Study the contents of the vagina, endocervical and urethral

Study the contents of the vagina

The bacterial flora of the vagina healthy, sexually mature women made up almost exclusively of Gram-positive rods Dederleyna, that degrade glycogen, released by decaying cells surface epithelium of the mucous membrane of the vagina, to lactic acid and thus maintain its acidic content (pH 4,5—5,0). In this reaction, sticks Dederleyna most viable, developing intensively other microorganisms and destroy them.

Pathogens, trapped in the vagina during intercourse, 2,5-70 die within hours. It plays a role in this as the secret of the cervical canal, has antibacterial properties. However, the ability of self-purification of the vagina is not unlimited, so when hit by numerous pathogens may develop an inflammatory process. The reaction with the contents of the vagina becomes alkaline.

Vagina newborns 52 % case of sterile. In the next few hours after birth, it appears scanty coccal flora.

Prior to the onset of puberty, as well as in menopause reaction, the contents of the vagina neutral or slightly alkaline, it is found coccal flora.

After puberty vaginal flora becomes rod-, content and pH ranges 4,0-4,7.

When inflammation of the vagina pH rises to its contents 5,5 and more. The exception is vulvovaginal mycotic, wherein the pH is normal or even content becomes more acidic.

Depending on the nature of the cellular composition of microflora and content are four degrees of vaginal cleanness.

The first degree of purity of the vagina

The contents of the vagina revealed sticks Dederleyna, which look pretty rough Gram-positive rods, often located next to two, as well as epithelial cells, isolated white blood cells and mucus; pH 4,0— 4,7. This picture of the contents of the vagina of healthy women is rare. Grossly allocation look like thick starch.

The second degree of purity of the vagina

The contents of the vagina a lot of sticks Dederleyna, There are cocci, epithelial, large amounts of mucus; pH 4,5— 5,0. Grossly semi-isolation, whitish. This content vagina is the most common and does not indicate any pathology.

The third degree of purity of the vagina

The contents of the vagina contains a small amount of sticks Dederleyna, many different cocci (including streptococci- and staphylococci), leukocytes, эpiteliotsitov; pH 5,0—6,5. Grossly yellowish vaginal contents, Liquid. This pattern is characteristic of inflammation in the lining of the vagina.

The fourth degree of purity of the vagina

Sticks Dederleyna missing, there is a large number of white blood cells, эpiteliotsitov, a variety of pyogenic microorganisms; pH 6,5—8,5. Grossly the contents of the vagina is a rich yellow purulent secret, When Trichomonas coleitis - frothy. A similar pattern is typical for a pronounced inflammation in the lining of the vagina.

There are also zero degree of purity of the vagina, at which no bacteria in the vagina, but there are white blood cells. Observed after treatment sulfanilamidnymi drugs, antibiotics and after douching.

For healthy women and girls are usually characterized by the first and second degree of purity of the vagina. Pregnant women, especially in the first months, It celebrated the first and second degree of purity of the vagina; pH 4,0— 5,0. Gynecological diseases usually observed the third and fourth degree of purity; the contents of the reaction is neutral or slightly alkaline vagina.

Reaction contents of the vagina and the development therein of microorganisms It depends on the hormonal activity of the ovaries. Therefore, in girls before puberty and in women during menopause, as well as in women with ovarian lesions of the contents of the vagina third or fourth degree of purity, neutral or slightly alkaline reaction.

The most common cause of chronic inflammation of the vagina, the cervix and the urethra is trichomonas infection.

Research on Trichomonas

Trichomonas - are single-celled parasites pear or oval, slightly larger than leukocytes; one end sharpened and has four flagella. Driven by a parasite undulating membrane.

Trichomonas can be in the vagina of women and girls, in the urethra, bladder and rectum. Perhaps the presence of Trichomonas as cystoid forms, t. it is. fixed, without flagella, more sustainable. Established, that Trichomonas pathogen and are the causative agents of vaginitis, cervicitis, etc.. d.

Vaginal trichomoniasis Liquid, whitish yellow, frothy. Patients complain of itching in the genital area. The native preparation Trichomonas easily detected, especially in case of mobility. They can be painted on Romanovsky, fuchsin or other dyes. The most effective method of coloring Romanovsky. This Trichomonas have the form of oval cells with foamy cytoplasm, painted in blue color, and pale purple blefaroblastom.

Research on gonokokki

If you suspect a gonococcal infection in women studied the contents of the canal of the cervix and the urethra. Study the contents of the vagina for GC in adult women is impractical because of the abundance of normal microflora. In young girls due to the immaturity of the squamous epithelium, covering the vulva and vagina, gonococcal infection manifests itself in the form of vulvovaginal.

Microscopic examination of secretions in the case of acute gonorrhea gonococci are located mainly in the preparation inside neutrophilic granulocytes and grouped in a staggered manner, and in the case of chronic - mainly extracellularly.

In chronic gonorrhea can be observed degenerative forms gonokokkov. In the first stage of degeneration appear slabookrashivayuschiesya micro- and macro-gonococcal; the second - they lose their typical kidney-shaped and are semicircular; in the third - in the form of rounded spherical diplokokkov; in the fourth - the compressed as separate points.

After 10-12 hours after initiation of treatment with penicillin gonococci disappear from the contents of the urethra and endocervix.

For the diagnosis of gonorrhea are of interest the following options microscopic picture.

• In a typical gonorrhea It has large numbers of neutrophilic granulocytes; gonococci disposed within leukocytes and extracellularly. Another bacterial flora is not.
• When latent flowing chronic gonorrhea there is a lot of neutrophilic granulocytes. Gonorrhea and other microflora missing. To detect Neisseria gonorrhoeae requires the use of the method of provocation for secretion of the cervical canal.
• On the recovery in the treatment of gonorrhea indicate a large number of degenerative changes in neutrophil granulocytes with dilapidated nuclei and cytoplasm, abundance of banal bacterial microflora; possible presence of sticks Dederleyna.

Investigation of the mucus of the cervical canal

Slime consists primarily of secret glands of the cervix and a small admixture of uterine gland secretions. Microscopically, in addition to its cylindrical epithelial cells from the cervical canal found a small amount of epithelial cells from the uterus, and leukocytes.

Changes in the contents of the cervical canal are observed at endocervicitis and endometrium, hormonal disorders, infertility; have a diagnostic value to determine the time of ovulation.

The physical properties of the mucus of the cervical canal It varies depending on the phase of the menstrual cycle.

In the follicular phase, with an increase in the influence of estrogen, especially before ovulation, copious mucus, glassy-clear, viscous, easily passes sperm; pH approx. 7,5. Outside the opening of the cervical canal filled with mucus, It takes the form of pupil.

During the luteal phase of the cycle, when progesterone stimulation, little mucus, its viscosity is increased, it does not pass sperm. Under the microscope revealed many leukocytes; pH 6,0—7,0. The opening of the cervical canal takes the form of the gap.

In recent years the study of mucus from the cervical canal attaches great importance to the establishment of the causes of infertility. This study is carried out in those cases, when the couple in sexual health and the presence of antagonism between the gland secretion of the cervix and sperm possible. It is believed, that such antagonism is an expression of some kind of immunity, t. it is. developing a long marriage when the wife or spermoantitel spermoingibitorov to the sperm of her husband.

Research secretions from the urethra

Research secretions from the urethra is of great importance for the diagnosis of urogenital infection. Material take a sterile platinum loop or a small metal spoon with blunt edges, carefully scraping the walls of the urethra, It is recommended to massage the urethra through the vagina.

Before taking the secret of a woman should not urinate for 2 no. The resulting secret is applied to the net, advance burnt slide, smear stained with methylene blue Pappenheim, Gram and explore. The secret for sowing taking a sterile swab.