Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

  • P. Vieira-Baptista
  • J. Lima-Silva
  • C. Pinto
  • C. Saldanha
  • J. Beires
  • J. Martinez-de-Oliveira
  • G. Donders
Original Article
First Online:
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Accepted:

Abstract

The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas© HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 ± 10.65 years (range 21–75). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs. 13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal milieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.

Keywords

Cervical Intraepithelial Neoplasia Bacterial Vaginosis Human Papilloma Virus Infection Aerobic Vaginitis Lactobacillary Grade 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Compliance with ethical standards

No funding or sponsorship was received by the authors for this research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Gynecology and ObstetricsCentro Hospitalar de São JoãoPortoPortugal
  2. 2.LAP—Laboratório de Anatomia Patológica, UnilabsPortoPortugal
  3. 3.Faculty of Health SciencesUniversity of Beira InteriorCovilhãPortugal
  4. 4.Department of Children and Women’s HealthCentro Hospitalar da Cova da BeiraCovilhãPortugal
  5. 5.Department of Obstetrics and GynecologyUniversity Hospital AntwerpAntwerpBelgium
  6. 6.Femicare Clinical Research for WomenTienenBelgium

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