Cytologic changes associated with vaginal pessary use. With special reference to the presence of Actinomyces

The cytopathology of Papanicolaou smears from 23 postmenopausal women with vaginal pessaries is described. The following alterations, when seen in the smear of an elderly postmenopausal woman, were found to be strongly suggestive of pessary use: cytologic atypia in the form of severe inflammatory changes in squamous cells, atypical metaplasia, and reparative changes with a background pattern of acute inflammation and prominent superficial maturation of the squamous cells. A notable additional finding in 13 of the 23 patients was the presence of filamentous organisms resembling Actinomyces and morphologically similar to organisms recently described and specifically identified as Actinomyces in patients with intrauterine devices.