title: Diagnosis of human papillomavirus infection by abnormal cervical cytology is highly reproducible after vaginal douching.
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  Our results indicate that self-administration of a vaginal douche is not a reliable method of eradicating HPV infection.
authors.affiliation: Department of Family Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan.
authors.forename: Fang-Chun
authors.initials: FC
authors.lastname: Chen
authors.forename: Sheng-Wen
authors.initials: SW
authors.lastname: Shaw
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Cheng
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
authors.forename: Cheng-Tao
authors.initials: CT
authors.lastname: Lin
mesh_terms: D003127:Colposcopy; D005188:False Negative Reactions; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D012680:Sensitivity and Specificity; D013624:Taiwan; D002577:Uterine Cervical Diseases / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000821:virology; D044364:Vaginal Douching; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000821:virology