Value of wet mount and cervical cultures at the time of cervical cytology in asymptomatic women

Abstract

To correlate Papanicolaou smear findings with the wet mount and cervical culture results in asymptomatic patients, and to review the value of doing wet mount and/or cervical cultures in these patients at the time of Papanicolaou smear. Asymptomatic women presenting for routine Papanicolaou smears at Sinai Samaritan Medical Center, Milwaukee, Wisconsin, between January 1991 and January 1994 were studied by preparing wet mount (saline and potassium hydroxide preparations) and cervical cultures for Chlamydia trachomatis and Neisseria gonorrhoeae at the same visit. Fisher exact test and Pearson chi 2 statistics were applied. Nine hundred sixty-three patients were studied. Nearly 50% of our asymptomatic young urban women had a vaginal and/or cervical infection. Papanicolaou smears with inflammation were associated with bacterial vaginosis (P < .0001), excess white blood cells (P < .0001), trichomoniasis (P < .0001), abnormal wet mounts in general (P < .0001), and positive cervical cultures for C trachomatis and/or N gonorrhoeae (P < .001). Papanicolaou smears showing atypical cells of undetermined significance were associated with bacterial vaginosis (P < .001) and abnormal wet mounts in general (P < .03). Seventy-five percent of patients with positive cervical cultures had abnormal wet mounts. Eighty-three percent of the patients whose initial Papanicolaou smear showed inflammation and whose initial wet mount was abnormal had a normal Papanicolaou smear when the wet mount became normal. Preparing wet mounts at the time of Papanicolaou smear in asymptomatic young urban women will help in the interpretation of minimally abnormal smears and will probably decrease the need for repeat smears and colposcopy. Simultaneous cervical cultures would not add much information for such interpretation.