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The infrequent use of office-based diagnostic tests for vaginitis
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.
Objective:
This study was undertaken to determine physician use of simple office-based tests in the evaluation of women with vulvovaginal symptoms.
Study Design:
A medical record review of 52 women seeking care at a referral-based vaginitis clinic was performed. The evaluation performed and the care management were recorded for 150 previous physician-provided office visits.
Results:
A microscopic assessment of vaginal fluid was not performed in 37% of office visits, and 42% of physicians did not perform microscopy as part of any evaluation of vaginitis. Whiff amine tests and measurement of vaginal pH were rarely performed (3% of office visits). Treatment without adequate evaluation of the etiology of the symptoms occurred in 54% of visits in which medication was prescribed.
Conclusions:
In our study population the evaluation and care provided to women presenting for evaluation of vulvovaginal symptoms were suboptimal. The use of simple inexpensive office-based tests can optimize the assessment of vaginal infections and should be encouraged.