Comparative Study of Pap smear and Colposcopic Findings in Patients Presenting with Vaginal Discharge Attending the Outpatient Department of a Tertiary Care Centre

Abstract

Background: Vaginal discharge is one of the most prevalent gynecological issues in outpatient settings. It can be associated with benign infections or malignant or premalignant cervical lesions. Early identification of cervical pathology is essential to preventing the development of invasive carcinoma in symptomatic women. The Papanicolaou (Pap) smear is a frequently used screening method, however colposcopy provides a magnified visual assessment of the cervical epithelium, allowing targeted scrutiny of troublesome areas.

Objectives: To assess how Pap smear cytology and colposcopic results relate to the detection of cervical epithelial abnormalities in women who have vaginal discharge.

Methods: This prospective comparison study was conducted at Darbhanga Medical College and Hospital's outpatient division of the Department of Obstetrics and Gynecology over an 11-month period. 110 women who reported vaginal discharge were included after the inclusion and exclusion criteria were applied. Following a Pap smear, each participant underwent a colposcopic examination. Conventional standards were used to document colposcopic impressions, and the Bethesda method was used to classify cytological results.

Results: Pap smears identified inflammatory changes and epithelial abnormalities in a subset of patients, while colposcopy identified additional concerning lesions not observed on cytology alone. There was a substantial correlation between abnormal Pap smear results and abnormal colposcopic findings, with colposcopy demonstrating a better ability to identify low-grade lesions.

Conclusion: Colposcopy improves Pap smear cytology in symptomatic women with vaginal discharge by improving the detection of cervical epithelial abnormalities. Combining both modalities enhances diagnostic precision and may reduce the number of premalignant lesions missed in routine clinical practice.

Keywords: Vaginal discharge, Pap smear, Colposcopy, Cervical cytology, Cervical lesions, Screening.