Clinical and Morphological Diagnosis and Treatment of Sexually Transmitted Diseases - Yakimova, T. P. 2007

Methods of Biomaterial Collection for Cytological Examination

Proper diagnostic verification relies heavily on collecting adequate specimens, as poorly collected biomaterial is often uninformative. Processing such samples still consumes time, stains, fixatives, and Glass slides, which diminishes the cytologist's workflow efficiency and incurs financial costs—while ultimately failing to achieve the diagnostic objective. Inadequate examinations typically stem from factors such as improper sample collection, faulty smear Preparation and Staining, or insufficient cytological expertise.

First and foremost, specimens for Cytological examination must be collected by a qualified professional. It is essential that the patient undergoes no therapeutic Procedures prior to collection. Specifically, patients should avoid vaginal douches, insertion of suppositories or ointments, and sexual intercourse; furthermore, at least 3 to 4 hours must elapse after urination or defecation before the Procedure.

Specimens are collected using an Ayre spatula, a Volkmann spoon, a cotton-tipped applicator moistened in saline, or a cytological brush. The most informative smears are obtained using an Ayre spatula and a brush. Disposable plastic brushes with spiral-arranged nylon bristles at the tip are the most convenient, yielding specimens exceptionally rich in cellular elements. These brushes facilitate the collection of adequate material from the vaginal walls, the cervix, and the endocervical canal alike. Vaginal smears are collected from the posterior or lateral fornices. Smears from the Urethra and endocervical canal are taken only after clearing their orifices of loose mucous or purulent discharge.

Following collection, proper smear preparation, thorough fixation, and staining are critical. Thick smears and clumped tissue fragments hinder the microscopic examination and Classification of cellular elements. Conversely, excessive or careless and rapid spreading damages the Cells. Inadequate fixation prevents proper staining of the cellular material, which complicates or sometimes entirely precludes the identification of cellular and non-cellular structures.

Among Sexually Transmitted Infections, the greatest clinical significance is attributed to “new-generation” infections, which were previously not as frequently recorded as they are today. These include Gardnerellosis, mobiluncus infection, human papillomavirus (HPV) infection, Herpes simplex virus infection, chlamydia, and others.

Traditional sexually transmitted infections, such as Gonorrhea, Trichomoniasis, and candidiasis, also remain highly relevant in the clinical practice of dermatovenerologists, gynecologists, and oncologists.