The inflammation of the cervix, which is the lower end of the uterus is called cervicitis. Diagnosis of cervicitis is important to prevent further complications. Let us understand about cervicitis, its causes and symptoms, with details of diagnostics tests for cervicitis and PAP smear test.
What is Cervicitis?
The inflammation of the cervix is called as cervicitis. The cervix is the lower end of the uterus which connects to vagina. The symptoms of cervicitis include abnormal vaginal bleeding, grey or white vaginal discharge, vaginal pain, and pain during intercourse, pelvic pressure, backaches. It can also develop as an open sore.
The causes of cervicitis include infections by Herpes simplex virus type 2, chlamydia, trichomoniasis, Human Papilloma Virus, gonorrhea. The other causes include allergy to spermicides, condom latex, cervical cap or diaphragm, tampons.1
Diagnostic Tests For Cervicitis
The diagnosis of cervicitis is important as it may also mimic other conditions of vagina. Screening for cervicitis is necessary as it may go undiagnosed. If left undiagnosed it may lead to pelvic inflammatory disease. The risk is high in women in the age group 15- 25 years, inconsistent condom use, multiple sexual relationships, previous history of STDs
Diagnostic tests for cervicitis includes the following investigations to confirm the diagnosis of cervicitis.
- Bimanual Pelvic Examination: The doctor inserts gloved finger into the vagina and this helps in diagnosis of abnormalities of cervix and vagina. This is one of the basic tests done for screening for cervicitis.
- PAP Smear Test: The doctor removes the swabs from the cells of the cervix and vagina and laboratory testing is done to detect abnormalities. This is the most popularly done test as a part of screening for cervicitis.
- Cervical Biopsy: The biopsy specimen is removed with the help of a colposcope and the examination of the biopsy specimen is conducted to detect the abnormalities.
- Cervical Discharge Culture: The vaginal discharge is sent for culture to diagnose the presence of yeast infections (Candidiasis, Vaginosis, Trichomoniasis).2
Pap Smear Test:
This is one of the screening procedures or diagnostics tests for cervical cancer and also detects the precancerous as well as cancerous cells on the cervix. Hence, it is commonly also performed as screening for cervicitis. It is recommended for all women who are sexually active and more often in women who have a weak immune system.
The PAP smear test is advised every 3 years in sexually active women.
The following precautions to be taken before PAP smear test:
- Avoid sexual intercourse, douching, spermicidal agents
- Inform the doctor if menstruating; it is better to schedule the Pap smear test after menstruation.
- Please inform if pregnant as well to the doctor.
Procedure of PAP Smear Test:
To perform the PAP smear test, the women lies down in lithotomy position. The doctor inserts speculum into the vagina and the cervix is accessible for removal of cells from the walls of cervix. The sample can be obtained by various ways namely by using spatula, spatula and a brush, cytobrush. The cells scraped will be preserved and sent to lab for analysis. There may be mild discomfort due to scraping.
Results of PAP Smear Test:
Normal: The normal morphology is found and no abnormal cells were detected.
Abnormal: There might me precancerous or cancerous cells detected. The abnormal cells can be –atypia, mild/moderate/severe dysplasia, carcinoma in situ.
Follow up on PAP Smear Test
The follow up is based on the test results. If abnormal cells are found, then the cervical biopsy may be advised for a confirmatory diagnosis, follow up, and treatment of the condition.2
These diagnostic tests help in screening and diagnosing cervical conditions. Screening for cervicitis helps to identify any abnormalities so that appropriate treatment can be planned. It is important to follow medical advice and continue with follow-up or treatment, as advised.