Gonorrhea is a sexually transmitted infection that affects the urinary tract. The causative agent of the infectious process is gonococcus, a bacterium from the genus Neisseria. The main symptoms of inflammation caused by gonococci are discharge from the urethra (urethra), pain and burning when urinating.

Gonorrhea is diagnosed on the basis of laboratory data. Based only on the clinical picture, it cannot be argued that the discharge from the urethra is caused by gonococcal infection.

The key methods that are used in the diagnosis of this disease are bacteriological. They include bacterioscopy (examination of a smear under a microscope) and cultural examination (inoculation of bacterial flora on nutrient media).

Bacterioscopy

For bacterioscopy, a smear is taken from an organ in which there are signs of gonococcal inflammation. Biological material (mucus, pus) is applied to a glass slide and stained with a special composition. The doctor examines a stained preparation under a microscope in order to detect gonorrhea pathogens in it.

Gonococci do not survive well outside the human body. Therefore, it is an important question how much time elapses between the moment of taking a smear and the beginning of its study. Ideally, this interval should not exceed 15 minutes.

Gonococci look quite characteristic. If gonococcal flora is detected in a smear when a person has a typical clinical picture of the disease, the diagnosis of gonorrhea is considered confirmed.

Bacterioscopy is a good, fast and cheap diagnostic method with a simple interpretation. However, for various reasons, gonococci may not be seen. Therefore, the absence of gonococci in a smear does not exclude gonorrhea.

Cultural study

The cultural method is most often used in parallel with the bacterioscopic method. Its essence lies in the fact that the excretions taken from the urethra or other organs are sown, i.e. applied to a special nutrient medium.

On this medium, a colony of microorganisms grows for the required time (usually up to a week). The nutrient medium contains all the necessary substances for the development of this type of microbial flora. In the thermostat, where the cultures of bacteria are located, the appropriate temperature regime is maintained.

After the colonies have formed, their properties (shape, color, and other features) can determine which bacterial organism formed them.

This method also allows you to determine the sensitivity of gonococci to antibiotics.

Culture is a highly accurate method for diagnosing gonococcal infection. Its disadvantage is the duration of execution (the analysis is done for about a week).

Where is the swab taken from?

A swab is taken from organs suspected of having a gonococcal infection. In both men and women, this can be the urethra, oropharynx, rectum, conjunctiva of the eye. A smear in women, in addition to the listed anatomical zones, can be taken from the vagina and cervix.

If a man complains of the classic symptoms of gonococcal infection, ie. discharge from the urethra, material for bacterioscopy should be taken from the urethra. The classic course of gonorrhea in women in most cases is manifested by urethritis, colpitis (inflammation of the vagina) and cervicitis (inflammation of the cervix). Therefore, a smear for bacterial flora is taken from the urethra, vagina and cervix.

Sampling technique

The universal rule for both women and men is that sampling for bacteriological analysis should be performed before taking an antibiotic.

Before going to the laboratory, a thorough toilet of the penis (washing with soap) is necessary. Before taking a smear, you need to refrain from urinating for 2-3 hours. Directly in the laboratory, the head of the penis is wiped with a sterile cloth.

The analysis of the gonococcal flora is taken with a special swab probe. The technique for taking a smear for gonorrhea in men is simple. If pus is abundantly secreted from the urethra, then it is often not necessary to insert a tampon deep into the urethra. In the case of chronic gonorrhea, when the discharge is scarce and hardly noticeable, the tampon is inserted into the urethra by 3 cm and rotated there for 10 seconds. The procedure is not so much painful as uncomfortable, it is easily tolerated by all patients.

Preparing for a study in women is similar to preparing for men. A toilet of the genitourinary organs and abstinence from urination for 2-3 hours are necessary.

The sampling of biological material is carried out using a swab, which is inserted into the urethra and/or vagina and cervical area.

Interpretation of survey results

Deciphering the results of bacteriological research is quite simple. According to the results of bacterioscopy, the doctor writes: gonococci were found (not found). Alternatively, the conclusion may say: gram-negative diplococci were detected, which means the same. Gram-negative diplococci are a descriptive characteristic of gonorrhea pathogens.

The conclusion on the results of a cultural study contains information about which microbe was detected, in what quantity (massive growth) and to which antibiotics this infectious agent is sensitive.

There are a lot of reasons for patients to apply: passing a medical examination for employment, pregnancy, pain or unpleasant cramping sensations in the lower abdomen, itching or burning, thrush, heavy menstruation or discharge of unknown origin.

A general smear or microscopy is performed during a preventive examination or during pregnancy planning. The result is the study of the cervical and urethra, vagina, in virgins - the rectum.

Papanicolaou analysis for cytology makes it possible to detect the papilloma virus, precancerous conditions of the epithelium, and the cervix in time. It is recommended to undergo a Pap test for all female representatives with hereditary oncological diseases, persons over 21 years of age.

The bacteriological method of research, bakposev in women, is recommended if there is a suspicion of an inflammatory process, a violation of the microflora, which was caused by opportunistic and pathogenic microorganisms.

PCR is carried out in the form of an analysis for infections transmitted mainly by sexual contact. Gives complete information about the bacterial composition of the internal microflora.

A smear for gonorrhea is a very common type of biomaterial sampling to determine the causative agent of this disease. Gonorrhea is a well-known disease that is transmitted during sexual intercourse. There are cases when the disease affects the body of an infant born naturally. If the mother is infected, then the child, passing through the birth canal, will also become infected with this dangerous disease.

The causative agent of gonorrhea is the bacterium gonococcus, which affects the genitourinary system. It actively multiplies on the mucous membranes of the urethra and internal genital organs, causing inflammation. Signs of gonorrhea are considered to be:

• pain, burning during urination;
• characteristic yellowish-white discharge from the urethra and genitals;
• a sore throat;
• elevated temperature.

However, it is impossible to establish a diagnosis only on the external manifestations of the disease. After all, many diseases of the genitourinary sphere can be accompanied by similar symptoms. Therefore, if you have any discomfort in the urogenital area, you should consult a doctor.

The causative agent of gonorrhea can only be detected by laboratory methods. Since the bacterium is equally dangerous for both men and women, both sexual partners should be tested for gonorrhea, and if the diagnosis is confirmed, both will also have to be treated.

The presence of infection in the body is detected using a smear. Since the disease caused by gonococcus is localized in most cases in the genitourinary system, a smear for gonorrhea is taken from the urethra in men and women. For the fairer sex, an analysis is also provided for gonorrhea from the vagina and cervix.

Before the study, the patient, regardless of gender, is recommended to make a thorough toilet of the genital organs and refrain from going to the toilet for 1.5-2 hours before sampling the biomaterial. Before taking the test, you should not take antibiotics and other potent drugs, and you should also refrain from sexual intercourse on the eve of going to the doctor.

In women, a smear for gonorrhea is no different from a regular gynecological smear, which is taken from the mucous membrane of the vagina, urethra, and cervical canal. The gynecologist inserts medical expansion mirrors into the vagina and takes the biomaterial with a special small swab. This may cause mild discomfort, but is not accompanied by pain.

In men, a swab is taken from the urethra. Before the procedure, the prostate and urethra are massaged. The pus secreted in case of illness is not suitable for research. Therefore, a special probe is inserted into the patient's urethra, which is turned with light movements for 10 seconds. This process is very rarely accompanied by pain, although it gives a man a lot of discomfort.

After obtaining the biomaterial, it is applied to a sterile glass slide for further research. Gonococci quickly die outside their usual habitat, so the analysis should be carried out immediately after taking a smear. The allowable time to start the analysis is 2-3 hours after the delivery of the biomaterial.

Research types

There are 2 main types of tests for gonorrhea:

1. Bacterioscopy - analysis of biomaterial using a microscope. The contents of the smear are stained with special reagents, then examined under a microscope, revealing gonococci by their characteristic shape and size.
2. Culture seeding is a more detailed and lengthy type of study that allows you to establish the presence of gonococci in a patient's smear with 100% accuracy.

The result of bacterioscopy can be confirmation or refutation of the presence of the pathogen in the body. However, this study does not always allow an accurate diagnosis. Sometimes a negative bacterioscopy result can be erroneous.

Culture involves the observation of bacteria in a specially created nutrient medium for a long period of time. Only after 7 days, the analysis is deciphered and provides information not only about the size of the gonococcus colony, but also about which antibiotics the bacterium is sensitive to. After that, the doctor can prescribe the right treatment that will help cure this disease and avoid complications.

In order to timely detect sexually transmitted diseases, including gonorrhea, tests must be taken at least 2 times a year, during scheduled appointments with a gynecologist and urologist.

These studies are free of charge and are included in the preventive examination of specialized specialists.

Features of the diagnosis of gonorrhea: a smear for gonorrhea

A smear for gonorrhea in men and women allows you to diagnose the disease. As the key methods, the decoding of which is carried out, are bacteriological. We are talking about bacterioscopy and cultural examination, that is, seeding for gonorrhea is performed.

If the norm is determined by bacterioscopy, then the smear is taken from the organ within which there are inflammations characteristic of gonococci. The doctor stains the preparation and examines it under a microscope. Deciphering such a test helps to detect the causative agent of gonorrhea.

It is important to note that gonococci are characterized by poor persistence when they are outside the human body. Therefore, an important issue is the time interval between the direct taking of a smear and the beginning of its study. The ideal option would be no more than a 15-minute interval. If the transcript of the smear has demonstrated the presence of gonococci, and the person has symptoms characteristic of gonorrhea, the diagnosis can be considered confirmed.

Doctors often prefer bacterioscopy due to the fact that the method is fast and cheap research. Deciphering it is not difficult. However, there are times when it is not always possible to detect gonococci, but the absence of flora does not mean the absence of the disease directly.

In this case, bakposev is connected. Often, the norm of the flora is determined simultaneously with the culture, or a blood test for gonorrhea is performed. Speaking of the cultural method, it is based on placing the sample in a nutrient medium, which helps to grow bacteria in large numbers, which means to understand which rate is increased.

However, the disadvantage of such a study is the speed of execution. Usually, it takes at least a week for the growth of the nutrient medium, during which the desired colony grows. After its formation, according to certain properties, the flora present in the analysis is deciphered. This method can additionally determine to which type of antibiotics specific gonococci are resistant.

The causative agent of the disease are gonococci belonging to the genus Neisseria. Bacteria infect the genitourinary tract, provoking the development of purulent inflammatory processes in various organs and tissues. The period from the entry of the virus into the human body to the manifestation of the first signs varies within 3-7 days. There are two forms of pathology progression: acute and chronic. In the first case, the patient is tormented by the following symptoms:

• frequent urge to urinate;
• pain and burning during trips to the toilet;
• the appearance of unusual yellowish-white discharge from the genitals;
• soreness in the throat (in the presence of a disease in the throat);
• increase in body temperature.

These symptoms appear 3-7 days after infection. The duration of disease progression is about 3-4 weeks. After this, healing or the transition of the disease to the chronic stage occurs. Many patients with a protracted course of the disease have no symptoms. Most often this is typical for women.

The recovery of an infected person is possible only with accurate and timely diagnosis and professional treatment. To detect the virus, a smear is taken, which is subjected to laboratory tests.

A smear for gonorrhea in men is taken much easier than in women. If purulent mucus is intensively secreted from the urethra, the introduction of a probe is not practiced. The neglected form of the pathology leads to a decrease in the manifestation of symptoms. If there is practically no pus, a swab is inserted into the urethra, about 3 cm deep. The doctor should hold it for no more than 10 seconds.

A smear for gonorrhea in women involves the collection of cervical mucus, as well as secretions from the cervix, vaginal walls and urethra. Often, the analysis is taken during routine examinations by a gynecologist.

The technique of taking a smear for gonorrhea in women requires the introduction of a special device into the vagina - a gynecological mirror. With its help, the walls are gently moved apart, facilitating the examination of the cervix. Many patients experience discomfort due to the penetration of a foreign object. As a rule, the procedure is not accompanied by pain.

To make it easier for the doctor to take the material, you need to calm down, relax as much as possible, and try not to move. First of all, the specialist visually assesses the condition of the vagina and cervix. After that, the necessary materials are collected. For this, sterile cotton swabs are used. From them, the secretions are transferred to the surface of a glass slide and sent to the laboratory for detailed study.

This algorithm for taking a smear for gonorrhea is the norm for modern medical institutions. In the same way, biological material is collected for research on Trichomonas.

Based on the finished results, some patients are assigned additional studies: colcospopia or cytological analysis. The procedure in most cases is easily tolerated, without complications. Occasionally, after a smear for gonorrhea, there are spotting spotting. In individual cases, this is the norm, as the body reacts to the penetration of gynecological instruments.

Such consequences are considered a natural reaction to medical intervention. The adoption of therapeutic measures in this case is not required. If after the procedure there are severe pulling pains, profuse bloody discharge, chills, body temperature rises, it is necessary to urgently consult a doctor to find out the causes of pathological changes and take measures to eliminate them.

If a doctor's examination raises suspicion of an infection, the gonorrhea test is examined in several ways.

Microscopy

The classical progression of the pathology leads to a pronounced accumulation of gonococci on the mucous membranes of the vagina and urethra. The decoding of the analysis consists of the following indicators:

• Detection of bean-shaped bacteria. They are located inside leukocytes, as well as two in one capsule. Neisser's gonococci have an unusual structure. They lead to a chronic course of pathology. When using the Gram stain technique, pathogens turn pink.
• Determination of the number of leukocytes. A small concentration of leukocytes in the mucous membrane is the norm. Gonorrhea, accompanied by a purulent infectious process, significantly increases the number of these blood cells.
• Increased mucus secretion. Such changes indicate the progression of the inflammatory process. The functioning of cells in an emergency is activated. As a result, they produce more mucus.

A smear on the flora with a protracted or non-standard course of the disease may not show the causative agents of the virus, even if they are present in the body. For a more accurate diagnosis, other types of analyzes are used.

The essence of the technique lies in the bacteriological study. For this, the collected material is placed in a special nutrient medium. If it contains pathogenic bacteria, then soon they create entire colonies. The study of bacteriological culture is considered not a very accurate diagnostic method, since it detects gonococci only in 95% of cases.

If the smear analysis showed the presence of pathogenic microorganisms, their sensitivity to various groups of antibiotics is revealed. This allows you to determine the most effective remedy for treatment.

An important disadvantage of cultural research is the long time required to obtain data. Such an analysis is done over several days, since it takes time for the virus to multiply in a nutrient medium. Diagnosis involves counting the number of gonococci per unit volume of material collected from the patient.

Refers to the most specific, but reliable methods of research. The DNA of the causative agents of the virus undergoes a multiple duplication reaction. PCR is done quite quickly compared to previous methods. In some cases, it is possible to obtain a negative result in the presence of gonococci in the body.

Details about how a smear is taken are always told to patients by the attending physician. He also determines which tests will be required, and which diagnostic methods will be optimal for a particular case. Laboratory examination of a smear on glass with gonorrhea does not cause difficulties.

The duration of the research varies from 1 to 3 days. Experts decipher the analyzes quite simply, but a lot depends on the workload of the laboratory. Sometimes the result becomes known the very next day, but it happens that you have to wait longer.

The medical report indicates that gonococci have been identified or not detected. The abs value indicates that the virus was not detected. After a cultural study, a document is issued indicating the microorganism that has become the source of the disease, as well as information about how and in what quantities it has spread throughout the body. The conclusion also lists antibacterial drugs that are detrimental to the identified variety of the virus.

How are men and women tested for gonorrhea? Preparation and transcript

Taking a smear should be done correctly, in compliance with established standards. Only in this case it is possible to establish an accurate diagnosis in the presence of an infection or to refute the initial suspicions. In order for the smears to be as accurate as possible, you should carefully prepare for the procedure. This will require the implementation of several rules:

• A few days before going to the medical facility, where the analysis will be done, it is necessary to give up sexual relations.
• Women 3 days before the procedure should not use solutions for douching, as well as all kinds of gels intended for intimate hygiene. Washing is done with warm water without any additives.
• 7 days before the delivery of the biomaterial, the use of all drugs is stopped. If the refusal of certain funds is impossible, it is worth talking about this with a specialist in advance.
• The night before, before taking a smear for gonorrhea, the intimate area must be cleaned with water. In the morning, before going to a specialist, you should not wash yourself.
• For a couple of hours before the proposed collection of material, you can not visit the toilet room.

A bacteriological smear, which is taken from the vagina, should be carried out a few days before the onset of menstruation or a couple of days before it ends. If the discharge began at the time when the examination was scheduled, you should postpone the visit to the clinic. The presence of foreign elements in the smear is unacceptable.

For maximum reliability of the examination results, it is necessary to have information about the rules for preparing for the delivery of a bacteriological smear. The recommendation algorithm looks like this:

• At least seven days before the test, you must stop using antibiotics and do not use vaginal ointments, creams, suppositories and tablets during this period of time. If this is not possible, then it is imperative to warn the doctor who will take the smear about these nuances. This must also be taken into account at the time when the results will be decoded.
• Two days before the examination, it is necessary to exclude sexual contact.
• Hygienic treatment of the genital organs should be carried out in the evening on the eve of the study.
• You should try to refrain from urinating at least 2 hours before the examination.
• The best period for testing for gonococci is the first days after the end of menstruation or a few days before it begins.

Take gynecological smears for gonorrhea from the mucous membranes of the vagina, cervix and urethra. The analysis for gonococci refers to painless procedures, because biological material is taken using a cotton swab. Discomfort can only occur during the sampling of material for a urogenital smear.

First of all, before taking a smear, the doctor conducts a gynecological examination of the genital organs using mirrors and palpation. After that, the material is taken and transferred to a nutrient medium. It should be noted that some women may complain during this manipulation of the appearance of uncomfortable sensations when touching the cervix.

The resulting material is sent to the laboratory, where the smear is analyzed. The results can be obtained in about four days from the date of its delivery.

Before prescribing an examination, the gynecologist or laboratory employee is obliged to warn the patient about how to properly take a smear for flora, which can and cannot be done before the procedure.

Preparation for microscopic examination provides for the rejection of potent antibiotics 2 weeks before the proposed analysis, visiting the bathroom the day before. You should try not to go to the toilet 2 hours before the analysis.

Diagnosis is best done not before, but during menstruation and in the first two days after.

To increase the sensitivity of the test, bakposev on the microflora is carried out in the absence of treatment with antibacterial drugs and douching. Be sure to follow a special diet 2-3 days before bacteriological analysis: limit foods that provoke fermentation or intestinal upset.

Refrain from sexual intercourse with a partner and do not wash yourself 24 hours before data collection.

3-5 days before the appointed PCR diagnosis, it is forbidden to take any antibacterial and contraceptives. For 36 hours it is necessary to exclude sexual contact. It is advisable not to take a shower the day before the PCR and on the eve of taking the analysis. The material is taken during menstruation and for 1-2 days after it ends.

Gonorrhea is a sexually transmitted disease. To diagnose it, you need to pass a special analysis.

According to statistics, the highest number of infections was registered among young people. As a rule, the carrier of the causative agent of gonorrhea, gonococcus, is a woman. This is due to the fact that often in the female body the disease can proceed latently, that is, hidden. That is why she may not even know that she is infected. She may find out that she has gonorrhea by chance, during a physical examination or at the next examination by a gynecologist.

gonorrhea symptoms

Symptoms of gonorrhea can be the following changes in the body:

1. Serous-purulent discharge;
2. Burning and itching of the pubis;
3. Violation of the menstrual cycle.

Tests for pregnant women

Before making a smear on gn, it is important to properly prepare for it. Preparation includes compliance with certain conditions. This is necessary for greater information content and reliability of the results. What is required for analysis? Lack of sexual activity for a day or two before delivery. A smear for gonorrhea in women involves a preliminary refusal to use creams, suppositories or vaginal tablets. In addition, there is a ban on surrender during menstruation. The rate of bacteria can change on the background of taking a bath or douching.

In addition, refuse to wash the genitals with any detergents; on the day of visiting the doctor, it is better to limit yourself to boiled water. A few hours before the flora smear is taken, it is recommended not to go to the toilet. When a woman is tested for gonorrhea, material is taken from three places. This is the cervical canal of the uterine neck, the opening of the urethra and the vaginal mucosa.

A special swab probe is used to take the analysis. If we talk about the male part of the population, then everything is simple. In the presence of abundant discharge from the urethra, the tampon is not required to be inserted far into the urethra. If the discharge is subtle, then a tampon is inserted into the urethra.

Many women are interested in how a smear for gonococci is taken during the period of bearing a child. There are several health check options. The initial diagnosis includes a smear on the flora, which is taken from the cervix or from the urethra. The next method is PCR.

Some patients are among the group of people most susceptible to infection with the virus. It includes:

• women infected before pregnancy;
• patients suffering from symptoms of other ailments transmitted through sexual intercourse;
• girls under the age of 25 who are sexually active;
• women who have refused barrier contraceptives.

Patients at risk are most often found to have a pathology that causes gonorrheal arthritis, colpitis and infertility.

The widespread prevalence of gonorrhea indicates a careless attitude to one's own health. For many people, the constant change of sexual partners and the rejection of contraceptives is the norm. Regular medical examinations allow you to identify gonococci at an early stage of development, and timely prescribe high-quality treatment.

If you notice the first symptoms of pathology, you should immediately consult a doctor. Only in this case a favorable outcome and hope for recovery is possible. If gonorrhea is suspected, a smear should be taken as soon as possible. When the tests are ready, decipher them from a medical specialist.

As already noted, a smear for gonococci should be taken regularly, during the annual medical examination of a woman. The state of the microflora in the evaluation of the results is divided into 4 degrees of purity. In addition, the number of bacteria, yeast fungi, leukocytes, as well as the condition of the epithelium, is evaluated.

When making a diagnosis, the doctor focuses on the following criteria, the so-called degree of purity.

• 1 degree is the best option, in the modern world it is not so common. Leukocytes in the smear are within the normal range. The flora of the vagina is represented by a large number of Dederlein sticks, desquamated epithelial cells and mucus in a small amount.
• Grade 2 - The most common variant - corresponds to the norm, in which leukocytes correspond to normal values, mucus and epithelium do not exceed acceptable levels. In this variant, a small amount of cocci or Candida fungi already appears in the microflora. Lactobacilli in sufficient quantity.
• Grade 3 - a large amount of mucus and epithelial cells are found in the smear. Useful lactobacilli are not enough, along with this, an increase in the number of Candida fungi and pathogenic microbes is observed.
• Grade 4 - there are so many leukocytes, the laboratory assistant describes them with the term "completely." Violation in the microflora is manifested by a large number of pathogens. Dederlein's sticks are single or completely absent. Mucus and epithelium in large quantities.

The interpretation of the study should be carried out only by the attending physician, who subsequently prescribes the necessary treatment and determines the duration of the therapy.

Diagnosis of an infectious process in one patient requires an examination of another, because gonococci in a smear in men may also be present. Regardless of the results obtained, mandatory treatment of both sexual partners is necessary.

The molecular biological method of PCR diagnostics is characterized by high sensitivity and reliability of the obtained data. Due to the creation of earlier samples of the selected and copied DNA segment, a comparison with the obtained biological material takes place.

Analysis for infections using PCR makes it possible in a short time to find the causative agent of the disease of the female genital organs by obtaining a positive or negative result.

Polymerase chain reaction facilitates the determination of chlamydia, ureaplasmosis, thrush, trichomoniasis, HPV, HIV, the search for the causes of severe pregnancy and hormonal disorders.

gonorrhea symptoms

Quite often there are cases of atypical localization and clinical symptoms of the course of gonorrhea (in common parlance, this disease is called gonorrhea). Therefore, for a reliable diagnosis of infection with the establishment of the type of pathogen, laboratory diagnostics is mandatory. For this, an analysis is made for gonorrhea.

In men, the study is carried out using several methods, and the material is taken not only from the structures of the urogenital tract. Smears are also taken for gonorrhea from the mouth, anus, and even the discharge of the eye.

If gonorrhea was suspected during a clinical examination by a doctor, the smear analysis is examined by several methods:

1. Microscopy. In the classic course of gonorrhea, a significant number of gonococci accumulate on the mucous membrane, which are detected by microscopic examination.
2. Tank sowing. The technique is a bacteriological study in which the material is applied to special nutrient media. Provided that bacteria are present in the test material, colonies grow on the media. Bacteria are identified by morphological, biochemical and antigenic properties, more.
3. Polymerase chain reaction (PCR). The study includes the identification and identification of the genetic material of the pathogen through the reaction of multiple doubling (amplification) of nucleotide bases.

How to establish a diagnosis of gonorrhea, what tests to pass, and also with what methods to investigate them, is determined by the attending venereologist.

The choice is made depending on the course of the infectious process, its localization, as well as the capabilities of the laboratory.

Microscopic examination is one of the methods by which a smear is analyzed. Gonococci are detected during the determination of the microflora of the mucous membrane of the urethra or vagina. The determination of the microflora of the mucous membrane of the structures of the urogenital tract is more often carried out in women. In men, this study is performed to detect gonococci.

In the case of an inflammatory process, the decoding of the analysis for gonococci, after microscopy, includes several indicators:

• The appearance of bean-shaped microorganisms. They are located in pairs under one capsule, as well as inside leukocytes. When stained by Gram, these bacteria have a pink coloration (gram-negative bacteria). In a smear with an acute course of gonorrhea, the number of gonococci is very significant. Often they occupy the entire field of view.
• A significant number of leukocytes. Normally, the mucous membrane contains a small number of leukocytes (1-2 in the field of view of the microscope). With the development of gonorrhea, which is an infectious purulent process, the number of leukocytes increases dramatically. They can cover the entire field of view of the microscope and cannot be counted.
• Increase in mucus. Indicates the development of an inflammatory process, because cells respond to inflammation with an increase in functional activity and an increase in mucus production.

In the chronic or atypical course of the infectious process, such changes in the smear may not be. Therefore, other laboratory diagnostic methods can be used to reliably diagnose gonorrhea.

An analysis for gonorrhea using bacteriological culture of a smear for gonorrhea is a very informative research method. It detects the pathogen in the material in 95% of cases. After the identification of gonococci, their sensitivity to the main groups of modern antibiotics is determined, which makes it possible to choose the most effective drug for the etiotropic treatment of gonorrhea.

The main disadvantage of bacteriological research is the long period required to obtain results. It can be several days, since it takes time for the accumulation of microorganisms on a nutrient medium and the growth of colonies. The test result can be positive or negative.

During diagnostics, the amount of pathogen per unit volume of biological material is counted, followed by indication of this value in the analysis results.

PCR is a specific and reliable diagnostic method. Thanks to the enzymatic amplification reaction (multiple doubling), the genetic material (DNA) of gonococcal microorganisms is accumulated and identified. To obtain the result of the study by PCR, a short period of time is sufficient.

A smear for gonorrhea - how it is taken, transcript

The material sampling technique is usually carried out in the morning in the gynecology department or directly in the laboratory itself. Taking vaginal discharge and sites for research is prescribed only for women who are sexually active. In girls, it is taken more carefully from the lateral fornix of the vagina to exclude damage to the hymen, and from the intestines, secretion.

All manipulations take place on the gynecological chair. At this time, the specialist introduces a special mirror, depending on the age and physiological characteristics of the patient. If the organs are not yet formed, size XS is used, girls will need a mirror S. After labor, examination instruments with a diameter of 25-30 mm, sizes M, L are used.

The collection of material is carried out with a spatula or spatula, brush, applied to a glass slide or placed in a test tube for further transfer of the results to the laboratory.

All patients, without exception, from the age of 14 until the onset of menopause, correspond to the same norm, obtained as a result of laboratory microscopic examination.

Leukocytes. Providing protection of the body from penetrating viruses, bacteria and infections, they can be in sight, but should not exceed the indicator in the vagina - 10, in the cervix - 30, urethra - 5.

Epithelium. A moderate amount of epithelial tissue is normal. A high number indicates possible inflammation, while a too low indicates insufficient production of the hormone estrogen.

Slime. Little or no amount is allowed. The maximum daily rate of secretions of the glands of the cervical canal is 5 ml.

Gram-positive rods, Gr. ". Lactobacilli and Doderlein sticks must be present in large numbers. They are responsible for the body's immune response to foreign bodies. They should not be in the cervix and urethra.

Gonococci with the symbol "gn", trichomonas, chlamydia, key and atypical cells, fungi, yeast, Candida are absent. If they are found in the results, the patient is assigned an additional examination for gonorrhea, trichomoniasis, chlamydia, bacterial vaginosis, thrush.

Gonorrhea is a sexually transmitted disease that affects both men and women. In women, it is asymptomatic or with minor manifestations, so a woman may not be aware of the presence of an infection and unprotected intercourse can lead to infection of a partner.

A swab is taken if gonorrhea infection is suspected.

Gonorrhea is caused by gonococci, bacteria that look like coffee beans. Most often, the mucous membranes of the genital organs (urethra, bladder) are affected, less often - the rectum, conjunctiva. Symptoms of acute gonorrhea include:

• whitish-yellow discharge from the urethra, often with an unpleasant odor;
• redness and swelling of the glans penis;
• burning and pain when urinating;
• frequent urge to urinate, including at night;
• swelling of the testicles, soreness when touched.

Discharge from the urethra - one of the signs of gonorrhea

This procedure includes the collection of biological material from the urethra with its further study.

If you suspect a sexually transmitted disease, the doctor prescribes various tests that will allow you to establish an accurate diagnosis; among these tests is a smear test for gonorrhea.

This sexually transmitted disease is transmitted sexually, most often through vaginal or anal sex, in rare cases - through oral sex.

Different names of the disease are common: gonorrhea, gonorrhea, gonorrheal urethritis. Typical symptoms: yellowish or whitish discharge from the genitals, frequent urge to urinate, burning and pain when going to the toilet, fever, sore throat.

If you turned to a venereologist with one or more of the above symptoms, then with a high degree of probability the doctor will recommend taking a smear for gonorrhea.

Smear sampling in women

A smear for gonorrhea in women is carried out in the first 10 days of the cycle, ideally - 3-4 days after the end of menstruation.

But if necessary, the material can be taken in other phases of the cycle, with the exception of the period of active menstrual flow.

The material is taken using a gynecological speculum and special disposable spatulas or loops.

For the most reliable determination of the localization of the disease, a smear is taken from three areas: the vaginal mucosa, from the cervix and urethra.

The doctor should use a new disposable spatula to take each swab and place the resulting biomaterial in different tubes marked with the area of ​​the sampling (V for the vagina, C for the cervix and U for the urethra).

Pregnancy is not a contraindication to taking a smear for gonorrhea. Since the disease can be transmitted to the baby during natural childbirth, expectant mothers are strongly recommended to take a smear for gonorrhea three times: when pregnancy is detected or registered, in the second trimester and shortly before childbirth.

By itself, the sampling of biomaterial for analysis is absolutely safe and does not pose any threat to the health of the expectant mother or fetus.

Despite the fact that gonorrhea is transmitted mainly through sexual contact, in rare situations it is possible to become infected by contact and household contact: through touching or using common utensils, hygiene items.

Therefore, a smear for gonorrhea can be prescribed even for small girls or young girls who are not sexually active.

In this case, the doctor must exercise maximum caution and delicacy. A smear is taken without the use of a gynecological speculum, the gynecologist receives material from the vaginal mucosa through a hole in the hymen, without violating its integrity.

If the analysis is assigned to a girl, then you must first inform her about the disease itself and how the doctor will take biomaterials for analysis so that the child does not harm himself with a careless movement. The procedure is absolutely safe and practically painless.

A slightly different smear is taken for gonorrhea in men. Despite the fact that outwardly the procedure seems simpler, with inaccurate sampling, it is possible to injure the penis, up to the appearance of bleeding and pain during urination.

Even with skillful and careful conduct, the procedure for men is not the most pleasant.

Biomaterial sampling is carried out using a special sterile (preferably disposable) probe with a swab (sterile cotton wool).

Before starting the procedure, the doctor can massage the prostate and urethra: with a full erection, it is easier to take a smear.

The probe will have to be inserted deep enough, about 3 cm. To obtain reliable results of the analysis, the swab must be kept inside for at least ten seconds, carefully turning in a circle.

If the disease is in the active stage and pus is released from the penis, the surface must be cleaned before inserting the probe.

It is also possible to take pus instead of introducing a probe, but the results of the analysis of such a biomaterial are less reliable, since the concentration of the pathogen microbe decreases and the presence of extraneous microflora is possible.

Since gonorrhea is caused by pathogens, the patient should not be on bacteriological treatment (taking antibiotics or other medicines aimed at eliminating bacteria) at the time of taking a smear.

If at the time of taking the material for analysis, the patient is taking any antibacterial medications, then it is necessary to notify the attending physician about this when prescribing a smear for gonorrhea.

If the smear is taken again to confirm the successful cure of the disease, then the procedure can be performed no earlier than 72 hours after the last medication.

On the day of the procedure, you can take a shower and use household cosmetics (soap, shower gel, etc.)

If a sexually transmitted disease is suspected, it is necessary to limit sexual contacts, and, if necessary, use condoms.

If you have been prescribed a smear for gonorrhea, it is better to refrain from sexual intercourse 3-4 days before the test at all: in addition to the risk of infecting your partner, there is a risk of getting distorted test results. 2-3 hours before the smear is taken, it is recommended to refrain from urinating.

gonorrhea symptoms

Deciphering such an analysis will allow the doctor to see changes in the female reproductive system that are not visible during an external examination.

• Taking a smear is an absolutely painless procedure and takes only a couple of minutes. It does not pose a health hazard, it can be carried out even in pregnant women.

Deciphering the analysis of the smear on the flora can tell the gynecologist about the presence of genital infections, inflammation, hormonal disorders in the woman's body.

A smear on the flora (gynecological smear) is mandatory if a woman complains of the following nature:

1. Discharge of an unusual color from the genital tract.
2. Abdominal pain at rest or during sexual intercourse.
3. Feeling of itching and burning in the genital area.
4. The appearance of an unpleasant odor in the discharge.

Smears are also taken during preventive examinations.

With the help of letters, the doctor marks the place where the smear is taken. The letters of the Latin alphabet are usually used: V, C, U.

Swabs are taken from three points: the vagina (V-vagina), the cervix (C-cervix) and the urethra (U-uretra).

In deciphering a smear on the flora in women, you can find the strange word "cocci". Cocci are microorganisms that have a rounded shape. This is a group of conditionally pathogenic organisms that are constantly present in the body.

However, they must be in a certain amount. As soon as their number exceeds the permissible, cocci can cause unpleasant symptoms due to inflammation. In gynecology, this condition is called nonspecific colpitis.

Cocci are divided into two groups: Gram-positive and Gram-negative. This division has an important diagnostic value in determining the pathogenicity of a microorganism that has settled in the vagina.

A smear test for gonorrhea is a special medical procedure that must be performed by an experienced health worker who is fluent in the technique of sampling.

Gonorrhea smear: methods for diagnosing adults and pregnant women

Speaking about the general smear on the flora, not every girl can decipher the test results. Ideally, decoding should be performed by the attending physician, for him it will not be difficult, and you can immediately get the necessary advice and recommendations. If you want to independently verify the normal state of affairs, you can perform a preliminary decryption.

For example, squamous epithelium. Normally, its number should not exceed 15 cells in the field of view. If the figure is higher than normal, then we can talk about the presence of inflammation in the body. If the amount of squamous epithelium is insufficient, we can talk about a violation of the normal level.

White blood cells are often direct signs of inflammation, but this does not mean that they should not be at all. Normally, they can be present in the vagina in an amount of no more than ten. If we are talking about the area of ​​\u200b\u200bthe uterine cervix, then the maximum allowable number increases to thirty.

The same lactobacilli that were mentioned above are called Dederlein sticks. In a healthy woman, the basis of the vaginal flora should be represented by them. If their number is small, this is a deviation. Normally, the amount of mucus should be minimal. The presence in the analysis of fungi or small rods, various cocci is a sign of the disease, which requires a deeper study.

The vaginal flora changes under a variety of circumstances. This can be a deterioration in immunity, antibiotic therapy, infection, even diabetes. It is impossible to exclude from the factors of microflora change and hormonal disorders. This situation can be attributed to pregnancy.

The fact is that until the moment of childbirth, a pregnant woman almost does not produce estrogens, which are replaced by progesterone. However, due to a change in the background of hormonal orientation, the content of Dederlein sticks increases several times. This can be considered a kind of natural protection for the unborn child.

In this regard, it is important for doctors to check the vagina of pregnant women for a degree of purity even at the stage when pregnancy is being planned. If you do not perform such an analysis, you can miss the start of the process of active growth of opportunistic flora in a pregnant woman. Sometimes this leads to all sorts of gynecological problems, which affects the condition of the vagina.

An analysis of this kind is able to demonstrate various kinds of pathologies. Their detection is possible not only within the framework of a smear from the vagina, but also with the help of blood tests. For this, a PCR technique is used, for which special antigens form the basis. The smear analysis is performed by the pregnant woman as soon as she goes to the antenatal clinic. It is also important to control the state of affairs in the later stages, starting from the 30th week.

Medical workers recommend that all representatives of the weaker sex undergo a bacteriological examination (at least once a year), this will allow timely identification of bacteria localized in the vagina. It is necessary to focus on the fact that in our time quite often gonococci are found in representatives of the weak half of humanity who have not reached the age of twenty-five.

It should be noted that normally there are no gonococci in a smear in women. Of course, the vaginal environment is not clean, because it contains a considerable amount of bacteria, their functional duties are to create a normal microflora. Dederlein's bacillus is considered the most important bacterium, it is she who is responsible for the acidic environment of the vagina and the destruction of pathogenic microorganisms.

When the infection enters the body cavity, a change in the normal microflora occurs, which is accompanied by the growth of bacteriological colonies. This process does not always lead to the appearance of pathological sensations, therefore, it will be auxiliary to conduct a bacteriological smear on gonococci to detect infection.

A fact that requires attention is that gonococci show themselves better when performing a cultural diagnostic method. It is based on the cultivation of bacteria to determine their resistance to antibacterial drugs.

It is impossible to independently draw a conclusion about how good or bad a smear turned out without the appropriate knowledge. With the help of special symbols, it is very easy to decipher the microscopic examination of a smear. Depending on the location of the biological material taken, they distinguish: the vagina - "V", the cervix - "C" and the urethra - "U".

Gram-positive rods, Gr. » and the absence of coccal flora. Result - " ". It is observed quite rarely, most often it is a consequence of intensive antibiotic therapy. Norm: "", "" sticks, the number of cocci does not exceed "".

Gram-negative bacteria gonococci - "Gn", Trichomonas vaginalis - "Trich", yeast of the genus "Candida". Correspond to diseases like gonorrhea, trichomoniasis and candidiasis.

The presence of key cells and Escherichia coli, if they are listed in the composition of the microflora, indicates that the patient has bacterial vaginosis.

gonorrhea symptoms

Most often, this disease is found in men and women from 19 to 35 years. During childbirth, the baby can also become infected with this infection, which results in infectious conjunctivitis. At the slightest suspicion of this disease, you should immediately take a smear for gonorrhea.

The first symptoms of the disease in men are yellowish mucus secreted from the penis. In this case, sharp pains appear. In women, vaginal discharge is yellowish-white in color, and there may be bleeding and pain in the lower abdomen and when urinating.

With advanced gonorrhea, not only the organs of the reproductive system are affected, but also many internal organs and systems of the body. In some severe cases, the disease can lead to serious cases such as infertility and even blood poisoning.

Smear for purity

Often, when smearing on the flora, it is important for doctors to understand what is the degree of purity of the patient's vagina. A total of four options are offered. In this case, only the first two are considered the norm, while the third and fourth are deviations.

The first degree is understood as a kind of ideal option, which is rare. In this case, the leukocyte count is within acceptable limits. Most of the flora is represented by Dederlein sticks, mucus and desquamated epithelial cells are found in small quantities.

The most common version of the norm is the second degree of purity. In this case, leukocytes are present within normal limits, and mucus and epithelium in moderate amounts. However, cocci, Candida fungi are detected in a small amount, but lactobacilli are still represented by the vast majority.

The first degree, signaling deviations, is the third. In this case, a smear contains a large amount of mucus and epithelial cells. Lactobacilli of a useful order are present in small quantities. At the same time, Candida fungi and pathogenic microbes show an increased number.

The fourth degree refers to the huge presence of leukocytes, as well as pathogenic microbes. Dederlein sticks in this case almost do not survive. A large amount of mucus and epithelium is present. In the first two cases, treatment is not required, the last two degrees of purity indicate the presence of an inflammatory process, which is caused by various pathogens. In this case, therapy is required on an urgent basis.

To avoid complications during the period of gestation, pregnant women are advised to determine the degree of purity of the gynecological smear. Normally, in a healthy woman, the vaginal microflora is 95-98% Bacillus vaginalis or Doderlein's lactobacilli. They produce lactic acid, which helps maintain acid levels.

Pathogenic and opportunistic microorganisms are not able to survive in such conditions. But under the influence of various factors, such as sexual activity, menopause, the menstrual cycle and a decrease in immunity, microflora indicators can change.

• 1 degree of purity of the vagina is normally pH 3.8-4.5. Wednesday is sour. Leukocytes and epithelial cells - no more than 10.
• 2 degree. Slightly acidic medium: pH=4.5-5. There is a slight increase in gram-positive cocci, Candida fungi.
• 3 degree. Pathogenic microorganisms are activated, mucus appears, epithelium indicators exceed the norm. Neutral acidity level, pH=5-7. There are more than 10 leukocytes. Mucus, key cells are present, gram-negative and gram-positive microorganisms multiply in favorable microflora conditions.
• At the last, 4th degree, the purity is low. The pH values ​​reach 7.5. Doderlein's sticks are either absent at all, or are in a single quantity. The vagina is filled with pathogens.

Pap smear test for gonorrhea

The diversity of the composition, in addition to the lactobacillus Doderlein sticks, which are an integral part of the microflora of the vagina of the examined woman, does not begin to be studied immediately. Sowing on a specially created favorable environment of the collected biological material for its subsequent growth, development and reproduction takes time.

It is possible to evaluate bacteriological seeding for flora through a microscope, provided that the number of representatives of microorganisms increases.

• 0 class. observed during antibiotic treatment. The causative agent is missing.
• I class. The number of bacteria does not increase or moderate growth.
• II class. Mixed nature of microflora. Up to 10 colonies of bacteria Gardnerella vaginalis or Mobiluncus, causative agents of gardnerellosis, are determined.
• III class. There are about 100 colonies. Gardnerella and Mobiluncus live mainly in the microflora. Symptoms of bacterial vaginosis appear.
• IV class. Lactobacilli are absent, immunity is weakened. Diagnosis of an acquired infectious disease - aerobic vaginitis.

The probability of detecting areas of altered epithelium, papillomavirus and oncological neoplasms is quite high after 30 years, the onset of sexual activity.

The correct interpretation of the Pap test depends on the presence or absence of cancerous, atypical cells.

• NILM. Clinical picture without features, CBO. Leukocytes and bacteria are isolated in small quantities. Possible primary candidiasis or bacterial vaginosis. The epithelial layer is normal.
• ASC US. Found atypical areas in the epithelial tissue of unknown origin. A re-analysis is carried out after 6 months to search for chlamydia, dysplasia, human papillomavirus.
• LSIL. To confirm a precancerous condition caused by atypical cells, a biopsy, colposcopy is prescribed. Mild signs of changes in the epithelium.
• ASC-H. A pronounced lesion of the squamous epithelium. In 1% of patients, the initial stage of cervical cancer is diagnosed, the remaining 98-99% have grade 2-3 dysplasia.
• HSIL. Concomitant symptoms preceding cancer of the squamous epithelium, cervix, were detected in more than 7% of the examined women. 2% have cancer.
• AGC. Atypical condition of the glandular epithelium. Diagnosis: cervical or endometrial cancer, an advanced form of dysplasia.
• AIS. Squamous cell carcinoma, cervical cancer.

One of the most common pathologies transmitted through sexual intercourse is gonorrhea (gonorrhea). The disease can be caught through traditional and anal sex, cases of infection by the oral route are known. Everyone is affected, both men and women. For diagnosis, you will need to pass a number of tests.

1) patients entering the gynecological department, the maternity ward; 2) in the antenatal clinic during the examination of gynecological patients; 3) during a preventive examination.

1) spoon-shaped or folding mirrors; 2) cotton swabs; 3) glass slides; 4) tweezers; 5) spatula; 6) grooved probe; 7) Volkmann's spoon; 8) forceps; 9) referral forms; 10) gynecological chair; 11 ) individual diaper; 12) sterile gloves.

Preparatory stage of the manipulation.

1. On the eve and on the day of taking smears, the patient should not have sexual intercourse, douching and should not urinate 2 hours before taking smears.

2. Lay the patient on a gynecological chair covered with an individual diaper.

3. Prepare a slide by dividing it into 3 parts, marking "U", "C", "V".

4. Wash hands, dry, put on sterile gloves.

The main stage of the manipulation.

1. Taking a smear from the urethra. To do this, with a finger inserted into the vagina, lightly massage it through the front wall of the vagina. The first portion of discharge from the urethra is supposed to be removed with a cotton ball, and then a Volkmann spoon or a grooved probe is inserted into the urethra to a depth of no more than 1.5–2 cm. – U.

2. After taking smears from the urethra, a sterile speculum is inserted into the vagina, the cervix is ​​exposed and wiped with a sterile cotton swab. The second end of a sterile Volkmann spoon is inserted into the cervical canal and a smear is taken with a light scraping and applied as a stroke on a glass slide marked with the letter C (neck).

3. Taking a smear from the vagina. A swab is taken with a spatula or tweezers from the posterior fornix of the vagina and applied as a stroke to a glass slide marked with the letter V (vagina).

The final stage of the manipulation.

1. Remove mirrors and immerse in disinfectant.

2. Remove gloves, immerse in disinfectant.

3. Fill in the direction: last name, first name, patronymic, age, address, name of the study, date, number of the antenatal clinic site, the name of the doctor or midwife.

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Pap smears for gonorrhea

Action algorithm.

Taking a smear from the vagina for purity

Target:

Resources: gynecological chair, gynecological mirrors, Volkmann's spoon or grooved probe, glass slide, referral to the laboratory, disposable gloves, individual diaper.

4. Put on disposable gloves.

5. Prepare the tools: gynecological mirror, Volkmann's spoon (grooved probe), glass slide.

6. Enter the speculum. With a Volkmann spoon or a grooved probe, take the discharge from the posterior fornix and apply it to a glass slide.

7. Carefully remove the speculum from the vagina, lower it into a 3% solution of chloramine. When working with a disposable mirror, throw it into the KBU.

8. Ask the woman to stand.

9. Remove disposable gloves, discard according to infection prevention regulations.

10. Wash your hands with soap and water.

Appointment of a smear (smear for purity)

Signature of the midwife or doctor

12. Send the swab to the lab.

Target: collection of material for microscopic examination.

Resources: gynecological chair, gynecological mirrors, Volkmann's spoon, glass jaw, glass slide, referral to the laboratory, disposable gloves, individual diaper, test tube, rubber bulb, saline solution.

1. Explain to the woman the need for this study.

2. Lay the woman on a gynecological chair (position on her back with legs bent at the knee and hip joints, legs apart), on an individual diaper.

3. Provide sufficient lighting to examine the cervix.

4. Put on disposable gloves.

5. Prepare sterile instruments: gynecological mirrors, glass jaws, Volkmann's spoon, glass slide.

6. With a glass jaw, after pre-massaging the urethra through the vagina, take a swab from the urethra and apply to a glass slide.

7. Enter the speculum. Take the discharge from the cervical canal with a Volkmann spoon and apply it to a glass slide.

8. Carefully remove the speculum from the vagina, lower it into a 3% solution of chloramine. If using a disposable speculum, dispose of it in the KSBU.

9. From the rectum, using a rubber bulb, take a flush of saline (10-20 ml) into a test tube. Having defended it, apply a smear from the sediment on a glass slide.

10. Ask the woman to stand.

11. Remove disposable gloves, discard according to infection prevention regulations.

12. Wash your hands with soap and water.

According to studopedia.su

Taking a smear for oncocytology.

Insert a speculum into the vagina and expose the cervix.

Remove excess mucus from the vagina with a cotton swab.

Insert the cytobrush into the cervical canal, rotate 360°.

When taking material from the surface of the cervix, bend the working part of the cytobrush at a right angle with respect to the handle (without opening the package).

Insert the tool until it touches the surface of the neck and slowly turn it a full turn.

A smear is obtained by “rolling” the cytobrush on a glass slide; for planting on flora, the cytobrush is “rolled” over the medium or placed in a transport flask.

Taking a smear for the degree of purity of the vagina, gonorrhea, trichomoniasis.

Taking a swab from the urethra. To do this, with a finger inserted into the vagina, lightly massage it through the front wall of the vagina. The first portion of the discharge from the urethra is supposed to be removed with a cotton ball, and then a Volkmann spoon or a grooved probe is inserted into the urethra to a depth of no more than 1.5–2 cm. — U.

After taking smears from the urethra, a sterile speculum is inserted into the vagina, the cervix is ​​exposed and wiped with a sterile cotton swab. The second end of a sterile Volkmann spoon is inserted into the cervical canal and a smear is taken with a light scraping and applied as a stroke on a glass slide marked with the letter C (neck).

Taking a smear from the vagina. A swab is taken with a spatula or tweezers from the posterior fornix of the vagina and applied as a stroke to a glass slide marked with the letter V (vagina).

Taking a smear for hormonal cytology.

Insert a speculum into the vagina, expose the cervix.

With a cotton ball, gently remove excess mucus from the cervix.

Use a spatula to take the contents of the anterior-lateral fornix of the vagina on days 8-14-18-21 of the menstrual cycle and apply it on a glass slide with a careful stroke-like movement.

Diathermoexcision (diathermo or electroconization) of the cervix - cone-shaped excision of the cervix with the Rogovenko electrode. The Rogovenko electrode consists of two metal tubes (long and short) covered with an insulating material, between which a nickel wire is soldered.

Indications for diathermoexcision of the cervix:

a) chronic endocervicitis with recurrent cervical polyps

b) suspicion of cervical cancer (for the purpose of a wide and deep biopsy)

c) suspicion of intraepithelial cancer (in situ) in case of full confidence in the absence of invasion (in young women)

Technique of diathermoexcision of the cervix:

1. The cervix is ​​exposed with the help of mirrors, a rubber vaginal cuff Rogovenko is inserted into the vagina to protect the walls of the vagina from burns.

2. The electrode is inserted into the cervical canal, a current of 2 A is turned on, the electrode is advanced to the required depth and slowly rotated around its axis by 360, cutting out a cone from the cervix, which is sent for histological examination.

3. If bleeding occurs, ligatures are applied to the bleeding vessels.

Cervical knife biopsy technique: the cervix is ​​exposed with mirrors, fixed with bullet forceps and pulled up to the area of ​​​​the entrance to the vagina. A section of the cervix with underlying tissue is excised with a scalpel and sent for histological examination. 1-2 absorbable sutures are applied to the wound.

targeted biopsy- a biopsy performed under the visual control of a colposcope or hysteroscope from altered areas of the cervical epithelium. According to the technique, it is performed as a knife or diathermoexcision.

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Can a smear show gonorrhea? Of course yes. Today, the gonorrhea smear is one of the most widely used tests for diagnosing gonorrhea. The algorithm for taking a smear for gonorrhea is as follows: the doctor performs a scraping from the cervix, rectum and urethra of the patient using a special swab inserted into the hole.

There are certain differences in taking smears for gonorrhea in men and women. So, to collect flora in men, a narrow tampon with an applicator is inserted into the urethra to a depth of 4 cm, and then, slowly rotating, it is removed. In addition to the urethra, a sample for flora is taken from the opening of the rectum. In women, the technique for taking smears for gonorrhea is somewhat different. A gynecologist, using a probe (spatula, a special loop) and a gynecological speculum, takes samples in all possible foci of infection, which usually include: the vagina, urethra and cervix. The doctor distributes the taken material on a glass slide and assigns it a letter designation:

• V for vagina;
• C for material from the cervix;
• U samples from the urethra.

The technique of taking a swab for flora and gonorrhea in virgins and children is similar to taking a sample for gonorrhea in sexually active women, except that in this case the speculum is not used, and the material from the vagina is taken through the opening in the hymen, which is absolutely painless and excludes damage to the hymen.

Having collected the necessary samples, they are sent to the laboratory, where the flora is to be dried. Then a special dye is added to the slides, which helps to decipher all the components of the collected sample flora under a microscope, namely: the presence of gonorrhea pathogens, fungi, lactobacilli, leukocytes, Trichomonas and the general composition of the flora.

A smear for gonorrhea in pregnant women is taken in the same way as before pregnancy. It is recommended to take this analysis for gonorrhea twice during pregnancy: the first time when registering, and the second - at 36 weeks before the birth itself. The first analysis allows you to diagnose diseases in time, and the second one can show the presence of gonococci if the first analysis gave a negative result, hitting the incubation period or if the infection occurred after pregnancy.

With a smear for gonorrhea, decoding occurs using a dye. Deciphering with a dye is facilitated by the fact that the reagent stains existing bacteria and cell parts in different colors. Therefore, if the technique of taking a smear for gonorrhea has been observed, all 3 samples will differ from each other in the content of non-pathogenic and pathogenic microorganisms.

This analysis takes no more than one day. If, before taking a smear, all the general rules for preparing for tests were followed, the main ones among which are: refusal to take antibiotics a week before visiting the doctor's office and not urinating 2 hours before the tests, the result will be accurate in more than 90% of cases.

It is the high accuracy, painlessness and speed of data acquisition that make this examination one of the most popular in the diagnosis of gonorrhea.

Gonorrhea is an unpleasant disease that you want to get rid of as soon as possible. But the first step on the road to recovery is the mandatory confirmation of the diagnosis. To do this, you need to take a smear for gonococci, after which the laboratory assistant will examine the discharge from the mucous membranes under a microscope and issue a conclusion about the presence of gonococcal infection.

A typical "habitat" of the gonorrhea pathogen is the mucous membrane of the genital tract. However, sometimes the infection also affects other organs: the eyes, throat, or rectum. Therefore, smears for gonorrhea are often taken from several places at once. The decision on this is made by the attending physician based on the clinical picture of the disease.

In a chronic infection, the bacteria often hide by forming cysts. Then the analysis is preceded by a procedure of provocation of gonococci. After it, the causative agent of gonorrhea is easily detected in smears from the urethra, vagina and cervix in women and from the mucous membrane of the urethra in men.

In order for the analysis to be reliable, it is important to follow a few rules before passing.

• You need to take a smear before starting antibiotic treatment. If you were taking medication before going to the doctor (you were prescribed them for another disease), be sure to tell him about it. If you are scheduled for a second smear, then make sure that the course of treatment ended no earlier than 3-4 days before the study.
• Before analysis, be sure to shower and wash with soap, but do not use other disinfectants if you do not want to get a distorted result.
• 2-3 hours before the smear, refrain from urinating.
• Do not have sex on the day of the diagnosis.

Material for research with gonorrhea in men is taken with a special swab probe. It is inserted into the urethra by 3 cm and rotated in a circle for 10 seconds. The procedure is unpleasant, because the mucous membrane may be slightly damaged in the process, but there should not be any sharp pain. Within a few hours after the smear, a burning sensation may be felt in the urethra, this is a normal reaction to the analysis.

In women, a smear for gonococci is performed on the 2nd-3rd day of the menstrual cycle - at this time there is a higher chance of detecting the pathogen. During the procedure, a speculum is inserted into the vagina. For a smear, a swab probe, spatula or a special loop is used. The doctor takes three samples, which are alternately placed on a glass slide. The first is from the vagina (it is denoted by the letter V), the second is from the cervix (letter C) and the third is from the urethra (letter U). In the future, during the study, this will help to establish the exact localization of the pathogen.

Pregnancy is not a contraindication for a smear test for gonorrhea. For preventive purposes, the obstetrician in the antenatal clinic will recommend that any patient do this procedure three times: when registering, and then in the second and third trimester. A smear for Neisser's gonococci, like the gynecological examination itself, does not pose a danger to the health of the expectant mother and baby.

Sometimes children and young girls who are not sexually active are required to take smears for gonorrhea. This happens when you suspect a gonorrhea infection by domestic means or in cases where it is transmitted to the child from the mother during childbirth. The swab technique in this case is almost the same as the procedure for adult women and men with one difference: the doctor will not use a speculum, and the sample from the vagina will be obtained through the opening in the hymen. This procedure is painless and non-traumatic.

To obtain informative results of the analysis, the doctor must observe the following rules:

• Only disposable spatulas are used for smearing. If samples are taken from several sites at the same time, it is better to change the spatula. This will prevent the spread of infection and eliminate the error in the study.
• A smear for gonorrhea is taken only from mucous membranes, with light superficial movements. This reduces the pain that is caused by the inflammatory response of the infection.
• Leaked pus or discharge on the patient's linen should not be used for analysis. The concentration of the pathogen in such samples is lower than in smears. And in the analysis, extraneous microflora can be found, which will distort the result of the study.

If the laboratory is located in the same place where the smear was taken, then a bacterioscopic examination will be carried out immediately after the procedure. If the equipment for analysis is located elsewhere, then the spatula will be sent there in a special sterile tube.

First, the laboratory assistant stains the material with a dye called methylene blue. This will give the bacteria a rich blue color, which makes it possible to detect them under a microscope. Another sample is stained with the Gram method, which makes it easier to distinguish Neisser's gonococci from other microorganisms. The sensitivity of bacterioscopy for gonorrhea is 40-85%, depending on the quality of the smear. If the pathogen cannot be detected by microscopy, the material is sent for bacterial culture. This analysis takes 3-5 days, during which bacteria grow on a nutrient medium. Bakposev additionally helps to draw conclusions about the number of microorganisms and their sensitivity to different groups of antibacterial drugs.

The specificity (the probability that the detected bacterium is gonococcus) of microscopy reaches 90%, therefore, in the case of a positive test result, other diagnostic methods are no longer required.

After the analysis, the patient is given a form that indicates whether the gonococcus is found in the smear or not. If bacteria are found, then in the corresponding column there is a “+” sign. And if the result of the analysis for gonorrhea is negative, then the laboratory assistant will write that gonococci have not been detected or put a dash in the column. Sometimes doctors write "gram-negative diplococci were found in the smear" or "Neisser's gonococci were detected" and use the Latin abbreviation "gn +". This also indicates the presence of gonorrhea in the smear.

back to gonorrhea back to gonorrhea

2. Soak used instruments for 1 hour in 1% lysafine solution until completely immersed

3.Rinse them with running water for 1 minute

4. Soak the instruments in the cleaning solution for 15 minutes

5. Rinse them with running water, and then rinse them twice with distilled water

6. Wipe the instruments dry with a sterile cloth and arrange them in sets.

Abortion tool kit:

Hegar expander by numbers

Metal female boat

6. Wrap each set in a cotton sheet and place in a dry autoclaving bix

Soak used rags in 1% lyzafin solution for 60 minutes.

Soak the tray in 1% lysafine solution for 60 minutes.

Remove and soak the mask in 1% Lyzafin solution for 60 minutes.

8.Processing hands at a hygienic level

"Technique for taking smears on flora"

Indications: smears are taken during preventive examinations - 2 times a year, for gynecological diseases, in all pregnant women, in women entering the gynecological hospital for surgical and conservative treatment

Equipment: gynecological chair, sterile guttering probe, Folkman spoon

tweezers-2 pieces, forceps, sterile balls, folding mirror, glass slides, gloves, bix with sterile liners, bix with bedclothes, tray, containers with 1% solution of lyzafin, 3% solution of lyzafin.

2. Using sterile bix tweezers, take a sterile diaper and place it on a gynecological chair

4. First, smears are taken from the urethra. To do this, a finger inserted into the vagina is lightly massaging it

5. The first portion of the urethra is removed with a cotton ball

6. A grooved probe is inserted into the urethra to a depth of 1-1.5 cm and the material is obtained with a slight scraping and applied to a glass slide in the form of a circle with a mark: AND

7. A mirror is inserted into the vagina, the cervix is ​​exposed

8. The cervix is ​​wiped with an automatic ball

9. With a grooved probe or a Folkman spoon, smears are taken from the cervical canal, penetrating to a depth of 1 cm and lightly scraping, the material is taken and applied to a glass slide in the form of a stroke with a mark: C

10. Then, discharge from the posterior vaginal fornix is ​​taken with tweezers, applied to a glass slide with a mark

12. Send to the laboratory with the appropriate referral

Soak the mirror, tweezers, cortsang, grooved probe, tray in 1% lyzafin solution for 60 minutes

Soak the treated balls in 1% lysafine solution for 60 minutes

Soak the diaper in a 1% solution of Lyzafin for 60 minutes.

Treat a gynecological chair in a 1% solution of lyzafin

Soak the used rags in a 1% solution of lyzafin for 60 minutes

Remove and soak gloves in 1% Lyzafin solution for 60 minutes

"Technique for taking smears for oncocytology"

Indications: smears are taken during preventive examinations, with gynecological diseases

Contraindications: smears are taken during preventive examinations, with gynecological diseases

Equipment: gynecological chair, grooved probe, Volkmann's spoon, tweezers-2, sterile balls, gloves, folding mirror, glass slides, bix with sterile liners, bix with bedclothes, tray, containers with 1%, 3% solution of lysafine

1. Hand hygiene, put on sterile gloves

3. Ask the woman to lie on a chair, on her back, her legs are bent at the knee joints and rest against the leg holders

5. With a grooved probe, a smear is taken from the cervical canal penetrating to a depth of 1 cm, the material is applied to a glass slide in the form of a stroke with a mark: C

6. Then, discharge from the posterior fornix of the vagina is taken with a Volkmann spoon and applied to a glass slide marked: V

Soak a mirror, tweezers, a probe, a Volkmann spoon, a tray in a 1% solution of lyzafin for 60 minutes

In a 1% solution of Lyzafin, a diaper for 60 minutes

Treat the gynecological chair with 1% lyzafin solution

Soak the treated rags in a 1% solution of lyzafin for 60 minutes

Remove and soak gloves in 1% Lyzafin solution for 60 minutes

"Technique for taking smears for colpocytology"

Equipment: gynecological chair, Volkmann's spoon, folding mirror, tweezers-2, glass slides, sterile balls, gloves, bix with sterile liners, bix with sterile rags, tray, containers with 1%, 3% solution of lyzafin

1. Hygienic treatment of hands, put on sterile gloves

2. Take a sterile diaper with sterile bix tweezers and place it on a gynecological chair

3. Ask the woman to lie on a chair, on her back, her legs are bent at the knee joints and rest against the leg holders

4. A mirror is inserted into the vagina, the cervix is ​​exposed

5. Smears are taken with a Volkmann spoon from the lateral fornix of the vagina and applied in equal layers on a glass slide

6.Smears are taken within three months on the 6th-12th-16th-20th-25th day of the menstrual cycle

7. The smears are dried and sent to the laboratory with the appropriate referral

Soak a mirror, tweezers, a Volkmann spoon, a tray in a 1% solution of lyzafin for 60 minutes.

Soak the spent balls in a 1% solution of lyzafin for 60 minutes.

Soak the lined diaper in a 1% solution of lyzafin for 60 minutes.

Treat the gynecological chair with 1% lyzafin solution for 60 minutes.

Remove and soak gloves in 1% Lyzafin solution for 60 minutes.

9.Processing hands at a hygienic level

"Technique for setting vaginal baths"

Contraindications: malignant tumors

Equipment: gynecological chair, folding mirror, sterile cotton balls, gloves, mask, bix with sterile diapers, bix with sterile rags, tray, medicines used for baths, forceps, tweezers, containers with 1%, 3% lysafine solution, solution potassium permanganate 1:6000

2. Take a sterile diaper with sterile bix tweezers and place it on a gynecological chair

8. Pour into the vagina a medicinal solution heated to 37 C-20-25 ml

9. The procedure lasts 15-20 minutes.

10. Then, tilting the mirror down, remove the solution from the vagina

11. Wipe the vagina with a dry cotton swab

12. The mirror is removed. Woman getting up from chair

14. Processing of hands at a hygienic level

"Technique for inserting tampons into the vagina"

Indications: gynecological diseases

Equipment: Equipment: gynecological chair, folding mirror, sterile cotton balls, gloves, mask, sterile diapers, sterile rags, tray, medicines used for vaginal tampons, forceps, tweezers, containers with 1%, 3% solution lyzafin, potassium permanganate solution 1:6000

1. Hand hygiene, put on sterile gloves and a mask

2. Take a sterile diaper with sterile bix tweezers and place it on a gynecological chair

3. Ask the woman to lie on the gynecological chair, on the back, legs bent at the knee joints and rest against the leg holders

4. Wash the external genitalia with a solution of potassium permanganate 1:6000

5. Forefinger and thumb of the left hand spread the labia

6. With the right hand, a folding mirror is inserted into the vagina, the valves are opened

7.Clean the vagina with a cotton swab from secretions

8. Kortsangom insert swab moistened with medicinal solution

9. Apply a swab to the cervix or insert into the posterior vaginal fornix

10.Carefully remove the vaginal mirror, and then forceps

11. Leave the ends of the ribbon with which the tampon is tied outside

12. A woman gets up from a chair

Soak used cotton balls in 1% lyzafin solution for 60 minutes.

Soak tweezers, forceps, mirror, tray, lined diaper in 1% lyzafin solution for 60 minutes.

Treat the gynecological chair with 1% lyzafin solution for 60 minutes.

Soak the used rags in a 1% solution of lyzafin for 60 minutes.

Remove and soak the mask in 1% lyzafin solution for 60 minutes.

14. Processing of hands at a hygienic level

"Vaginal Douching Technique"

Indications: gynecological diseases

Contraindications: malignant neoplasms

Equipment: gynecological chair, cotton balls, tweezers, forceps-2 pieces, gloves, mask, Esmarch's mug, medicines used for douching, bix with sterile diapers, bix with sterile rags, tray, containers with 1%, 3% solution of lyzafin , potassium permanganate solution 1:6000, douching tips.

1. Hand hygiene, put on sterile gloves and a mask

2. Take a sterile diaper with sterile bix tweezers and place it on the gynecological

3. Ask the woman to lie on the gynecological chair, on the back, legs bent at the knee joints and rest against the leg holders

4. Wash the external genitalia with a solution of potassium permangant 1:6000

5. Place the douching cup on a special tripod no higher than 50 cm above the level of the woman's body

6. Pour into a sterile mug the medicinal solution, heated to 36-37 C, in the amount of 500-600 ml

7.Spread the labia majora

8. Drain a small amount of liquid from the tube to remove air and the solution that has cooled in the tube

9. Insert the tip for douching into the vagina along its back wall to a depth of 4-5 cm and connect it to the rubber tube

10. Performing douching, it is necessary to periodically change the position of the tip

11. Having finished douching, remove the tip

12.Lightly dry the vagina with a sterile cotton swab

13. A woman gets up from a chair

Soak used cotton balls in 1% lyzafin solution for 60 minutes.

Soak tweezers, forceps, mirror, tray, lined diaper, tip, Esmarch's mug in 1% lyzafin solution for 60 minutes.

Treat the gynecological chair with 1% lyzafin solution for 60 minutes.

Soak the used rags in a 1% solution of lyzafin for 60 minutes.

Remove and soak the mask in 1% lyzafin solution for 60 minutes.

15. Processing hands at a hygienic level

"Basal Temperature Measurement"

Indications: to assess the functional activity of the ovaries

1. A woman measures the basal temperature (temperature in the rectum) on her own in the morning, without getting out of bed, with a thermometer that is stored in 2% with a soda solution, for 10 minutes - 3 months

2. After measuring the temperature with a thermometer, wash under running water with soap and place in a 2% soda solution

3. The basal temperature during the normal course of the menstrual cycle is two-phase: in the first phase of the cycle -36.3-36.8 C, which is associated with the influence of estrogens, in the second phase it rises to 37-37.3 C under the action of progesterone

4. In the absence of ovulation, basal temperature is single-phase, monotonous

5.After measuring the temperature, record daily, and then draw the temperature curve

6.Processing hands at a hygienic level

"Palpation of the mammary gland"

Equipment: Disposable gynecological sets.

1. Hygienic treatment of hands.

2. Palpation of the mammary gland is carried out with the patient standing, lying on her back and on her side

3. Palpation is performed with an open palm or fingertip.

4. Palpation is performed clockwise, in a circular motion: each quadrant, the area of ​​the nipple-areolar complex, the area of ​​the submammary fold are examined.

5. Palpation of the lymph nodes: above and subclavian, axillary, edges of the shoulder blades.

6. Infection safety:

- treatment of the couch with 1% solution of lyzafin

7. Processing of hands at a hygienic level.

"Schiller test technique"

Indications: diseases of the cervix

Equipment: gynecological chair, tweezers - 2, sterile balls, gloves, folding mirror, bix with sterile rags, tray, Lugol's solution, containers with 1% lysophine solution, bix with sterile liners (gynecological disposable set).

2. Take a sterile diaper with sterile bix tweezers and place it on the gynecological chair.

3. Ask the woman to lie on a chair, on her back, legs bent at the knee joints, rest against the leg holders.

4. The cervix is ​​exposed using mirrors.

5. clean the cervix from mucus with a sterile swab.

6. Bring a swab richly moistened with Lugol's solution to the cervix and leave for 1 minute.

7. After 1 min. The swab is removed and tissue color is assessed.

8. Unchanged epithemia, containing a sufficient amount of glycogen, evenly stained dark brown.

9. Pathological areas due to insufficient glycogen content are not stained with Lugol's solution and stand out against a brown background in the form of lighter spots of various shades - from light brown to completely uncolored.

10. The reaction is considered iodine-positive when a uniform dark brown color is obtained and iodine-negative in the presence of separate lighter areas.

11. The mirror is removed, the woman gets up from the chair.

- Spent cotton balls are soaked in a 1% solution of lyzafin for 60 minutes.

- Tweezers, a mirror, a tray, a linen diaper are soaked in a 1% solution of lyzafin for 60 minutes.

– Treatment of the gynecological chair with 1% solution of Lyzafin

- Soak the used rags and gloves in a 1% solution of lyzafin for 60 minutes.

13. Processing of hands at a hygienic level.

"Puncture of the abdominal cavity through the posterior fornix of the vagina"

Indications: in case of suspected interrupted ectopic pregnancy, ovarian anoplexia, for taking exudate from the abdominal cavity.

Contraindications: serious condition of the patient

Equipment: single-leaf mirrors, sterile balls, mask, gloves, puncture needle, 10 gram syringe, 70% alcohol, alcohol solution

Iodine 3%, tweezers - 2, bix with sterile diapers, bix with sterile rags, tray, containers with 1%, 3% solution of lyzafin, Muso bullet tongs.

1. Hand hygiene, put on sterile gloves and a mask.

2. Take a diaper with sterile bix tweezers and place it on a gynecological chair.

3. Ask the woman to lie on the gynecological chair, on her back, her legs are bent at the knee joints and rest against the leg holders.

4. The external genitalia are treated with a 3% alcohol solution of iodine.

5. Folding mirrors are inserted into the vagina, the cervix is ​​exposed.

6. The vagina of the cervix is ​​treated with alcohol.

7. The posterior lip of the cervix is ​​grasped with bullet forceps and pulled to the front (to the symphosis).

8. A puncture needle is put on the syringe.

9. The protocol is made in the center of the posterior fornix to a depth of 1-2 cm.

10. The contents of the abdominal cavity are removed by the reverse movement of the syringe plunger.

11. After removing the needle, the puncture site is smeared with a 3% alcohol solution of iodine.

13. A woman is transported to the ward on a stretcher.

14. Infection safety:

Soak used cotton balls in 1% lyzafin solution for 60 minutes.

- Soak tweezers, Muzo bullet tongs, syringe, needle, tray, lined diaper in a 1% solution for 60 minutes.

- Treat the gynecological chair with a 1% solution of lyzafin.

- Soak the used rags in a 1% solution of Lyzafin for 60 minutes, mask, gloves, soak in a 1% solution of Lyzafin for 60 minutes.

Hand treatment at a hygienic level

"Taking swabs for gonorrhea with provocation"

Indications: gynecological diseases, confirmation of the criterion of cure of the patient

Equipment: Volkmon's spoon, grooved probe, tweezers-2 pcs., forceps, sterile cotton balls, folding mirror, glass slides, bix with sterile diapers, bix with sterile rags, tray-2 pcs., gloves, containers with 1%, 3 % solution of lyzafin.

Provocation is an artificial exacerbation of the inflammatory process.

The following provocation methods are used:

Physiological - these are the days of menstruation

Biological - the introduction of gonovaccine, pyrogenal

Thermal - thermal procedure

Mechanical – gynecological massage

Chemical - treatment of the cervical canal, urethra with 3% solution of silver nitrate.

The patient is invited on the last day of menstrual flow, some method of provocation is taken, and after 24-48-72 hours swabs are taken from the urethra, cervical canal and rectum. The patient should not urinate for 1.5-2 hours. Swabs are taken 3 days in a row for three cycles. If all smears are negative, the woman is considered healthy and is removed from the dispensary.

1. Hand hygiene, put on sterile gloves.

4. First take swabs from the urethra. To do this, with a finger inserted into the vagina, lightly massage the anterior wall of the vagina in the urethra.

5. The first portion of the urethra is removed with a cotton ball.

6. Folkmon's spoon is inserted into the urethra to a depth of 1-1.5 cm and the material is obtained with a light scraping and applied to a glass slide marked "U"

7. A speculum is inserted into the vagina, the cervix is ​​exposed

8. Wipe the cervix with a cotton ball

9. At the other end of the Folkmon spoon, a smear is taken from the cervical canal, penetrating to a depth of 1 cm and lightly scraping, the material is taken and applied to a glass slide in the form of a stroke marked "C"

10. Then they take the discharge from the posterior fornix of the vagina with tweezers, put it on a glass slide marked "V"

11. A grooved swab is taken from the rectum with a probe and applied to a glass slide marked "R"

13. Send to the laboratory with the appropriate referral

14. Infection safety:

¾ Soak the mirror, tweezers, Volkmon's spoon, cortsang, grooved probe, tray in 3% solution of lyzafin for 60 minutes

15. Hand sanitizing

Indications: suspicion of a malignant process in the cervix, vagina, vulva.

Equipment: single-leaf mirrors, bullet forceps - 2 pcs, scalpel (conchotomy), forceps, needle holder, needle, suture material (catgut), tweezers - 2 pcs, sterile cotton balls, gloves, mask, bix with sterile diapers, bix with sterile rags , tray - 2 pcs, containers with 1%, 3% solution of lyzafin, a bottle with 5% solution of formalin, tincture of iodine 5%.

A biopsy is the taking of a piece of tissue in vivo for subsequent histological examination.

1. Hand hygiene, put on sterile gloves.

2. Take a sterile diaper with sterile bix tweezers and lay it on a gynecological chair.

3. Ask the woman to lie on a chair, on her back, her legs are bent at the knee joints and rest against the leg holders.

4. Folding mirrors are inserted into the vagina, the cervix is ​​exposed.

5. The cervix is ​​treated with 5% iodine solution

6. The cervix is ​​grasped in two places with bullet forceps so that this area to be biopsied is between these bullet forceps.

7. A wedge-shaped piece is cut out from the suspicious area with a scalpel, which should contain not only the affected tissue, but also part of the healthy tissue.

8. Knotted catgut sutures are applied to the wound.

9. The wound is treated with 5% iodine solution.

10. The material is placed in a vial with 5% formalin solution.

11. In the direction for a histological examination, indicate: last name, first name, patronymic, age of the patient, address, clinical diagnosis and the nature of the material being sent.

12. Infection safety:

¾ Mirror, tweezers, bullet forceps, scalpel, forceps, needle holder, soak the needle in 3% solution of lyzafin for 60 minutes

¾ Soak the diaper in 1% Lyzafin solution for 60 minutes

¾ Soak the spent balls in 3% solution of lyzafin for 60 minutes

¾ Treat the gynecological chair with 1% Lizafin solution twice with an interval of 15 minutes

¾ Soak the rags in 1% solution of Lyzafin for 60 minutes

¾ Remove and soak gloves in 1% Lyzafin solution for 60 minutes

13. Hand sanitizing

Indications for tight tamponade:

¾ Bleeding from the uterine cavity in order to temporarily stop bleeding;

¾ Bleeding from the cervix: with erosion, with cervical cancer

Indications for loose tamponade:

¾ Preoperative preparation before the operation "extirpation of the uterus"

¾ In acute inflammatory with a pronounced pain syndrome in order to relieve pain during patient movements

Equipment: vaginal mirrors, forceps - 2 pcs, tweezers - 2 pcs, sterile gauze swab, gloves, mask, sterile cotton balls, bix with sterile diapers, bix with sterile rags, tray - 2 pcs, containers with 1%, 3% r -rum of lyzafin, solution of potassium permanganate 1:6000

1. Hand hygiene, put on sterile gloves.

2. Take a sterile diaper with sterile bix tweezers and lay it on a gynecological chair.

3. Ask the woman to lie on a chair, on her back, her legs are bent at the knee joints and rest against the leg holders.

4. Wash the external genitalia with a solution of potassium permanganate 1:6000.

5. Insert a speculum into the vagina

6. Clean the vagina with a cotton swab from blood

7. Using tweezers or forceps, gradually tightly or loosely fill the vaginal cavity with a sterile swab

8. When bleeding, they ensure that the removed tip of the bandage is dry, which means the goal has been achieved.

9. Infection safety:

¾ Mirror, tweezers, cortsang, soak in 3% lizafin solution for 60 minutes

¾ Soak the diaper in 1% Lyzafin solution for 60 minutes

¾ Soak the spent balls in 3% solution of lyzafin for 60 minutes

¾ Treat the gynecological chair with 1% Lizafin solution twice with an interval of 15 minutes

¾ Soak the rags in 1% solution of Lyzafin for 60 minutes

¾ Remove and soak gloves in 1% Lyzafin solution for 60 minutes

¾ Remove and soak the mask in 1% Lyzafin solution for 60 minutes

10. Hand sanitizing

1. Forms of gonorrhea in men
2. Analyzes and diagnostic methods
3. Preparation for taking a smear
4. Microbiological diagnostics
5. Molecular genetic methods
6. Serological method
7. Immunofluorescence method
8. Immunoenzymatic method
9. Prevention of gonorrhea

Gonorrhea is a sexually transmitted disease caused by a gonococcal infection. Transmitted exclusively sexually from a sick partner. Since women carry the disease almost without any signs, they are the main carriers. You can identify the pathogen by conducting tests and diagnosing gonorrhea in men, in most cases, this is what happens. It is a laboratory study of smears that can give a clear answer to what causes unpleasant symptoms.

The disease is caused by gonococcus, which affects the mucous membrane of the genitourinary system. Sometimes the first symptoms appear as early as three days after unprotected intercourse.

In men, there are three forms of the disease:

In the acute form, gonorrhea is manifested by pronounced symptoms, namely, purulent discharge from the urethra, burning and pain when urinating. The latent form of the disease may be asymptomatic, or the signs are mild.

In order to diagnose gonorrhea, it is necessary to detect the causative agent of the disease, gonococcus, in the body of a man. The accuracy of the diagnosis depends on the stage of the disease.

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To make an accurate diagnosis, it is necessary to pass a general blood and urine test.

The acute form allows you to quickly identify the pathogen in smears, and usually one laboratory analysis is enough at this stage. If a man asked for help during a chronic or latent course of the disease, then in this case several additional research methods are prescribed. Diagnosis of gonorrhea involves taking a detailed history and ordering a range of tests, including blood tests and urethral swabs. Usually, thanks to the laboratory procedures carried out, it is possible to accurately diagnose the presence of gonorrhea in men in 90% of cases. Basically, the following tests are prescribed:

• general blood and urine tests;
• smear examination;
• polymerase chain reaction (PCR);
• ligase chain reaction (LCR);
• determination of the sensitivity of the pathogen to antibiotics.

In order for the diagnosis to be made as accurately as possible, the sampling of material for research must be approached with all seriousness. There are a number of specific preparatory points that the doctor will strongly recommend to perform. Since they take a smear for gonorrhea without fail, even if there are no obvious symptoms of the disease, this helps to identify the pathogen even at the stage of the incubation period. If a man had unprotected sexual intercourse, then such an analysis will help, if gonococcus is detected, to start treatment as early as possible.

A smear for gonorrhea is usually done in the morning, so you need to prepare for it the day before. If for any reason a man takes antibiotics, then the treatment should be stopped. Under no circumstances should alcoholic beverages be consumed. It is advisable to refuse sexual contact. In addition, 3 hours before the procedure, it is recommended not to urinate. Hygiene of the genital organs should be carried out in the evening; this should not be done immediately before taking a smear. These simple rules cannot be ignored, since the accuracy of the diagnosis directly depends on them. And this means that timely and correct treatment will be prescribed.

The algorithm for taking a smear for gonorrhea in men is quite simple. A probe specially designed for analysis is inserted into the urethra, on which, after extraction, the biomaterial remains. Next, the resulting material is transferred to a glass slide, and transferred to the laboratory for research. A smear from the urethra is taken even when the purulent discharge is quite abundant. One purulent discharge is not enough for a qualitative analysis.

This type of diagnosis helps to identify and determine the type of pathogen. Microbiological methods include cultural and bacterioscopic.

1. The bacterioscopic method, which is the most common, allows you to examine smears specially stained with aniline dyes using a microscope. Thanks to him, the presence of pathogenic microflora is detected. In order to conduct such a diagnosis, a smear for gonorrhea in men is taken mainly from the urethra. Usually, when a gonococcus is detected in the test material, additional methods are not required. Bacterioscopy is a fairly simple diagnostic method, but it is not always possible to make a diagnosis thanks to it, since microorganisms are not always detected. After the biological material has been taken, it is prepared for examination by staining, which is carried out with a special solution of methylene blue. In this case, the bacteria, as it were, absorb the dye, and become visible when viewed under a microscope. Another reliable method for examining a smear is Gram staining. It allows you to identify mixed flora, while the gonococci will be clearly identified. During the method, the gonococci turn pink, and the rest of the flora blue.
2. The cultural diagnostic method consists in the fact that the test material is placed in a special environment in which microorganisms form colonies over time. Subsequently, the culture is examined and it is determined which type of bacteria is present in the smear. Thanks to this method, gonorrhea is diagnosed with an accuracy of 99.9%. The only drawback of the technique is the time it takes to grow a colony. It usually takes at least a week. During this period, the patient is not treated correctly, and the disease can become chronic.

PCR analysis is able to detect the gonorrhea pathogen with high accuracy

Sometimes, after the studies, there are still some doubts about the correct diagnosis. This usually happens in the chronic form of the disease, when the clinical form is lubricated and does not have clear symptoms. In this case, PCR and LCR come to the rescue. They are able to detect the gonorrheal pathogen with high accuracy. Both methods are based on the identification of genetic traces of the causative agent of gonorrhea in the biological material. Such analyzes do not take much time and are quite sensitive.

Usually, the results of the analyzes are ready on the second day, the accuracy of the indicators is from 90 to 95%. With the help of polymerase and ligase chain reaction, the causative agent of the disease is detected at the earliest stages, when there are no pronounced symptoms, as well as in the chronic course of gonorrhea.

But, despite all these advantages, PCR and LCR have their drawbacks. First, these analyzes are quite expensive. Secondly, they are not carried out in ordinary laboratories, since special equipment is required. Thirdly, the sampling of material for research should be taken by a highly qualified specialist, since there are a number of special requirements.

In the diagnosis of gonorrhea, an important role is played by a laboratory study of blood serum. This is the so-called serological method. For analysis, it is necessary to take a venous blood sample, from which serum is isolated. This method is called the Borde-Gangu reaction. This technique is used in the same way as PCR in the diagnosis of chronic gonorrhea or at the stage of the incubation period.

Serological diagnostics is performed infrequently. This method plays more of a supporting role. It is used when there are no positive results after all other tests. The essence of the method lies in the property of the antigen + antibody compound to fix the complement, which is in a free state.

The analysis is carried out in two stages:

• deposition of antibodies on the surface of the antigen;
• determination of the reaction of this compound when an indicator is added, in the role of which the hemolytic system acts (this is the process of hemolysis).

Results are evaluated based on whether complement fixation has occurred by the immune system. A positive reaction is considered if the complement was fixed and hemolysis did not occur. This means that a foreign antigen is present in the blood. If there is no complement fixation, then the hemolysis process is successfully carried out, and the reaction is considered negative.

This diagnostic method is not particularly difficult. A smear is examined, which was applied to a glass slide and prepared for examination under a microscope. The preparation of the preparation consists in the fact that it is heated over an alcohol lamp and stained with methylene blue. After that, a special composition is applied that has the ability to fluorescent, that is, to emit light. A glass slide prepared in this way is placed under a microscope and light is directed onto it. When viewed, you can clearly see pathogenic microorganisms, which are luminous spherical clusters.

Thanks to this technique, it is possible to detect antibodies that are produced in response to the introduction of pathogens into the body. Moreover, these antibodies are specific for each specific pathogen. Therefore, in the diagnosis, those antibodies that are suitable for this disease are used.

After the sampling of the test material has been performed (blood is used for this analysis), it is placed in prepared containers for settling. Artificially grown antibodies are preliminarily applied to the walls of the containers, with which the blood reacts throughout the entire settling period.

At the next stage of the study, the material is poured into another container, and the walls of the container are thoroughly rinsed to remove all antibodies from them that have not bound to the antigens. After that, a special enzyme preparation is added, which has the ability to change color according to the amount of unbound antibodies. The calculation of the concentration of antibodies and antigens is carried out by the colorimetric method.

The disadvantage of this technique is that it does not determine the presence of gonococci, but only the immune response of the male body to the presence of a pathogen, followed by the production of antibodies. The indicators of this analysis may indicate that the patient has previously had gonorrhea and there are traces of infection in the blood. But, despite this, such an analysis can also be done for diagnostic purposes, since if gonococcus is present in the body, then the concentration of associated antigens will be very high.

Since the causative agent of the disease, getting into the external environment, quickly dies, the only way of infection is unprotected sexual intercourse with a sick partner. Therefore, the main preventive measures are the use of a condom and the complete exclusion of casual sexual contacts. This is the so-called primary prevention.

If, nevertheless, unprotected sexual intercourse has occurred, and the man is unsure of the decency of his partner, then there is a secondary prevention using medications. To do this, it is necessary to contact a venereologist within the first days after sex, who will prescribe the appropriate treatment, after tests that confirm the disease.

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Occurs through sexual intercourse. This affects all the mucous membranes of the genitourinary system, intestines, mouth, throat and eyes.

Most often, this disease is found in men and women from 19 to 35 years. During childbirth, the baby can also become infected with this infection, which results in infectious conjunctivitis. At the slightest suspicion of this disease, you should immediately take a smear for gonorrhea.

The first symptoms of the disease in men are yellowish mucus secreted from the penis. In this case, sharp pains appear. In women, vaginal discharge is yellowish-white in color, and there may be bleeding and pain in the lower abdomen and when urinating.

With advanced gonorrhea, not only the organs of the reproductive system are affected, but also many internal organs and systems of the body. In some severe cases, the disease can lead to serious cases such as infertility and even blood poisoning.

Diagnostic methods

A number of examinations are used to diagnose an infectious disease. Gonorrhea has such vivid symptoms that an experienced doctor is able to determine the diagnosis. However, for such a diagnosis, symptoms alone are not enough, so the patient is immediately sent for an appropriate examination.

An infected person must necessarily undergo the necessary diagnostics in order to clarify the severity of this disease. So, in women, the infection can be hidden, so it is more difficult for them to make a primary diagnosis. It is necessary to pass a considerable number of tests in order to detect the exact infection.

Basically, the laboratory diagnosis of this infectious disease has two examination bases: bacterioscopic, bacteriological. There are a number of other methods for determining gonorrhea, which we will also consider.

Bacterioscopy

To solve the problem today, the method of bacteriological research is widely used, thanks to which additional information about this microorganism can be obtained. The finished product undergoes macroscopic and microscopic examination, as well as the special properties of this culture. In some cases, the enzymatic properties of the infection under study are determined.

Cultural study

This method is most effectively used to determine the nutrient medium. For the cultivation of gonococcus, Russian scientists have developed four variants of such a medium that have sufficient protein and also have the properties of rapid growth. A similar product in terms of quality can be put on the same level with foreign analogues.

The cultural method of diagnosing a disease such as gonorrhea is undoubtedly superior to the microscopic version of the study. If with the bacteriological method there are cases in which gonococci are not found in patients or have questionable data, then with the cultural method an accurate diagnosis is made.

We see that this method of studying gonorrhea has obvious advantages. The culture method is especially important for determining an accurate diagnosis in sick children. It should be noted that in our time, in almost all countries, when determining gonorrhea, the main diagnostic methods are used - bacteriological.

PCR

If the specialist doubts the results of microbiological studies, he directs the patient for analysis by the molecular genetic method. PCR for gonorrhea can determine the exact type of pathogen.

To do this, a swab for gonorrhea is taken from the problem area. These are organs such as the vagina or urethra, from which a thick gray liquid is discharged. When the anus is infected, a discharge is taken from it for analysis. Due to the high sensitivity of PCR, it is possible to accurately determine the severity of gonococci and the development of the disease in a patient.

This method of studying gonorrhea does not take much time, however, not every patient can use it. The problem is that it is quite expensive. In addition, there is another significant drawback - such a study is carried out only in some laboratories.

Microscopy

For microscopy, special rules must be observed. Mucus sampling for analysis is taken from the vagina, cervix, urethra, rectum. 5 days before the biomaterial is taken, the patient must stop taking antibiotics. You should refrain from urinating 3-4 hours before the procedure.

To determine the infection, two samples are taken. The first smears are stained in certain colors that will help identify the presence of cocci. If they have been identified, the study of the second specimen of the sample begins according to the Gram method. In this case, the detected gonococci acquire a bright pink color. Only after such an examination is an accurate diagnosis of gonorrhea made.

Tests for pregnant women

A fetus developing in the womb of an infected woman can be seriously affected. In medical practice, miscarriages are often observed in this case. Therefore, genital infections in pregnant women should be treated under medical supervision.

At the first suspicion of gonorrhea, the expectant mother should immediately undergo an appropriate examination:

• It is necessary to examine the microscopic method of isolation from the cervical canal, vagina and urethra. The sample is taken at the first visit and then in the third trimester.
• At the same time, a blood test for HIV infection is taken.
• At the first visit, a survey is carried out to determine the type of pathogen.

How much analysis is done for gonorrhea and how the results are deciphered

Diagnosing this disease includes a whole list of tests that can help determine the type of pathogen and its approximate amount in the patient's body. That is why only a specialist should be sent to such an examination, who will tell you about how much analysis is done for gonorrhea.

First of all, the patient is sent for a smear test for infection. It is worth knowing that the technique of this procedure has significant differences in men and women. So, in women, a test for gonorrhea is taken from the vaginal mucosa. In addition, an analysis of the contents of the urethra and cervical canal is often done. Moreover, such a study is not carried out in women during menstruation.

Where is the swab taken from?

As a rule, the sample is taken from those organs that have suspicious discharge, similar to gonococcal infections. Such problem areas can be the mouth, throat, eyes, urethra, rectum. In women, samples may also be taken from the cervix.

Men mainly complain of unpleasant discharge of cloudy mucus from the urethra, which may be signs of infection. For bacterioscopy, they take a smear from the urethra. In women, the contents are taken from the cervix, vagina, since gonococcus, in most cases, first affects these organs.

Sampling technique

The general rule for infected men and women is that antibiotics should not be taken before bacteriological analysis of the biomaterial. Before starting the procedure, you should carefully wash the toilet of the penis. 2 hours before sampling for gonorrhea, start filling the bladder.

Taking a smear for gonococcal flora in men is much easier than in women. In this case, only biomaterial is taken from the urethra. It is important to prescribe minor manipulations of the prostate and male organ before sampling. A medical probe is inserted into the patient's urethra, from the surface of which a smear is then taken. If the discharge is abundant, then the probe with a swab is inserted shallowly into the urethra.

If the disease is in the chronic stage, the probe is inserted into the urethra 3 cm deep and rotated there several times. Despite the fact that this procedure brings some discomfort to patients, it is painless and tolerated quite easily. In a similar way, secretions are taken for analysis for gonorrhea in women.

Interpretation of survey results

It takes a small amount of time to decipher the data of the analyzes carried out, and its technique is quite simple. As usual, the specialist describes in detail the results of bacteriological research. He writes about whether gonococci are found or not.

If the doctor in the conclusion indicates that gram-negative diplococci are found, this is the same as gonococci. These are the features of the pathogens of this infection, which the doctor describes in detail in the certificate. In conclusion, there is information about what type of infection was detected, as well as its number and weight. And most importantly, the doctor indicates the type of antibiotics that can kill this infectious agent.

How much is done depending on the type of study

The most effective diagnosis of gonorrhea is a pap smear. It is best identified in mucus, which is taken from the urethra, urethra, or vagina. As a rule, patients are sent for blood and urine tests.

Patients want to get the results of the study as soon as possible, so the question is often asked about how much the analysis for gonorrhea is done. The fact is that it all depends on the type of examination. For example, culture data will be known in 7-10 days.

If a person wants to know much faster whether he is infected or not, rapid tests are being sold today. With their help, you can get the results of the analysis at home. They are very convenient and easy to use. In addition, you will get the result immediately. However, the tests have one important disadvantage - they can show a dubious result.

It is better to take material from the urethra. With good organization, the resulting smear is examined immediately after it is taken. In this case, the patient can receive ready-made results within a day. The next day, all the data goes to the doctor, who deals with their decryption. In some cases, the doctor may prescribe additional examinations such as cytology and colposcopy.

It is worth paying attention to the fact that no matter how long it would take to study an infectious disease, after receiving the data, you should definitely visit a venereologist for a consultation.

Today there are high rates of various sexually transmitted diseases in men and women. This list includes gonorrhea. People carelessly treat their health, as well as the health of their children. It is necessary to undergo a medical examination in a timely manner and, at the first suspicion, visit a doctor to identify such diseases. If gonorrhea is treated correctly in the initial stage, it can be defeated.

Gonorrhea is a sexually transmitted disease, which quite often becomes the main cause of the development of various inflammatory processes in the female genital organs. This disease is caused by a gonococcal infection.

In contact with

Most often, gonorrhea is transmitted from a man to a woman during sexual intercourse, while dangerous bacteria enter the vagina, from where they penetrate the uterus, cervix, ovaries and tubes. In the future, gonococci can affect the rectum and urethra.

When should women get a pap test for gonorrhea?

The main symptoms of gonorrhea infection are itching and burning in the vagina, and purulent discharge is also possible. Recently, the asymptomatic course of various gynecological diseases, including those that are sexually transmitted, has been quite common.

Sometimes, even with such diseases, there is no pathological discharge from the vagina, so it is difficult to distinguish them from normal discharge without taking tests. With a latent course of diseases, pain in the abdomen, menstrual irregularities, and bleeding are not observed, so every woman needs to regularly undergo a preventive examination by a gynecologist and take tests.

The main indications for taking a smear for gonorrhea are:

• infertility;
• the presence of signs of acute inflammation;
• the presence of chronic urogenital infections;
• pathology of pregnancy;
• spontaneous abortions;
• the presence of a sexual partner with urogenital infections.

How to prepare for a smear test

If the gynecologist has prescribed a smear from the vagina, you need:

• refuse sexual relations one or two days before the examination;
• stop douching and refuse any intimate hygiene products two to three days before the examination. It is recommended to wash the genitals with warm water;
• stop using any medicine in the form of tablets, suppositories or sprays a week before the examination. The exceptions are those cases when their use was agreed in advance with a gynecologist;
• in the evening before the examination, it is necessary to conduct hygiene of the genital organs. On the day of the examination, in the morning, it is not necessary to wash;
• refrain from going to the toilet two to three hours before taking a smear.

A bacteriological smear from the vagina is often carried out in the first few days after the end of menstruation or before they begin. If menstruation began on the days for which the examination is scheduled, you should try to reschedule the visit to the doctor.

Where and how to take a smear for gonorrhea

To test for gonorrhea, the doctor uses a small amount of mucus and secretions taken from the vagina, cervix, and urethra. Most often, a bacteriological smear is taken during a simple examination by a gynecologist.

At the very beginning of the examination, the doctor introduces a gynecological speculum into the vagina, selected by size, with which he pushes the walls of the vagina. Due to the sensation of a cold foreign object, the insertion of speculums can be an unpleasant procedure. To facilitate the work of the doctor, you must try not to strain, breathe evenly and deeply.

After a gynecological examination of the cervix and vaginal walls, the doctor will collect a small amount of discharge from the uterus, cervical canal, vagina, and urethra. This is done using special sterile swabs. The gynecologist applies the collected secretions to special glasses using swabs, which are then sent to the laboratory, where they are stained and studied under a microscope.

How many smears are done for gonorrhea. Usually, the smear results are ready on the same day after a couple of hours or from one to three days. Sometimes, depending on the results of the initial examination by a gynecologist, the doctor may decide that it is necessary to prescribe some additional tests - cytology and colposcopy.

Most often, a smear for gonorrhea is easily tolerated, it does not cause any complications. In rare cases, after being examined by a gynecologist and taking a smear for gonorrhea, a woman may experience slight dull pains in the lower abdomen or spotting scanty vaginal discharge. All this stops after a few hours.

It is worth contacting a gynecologist if, a few days after a gynecological examination and receiving a smear from the vagina, the following symptoms are observed:

• prolonged pulling pain in the lower abdomen;
• temperature;
• chills;
• bloody issues.

Pap test for gonorrhea during pregnancy

In the case when a woman is pregnant, there are several ways to smear for gonorrhea. For preliminary diagnosis, a smear is taken on the flora from the urethra or cervical canal, but the accuracy of such a study is only 30-70%.

The next method is a PCR (polymerase chain reaction) smear, but this can often give a false result. The most reliable method is bacteriological culture, which allows to detect gonorrhea in 95% of cases.

There is a certain risk group:

• infected with gonorrhea before pregnancy;
• the presence of any other infections transmitted during sexual intercourse;
• girls who have an active sexual life up to 25 years;
• the presence of an active sexual life from an early age;
• girls who refused the barrier method of contraception.

At its discretion, the gynecologist may prescribe any additional examination.

Gonorrhea swab results

Deciphering the results of the analysis is quite simple. According to the results of the bacteriological study, they write: gonococci were found (not found). Alternatively, in the conclusion it can be written: gram-negative diplococci were detected (not detected), which means the same thing. Gram-negative diplococci are a descriptive characteristic of the causative agents of the disease.

The conclusion after a cultural study should contain information about which microbe was detected and in what quantity (massiveness of its growth), to which antibiotics this infectious agent is sensitive.

Deciphering a smear for gonorrhea should be done exclusively by a specialist, since the correct interpretation of the results is very important. The slightest inaccuracies and inattention can lead to an erroneous diagnosis and the appointment of the wrong one.

Thus, a smear for gonorrhea is performed during a gynecological examination. Often it is carried out easily and does not cause any complications. Pap smears for gonorrhea are required if you have symptoms or are at risk of the disease.

We also invite you to watch a video on how to properly prepare for the upcoming test for sexually transmitted infections: