Diagnostic Value of Vaginal Discharge - Wet Mount and Vaginal pH - An Update on the Basics of Gynecologic Infectiology

Sep 27, 2026

This overview addresses how to evaluate common uncomplicated vulvovaginal complaints such as bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis using basic infectiological diagnostics. It emphasizes measuring vaginal pH, preparing and assessing wet mount slides from vaginal or cervical discharge, and correctly classifying findings clinically and microbiologically. It also summarizes aerobe vaginitis and explains why pelvic inflammatory disease needs immediate pathogen culture or molecular testing by specialist labs.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract!

Zusammenfassung!

Introduction!

Diagnostic approach and training gaps

Key tests: vaginal pH and wet mount assessment

| | DGGG Review | 355 | | --- | --- | --- | | Diagnostic Value of Vaginal Discharge, | | | | Wet Mount and Vaginal pH – An Update on the Basics of Gynecologic Infectiology | | | | Was Fluor, Nativpräparat und pH-Wert verraten – | | | | Ein Update zu den Grundlagen der gynäkologischen Infektiologie | | | | Authors W. Frobenius 1, C. Bogdan 2 | | | | Affiliations 1 Frauenklinik, Universitätsklinikum Erlangen, Erlangen
2 Mikrobiologisches Institut, Universitätsklinikum Erlangen, Erlangen | | | Key words bacterial vaginosis vulvovaginal candidiasis trichomoniasis pelvic inflammatory disease vaginal pH Schlüsselwörter bakterielle Vaginose Vulvovaginalkandidose Trichomoniasis Pelvic inflammatory Disease vaginaler pH‑Wert received revised accepted 7.11.2014 22.12.2014 9.1.2015 Bibliography DOI [http://dx.doi.org/](http://dx.doi.org/)[ ](http://dx.doi.org/)[10.1055/s-0035-1545909](10.1055/s-0035-1545909)[ ](10.1055/s-0035-1545909)Geburtsh Frauenheilk 2015; 75: 355–366 © Georg Thieme Verlag KG Stuttgart · New York · ISSN 0016‑5751 Correspondence PD Dr. Wolfgang Frobenius Frauenklinik Universitätsklinikum Erlangen Universitätsstraße 21–23 91054 Erlangen wolfgang.frobenius@ [uk-erlangen.de](uk-erlangen.de) Abstract! The majority of uncomplicated vulvovaginal complaints (e.g. bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis) can be detected with uncomplicated basic infectiological tests and can usually be treated effectively without requiring further diagnostic procedures. Tests include measurement of vaginal pH, preparation and assessment of wet mount slides prepared from vaginal or cervical discharge, and the correct clinical and microbiological classification of findings. In Germany, at least in recent years, this has not been sufficiently taught or practiced. As new regulations on specialist gynecologic training in Germany are currently being drawn up, this overview provides basic information on gynecologic infectiology and summarizes clinically relevant aspects of recent microbiological findings on the physiology and pathology of vaginal flora. The clinical signs and symptoms of aerobic vaginitis, the pathogenesis of which is still not completely understood, are also reviewed. Finally, the symptoms, indications and risk factors for pelvic inflammatory disease (PID) are presented. In contrast to the above-listed infections, PID requires immediate culture of the pathogen from samples (e.g. obtained by laparoscopy) with microbiological diagnostic procedures carried out by specialist laboratories. A schematic summary of all pathologies discussed here is presented. Zusammenfassung! Die überwiegende Zahl unkomplizierter vulvovaginaler Beschwerden (z. B. bakterielle Vaginose, Vulvovaginalkandidose, Trichomoniasis) lässt sich durch eine einfache, infektiologische Basisuntersuchung abklären und ohne weitergehende Diagnostik meist auch effektiv behandeln. Zu dieser Untersuchung gehören die Messung des vaginalen pH-Wertes, die Anfertigung und Beurteilung eines Nativpräparats aus vaginalem bzw. zervikalem Fluor sowie die korrekte Einordnung der erhobenen Befunde in das klinische Bild und den mikrobiologischen Kontext. Zumindest in Deutschland wird dies seit Jahren zu wenig gelehrt und praktiziert. Die vorliegende Übersichtvermittelt deshalb auch im Hinblick auf die kommende neue Weiterbildungsordnung grundlegende Kenntnisse dazu und fasst gleichzeitig den klinisch relevanten Teil der aktuellen mikrobiologischen Erkenntnisse zur Physiologie und Pathologie der Vaginalflora zusammen. Ferner wird das pathogenetisch nach wie vor unvollständig verstandene Krankheitsbild der aeroben Vaginitis diskutiert. Letztlich werden auch Symptome, Zeichen und Risikofaktoren einer Entzündung des kleinen Beckens („Pelvic Inflammatory Disease“, PID) vorgestellt, da diese Erkrankung im Gegensatz zu den obengenannten einen unverzüglichen kulturellen und/oder molekularen Erregernachweis durch

FAQs

Which uncomplicated vulvovaginal complaints does the overview focus on, and how are they detected?

It focuses on bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis, using basic infectiological tests such as vaginal pH measurement and wet mount assessment of discharge.

What basic diagnostic procedures are recommended for vaginal or cervical discharge?

Recommended procedures include measuring vaginal pH and preparing and assessing wet mount slides from vaginal or cervical discharge, followed by correct clinical and microbiological classification.

How does the diagnostic strategy differ for pelvic inflammatory disease (PID)?

Unlike the infections discussed earlier, PID requires immediate pathogen culture and/or molecular detection using appropriate sample collection and microbiological diagnostic work by specialist laboratories.

Sep 27, 2026

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