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Croatian Society of Gynaecology and Obstetrics, and Croatian Society of Perinatal Medicine of Croatian Medical Association
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  • Subklinička Infekcija Hpv
  • Dijagnostičke Metode
  • Vulvoskopija
  • Subclinical Hpv Infection
  • Diagnostic Methods
  • Vulvoscopy
  • Biology
  • Ecology
  • Medicine


Objective. To compare diagnostic procedures for subclinical HPV infection, with a special attention to vulvoscopy. Further, to make sure that many infections that did not cause abnormal cytologic findings, especially among adolescent patients, can be seen by means of vulvoscopy. Methods. After smearing 5% acetic acid, 400 new patients were subjected to vulvoscopy and in 124 suspect findings were established. From 76, out of 124 subjects, smears were taken for cytologic and HPV test, then extended colposcopy was performed and their tissue for histological analysis taken. Results. Mean age of the patients was 27 years. Younger subjects (29 years, n=41) had more lesions – LSIL (11) and cytologic findings of inflammation (48) than 35 older subjects (30 years, 7 and 37), but the difference was not statistically significant. HPV tests were more frequent in younger patients and they had more low risk findings (P<0.05). In high risk HPV strains, a higher dysplasia (P<0.05) and more colposcopic abnormalities were found (P<0.05) than in low risk infections. Of all 76 vulvoscopic suspect findings, there were significantly more positive tests (38=50%) than cytologically abnormal findings (22=29%; P<0.01). There were no histological findings to HSIL. Conclusion. It is very important to detect more initial subclinical HPV infections, preferably at the first examination and immediately teach the patient self-protection and start the treatment of side discomforts. After smearing the genito-anal area with 5% acetic acid, it is possible, by using vulvoscopy, to suspect a HPV infection in a bigger number of patients than by visualisation. Therefore, adolescent patients, who are usually reluctant to present themselves for a gynecological examination, and particularly for check-ups, are those who were especially in favour of vulvoscopy considering it acceptable (without speculum introduction).

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