Gynecology tests in Kiev

It is worth remembering that a preventive examination by a gynecologist is extremely important and should be performed at least once a year and in the presence of complaints and certain symptoms more often.
There are many diseases of the genital system, which symptoms do not appear immediately, but over a long period of time if the patient does not seek medical attention in time, the disease is detected in the late stages.
Modern methods of laboratory tests help the doctor in the early diagnosis of diseases, their prevention and treatment.

In gynecology use the following tests:

• Microscopy of urogenital secretions - it is a test of a smear from the vagina and cervix with a microscope, that  allows to determine the nature of the microflora,  also helps in the diagnosis of some inflammatory diseases of the genital organs. The material is taken in two days after menstruation. Recommended to abstain from sexual intercourse, to exclude douching, treatment with vaginal suppositories two days before test. Material for the test - discharge from the vagina and cervical canal.
• Pap smear test is a test of a cervical and cervical canal smear that is used to screen for cervical cancer. In most countries of the world the PAP test is recommended every three years from the age of  21, but  if there are risk factors, this test should be done once a year.

Risk factors for cervical cancer include:

• smoking
• HIV infection
• low  immune system 
• using corticosteroids
• frequent change of sexual partners without the use of condoms
• cervical cancer in mother / grandmother / sister
• early sexual intercourse (up to 16 years)

At high risk of cervical cancer from the age of  30 recommended is combined test: PAP test + test for human papilloma virus (cotesting).
There are PAP test by traditional method and liquid cytology.
Researches have shown significantly higher sensitivity and specificity of the liquid PAP test compared to traditional.
Both methods allow to assess the morphological structure of cells and determine the nature of tumors of the cervix (benign, malignant, non-neoplastic lesions).

Preparation for cytology involves abstinence from sexual intercourse, exclusion of douching, treatment with vaginal suppositories two days before the visit to the doctor.

• Bacteriological test of urogenital secretion. This method allows to determine the state of the microflora of the vagina, helps to identify opportunistic and pathogenic organisms, vaginal dysbiosis and to detect the sensitivity of bacteria to certain antibiotics.Indications for this test are the patient's complaints from the genital system, urogenital infections, diagnosis of infertility.Before taking secretions from the vagina a patient should not use douching, vaginal suppositories,in two days before test to exclude sexual intercourse. During menstruation the test can't be perfomed.
• PCR diagnosis of sexually transmitted infections is a method of determining fragments of genetic material in the biological mediums, is the most accurate and fastest in the diagnosis of sexually transmitted infections. Prescribed in the presence of complaints in patients (changes in the nature of vaginal discharge, discomfort and itching, unpleasant odor of discharge, pain and discomfort during urinating). PCR method allows to detect in a woman's body opportunistic pathogens (Ureaplasma urealiticum, Ureaplasma parvum, Mycoplasma hominis, Candida, Gardnerella).

As additional tests that help confirm the diagnosis and are prescribed by a doctor according to the indications, use:

• General blood test. Preventively recommended to take once a year and in the presence of chronic diseases prescribed by a doctor.
• Tests of hormones in the blood is a laboratory method that helps to determine the state of a woman's reproductive health, carbohydrate metabolism,thyroid function.
• Rapid gonorrhea test is a test that allows you to quickly and efficiently detect the antigen of gonococcal infection.
• Type 1/2 HIV test - a rapi test for qualitative determination of antibodies in blood / serum.
• Ovarian tumor markers - use for early diagnosis of ovarian malignancies.

Cancer antigen Ca-125 is the most commonly used marker for the diagnosis of ovarian cancer and for assessing the risk of recurrence of malignant processes.

Tumor marker HE4 is a protein of the protease inhibitor family, can be used to help diagnose epithelial forms of ovarian and endometrial cancer and may be more sensitive than CA125.

Tumor markers measured using a blood test.

• Breast cancer markers Breast -  used for early detection of tumor recurrence and metastasis, control of disease treatment. Include Ca 15-3 and cancer-embryonic antigen. Material for the test - venous blood.

All additional tests are prescribed by the doctor based on individual anamnestic data and the general condition of the patient.

Researches:

• https://health-ua.com/ "Скринінг раку шийки матки: ПАП-тест, цитологія, ВПЛ-тест?"  Автори: О.А.Бурка, к. мед. н., доцент кафедри акушерства та гінекології № 1 Національного медичного університету ім. О. О. Богомольця, м. Київ. 2021.
• Программы скрининга: краткое руководство. ¬Повышение эффективности, максимальное увеличение пользы и минимизация вреда. [Screening programmes: a short guide. Increase effectiveness, maximize benefits and minimize harm], ВОЗ, 2020. 
• Human Papillomavirus and Related Diseases in Ukraine. Summary Report 17 June 2019.
• https://moz.gov.ua/article/health/Що таке ПАП-тест і чому його треба проходити кожній жінці. 2018.