CHAPTER 160 Wet Smear and KOH Preparation
Abnormal vaginal discharge is a common complaint. In fact, vaginitis is the most common gynecologic diagnosis in primary care. Vulvovaginal candidiasis (VVC), bacterial vaginosis (BV), and trichomoniasis (trich) account for over 90% of abnormal vulvovaginal symptoms and discharge. Frequently, several pathogens may coexist. Office-based wet smear, potassium hydroxide (KOH) preparation, and vaginal secretion pH should be used to ensure a more accurate diagnosis and effective treatment of vaginitis. Empiric treatment for vulvovaginal symptoms including vaginal discharge should be avoided until appropriate testing is performed making a specific diagnosis.
Obtaining vaginal or vulvar samples to determine the cause of vulvovaginal symptoms and discharge requires familiarization with lower female genital anatomy and the basic skills of pelvic examination. Chapter 137, Colposcopic Examination, and Chapter 151, Pap Smear and Related Techniques for Cervical Cancer Screening, review the anatomy and basic steps of the pelvic examination.