The management of patients with inflammatory smear results in general practice. C M Bates
Department of Genito-Urinary Medicine, Arrowe Park Hospital, Wirral, Merseyside.
Abstract
OBJECT--To ascertain the management of inflammatory smear results by general practitioners. DESIGN--Postal questionnaire survey. SUBJECTS--All 200 general practitioners on Wirral Family Health Services Authority list as principals in 1990 and 1991. MAIN OUTCOME MEASURES--Answers to questions covering a variety of aspects concerning the management of inflammatory smear results in general practice. RESULTS--One hundred and thirteen (57%) replied. Ninety per cent have facilities to test for Trichomonas vaginalis and Candida albicans. Sixty eight per cent were able to test for Chlamydia trachomatis. A high vaginal swab (HVS) was the commonest swab taken (88%); 31% of doctors included a swab for Chlamydia trachomatis. Of doctors who gave treatment without microbiological confirmation 74% gave metronidazole and 64% gave tetracycline or erythromycin. Eighty five per cent repeat smears are undertaken within three months. Ninety seven per cent of doctors said more detailed information would be helpful on the cytology report. One hundred per cent of doctors referred to a gynaecologist of colposcopy was advised. Male sexual partners were advised to attend the Department of Genitourinary Medicine by 12% of doctors (70% do not refer to either their general practitioner or genitourinary department). CONCLUSION--Most patients with inflammatory smear results are managed by their general practitioner without reference to specialist services. Many patients are not investigated for infection but treatment often includes medication which covers the most likely or potentially serious genital pathogens. More detailed advice given with the cytology report on further management or a local protocol would be helpful to aid management in this difficult area. If recommendations for referral of certain groups of patients to genitourinary departments were implemented the present workload of the department would be increased.
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Selected References
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- Wilson JD, Robinson AJ, Kinghorn SA, Hicks DA. Implications of inflammatory changes on cervical cytology. BMJ. 1990 Mar 10;300(6725):638–640. [PMC free article] [PubMed]
- Wilson JD, Robinson AJ, Kinghorn SA, Hicks DA. Implications of inflammatory changes on cervical cytology. BMJ. 1990 Mar 10;300(6725):638–640. [PMC free article] [PubMed]
- Carne CA, Dockerty G. Genital warts: need to screen for coinfection. BMJ. 1990 Feb 17;300(6722):459–459. [PMC free article] [PubMed]
- Carne CA, Dockerty G. Genital warts: need to screen for coinfection. BMJ. 1990 Feb 17;300(6722):459. [PMC free article] [PubMed]
- Werness BA. Cytopathology of sexually transmitted disease. Clin Lab Med. 1989 Sep;9(3):559–572. [PubMed]
- Sekhri A, Le Faou AE, Tardieu JC, Antz M, Fabre M. What can be expected from the cytologic examination of cervicovaginal smears for the diagnosis of Chlamydia trachomatis infections? Acta Cytol. 1988 Nov–Dec;32(6):805–810. [PubMed]
- Ghirardini C, Boselli F, Messi P, Rivasi F, Trentini GP. Chlamydia trachomatis infections in asymptomatic women. Results of a study employing different staining techniques. Acta Cytol. 1989 Jan–Feb;33(1):115–119. [PubMed]
- Arroyo G, Linnemann C, Wesseler T. Role of the Papanicolaou smear in diagnosis of chlamydial infections. Sex Transm Dis. 1989 Jan–Mar;16(1):11–14. [PubMed]
- Kelly BA, Black AS. The inflammatory cervical smear: a study in general practice. Br J Gen Pract. 1990 Jun;40(335):238–240. [PMC free article] [PubMed]
- Kelly BA, Black AS. The inflammatory cervical smear: a study in general practice. Br J Gen Pract. 1990 Jun;40(335):238–240. [PMC free article] [PubMed]
- Avonts D, Sercu M, Heyerick P, Vandermeeren I, Piot P. Sexually transmitted diseases and Chlamydia trachomatis in women consulting for contraception. J R Coll Gen Pract. 1989 Oct;39(327):418–420. [PMC free article] [PubMed]
- Avonts D, Sercu M, Heyerick P, Vandermeeren I, Piot P. Sexually transmitted diseases and Chlamydia trachomatis in women consulting for contraception. J R Coll Gen Pract. 1989 Oct;39(327):418–420. [PMC free article] [PubMed]
- Macaulay ME, Riordan T, James JM, Leventhall PA, Morris EM, Neal BR, Ellis DA. A prospective study of genital infections in a family-planning clinic. 2. Chlamydia infection--the identification of a high-risk group. Epidemiol Infect. 1990 Feb;104(1):55–61. [PMC free article] [PubMed]
- Macaulay ME, Riordan T, James JM, Leventhall PA, Morris EM, Neal BR, Ellis DA. A prospective study of genital infections in a family-planning clinic. 2. Chlamydia infection--the identification of a high-risk group. Epidemiol Infect. 1990 Feb;104(1):55–61. [PMC free article] [PubMed]
- Malotte CK, Wiesmeier E, Gelineau KJ. Screening for chlamydial cervicitis in a sexually active university population. Am J Public Health. 1990 Apr;80(4):469–471. [PMC free article] [PubMed]
- Malotte CK, Wiesmeier E, Gelineau KJ. Screening for chlamydial cervicitis in a sexually active university population. Am J Public Health. 1990 Apr;80(4):469–471. [PMC free article] [PubMed]
- Livesley B. Running out of staff for the NHS. BMJ. 1989 Jul 1;299(6690):1–2. [PMC free article] [PubMed]
- Livesley B. Running out of staff for the NHS. BMJ. 1989 Jul 1;299(6690):1–2. [PMC free article] [PubMed]
- Singer A. The abnormal cervical smear. Br Med J (Clin Res Ed) 1986 Dec 13;293(6561):1551–1556. [PMC free article] [PubMed]
- Singer A. The abnormal cervical smear. Br Med J (Clin Res Ed) 1986 Dec 13;293(6561):1551–1556. [PMC free article] [PubMed]
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