Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 412-416, December 2008

Diagnosis of Human Papillomavirus Infection by Abnormal Cervical Cytology is Highly Reproducible After Vaginal Douching

  • Fang-Chun Chen

      Affiliations

    • Department of Family Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
    • ,
  • Sheng-Wen Shaw

      Affiliations

    • Department of Family Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • ,
  • Po-Jen Cheng

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • Swei Hsueh

      Affiliations

    • Department of Pathology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • ,
  • Cheng-Tao Lin

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Cheng-Tao Lin, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Shin Street, Kueishan, Taoyuan 333, Taiwan

Accepted 7 March 2008.

Article Outline

SUMMARY 

Objective

To evaluate whether human papillomavirus (HPV) activity in symptomatic patients with abnormal Papanicolaou smears (minimal abnormal cytology) was affected by a complete vaginal douche, applied to the cervix prior to colposcopic examination.

Materials and Methods

A total of 132 women with abnormal Papanicolaou smears were prospectively registered in this study from 1999 to 2004. Two specimens were collected from each patient; one before and one after the cervix was swabbed with a complete vaginal douche during a colposcopic examination. We compared the HPV detection results before and after douching in the same patients. The samples were analyzed using the Hybrid Capture II assay.

Results

Before douching, 57.6% (76/132) of the samples were HPV-positive, compared with 58.3% (77/132) of the samples after douching. There was a strong correlation between the cervical HPV detection rates between the before and after douche samples (p < 0.001). The kappa statistic was 0.891 for the correlation (positive– positive, negative–negative) and the discrepancy (positive–negative) between the inter-douche rates of HPV activity. A comparison of the HPV assay before and after vaginal douching demonstrated a statistically significant relationship (p < 0.001). The sensitivity of the HPV test after douching was higher (97.8%) than that before douching (95.6%). The false-negative rate before douching in women with inflammatory smears was 3% (4/132) and the false-positive rate before douching in women with atypical squamous cells of undetermined significance was 2.1% (3/132).

Conclusion

Our results indicate that self-administration of a vaginal douche is not a reliable method of eradicating HPV infection.

Key Words:  human papillomavirus , Papanicolaou smear , vaginal douche

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PII: S1028-4559(09)60008-5

doi:10.1016/S1028-4559(09)60008-5

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 412-416, December 2008

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