{{Short description|Gynecologic test}} [[File:Vaginal wet mount of candidal vulvovaginitis.jpg|thumb|Vaginal wet mount showing slings of pseudohyphae of ''[[Candida albicans]]'' surrounded by round vaginal epithelial cells, conferring a diagnosis of [[candidal vulvovaginitis]].]] A '''vaginal wet mount''' (or '''vaginal smear'''<ref name=webmd>[http://women.webmd.com/vaginal-wet-mount WebMD - Vaginal Wet Mount] {{Webarchive|url=https://web.archive.org/web/20140208101116/http://women.webmd.com/vaginal-wet-mount |date=2014-02-08 }} Last Updated: July 15, 2008</ref> or '''wet prep'''<ref>{{Cite web|last=Vorvick|first=Linda J.|title=Vaginitis test - wet mount: MedlinePlus Medical Encyclopedia|url=https://medlineplus.gov/ency/article/003916.htm|access-date=20 November 2020|website=medlineplus.gov|language=en}}. Last updated 7 November 2019</ref>) is a [[gynecology|gynecologic]] test wherein a sample of [[vaginal discharge]] is observed by [[wet mount]] microscopy by placing the specimen on a glass slide and mixing with a salt solution.<ref name=webmd/> It is used to find the cause of [[vaginitis]] and [[vulvitis]].<ref name=Frob2015>{{Cite journal|last1=Frobenius|first1=W.|last2=Bogdan|first2=C.|date=April 2015|title=Diagnostic Value of Vaginal Discharge, Wet Mount and Vaginal pH – An Update on the Basics of Gynecologic Infectiology|journal=Geburtshilfe und Frauenheilkunde|volume=75|issue=4|pages=355–366|doi=10.1055/s-0035-1545909|issn=0016-5751|pmc=4437757|pmid=26028693}}</ref>
==Applications== Vaginal wet mounts are used in case of vaginitis symptoms such as vaginal itching, burning, rash, odor, or discharge. It may assist in suspicion of [[vaginal yeast infection]], [[trichomoniasis]] and [[bacterial vaginosis]].{{cn|date=June 2021}}
Infections such as [[Chlamydia infection|chlamydia]], [[genital warts]], [[syphilis]], [[herpes simplex]], and [[gonorrhea]] can also affect the vagina, but these diseases are found by doing other tests.<ref name=webmd/>
It may also be used in a [[rape investigation]] to detect presence of [[semen]].{{cn|date=June 2021}}
==Method==
Vaginal wet mounts are not done during the menstrual period, because menstrual blood on the slide can confound the results. [[Vaginal irrigation]], tampon use or sex (potentially disrupting the vaginal [[pH]]) should be avoided for 24 hours before the test. Vaginal medicines (such as a nonprescription vaginal yeast medicine) should not be used during the 2 to 3 days before the test.<ref name=webmd/>
The sampling is done with the patient in [[lithotomy position]]. A [[Speculum (medical)|speculum]] is used to facilitate use of a swab or spatula to sample fluid inside the vagina. The sampling procedure may cause some discomfort and minor bleeding, but otherwise there are no associated risks. The sample is then smeared upon a [[microscope slide]] and is observed by [[wet mount]] microscopy by placing the specimen on a glass slide and mixing with a salt solution.<ref name=webmd/>
==Interpretation== Normally, no yeast or trichomonas are found on the slide. White blood cells and [[clue cell]]s are normally absent or very low in number.<ref name=webmd/>
Symptoms of infections able to be diagnosed by wet mount: * A vaginal [[yeast infection]] often causes a white, lumpy discharge that looks like cottage cheese.<ref name=webmd/> :*diagnosis is made if pseudohyphae or yeast buds are present (these are visible only 50% of the time) * [[Trichomoniasis]] causes a vaginal discharge that is yellow-green, foamy, and bad-smelling.<ref name=webmd/> :*Diagnosis is made if mobile trichomonads are visible on the slide [[File:Vaginal wet mount with clue cell - annotated.png|thumb|A vaginal wet mount with a [[clue cell]], indicating [[bacterial vaginosis]].]] * [[Bacterial vaginosis]] generally produces a vaginal discharge that is thin and milky with a fishy odor.<ref name=webmd/>
:*Diagnosis is made using Amsel Criteria - three of the four following criteria must be met: ::*>20% of the epithelial cells are clue cells (the single most reliable predictor)<ref>{{Cite journal|last1=Eschenbach|first1=D. A.|last2=Hillier|first2=S.|last3=Critchlow|first3=C.|last4=Stevens|first4=C.|last5=DeRouen|first5=T.|last6=Holmes|first6=K. K.|date=April 1988|title=Diagnosis and clinical manifestations of bacterial vaginosis|journal=American Journal of Obstetrics and Gynecology|volume=158|issue=4|pages=819–828|issn=0002-9378|pmid=3259075|doi=10.1016/0002-9378(88)90078-6}}</ref> ::*Discharge is thin and homogeneous ::*Sample smells fishy when mixed with potassium hydroxide ("whiff test") ::*Vaginal pH is >4.5
Furthermore, presence of [[white blood cells]] is a general sign of infection.<ref name=webmd/>
==Concomitant vaginal discharge tests== A vaginal discharge sample wet mount is often also used for the following additional tests:
* [[KOH test|KOH slide]]. A sample of the vaginal discharge is placed on a slide and mixed with a solution of [[potassium hydroxide]] (KOH). The KOH kills bacteria and cells from the vagina, leaving only yeast for easier detection of a yeast infection. Several drops of a potassium hydroxide (KOH) solution may also be added to a sample of the vaginal discharge to test for any resultant strong fishy odor from the mix, which would indicate bacterial vaginosis. The latter procedure is called a ''Whiff test''.<ref name=webmd/> * Vaginal pH test. The normal vaginal pH is 3.8 to 4.5. Bacterial vaginosis, trichomoniasis, and atrophic vaginitis often cause a vaginal pH higher than 4.5.<ref name=webmd/>
If indicated, the sample can also be used for: * Detecting [[atrophic vaginitis]] by additional staining.<ref name=webmd/> * [[Vaginal culture]], to see if bacteria or yeast will grow.<ref name=webmd/>
==See also== * [[Pap smear]]
==References== {{reflist}}
{{Female genital procedures}} {{Clinical microbiology techniques}} {{DEFAULTSORT:Vaginal Wet Mount}} [[Category:Female genital procedures]]