Study of PAP smear examination in patients complaining of leucorrhoea - A 2 years prospective study in a teaching hospital

Background: Leucorrhoea is the clinical evidence of infection and can be treated satisfactorily whenever diagnosed. Occurrence of cervical cancer associated with discharge/leucorrhoea can be easily prevented if detected early. Majority of patients attending hospital present with varying degree of vaginal discharge and cytological monitoring of these subjects is mandatory to know any cellular changes in the cervical epithelium as well as the presence of any sexually transmitted diseases (STD’s) in the genital tract. Materials and methods: This research study was done at Malla Reddy Institute of Medical Sciences (MRIMS), Suraram, Hyderabad, Telangana State, India for a period of 2 years. A total of 500 cases were included in the study with women of age ranging from 20-50 years, complaining of Leucorrhoea. As told by the patients on questioning as a part of clinical history, the Leucorrhoea was found to be of different types white discharge, yellowish discharge, greenish discharge; blood stained and fouls smelling discharge. Smears were taken with a thorough history in particular reference to age at first child birth, parity, personal and genital hygiene, history of husband suffering from any sexually transmitted diseases, vaginal discharge, mass per vaginum, duration of labour and history of sexually transmitted diseases were elicited. Results: In our study of 500 cases, 348 (69.6 %) cases showed reactive cellular changes associated with repair (Inflammatory smear), 56 (11.2%) cases were due to various infectious agents, 32 cases (6.4%) were of Reactive changes with Atrophic vaginitis, Low grade squamous intraepithelial lesion (LSIL) 18 cases (3.6%), High grade squamous intraepithelial lesion (HSIL) 5 cases (1%), Atypical squamous cells of undetermined significance (ASCUS) 4 cases (0.8%), Atypical glandular hyperplasia 4 cases (0.8%),Suspicious of malignancy 9 cases (1.8%),Shift in flora suggesting Bacterial vaginosis 7 cases (1.4%), Normal smear/ Normal study 13 cases (2.6%) ,Unsatisfactory for evaluation as more than 75 % of smear is obscured by blood ? 4 cases (0.8%). Conclusion: A Pap test (Pap smear) is a quick and simple test that checks for changes to the cells of your cervix that may lead to cervical cancer. Pap smear reduces the mortality and morbidity with cervical cancer. This cytological screening should gain much popularity and should be accessible to all. It is recommended as part of routine medical examination in gynecological practice.