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Diagnostic Tests 2023

What a positive or negative Schiller test means (and when to do it)

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What a positive or negative Schiller test means (and when to do it)
What a positive or negative Schiller test means (and when to do it)

The Schiller test is a diagnostic test that consists of the application of a solution with iodine, Lugol, in the internal region of the vagina and cervix, with the objective of verifying the integrity of the cells in this region.

When the solution reacts with the cells present in the vagina and cervix and turns brown, it is said that the result is normal, however when it cannot color a specific area, it is a sign that there is a change, requiring more specific exams.

Normally, the Schiller test is performed during colposcopy, which is why it is indicated for women who are sexually active or who have had altered results in the Pap smear.

When to do the Schiller test

Schiller's test is indicated by the gynecologist for sexually active women as a routine exam, in those who present any symptoms such as pain, discharge or bleeding after sexual intercourse or who have had altered results in the Pap smear, also known as a preventive exam.

In addition, the doctor may request the exam when there is a suspicion of any gynecological disease, such as HPV, syphilis, vaginal inflammation or cervical cancer. In these cases, in addition to performing the Schiller test, it may be necessary to perform additional tests, such as biopsy, transvaginal ultrasound and colposcopy, for example. Learn more about the exams that may be requested by the gynecologist.

Positive Schiller test

Schiller's test is said to be positive when, after placement of the lugol, not all of the lugol is absorbed by the tissue, and yellowish areas can be seen on the cervix, which indicates that there is a change in the cells, which may suggest the presence of benign or malignant changes, such as:

  • IUD incorrectly placed;
  • Vaginal inflammations;
  • Syphilis;
  • HPV Infection
  • Cervical cancer.

However, the Schiller test can give a false positive result, and therefore the Pap smear is usually requested instead, as a form of investigation of cervical cancer, as it provides clearer and more concrete results. In addition, to confirm Schiller's test positivity and identify the cause of the change, the physician may request a biopsy to visualize tissue and cell characteristics.

Another exam similar to this is the acetic acid test where the same principle of staining the vagina and cervix is ​​used, in which case the region should be whitish. Where the white is more evident, there are signs of cellular changes. This test is particularly suitable for women who are allergic to iodine and therefore cannot undergo the Schiller test.

Negative Schiller test

Schiller's test is said to be negative when, after staining with Lugol, the entire vaginal mucosa and cervix were stained, with no yellowish regions being observed, which indicates that there are no changes in the woman's genital region, that is, it is normal.

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