Institute of Diabetes of the Federal State Institution Scientific Center under the program “Organization and conduct of schools for training patients with diabetes mellitus”
2008-2010 – clinical residency at the Federal State Institution Endocrinology Research Center (ERC), full course of study in the specialty of endocrinology. Advanced training, access to medical activities in the specialty of endocrinology 05/26/2015 - 06/23/2015 on the basis of the Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. Advanced training "Examination of temporary disability and quality control of medical care" 02/24/2016 - 03/24/2016 on the basis of the First Medical State University named after I.M. Sechenov.
Area of professional interests:
Diagnosis of distal diabetic polyneuropathy (impaired sensitivity of the feet), diagnosis of the cardiovascular form of diabetic autonomic neuropathy. Prevention, diagnosis and treatment of endocrine pathology (thyroid disease: nodular goiter, focal changes, autoimmune thyroiditis, hypothyroidism, thyrotoxicosis, observation after surgery, counseling patients before massage and physiotherapy of the cervical-collar area, diabetes, including the development of an individual nutrition plan and selection of optimal therapy, hypoparathyroidism, hyperparathyroidism, hormone-producing pituitary tumors, diabetes insipidus, adrenal tumors, arterial hypertension endocrine genesis, endogenous hypercortisolism, adrenal insufficiency, osteoporosis in women and men, age-related androgen deficiency in men, vitamin D deficiency, weight correction through the development of an individual nutrition plan, counseling women planning pregnancy and pregnant women with endocrine pathology, screening for the presence of endocrine pathology before and during pregnancy. Drawing up a “sex formula” for adolescents during medical examination. Primary consultation for children over 5 years old with newly diagnosed endocrine pathology, prevention of thyroid pathology in children. Diseases that the doctor treats, at least 10 names: Nodular goiter, hypothyroidism, thyrotoxicosis, autoimmune thyroiditis, gestational hypothyroidism, Graves' disease (Graves' disease), hypoparathyroidism, hyperparathyroidism, osteoporosis, pheochromocytoma, aldosteroma, Itsenko-Cushing disease, Itsenko-Cushing syndrome, ACTH-ectopic syndrome, adrenal insufficiency, prolactinoma, stomatotropinoma, diabetes insipidus, diabetes mellitus, obesity, osteoporosis, osteopenia, hypopituitarism, hypogonadism. Does the doctor advise on these diseases, if we are talking about a child? Drawing up a “sex formula” for adolescents during medical examination. Primary consultation for children over 5 years old with newly diagnosed endocrine pathology, prevention of thyroid pathology in children, prevention of vitamin D deficiency, development of a weight loss program.
Scientific activity:
Participation in professional associations, conferences; regular participation in conferences and schools for endocrinologists.
Savlaev Vyacheslav Taimurazovich
Specialization: Anesthesiologist-resuscitator
Work experience: 9 years of experience
2001 He graduated from the Chita State Medical Academy with a degree in general medicine. 2012 He completed his internship in anesthesiology-resuscitation and intensive care. 2012-2014 Anesthesiologist-resuscitator in the department of anesthesiology and intensive care of the regional clinical hospital in Chita 2014-2018. Anesthesiologist-reanimatologist at Zaigraevskaya Central District Hospital. 2015. Improvement course in the program of anesthesiology and intensive care in obstetrics and gynecology in Ivanovo. 2017 Advanced training in the course “anesthesiology, resuscitation and intensive care” at the Buryat State University in Ulan-Ude. 2018 In the State Clinical Hospital named after V.P. Demikhov, Moscow. 2018. To date, anesthesiologist-resuscitator at the Moscow Doctor Clinic.
Area of professional interests:
Anesthesiology and resuscitation
Dashieva Elena Innokentievna
Specialization: Endoscopist
Work experience: 16 years of experience
2003-2004 surgeon at the State Budgetary Healthcare Institution Zaigraevskaya Central District Hospital Onokhoiskaya District Hospital of the Republic of Buryatia.
2003-2004 surgeon at the State Budgetary Healthcare Institution Zaigraevskaya Central District Hospital Onokhoiskaya District Hospital of the Republic of Buryatia.
2004-2008 surgeon at the Muya Central Regional Hospital of the Republic of Buryatia.
2004-2008 surgeon at the Muya Central Regional Hospital of the Republic of Buryatia.
2008-2012 endoscopist at the State Budgetary Healthcare Institution City Hospital No. 2 of Chita.
2012-2013 endoscopist at the State Budgetary Healthcare Institution City Clinic No. 1 of Ulan-Ude, Republic of Buryatia.
2013-2015 - endoscopist at the Republican Oncology Dispensary of the Republic of Tyva.
2015-2016 endoscopist at the State Budgetary Healthcare Institution City Hospital No. 4 of Ulan-Ude, Republic of Buryatia.
2016-2017 - surgeon at the State Budgetary Healthcare Institution Zaigraevskaya Central District Hospital Novo-Bryansk Hospital of the Republic of Buryatia.
2017 to present: endoscopist at Moscow Doctor LLC, Moscow.
Education: 1996-2002 studying at the Cheta State Medical Academy, majoring in pediatrics.
2002-2003 internship in surgery in Ulan-Ude emergency hospital.
2008-2009 Faculty of advanced training and professional retraining of specialists at ChSMA, Chita, professional retraining in the specialty of endoscopist.
2012 Certification cycle in surgery, Department of Postgraduate Education, BSU, Ulan-Ude.
2014 Certification cycle in endoscopy - Novokuznetsk State Institute for Advanced Training of Physicians of the Ministry of Health and Social Development of the Russian Federation - endoscopist.
2017 Certification cycle of surgery - Department of Postgraduate Education of the BSU, Ulan-Ude.
Area of professional interests:
Surgical treatment, endoscopic diagnosis of planned and emergency pathology (gastroscopy, sigmoidoscopy, colonoscopy, bronchoscopy, cystoscopy), maintaining medical records, monitoring the use of endoscopic equipment.
Sidakov M.T.
Specialization: "Orthopedic dentistry"
Work experience: 17 years
Education: In 1998 he graduated from the Faculty of Dentistry of Tver Medical Academy.
From 1998 to 1999 he completed a clinical internship.
From 2000 to 2002 completed his residency at the dental clinic of the TSMA, specializing in dentist-orthodontist.
Completed specialized courses in endodontics, microinvasion and caries prevention, lingual orthodontic technique.
In 2013, he attended the course “Fundamentals of decision making in implantology: surgical and orthopedic aspects” Nobel Biocare.
Scientific activity:
In 2012 he took part in a master class for Ph.D. Chikunova S.O. and master technician Nikonenko D.M. on the topic: Adhesive ceramic restorations. In 2013, he took part in a lecture by University Professor (UCLA), head of the Center for Aesthetic Dentistry, member of the international group ART ORAL Edward McLaren. DDS, MDC on the topic: “Aesthetic ceramics - the art of passion” (veneers, inlays, onlays).
Ryasova E.K.
Specialization: Dentist-therapist
Work experience: More than 5 years
Education:
2004 – Omsk State Medical Academy, majoring in dentistry, completed a one-year specialization in dentistry. Advanced training/courses.
2009-Course “Modern techniques in endodontic treatment, nickel-titanium technologies”, Moscow.
2009-seminar on teeth whitening and master class with the ZOOM clinical system, Discus Dental, Moscow
2010-Participation in the conference “Direct aesthetic restoration of the anterior group of teeth using composite materials” Moscow, Dentsply.
2010-Specialization in therapeutic dentistry GOU DPO RMAPO ROSZDRAVA 144 hours.
2010-Specialization in orthopedic dentistry at the Federal State Educational Institution Institute for Advanced Studies of the Federal Medical and Biological Agency of Russia, 576 hours.
2010 Master class - “Fiberglass reinforcement of composite restorations in everyday practice, adhesive splinting of teeth.” Proteko, Moscow.
2011-Course “Retreatment, clinical decisions and techniques”, Solomonov, Moscow.
2011-Theoretical and practical course “Microscope, working with an endodontic microscope”, Rome, Nicola Grande, Gianluco Plotino
Information:
I conduct therapeutic appointments in full - endodontic preparation for prosthetics, restorations, whitening, professional hygiene, not complex deletions, I work on an endodontic microscope.
Eremin D.S.
Specialization: Implantologist, dentist
Work experience: More than 5 years
Education:
2011-2013 - Clinical residency in the specialty "Surgical Dentistry" at the Department of "Clinical Dentistry and Implantology" of the Federal State Budgetary educational institution additional professional education "Institute for Advanced Studies of the Federal Medical and Biological Agency", Moscow.
2008 - Graduated from the Far Eastern State Medical University in Khabarovsk.
2008-2009 - Internship in the specialty "Dentistry" general practice"on the basis of MUZ SP No. 25 "Den-Tal-Iz" Khabarovsk.
2014 - Participant in the scientific and practical seminar "Bone grafting" Lecturer: Khabiev K.N. Moscow city.
2015 - Features of working with the ANKYLOS DENTSPLY FRIADENT implantation system, certificate Lecturers: Shatarov D.M. and Dovbnev V.A. Moscow city.
2015 - Participated in a round table on the topic “Biological, physiological and mechanical causes of pericervical tissue recession, affecting the reduction in the prognosis of prosthetics supported by dental implants” Lecturer: Ilya Fridman, Moscow.
2015 - Practical course on the ASTRA TECH implant system, certificate Lecturers: Kirill Polyakov and Renat Ayubov, Moscow.
2015 - Completed the theoretical course “Complex clinical situations in implantology and periodontal surgery, ways to solve them using modern biomaterials” Lecturer: Dudin M.A. Moscow city.
2015 - Course on "Planning implantological operations 3D modeling. Manufacturing surgical templates. Features and advantages of the CORTEX line of implants. Installation of CORTEX implants. Lecturers: Filinov D, Ozhigov E, Rarov A, Pryadilshchikov A. Moscow.
2016 - Participant in the lecture-practical course "Achieving an aesthetic result when eliminating gum recession - comparative analysis of surgical methods" Lecturer: Fevraleva A.Yu. Moscow city.
2016 - Took part in the practical and theoretical course “Bone grafting at a dental appointment” Lecturers: Urazbakhtin I.I. and Ponomarev O.Yu. Saint Petersburg.
Information
Specialization: all types of outpatient surgical interventions: simple and complex tooth extractions; hemisection and amputation of tooth roots, alveolotomy, resection of the root apex, cystectomy, removal benign neoplasms. Implantology: installation of implants Astra Tech, Nobel, Straumann, Ankylos, Impro, Luna, BioHorizons, Alpha-Bio, Mis, Xive Friadent, Implantium, Adin, Biomet, Osstem. Open and closed sinus lift, bone tissue restoration using titanium mesh , horizontal osteotomy, sosage technique, guided bone regeneration, splitting of the alveolar process using piezo instruments, use of a-prf, i-prf. Periodontal surgery: vestibuloplasty, frenuloplasty, gingivoplasty, closed and open curettage‚ patchwork operations to close gum recession in the area of the tooth and implant, changing the biotype of the gum, creating a zone of attached gum.
Lysyakova L.A.
Specialization: Ultrasound doctor
Work experience: General medical experience is 22 years, including 8 years in the specialty of ultrasound diagnostics. First qualification category in the specialty of ultrasound diagnostics.
Education: St. Petersburg Medical Institute named after Academician I.P. Pavlov, 1993, specialty "general medicine". Internship in the specialty "dermato" RKVD, Nalchik. 1994. Professional retraining in the specialty “ultrasound diagnostics” RMAPO, Moscow 2007 Educational institutions and technical colleges in the specialties “dermato”, “ultrasound diagnostics” 1999, 2004, 2007, 2012, 2013
Area of professional interests:
Ultrasound examination of adults: thyroid gland, salivary gland, mammary gland, heart (ECHO-CG), abdominal cavity, pleural cavity, liver, gallbladder, pancreas, spleen, kidneys, adrenal glands, bladder, prostate gland, scrotum, uterus, ovaries, duplex scanning of vessels (arteries, veins of the upper, lower extremities, neck-carotid and vertebral arteries), ultrasound examination in obstetrics, 3D-4D, ultrasound examination of joints, soft tissues, lymph nodes.
Kravtsova E.V.
Specialization: Neurologist
Work experience: 12 years old / Doctor of Medicine
(Medical rehabilitation center under the scientific direction of V.I. Dikul). Lecturer at the Department of RUDN University. Highest medical category.
Education:
RUDN Faculty of Medicine, specialty "General Medicine". Diploma with honors, International diploma with honors.
Area of professional interests:
Vertebroneurologist, Rehabilitologist, Proficient in the technique of paravertebral blockades, pharmacopuncture, local injection therapy, massage on trigger zones. Residency at the Department of Neurology and Clinical Neurophysiology of RUDN University.
Moisov Adonis Alexandrovich
Specialization: Traumatologist, orthopedist
Work experience: More than 5 years
Education:
In 2009 he graduated from the Yaroslavl State Medical Academy with a degree in general medicine.
From 2009 to 2011, he completed a clinical residency in traumatology and orthopedics at the Clinical Emergency Hospital named after. N.V. Solovyov in Yaroslavl.
Scientific activity:
From 2011 to 2012, he worked as an orthopedic traumatologist at Emergency Hospital No. 2 in Rostov-on-Don. Scientific and practical interests: foot surgery and hand surgery.
Malikova T.V.
Specialization: Otolaryngologist (ENT)
Work experience: 34 years old / Doctor of the highest category
Education:
Diploma in the specialty "General Medicine (Treatment and Prevention)", Moscow State Medical Academy (1981)
Internship in the specialty "Therapist", Moscow City Clinical Hospital No. 67 (1992)
Diploma in Otorhinolaryngology, City Clinical Hospital No. 67 (1993)
"Otorhinolaryngology", Moscow State Medical and Dental Institute (2012)
Area of professional interests:
Spicy and chronic rhinitis(runny nose): including allergic, vasomotor rhinitis; acute inflammatory diseases of the pharynx: acute tonsillitis, acute pharyngitis, paratonsillar abscess; spicy and chronic sinusitis: sinusitis, ethmoiditis, frontal sinusitis, sphenoiditis, nasal polyposis; spicy and chronic otitis: external otitis, otitis media; inflammatory diseases of the larynx: acute and chronic laryngitis, laryngeal tonsillitis; inflammatory diseases of the head, neck: boils, carbuncles of the face, neck; injuries of the external nose, ear; foreign bodies pharynx, larynx.
Scientific activity:
ENT doctor, City Clinic No. 195, Moscow (1983-2012) ENT doctor, City Clinic No. 139, Department of Otorhinolaryngology, Moscow (1983-1986) ENT doctor, Medical Center "Our Clinic", Moscow city (2012-2016)
Vereshchagina Natalya Sergeevna
Specialization: Dermatovenerologist
Work experience: 9 years
Education:
Graduated from Altai State Medical University (2002-2008) with a degree in General Medicine (Barnaul).
She specialized in Dermatovenereology (2008-2010). (Internship) on the basis of the Dermatovenerological Dispensary at the Altai State Medical University (Barnaul).
She completed advanced training in Dermatovenereology (144 hours) in 2015 in Moscow on the basis of the Federal State Budgetary Educational Institution of Additional Professional Education “Institute for Advanced Training of the Federal Medical and Biological Agency.”
Area of professional interests:
He has extensive experience in removing benign tumors using the Surgitron device (electrocoagulation). She receives patients with various diseases of the skin and scalp, including chronic ones (fungal, viral, autoimmune, allergic, infectious lesions). Widely approaches to solving various skin problems, based on the etiology and pathogenesis of diseases. Deals with the correction of trichological problems, diagnosis and treatment of sexually transmitted diseases. Constantly improves his professional level preparation.
Slabukha O.V.
Specialization: Dermatologist, trichologist / Highest medical category
Other specializations: Therapy, infectious diseases
Work experience: More than 20 years
Education:
Siberian State Medical University, Tomsk. "Healing."
Pacific State University, Khabarovsk-jurisprudence.
Area of professional interests:
Extensive experience in the diagnosis and treatment of patients with diseases of the skin and subcutaneous fat: dermatitis of various etiologies, pyoderma, dermatoses (psoriasis, atopic dermatitis), dermatomycosis, onychomycosis, ectopariasitosis, viral skin diseases, diseases of the sebaceous glands, focal and diffuse alopecia, seborrhea , sexually transmitted diseases and STIs, emergency prevention of STIs, Trichoscopy, dermatoscopy, Individual selection of treatment regimens according to the diagnosis. Operation of the Surgitron radio wave apparatus: removal of benign growths of the skin and mucous membranes.
Professional achievements:
Member of the Russian Scientific Society of Dermatologists and Cosmetologists, the Union of Trichologists.
Normatova Dilfuza Yashinovna
Specialization: Obstetrician-gynecologist
Work experience: More than 15 years
Education: TSMU named after Abuali ibni Sino
2004 – Research Institute of AGiP of the Ministry of Health of the Republic of Tatarstan Seminar “Promoting effective perinatal care”, Dushanbe
2005 – Tajik Institute of Postgraduate Training of Medical Personnel “Colposcopy”, Dushanbe
2006 – The project simplemented by CARE Tajikistan - Training “STI Management” Dushanbe
2007 - The project simplified by CARE Tajikistan - training “Structures for the provision of services for the friendly attitude of sexual and reproductive health of youth”, Dushanbe; Ministry of Health of the Republic of Tatarstan, UNISEF, Association of Family Doctors of the Republic of Tatarstan Seminar “Promotion and introduction of breastfeeding in a child-friendly hospital” Dushanbe
2009 – GTZ Parter for the Future. Worldwide. Ministry of Health of the Republic of Tajikistan, training “Implementation of national standards for the provision and management of safe antenatal care”, Dushanbe
2010 – RMAPO Colposcopy, Moscow
2012 – Federal Budgetary Institution “Central Research Institute of Epidemiology”, 18th scientific and practical seminar “New foreign and domestic recommendations for the prevention and early detection of cervical cancer. New developments of the Center for Molecular Diagnostics for screening cervical pathology" Moscow
2014 – JSC “PENCROFT-PHARMA” seminar “Use of Dr. Arabin’s pessaries in obstetrics and uro-gynecology”; FBUN TsNIIE 26th scientific and practical seminar “Florocenosis - rational PCR diagnostics in gynecology. Experience of application in clinical practice" Moscow; courses and trainings of JSC "PENCROFT-PHARMA" seminar "Safe abortion: manual vacuum aspiration, medical termination of pregnancy" Moscow
Systematically improves the level of his knowledge and the level of medical skills through courses in his specialty, and has a specialist certificate. Engaged in research activities, takes an active part in seminars, master classes, and exhibitions on gynecology. Provides specialized care to gynecological patients at the clinic and hospital level. Conducts outpatient visits, minor operations and manipulations (RDV, HS, hymo-, labiaplasty, ECHO HSG, pneumo- and hydrotubation, intrauterine instillations, insertion and removal of IUDs, surgical and medical abortions), assistance in laparotomic and laparoscopic operations, diagnostics in gynecology, obstetrics, treatment, dispensary observation, masters colposcopy techniques and methods of treating cervical pathologies, ultrasound in gynecology and obstetrics. Managed the City Center Reproductive Health, Medical Advisory Center for Friendly Youth Services.
Armashova Olesya Yurievna
Specialization: Endoscopist, surgeon
Work experience: 6 years
GBUZ MO "Vidnovskaya Regional Clinical Hospital" (Vidnoye)
07/2009 - present time (surgeon, endoscopist)
GOUVPO State Classical Academy named after Maimonides (Moscow), Faculty of Medicine
09/2008 - present time (Assistant at the Department of Topographic Anatomy and Operative Surgery)
Education:
GOUVPO State Classical Academy named after Maimonides (Moscow)
08/2003 - 07/2009 Faculty of Social Medicine, special. "Medicine"
Clinical residency GOUVPO State Classical Academy named after. Maimonides (Moscow)
09/2009 - 07/2011 Clinical resident in general surgery
GOUVPO Russian Medical Academy of Postgraduate Education (Moscow)
Department of Endoscopy, primary specialization 2011
Area of professional interests:
Treatment of acute surgical pathology(felons, purulent diseases of the skin, subcutaneous tissue, joints, perforated ulcer stomach and duodenum and other acute diseases of the abdominal cavity)
- Operations performed: hernia, cholecystitis, appendicitis, removal of skin formations, subcutaneous tissue, etc.
- Ability to work independently,
- Knowledge of current trends in surgical anatomy
- Conducting and interpreting studies: esophagogastroduodenoscopy (EGD), colonoscopy, bronchoscopy, sigmoidoscopy,
- Therapeutic gastro-, broncho- and colonoscopy (removal of polyps, formations, NO therapy, taking a biopsy, stopping gastrointestinal bleeding, sanitation of the bronchial tree, removal of colon formations, installation of stents for strictures, including burns).
Professional achievements:
Certificate “For personal contribution to the development of the healthcare system of the Leninsky district of the Moscow region” (2011)
Voitashevskaya N.V.
Specialization: Gastroenterologist-endoscopist
Work experience: 15 years
2001-2003 Clinic No. 106, Moscow, endoscopist.
2004-2007 City Clinical Hospital No. 64 of Moscow, emergency endoscopist.
2004-2015 GP No. 5 of the Department of Health, General Practitioner.
2012-2015 Children's city clinic No. 118, Department of Health, endoscopist.
Education:
1993-2000 - Russian University Friendship of Peoples, Faculty of Medicine, qualification as a doctor, specialty “General Medicine”.
2000-2002 - Peoples' Friendship University of Russia, Faculty of Medicine, clinical residency at the department general surgery in endoscopy and ultrasound diagnostics, specialty endoscopy.
2002-2005 - Peoples' Friendship University of Russia, Faculty of Medicine, postgraduate study at the Department of Faculty Surgery, academic degree Candidate of Medical Sciences.
2011 - Russian State Medical University, advanced training courses, specialty endoscopy.
Gaponov M.V.
Specialization: Ultrasound diagnostics. Conducts ultrasound diagnostics of the abdominal organs, urinary system, lymph nodes, mammary glands, thyroid gland, pelvic organs, prostate and scrotum. Doppler ultrasound of the arteries and veins of the extremities, brachiocephalic vessels of the neck.
Work experience: More than 5 years
Education: 2008 Tashkent Medical Academy, Republic of Uzbekistan, specialty “General Medicine” 2010. Tashkent Medical Academy, Republic of Uzbekistan, residency in Oncology, 2014. FSBI National Medical and Surgical Center named after. N.I. Pirogov, retraining in the specialty “Ultrasound diagnostics” 2014. TIC "SoMeT" on the basis of the Federal State Budgetary Institution " Science Center Cardiovascular Surgery named after. A.N. Bakulev”, advanced training on the topic “Ultrasound diagnosis of pathology of the heart and blood vessels” 2014. GBOU VPO MGMSU named after A.I. Evdokimov, advanced training in the course “Palliative medical care”
Area of professional interests:
Ultrasound diagnostics of joints and spine. ECHO-KG, ultrasound diagnostics of superficial organs (soft tissues).
Romanchenko A.I.
Specialization: Obstetrician, gynecologist, ultrasound diagnostician.
Work experience: 9 years
Area of professional interests:
Professional goals: Consultation on obstetrics and gynecology - outpatient appointment, ultrasound; treatment of the cervix, radio wave treatment of the cervix with Fotek Surhydron devices, inflammatory diseases of the pelvic organs, ovarian dysfunction, Bartholin gland disease, menopause and menopause, atrophic vaginitis, condition associated with artificially induced menopause, postmenopausal bleeding, endometriosis, adenomyo, treatment of STDs, pipel biopsy, pregnancy management, colposcopy.
Alasheeva Margarita Nikolaevna
Specialization: Obstetrician-gynecologist, endocrinologist, ultrasound diagnostician
Work experience: More than 25 years / Doctor of the highest category
Education:
In 1989 she graduated with honors from the Turkmen Order of Peoples' Friendship State Medical Institute.
In 2013, she passed the final certification in the professional retraining program “Ultrasound Diagnostics”
Direct speech from the doctor:
Currently, he continues to actively use high-tech medical care for patients with urological pathology in the Moscow Doctor clinics.
Scientific activity:
While working at the Research Institute of Urology I studied scientific activity in the department - Inflammatory kidney diseases, in the department - Efferent methods of treatment urological diseases- accompanied by renal failure (hemodialysis, hemosorption, plasmapheresis). Is the author of 26 scientific works, including inventions on the topic “Latent infectious and inflammatory diseases genitourinary system– diagnosis and treatment.” Simultaneously with scientific activities, he was engaged in operational work. He performed more than 11,000 surgical interventions on the genitourinary system. Based on the family house No. 20 \with urological pathology of pregnant women\, he treated a large number of patients with pyelonephritis in pregnant women. At the Marriage and Family Medical Center, natural. house No. 20 treated men with various forms infertility.
Professional achievements:
He is a member of the Association of Urologists of Russia, Andrologists of Russia, a permanent participant in the All-Russian Urological Video Conference, and constantly takes part in master classes at the Karl Storz School (Germany).
Komrakov Vladimir Evgenievich
Specialization: Professor / Doctor of Medical Sciences
Work experience: 32 years
Education:
Graduated from the 2nd Moscow State Medical Institute named after. N.I. Pirogov (Federal State Budgetary Educational Institution of Higher Education Russian National Research Medical University named after N.I. Pirogov) in 1984 with a degree in general medicine. After completing clinical residency and graduate school, he worked as an assistant, associate professor, and professor in the departments of surgical diseases, headed the departments of vascular surgery, was a consultant to the Main Military Clinical Hospital of the Military Forces of the Ministry of Internal Affairs of the Russian Federation on vascular surgery, and the head of the emergency cardiovascular surgery course at the Faculty of Advanced Training for Physicians. Working at the Department of Surgical Diseases, in 1990 he completed and defended a dissertation for the degree of Candidate of Medical Sciences: “Infection of vascular grafts (diagnosis, treatment, prevention)”, in 1998 - a dissertation for the degree of Doctor of Medical Sciences: “Purulent septic complications in reconstructive surgery of the aorta and arteries of the extremities"
Area of professional interests:
Over the past 3 years, Professor Komrakov V.E. Head of the Department of Surgery of the Moscow Doctor network of clinics at the Protek Research and Production Company. In her work she uses high-tech innovative methods for diagnosing and treating vascular diseases. The professor continues active work on organizing and conducting high-tech medical care for patients in a multidisciplinary clinic, introducing modern innovative methods for diagnosing and treating various diseases of the cardiovascular system and surgical pathology, used in addition to state medical and economic standards, especially for elderly and senile patients with multifocal concomitant pathology .
Scientific activity:
For 5 years Komrakov V.E. combined work at the department with administrative work at the university: he worked as dean for work with foreign students, and acted as head of the international department of the university. He is the author of more than 140 scientific works, including 3 monographs (co-authored), a manual on internal diseases edited by Academician E.I. Chazov (chapter - Vascular diseases), a multi-volume manual on Gerontology and geriatrics edited by Academician of the Russian Academy of Medical Sciences V.N. Yarygina (editor, compiler, co-author of 16 chapters), inventions, methodological recommendations for students. Published (co-authored) over a number of years; monographs “Infection in Vascular Surgery”, “Surgical Sepsis”, “Thromboangitis Obliterans”: in 2010 - a manual for doctors “Thrombotic Conditions in Obstetric Practice”.
Professional achievements:
For his many years of contribution (more than 30 years) to the development of the medical industry, he was awarded the medal “For Services in Healthcare” by the Intersectoral Joint Awards Committee of the Russian Federation.
Shiukashvili Marina Borisovna
Specialization: Ultrasound diagnostics, functional diagnostics doctor, therapist
Work experience: More than 20 years
1993 - 2003 - local therapist at the Federal State Securities Hospital of the Primorsky Territory, since 2003 headed the therapeutic department of the Federal State Securities Hospital of the Primorsky Territory.
2006 – 2008 – senior local physician-therapist at the clinic of the Federal State Securities Hospital of the Primorsky Territory.
2008 – 2011 – general practitioner, functional diagnostics doctor at the Central District Hospital in the Mozhaisk district of Uvarovka.
Since 2011 – general practitioner, functional diagnostics doctor at Russian Railways, Moscow.
2012 – 2017 – functional diagnostics doctor, ultrasound diagnostics doctor at the North-Eastern Administrative District clinic in Moscow.
Ultrasound diagnostics doctor – 5 years, functional diagnostics doctor – 13 years, general practitioner.
Education:
1993 – Vladivostok State Medical Institute (VSMI), diploma in “General Medicine”
1997 – Internship in therapy in Vladivostok
2004 – Professional training in functional diagnostics, Vladivostok
2005 – Far Eastern State Medical University, Khabarovsk, TU “Echocardiography”
2008 – MGMSU, Moscow, TU “Functional Diagnostics” Certification cycle
2009 – MONIKI, Moscow, certification cycle in therapy “ Current issues cardiology and pulmonology"
2012 – Research Institute named after. Myasnikov, Moscow, TU “Holterovskoye” ECG monitoring and blood pressure", TU "Echocardiography. Dilated cardiomyopathy"
2013 – Institute of Science named after. Pirogov, Moscow “Angiology”, TU “Vascular Dopplerography”
2014 – FMBA Moscow, professional training “Ultrasound diagnostics”, Institute named after. Sechenov – certification cycle in functional diagnostics, Moscow
2017 – Federal State Budgetary Educational Institution of Further Professional Education RMANPE of the Ministry of Health of Russia, certification cycle in therapy. 1971 – 1973 – Residency in pediatric urology at the Research Institute of Urology in Kiev
Area of professional interests:
1973 – 1975 – worked as a urologist in Yerevan 1975 – 2015 – State Clinical Hospital named after. S.P. Botkin, Moscow, urologist (since 2005, outpatient work at the S.P. Botkin City Clinical Hospital, previous years he worked mainly in a surgical hospital).
Professional achievements:
Has the highest category. He has mastered and independently performs circumcision, operations for dropsy, varicocelectomy, removal of bladder stones, ureters, kidneys (including staghorn), TUR operations, adenomectomy, urethral resection, bladder resection due to ocular diseases, resection of kidney cysts, cyst puncture, plastic surgery(using various methods). Assisted in kidney transplants and radical prostatectomy due to cancer. On an emergency basis, he performed dissection of the strangulating ring in case of paraphimosis, puncture cystostomy, puncture nephrostomy, nephrectomy and other emergency interventions.
Provides consultation and outpatient treatment for patients with chronic prostatitis, urolithiasis, and patients with urinary incontinence, as well as sexually transmitted diseases. - pregnancy management;
- diagnosis and treatment of infertility;
- diagnosis and treatment of inflammatory diseases of the female genital organs;
- diagnosis and treatment of ovarian dysfunction;
- diagnosis and treatment of cervical diseases;
- diagnosis and treatment benign tumors female genital organs;
- diagnosis and treatment of dysfunctional uterine bleeding;
- diagnosis and treatment of mastopathy;
- family planning (consultations on contraception and selection of the optimal contraceptive);
- pregravid preparation;
- preparation for the IVF program
Professional achievements:
Doctor of Medical Sciences (has more than two hundred scientific works, including monographs).
Khalitov Ranil Ravilievich
Specialization: Urologist
Work experience: More than 15 years
Education: Samara State Medical University
Professional skills:
Mastered surgical interventions: cystoscopy, tour and vaporization of the bladder, contact lithotripsy in the bladder, ureter and kidney, catheterization of the ureter, installation of a stent in the ureter, operations for hydrocele, adnexal cysts and spermatic cord. totomy nephrostomy, resection kidneys, PPNS, operations for priapism, penile fracture.
Knowledge modern methods treatment and diagnosis of coloproctological diseases, rules for preparing medical documentation. 1. Assistance during abdominal surgeries and laparoscopic surgeries. 2. Independent operations - hemorrhoidectomies (closed, open, ultrasonic scalpel), excision of anal fissures (with pneumodivulsion, with sphincterotomy), excision of rectal fistulas (into the intestinal lumen, with a latex ligature), excision of the EC (with suturing to the bottom, parallel sutures, sinusectomy) excision of perianal condylomas, sclerotherapy of hemorrhoids, ligation of hemorrhoids with latex rings, opening and drainage of subcutaneous, submucosal, ischiorectal, pelverectal, paraproctitis, closure of double-barreled colostomy and ileostomy. 3. Maintaining medical documentation 4. Maintaining medical documentation, electronic stories diseases, 5. Preparation of presentations, lectures
2016 - Kuban State Medical University, Krasnodar (Professional retraining, Coloproctologist) Current confirmation of qualifications of a medical worker from. 03/13/2015
Certificate of a specialist in the specialty of therapy (see a copy of the document in the attachment);
Certificate of specialist in cardiology from 2017.
Additional education:
Ministry of Health of the Russian Federation (Certificate of a specialist in functional diagnostics)
Ministry of Health of the Russian Federation (Certificate of Ultrasound Diagnostic Specialist)
Advanced training in echocardiography at the Department of Functional Diagnostics of City Clinical Hospital No. 85
Professional skills::
Examination and consultation of patients with any therapeutic pathology;
Mastery of decoding techniques ECG of adults and children;
Knowledge of methods for deciphering spirometry in adults and children and extended spirographic studies of diffusion and body
Knowledge of EEG decoding techniques
Knowledge of methods for conducting stress tests (bicycle ergometry, treadmill test);
Knowledge of cardiac echocardiography;
Knowledge of the methodology for deciphering Holter monitoring of ECG and blood pressure;
Carrying out ultrasound examination abdominal organs, urology, heart diseases;
Lenev Oleg Glebovich
Specialization: Neurologist, neurosurgeon
Work experience: 21 years
Education: Dagestan Medical Institute
In Moscow, he completed his clinical internship and residency at the Federal State Budgetary Educational Institution of Higher Education Russian National Research Medical University named after. N.I. Pirogov. at the Department of Child Neurology, Neurosurgery and Medical Genetics.
Certified doctor, specialist in functional diagnostics, radiology “neurovisualization”, reflexologist.
Second higher education at the Department of Psychophysiology, Faculty of Psychology, Moscow State University named after M.V. Lomonosov, specialty psychophysiologist. I have permission to work with polygraph “lie detector”, electroencephalography “EEG”, biofeedback “BFB-training” evoked potentials “auditory, visual, cognitive”, psychology of stress.
2015-2018 surgeon at the Family Doctor clinic
Area of professional interests:
Conservative and surgical treatment of purulent diseases (boils, carbuncles, ingrown nails, abscesses, cellulitis, etc.), including radio wave scalpel
- Conservative and surgery neoplasms of the skin and subcutaneous tissue (atheromas, lipomas, fibromas, warts, calluses and calluses, papillomas, etc.), including radio wave scalpel
- Plastic surgery of postoperative and keloid scars, ear urine, etc.
- Conservative treatment of joint diseases, intra-articular injections, therapeutic blockades
- Conservative treatment of arterial diseases (atherosclerosis, diabetic foot syndrome, etc.)
- Conservative and surgical (operative) treatment of venous insufficiency and varicose veins (including radiofrequency and laser obliteration of veins, sclerotherapy). Treatment of venous thrombosis n/c
- Emergency treatment exacerbation of hemorrhoids and fissures anus(including acute thrombosis of hemorrhoids, paraproctitis, etc.), therapeutic blockade of hemorrhoids, Anoscopy
- Treatment and preventive consultations in all areas of surgery, incl. mammology, proctology, phlebology 2004 - Doctoral dissertation “Treatment and diagnostic strategy for patients with thyroid diseases.”
Education: In 2015 he graduated from the Faculty of Dentistry of the State Budgetary Educational Institution of Higher Professional Education of the Moscow State Medical and Dental University named after. A.I. Evdokimova
2015-2016 completed an internship at the department surgical dentistry oral cavity, Faculty of Dentistry, State Budgetary Educational Institution of Higher Professional Education, Moscow State Medical and Dental University. A.I. Evdokimov. Upon completion, he was awarded the qualification: general dentist.
2017 - graduated from the primary specialization in therapeutic dentistry of the Russian Medical Academy of Continuous Education Vocational Education Ministry of Health of the Russian Federation. Upon completion, he was awarded the qualification: dentist-therapist.
Also in 2017, he graduated from the primary specialization in surgical dentistry at the Moscow State Medical and Dental University. A.I. Evdokomova. Upon completion, he was awarded the qualification of a dental surgeon.
2016 - Basics of tooth preparation for metal-ceramic and metal-free crowns (Rybalka E.I., Stomport)
2017 - Practical nuances of everyday endodontics (Solomonov M., Medical Consulting Group)
2017 - Review of modern methods of instrumentation and obturation of canals (Solomonov M., Medical Consulting Group)
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 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.
- Before visiting a gynecologist or laboratory, 3 hours before visiting a gynecologist, 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 urethra 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 it does not have diagnostic value. But too scanty an amount of epithelium indicates an atrophic type of smear - which 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. By 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 4 degrees. 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 the results of scientific research, in most women about 10% of the microflora consists of them, as well as streptococci, staphylococci, coli, 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 (Enterococcus)- representatives intestinal microflora, which sometimes end up in 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, it is required antibacterial treatment- sanitization of the vagina.
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.
Analysis of cervical microscopy allows you to assess the composition of the microflora. During development pathological processes the composition of microorganisms changes towards an increase in opportunistic pathogens and/or the appearance of pathogenic pathogens. Cervical smears are performed in two main ways: microscopy And sowing material.
Taking a smear from the cervical canal for flora is carried out no earlier than 24 hours after douching, because this procedure reduces the number of microorganisms for inoculation.
WHAT DOES A CERVICAL CANAL smear show?
Normally, the cervical canal is sterile. A large number of leukocytes in a smear from the cervical canal is a consequence of inflammation (cervicitis). The causes of leukocytosis can also be: failure to comply with hygiene rules, hormonal changes (lack of estrogen in girls and women during premenopause and menopause), metabolic disorders, diseases genitourinary organs, consequences of other therapy.
The development of the inflammatory process depends on the characteristics of the causative agent of the disease and the condition immune system woman's body. It may be spicy or chronic inflammation. Sometimes endocervicitis occurs in an erased form from the very beginning of the disease. The localization of the pathology (uterus, appendages, cervical canal) can only be determined after a gynecological examination.
CULTURING FROM THE CERVICAL CANAL |
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The study allows us to evaluate the qualitative and quantitative composition of the microflora of the biomaterial under study and assess the sensitivity of microorganisms to the main range of antibiotics, which will allow the doctor to prescribe adequate therapy.
Normally, the flora contains lactobacilli at least 10x7, and it may also contain enterococci up to 10x2, Escherichia coli up to 10x2, yeast fungus up to 10x2 CFU/ml. Opportunistic strains of bacteria that cause inflammatory reaction cervix, such as staphylococci, enterococci, E. coli, Citrobacter, Enterobacter, Proteus, yeast fungus (Candida albicans).
The culture study is aimed at detecting the growth of bacteria in the cervix: enterobacteria (genus Escherichia, Klebsiella, Enterobacter, Proteus, etc.); non-fermenting gram-negative bacteria (genus Pseudomonas, including Pseudomonas aeruginosa, Acinetobacter, etc.); streptococci (Streptococcus agalactiae (group B), Streptococcus (group A), etc.); enterococci (Enterococcus faecalis, Enterococcus faecium, etc.); staphylococci (Staphylococcus aureus, Staphylococcus epidermidis, etc.);
At the next stage laboratory research the sensitivity of the pathogen to antibiotics is determined and medicines. The result of the study is issued in accordance with the identified microorganisms in a quantitative format, contains an antibiogram and a conclusion.
INDICATIONS FOR ANALYSIS
- Presence of symptoms of infectious and inflammatory diseases;
- Selection of antibacterial therapy;
- Evaluation of the effectiveness of antibacterial therapy.
CYTOLOGY OF THE CERVICAL CANAL |
The vaginal part of the cervix, the ectocervix, is lined with stratified squamous non-keratinizing epithelium. In women of reproductive age, it is constantly rebuilt during the menstrual cycle through renewal-maturation-rejection and is completely replaced by a new population of cells every 4 - 5 days. Cellular composition depends on the presence/absence of the menstrual cycle and its phase. Flat epithelium performs a protective function. The cervical canal - endocervix - is lined with cylindrical mucus-producing epithelium. Cyclic changes in the epithelium of the endocervix are weakly expressed. The main function of the columnar epithelium is secretory.
The transformation zone is the area at the junction of stratified squamous and cylindrical epithelium in women of reproductive age, which basically coincides with the area of the external os of the cervical canal. Depending on age and hormonal balance in the body it can also be located on the vaginal part of the cervix.
In women of older reproductive and postmenopausal age, the border line is actually localized within the external pharynx. According to statistical data, precancer occurs from the transformation zone. For these reasons, regular testing for oncocytology of a smear from the cervical canal is of particular importance. Due to its high accuracy, it is one of the leading research methods for diagnosing background, precancerous and cancerous processes of the cervix.
During a preventive examination of women, it is advisable to obtain smear cytology material from the cervical canal from the surface of the vaginal part of the cervix (ectocervix) and the walls of the cervical canal (endocervix).
In women of reproductive age, it is necessary to take smears for cytology of the cervical canal no earlier than on the 5th day of the menstrual cycle and no later than 5 days before the expected start of menstruation. You should not take cellular material for research within 24 hours after sexual intercourse, vaginal sanitation, extended colposcopy, or insertion of medications into the vagina.
Smears for cytological examination should be taken from all women over 18 years of age, regardless of clinical data, once a year. In the presence of pronounced pathological changes in the cervix, cellular material is taken specifically, the frequency of delivery is determined by the attending gynecologist.
COST OF SERVICES
| Cervical smear: | Type of analysis | Price |
|---|---|---|
| To the flora | microscopy | 450 |
| Cytology | microscopy | 2 500 |
| For PCR infection | DNA | 450 |
| Culture from the cervical canal | microbiology | 1 750 |
| For mycoplasma/ureaplasma | microbiology | 1 750 |
| Antibiotic sensitivity (extended spectrum) | microbiology | 2 000 |
| For Escherichia coli (Escherichia coli) | microbiology | 1 750 |
| Cervical canal culture for listeriosis | microbiology | 1 450 |
| For gardnerella / thrush | microbiology | 1 750 |
| Taking analysis | 350 |
