Microscopic (bacterioscopic) examination of a Gram-stained smear (Gram Stain. Bacterioscopic examination of different smears)

At each visit to the gynecologist, the doctor takes a swab from the women's urethra. A similar procedure is necessary to study the cells present in the urinary system.

A smear makes it possible to identify the course of pathological processes at the initial stage. The procedure for taking a sample of microflora is not accompanied by pain.

A smear from the urethra should be taken once every 6 months, during a routine visit to the gynecologist. The article will talk about how a smear is taken, what the test shows and how it is interpreted.

Diagnostic value

A male urethral analysis, like a female one, is called a smear. It involves collecting cells from the canal walls, which are then subjected to laboratory testing. Often a regular smear is enough, but to identify chlamydia and a number of other pathogens, a scraping is done on the tank.

The study reveals:

• venereal disease;
• viral pathology;
• nonspecific infection;
• form of the disease (acute or chronic).

Examination of a smear from the urethra allows you to identify an infection and clarify the type of pathogen. Based on these data, competent treatment is selected.

Microscopic examination of a smear allows you to determine the type and number of microorganisms. Also, during this study, their resistance to antibiotics is established. In addition to smear microscopy, men are prescribed a study of prostate juice, and women are prescribed an analysis of biomaterial from the walls of the vagina and uterine cervix.

Analysis for bacterial culture: features

Human organs that come into contact with the external environment have a special microflora. This is a whole set of pathogenic and rather dangerous microorganisms, the number of which should not exceed normal levels.

Their ratio changes if an infection enters the body or inflammation develops.

A smear or bacterial culture test is a bacteriological method for studying seized biomaterial.

The main advantages of this method are high efficiency and simplicity. During the test, discharge is collected from the mucous membrane. Next, the biomaterial is stained or treated with a saline solution for further study under a microscope and inoculated in a special nutrient medium while maintaining the basic requirements.

After submitting the biomaterial, fungi, bacteria and simple microorganisms can be identified, although determining their type is much more difficult. Such analyzes help to find out about the number of microorganisms, their shape and location. Thanks to this, it becomes possible to identify even hidden infections and diseases, assess the condition of organs and systems, and find out about the presence of inflammation.

Bacterial culture is a fairly accurate analysis that shows the proportional ratio of microorganisms and their sensitivity to certain medications.

Indications

Taking a smear of the flora from the urethra in men is prescribed when the following symptoms bother you:

• discharge;
• burning, pain in the urinary canal;
• difficulty, frequent urination;
• blood in urine;
• unpleasant smell of urine.

If a man does not go for routine examinations to a urologist, urinary problems should be a signal that he should visit a specialist who will take a smear.

Since the canal is wider and shorter in women, inflammation spreads more quickly to the bladder. Abdominal pain and colic are often added to the list of symptoms. In case of infectious diseases, the temperature rises to a maximum of 38 degrees.

Taking a smear from the urethra is necessary in case of infection of the bladder, canal, or kidneys. The analysis is also carried out to assess the effectiveness of therapy when planning pregnancy, as part of a comprehensive examination before surgery.

What to do if the tests are bad

A microscopic examination of a smear can show the number of leukocytes, red blood cells and squamous epithelium. Also the presence of pus, bacteria, mucus and pathogenic microorganisms, the state of the urethral microflora. The smear is deciphered by the attending doctor. After treatment, the smear is taken again.

If a microscopic examination of the discharge of the genitourinary organs reveals the presence of an infectious disease, it is necessary to begin supervision. Delay in treatment leads to complications and the disease becoming chronic. The acute phase of inflammation of the genitourinary area has a short period. Then the disease passes into the stage of imaginary relief.

DETAILS: Urological diseases in men and women: symptoms, treatment

In the laboratory, the doctor places the material on a special laboratory glass and examines it under a microscope. Such a study will help detect the simplest microorganisms. For example, this is how trichomoniasis is detected. Everything else that is contained in the smear is motionless, and only Trichomonas actively move. Therefore, to identify this disease, smear analysis is very important.

For further research, the biomaterial is securely fixed on medical glass. This is done for the purpose of high-quality staining for further use.

The smear analysis is carried out on a colored material, since otherwise it is impossible to detect any foreign elements - everything looks as if transparent glass was placed on another of the same kind.

Glass with smears is painted with special dyes that make it possible to distinguish bacteria in the material under study and all its cells. The dyes used are not the same. They are selected according to what the smear test is being done for. In one case, the analysis is carried out for microflora, in the other - for cytology. And the dyes used in these cases are completely different.

The analysis technique is designed so that cells react differently to different dyes. Colored elements that were previously invisible become visible and accessible for study. The collected material is deciphered.

If it is necessary to identify inflammatory diseases, the biomaterial is examined under a microscope with 900x magnification. The results are studied, analyzed and deciphered. And then a diagnosis is made and treatment is prescribed.

The smear taken contains various cells and a certain number of microorganisms. After reviewing the analyzed results, you should understand what is normal and what signals a developing pathology in the body.

They are necessarily present in the urinary canal of all healthy men. Their norm is up to 5 units. An increased amount of them should alert the attending physician, since there may be an infection in the body in the form of prostatitis or urethritis.

Inside the urethra there is epithelium. Its cells are found in the analyzed biomaterial. Their norm is from 5 to 10 pieces. If the transcript shows a large number of them, then the man may have various inflammations of the genitourinary area.

Mucus is another component of the smear. Like the other components, any healthy man must have it. Its excess indicates the presence of an infectious disease.

Various cocci (strepto-entero- and staphylo-) are microbes that can cause disease or may not cause harm to health. They are necessarily present in the microflora of a healthy body, but their quantity is limited. Their excess may serve as evidence that the body is affected by urethritis or another disease.

But gonococci should be completely absent in a healthy man. If they are present, we can safely say that the patient has gonorrhea. The same can be said about Trichomonas. They are a mandatory component of a smear of a patient with trichomoniasis.

If decoding the analysis upset a man, then the first thing you need to do is pull yourself together and discard negative emotions. It is necessary to consider further actions, the main one of which is treatment. Negative emotions can provoke the patient to want to abandon the problem. For example, some are in no hurry to visit a doctor, and this is fraught with consequences in the future.

If the patient tries to run away from the problem, then he should know that complications will arise in the near future. The disease will begin to develop, become chronic over time, and lead to undesirable consequences. This is prostatitis, possible infertility, impotence and much more.

DETAILS: Center for Women's Urology at the EMC Urological Clinic. Female urologist in Moscow. Make an appointment.

Inflammatory diseases of the genitourinary area in the acute phase last a very short time. Then they turn into a chronic form and take on a sluggish nature of manifestation. Almost no clinical signs are observed. Meanwhile, the harmful microbe ends up in the prostate, getting there from the urination canal.

Therefore, you should not think that if there are no symptoms, there is no disease, and the smear results are incorrect. It is imperative to visit a doctor and think with him about how to proceed further and how to start treatment.

A urethral smear is prescribed by the attending physician and will be performed when the patient has:

• past infectious diseases;
• inflammatory processes of the urinary system;
• disturbed by discharge with an unpleasant odor;
• there is itching of the genitals;
• pain when urinating;
• bothered by pain during sexual intercourse;
• suspicion of a sexually transmitted disease;
• prevention of chronic disease is necessary.

A smear is taken to identify:

• what is the composition of the flora;
• determining the presence of bacteria and microorganisms;
• are there fungi and parasites?
• determination of the number of leukocytes and epithelium.

Preparing for analysis

Rules on how to prepare for a study for women:

• Do not use antibiotics and antiseptics for 2 weeks;
• 3 days before the analysis, wash with water alone, without soap or other products;
• the day before your visit to the doctor, abstain from alcohol and sexual intercourse;
• 6 hours without washing, 3 hours without urinating.

To make the analysis more accurate, a urethral smear is taken from women a week after the end of menstruation. If the case is acute, the fence is carried out immediately.

Preparation for men also includes abstaining from alcohol and sexual intercourse for 1-2 days before the test, and not urinating for 3 hours before it. Genital hygiene should be carried out in the evening before the day when you are supposed to take a smear. Any medications can be taken only in consultation with a doctor.

Preparatory stage

A smear test is quite informative, but its results can be unreliable without proper preparation. You won't have to make any adjustments to your diet. It is allowed to drink water immediately before the analysis, but regular, non-carbonated water. Alcohol of any strength is prohibited due to its weak disinfectant effect.

It is advisable to refrain from heavy physical activity, including sports training, the day before the delivery of the biomaterial. When testing may be delayed:

• the patient feels unwell - weakness, drowsiness, physical fatigue;
• increased body temperature, including due to an infection occurring in the body;
• exacerbation of any chronic pathology;
• surges in blood pressure.

The effect of pharmacological drugs can distort test results. They will be affected by taking antibiotics, glucocorticosteroids, immunomodulators, immunosuppressants, and cytostatics. If it is not possible to interrupt the course of treatment, then before taking a smear, you need to inform your doctor about this. When decoding the data, he will take into account that the subject is undergoing drug treatment.

Useful information: Before collecting a smear from the vagina or urethra, wash the genitals with warm water and soap and dry. It is necessary to use products without fragrances or antibacterial additives.

Doctors recommend avoiding sexual intercourse two days before the examination, not douching, and not using hygienic tampons, vaginal suppositories, creams and gels. The optimal time to submit material for gonorrhea is the first 3-5 days after the end of your period or before it starts. But if there is an urgent need, a smear can be taken from women at other times of the cycle.

Procedure

The way a smear is taken for men is similar to the procedure for women. The technique is simple, the whole process lasts up to 2 minutes. Taking a smear of flora from the urethra in women is carried out in a gynecological chair, while men stand. A sterile thin applicator is inserted into the canal to a depth of 3-4 cm. Rotational movements are performed to collect more biomaterial. After taking a smear, the instrument is removed. The biomaterial is placed in a test tube and taken to the laboratory.

The method of taking a smear from the urethra in men differs in that sometimes they massage the urethra to increase sensitivity to the analysis. This may be necessary to more accurately identify hidden infections. Sometimes a culture sample from the urethra is taken from men along with prostate massage. Her juice enters the urethra and is also examined.

For infectious diseases, the smear is examined using the PCR (polymerase chain reaction) method to determine the presence and number of pathogens. The taken material is applied to glass, dried and stained, and then the reaction of the particles is studied under a microscope.

Whether it hurts to take a smear is an individual indicator. In women, the procedure is easier, which is due to the anatomy of the canal - it is wider and shorter. When a smear is taken from the urethra in men, the pain is stronger, but it is usually tolerable.

Severe pain indicates that the rules for taking a smear have been violated or that there is severe inflammation.

Urethral smear: how and why is it taken?

A smear from the urethra is one of the mandatory components of a urological examination. The purpose of taking a smear is to detect pathogenic microbes in the urinary tract, which are the causative agents of many unpleasant and dangerous diseases. Also, this manipulation in some inflammatory diseases (for example, cystitis) can allow you to select the most effective medicine for a particular case.

Despite the necessity of such a procedure, many are afraid of it. Often - due to ignorance of its essence. What is a urethral smear? Does it hurt? These questions are often asked in the urologist's office. So why not find out about the upcoming procedure in advance so that you can go for the test without any fear?

So, let's talk about taking a smear in more detail. This procedure takes very little time, so the patient will not have to endure hellish torment for several hours in any case. As the name suggests, a urethral swab is taken from the urethra. The urologist inserts a special probe or Volkmann spoon into it to a depth of two to three centimeters and scrapes one of the walls of the canal. Of course, this procedure can be very unpleasant for the patient and even painful, but the discomfort will quickly pass. A smear from the urethra is taken in exactly the same way for men and women.

After taking a smear, the doctor places it on a glass slide and examines it under a microscope. As a rule, to facilitate study, it is painted with special dyes.

A smear from the urethra contains a large amount of valuable information that can help the doctor identify at an early stage diseases such as prostatitis, cystitis, urethritis, trichomoniasis, gonorrhea, ureaplamoz, chlamydia, infections caused by candida, gonococcus and trichomonas, as well as disorders of the vaginal microflora .

Like any other analysis, a urethral smear has its normal values. Thus, normally there may be leukocytes (up to five in the field of view), epithelial cells (from five to ten), mucus (in small quantities), as well as cocci (single), red blood cells (up to two). But bacteria, gonococci, key cells, trichomonas, candida, sperm and lipoid bodies should be absent.

It is recommended to take a urethral smear for analysis regularly, during preventive examinations, however, there are situations when it is advisable to do the analysis immediately. Thus, it is not recommended to wait for a general examination when planning pregnancy or at the beginning. In addition, you should immediately consult a doctor if you experience pain and discomfort during urination and sexual intercourse, as well as frequent urination and urethral discharge.

It should be borne in mind that before taking a urethral smear, you must stop taking medications for one to two weeks (if this is not possible, it is advisable to at least give up antibiotics or postpone the test). One day before the examination, you need to abstain from sexual intercourse, and it is advisable not to urinate 2-3 hours before the examination.

It is best to go for this test in the morning; the day before, the genitals must be washed. If the patient does not tolerate painful procedures well, he needs to warn the doctor about this - then the smear will be taken in a horizontal position.

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results

The smear analysis is deciphered in the laboratory. Doctors note that culture from the urethra shows the presence of bacteria, viruses, and fungi. Based on these data, it is established that a person is sick with urethritis, cystitis or pyelonephritis if the kidneys are infected.

There are standards for bacterial culture indicators, and they are almost the same for both sexes:

1. Leukocytes – 0-5 (in the vagina – up to 10).
2. Epithelium – 5-10.
3. Red blood cells – 0-2.
4. Gonococci, Trichomonas – 0.
5. Yeast – 0 (in the vagina – little).
6. Mucus – 0 (a small amount is possible in the vagina).

Decoding the analysis allows you to get a picture of infectious pathology and the functioning of the immune system. The presence of dysbacteriosis in the body is also established.

Leukocytes

The norm of leukocytes in women in the urethra is from 0 to 5, as in men. If the indicator is exceeded, there is inflammation. It is important to study the types of leukocytes in more detail, and then understand what this means. If they are represented mainly by neutrophils, the inflammation is acute; if they are lymphocytes, then this is allergic urethritis.

Epithelium

An increased rate of epithelial cells indicates their detachment from the urethral mucosa. This is a consequence of inflammation and an indication of chronic urethritis. Many squamous epithelial cells along with an increased number of red blood cells are signs of a tumor, ulcer or injury to the urinary canal. If there are few epithelial cells, urethral leukoplakia is possible.

Flat epithelium

If, when examining biological material, there are no more than 10 cells in the field of view, then everything is fine. This indicator is always present in the smear, since these cells are regularly updated.

If it is present in large quantities, more than ten in the field of view, then such an increase in the number of epithelial cells is a sign of the presence of inflammatory processes in the vagina.

If squamous epithelium is not detected at all, it can be assumed that the woman has a hormonal imbalance along with an insufficient amount of estrogen. This is considered an indirect symptom of atrophy of the vaginal mucosa.

Consequences and complications

In men, scraping from the urethra onto the tank causes more discomfort. There is a feeling of pain in the urethral opening during the procedure, but there should be no blood. Several hours after a smear taken from the urethra, there is pain and burning in the urinary canal. However, these sensations soon pass.

After an inaccurately taken smear in men, it is possible that urination problems may occur. Sometimes patients are in so much pain that they are afraid to go to the toilet. In such cases, local urological medications help, and you can also try urinating in warm water.

Bleeding after a smear and purulent discharge require immediate medical attention. Occasionally, an infectious disease becomes a complication, which should be treated with antibiotics.

Useful tips

Tip #1

It makes sense to take a smear test for gonorrhea and other sexually transmitted infections once a year if you have a regular partner, and every time after unprotected sex with a casual partner.

Tip #2

Sometimes bloody discharge occurs after a smear test. If they do not stop within several hours, then you should immediately contact a specialist.

Tip #3

A repeat analysis for the presence of gonorrhea pathogens is carried out in the same medical institution where the first study was performed, since the average value of a specific indicator, which is obtained during a mass examination of a healthy population, may vary among clinics. And this will cause a false interpretation of the data obtained.

Reviews about the procedure

More often, reviews are left by men, since the procedure causes more discomfort for them. Women usually feel little or no pain. However, after the analysis, all patients complain of discomfort when urinating.

Oleg: “I had a general smear test at Invitro. It was painful, but tolerable, I thought it would be worse. They took it 4 times, inserted the applicator about 8 cm. I heard that it was painful to write after taking a smear, but it turned out to be true. I tried this under a hot shower. First he warmed the genitals, then he urinated. It helped a little, although there were still some stings.”

Evgeniya: “The gynecologist had virtually no unpleasant sensations. The disaster began already at home. When I tried to go to the toilet, I ended up crying in pain. I took painkillers and sat over a basin of hot water. It got better, but I still tried not to drink, so as not to have to run to the toilet again. By the end of the second day everything was finally back to normal.”