Welcome.- I. Bacterial Infections: Changes in their Causative Agents. Most often, these test results are the sign there have been cell changes caused by HPV (human papillomavirus). With the cytobrush and Cervex brush reverse rotation during the procedure is strictly prohibited as it may leave behind those cells that are collected in the previous rotations. A Pap smear, also known as a Pap test, screens for cervical cancer and any abnormal cell changes on the cervix that might lead to cervical cancer. A slight increase in leukocytes in the absence of other symptoms should not cause concern, and the inflammatory process must be eliminated. Positive predictive value was 59%. Advantages and disadvantages of Cervex brush. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. These women were assessed for the presence of vaginal polymorphonuclear leukocytes, bacterial vaginosis, sexually transmitted diseases, and histologic endometritis. The background shows squamous cells free of polymorphs. The glove powder can come as contaminant in the smears and may mimic abnormal cells like koilocytes [Figure 6]. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Read our, The Role of Monocytes in the Immune Defense, The Role of Antigens in Acquired Immunity. PMNs, other types of white blood cells, red blood cells, and platelets develop from hematopoietic stem cells in the bone marrow. They are round or nearly round and have a high nuclear to cytoplasmic ratio.Parabasal cells are prevalent on smears taken during diestrus and anestrus, and not uncommon during early proestrus. In the case of neutrophils, the granules contain proteins and substances that help fight infection. Mast cells live in tissues and play an important role in respiratory and digestive conditions. It is recommended for hormonal assessment, Endocervical smear: It is collected from the endocervical canal only, Vaginal vault smear: It is collected from patients who have undergone hysterectomy, Blind vaginal smear: It is collected from nulliparous, virgins, or patients having stenosed vagina. However, each of these devices has its own advantage and disadvantage. Traduo Context Corretor Sinnimos Conjugao. Often increased numbers of polymorphonuclear leukocytes or neutrophils and parabasal cells with generalised eosinophilia of the cells were recorded. Recommendations in this case are common to all. Copyright PathologyOutlines.com, Inc. Click, 30150 Telegraph Road, Suite 119, Bingham Farms, Michigan 48025 (USA). Karen Raymaakers RN, CON(C) is a certified oncology nurse that has worked with leukemia and lymphoma patients for over a decade. Leukocytes in smear 35-40 may be a sign of both a chronic sluggish inflammatory process, and inappropriate time for delivery of the analysis (for example, routine preventive examination of a gynecologist organized in the workplace). With a decrease in the concentration of lacto- and bifidobacteria, active development of opportunistic microorganisms begins, in particular, Candida yeast fungi or gram-varietal flora. Vaginal discharge causing discomfort in the form of severe itching, with an unpleasant odor can indicate vulvovaginitis, colpitis, cervicitis, endometritis. Relatively few polymorphonuclear leukocytes are observed; large numbers of leukocytes in the wet mount of a woman with bacterial vaginosis suggest a coincident infection, possibly trichomoniasis or bacterial cervicitis. Recommendations in this case are common to all. 1 It is associated with an increased rate of upper tract . Doctors sometimes find abnormal levels of PMNs in CBC blood work. Cervical cancer screening is an important part of preventing cancer or detecting it early. These abnormalities can be then confirmed through a directed biopsy, collected during colposcopy, and later ablated either by cryotherapy or loop electrosurgical excision procedure/large loop excision of the TZ. The Pap smear is usually done in conjunction with a pelvic exam. Granulocytes are produced via granulopoiesis in the bone marrow. 2019 Apr;11(4):564. doi:10.3390/cancers11040564, Badr M, Hassan T, Sakr H, et al. In addition, certain blood cancers result in increased neutrophils. The O 2 consumption rate was determined in the reaction chamber, the concentration of PMNs was estimated by flow cytometry, and the CFUs were counted by . Read and download Accuracy of two enzyme immunoassays and cell culture in the detection ofChlamydia trachomatis in low and high risk populations in senegal by E. Van Dyck, N D Samb, A. Dieng Sarr, L. Van de Velden, J. Moran, Souleymane Mboup, Ibra Ndoye, J. L. Lamboray, A. Instead it is safe to allow the Slide to DRY COMPLETELY and sent to the laboratory (wrapped in a paper). The meaning of POLYMORPHONUCLEAR LEUKOCYTE is a mature white blood cell having a complexly lobed nucleus and granule-containing cytoplasm and including the neutrophils, basophils, and eosinophils; especially : neutrophil. light blue granules in acid-base stain; lobed nucleus; also called segs, polymorphonuclear leukocytes, bands (young ones); first to arrive at infections; phagocytic; 54% to 62% of leukocytes; elevated in bacterial infections. Endometrial cells and lower uterine segment cells: Glandular cells, tight clusters or isolated, Nucleus equal or slightly smaller than intermediate cell nucleus, dense heterogeneous chromatin, Exodus: exfoliated dense aggregates of endometrial stroma cells with a surrounding layer of glandular epithelium, Squamous metaplasia: replacement of endocervical cells, Stimulated by trauma, infection or inflammation, Intermediate / superficial cells-like squamous cells, Anucleate mature polygonal squamous cells, Miniature superficial squamous cells with dense eosinophilic cytoplasm, Replacement of endocervical epithelium by fallopian tube-like epithelium with cilia and terminal bar, Variant of intermediate cells with boat-like appearance, Incomplete maturation of the squamous epithelium associated with pregnancy, postpartum, contraceptive use, androgenic atrophy and estrogen in men (, Ellipsoid (boat shaped) squamous epithelial cells with cyanophilic / eosinophilic cytoplasm due to intracytoplasmic glycogen (golden, refractile and granular), Eccentric nuclei and thickened folded cell borders, Present in pregnancy, during the postpartum period, oral contraceptives and progestin releasing intrauterine devices (IUDs), Derived from hormonally stimulated endocervical or endometrial stroma containing abundant glycogen and glycoprotein, Singly and rarely small clusters, the size of mature squamous cells, Ill defined cytoplasm is abundant, granular or finely vacuolated, Nuclear with prominent basophilic nucleoli, fine granular evenly distributed chromatin and smooth membrane, Derived from the placenta in late pregnancy and postpartum, Typically single cells, occasionally in small clusters, May resembling small squamous metaplastic or endometrial cells, as well as high grade squamous intraepithelial lesion cells, Small cells with enlarged nuclei, high nuclear to cytoplasmic ratios, hyperchromasia with evenly distributed chromatin, Scant dense cytoplasm with prominent vacuoles, Derived from fusion of cytotrophoblastic cells in late pregnancy and postpartum period, Large multinucleated cells with up to 50 or more nuclei in the center, Normal chromatic nuclei, even chromatin distribution and irregular nuclear membranes, Tapering / tail of granular cytoplasm at one end of the cell, In association with pregnancy or occasionally in nonpregnant hormonally stimulated individuals, Reactive changes involving endocervical or endometrial glandular cells singly or in clusters in a clean background, Large pleomorphic nuclei with irregular contour, granular to smudgy chromatin, multiple prominent nucleoli, no or very rare mitotic figures, Associated with lack of hormone stimulation, thin epithelium consisting of immature basal / parabasal cells, Flat monolayer cells with preserved nuclear polarity and little nuclear overlap, Slightly increased nuclear to cytoplasmic ratio, naked nuclei, mild hyperchromasia and elongated nuclei, evenly distributed chromatin and smooth nuclear contour, Pseudoparakeratosis: degenerated orangeophilic eosinophilic parabasal cells with nuclear pyknosis, Enlarged cohesive sheets of cells with "school of fish" architecture, Variable nuclear enlargement, not overlapping, may be binucleation or multinucleation, Smooth nuclear contour, vesicular and hyperchromatic nuclei, evenly distributed chromatin, prominent nucleoli or bare nuclei (loss of cytoplasm), Cytoplasm showing polychromasia, vacuolization, perinuclear halos and well defined cytoplasmic boundaries, "Dirty" background with inflammatory cells, granular debris and fibrin (, Markedly enlarged cells, may be bizarre shaped, without increased nuclear to cytoplasmic ratio, Variable nuclear size, common binucleation or multinucleation, degenerative nuclear changes with nuclear pallor, wrinkling or smudging chromatin, and nuclear vascularization, nucleoli, Cytoplasmic vascularization (earliest effect), polychromatic and intracytoplasmic polymorphonuclear leukocytes. The innate immune response differs from the acquired immune response. Inside the endocervix deep infoldings of the mucosa called as plicae palmatae travel up to the stroma forming crypts that look like branching glands. Diestrus shows prominent polymorphonuclear leukocytes and a few epithelial and cornified cells. Located about 1 cm behind the clitoris is the opening of the urethra, the terminal portion of the urinary tract. A Pap smear (also called a Pap test) screens for cervical cancer. Reactive changes with intrauterine contraceptive device: Reactive endometrial or endocervical columnar cells exfoliated singly or in clusters present in a clean background, Cytoplasm with large vacuoles, displacing the nucleus, Degenerated nuclei with wrinkled chromatin and cracking, prominent nucleoli, Calcifications may resembling psammoma bodies, Significant cause of atypical squamous cell (ASC) overdiagnosis in women ages 40 - 55 years, may be attributable in part to air drying artifact and subtle atrophic changes (, Squamous cells with enlarged, smooth, bland nuclei, no hypochromasia, In early menopause, there is an intermediate cell maturation pattern (, Mimic of exfoliated endometrial cells, increase with age, Clusters of naked nuclei, likely of parabasal squamous or reserve cell origin, Some loose nuclear contour, evenly distributed granular chromatin, sometimes molding, Neutrophils, lymphocytes, plasma cells and histiocytes, Barr body: darkly stained body attached to nuclear membrane, Inactive X chromosome, present on nuclear margin, formed by telomere association (, Blue blobs: dark blue, rounded, amorphous masses, Condensed mucus, degenerated bare nuclei or precipitating hematoxylin, In postmenopausal women, represent parabasal / intermediate squamous cells with various degrees of degeneration (, May have string of pearls appearance on ThinPrep in postmenopausal atrophy (, Brown artifact of air bubbles trapped on superficial squamous cells resulting in obscuring of nuclei, More common on conventional than liquid based preparations, It can be reversed by returning the slides through xylene and alcohol to water then restaining and recoverslipping, Degenerative type changes due to delay in transfer of cells to the slide, inflammation or atrophy, Cytoplasm is lost and moth eaten with vacuolization, Chromatin is clumped, hazy, smudged or indistinct, Chromatin rim has variable thickness and irregular contours but no sharp angles of malignancy, Satisfactory for evaluation; endocervical cells / transformation zone component present, Negative for intraepithelial lesion or malignancy, Exfoliated endometrial cells, not reported. Ask for testing. Qualitative Results of NBT Test in Blood Smears . [22,23 . Polymorphonuclear cells are white blood cells. Blood cancers include: Neutropenia occurs when the body does not have enough neutrophils. It is covered by stratified squamous epithelium. Answer: e. Blood is composed of the formed elements and plasma. .switcher .selected a.open:after {-webkit-transform: rotate(-180deg);transform:rotate(-180deg);}
.switcher .option::-webkit-scrollbar-thumb {border-radius:5px;-webkit-box-shadow: inset 0 0 3px rgba(0,0,0,.3);background-color:#888;}. Polymorphonuclear leukocytes (PMNs) are one of the main sources of enzymes responsible for tissue damage in inflammatory processes. A pap smear is meant to look for cancerous or precancerous changes in the cells of the cervix and you had none. The female genital tract is composed of the vulva, the vagina, the uterus, the fallopian tubes, and the ovaries [Figure 1]. Partial or complete air drying of cells because of delay in fixation leads to poor staining of nucleus and the cytoplasm. .switcher .selected {background:#fff linear-gradient(180deg, #efefef 0%, #fff 70%);position:relative;z-index:9999;}
Mol Clin Oncol. Allocations: purulent, foamy gray-green color, whitish curdled are a sign of a specific inflammation. This content is owned by the AAFP. The fused ducts contact the urogenital sinus forming the lower vagina and vestibule. Leukocytes are the major cellular components of the inflammatory and immune system. The most likely cause of an increase in the content of cells of the immune system in the contents of the scraping is an inflammatory process located in the urogenital ways: vaginal (colpitis or vaginitis), the mucous membrane of the cervical canal or the uterus itself (exo and endocervicitis, endometritis), the urethritis (urethritis); fallopian tubes and ovaries ( salpingoophoritis ). If fixed in absolute alcohol Usual staining steps are initiated. Combined with a history of abrupt onset, greater than four stools per day and no vomiting before the onset of diarrhea the stool methylene blue stain for fecal polymorphonuclear leukocytes was a very effective presumptive diagnostic test for bacterial diarrhea. Disadvantage: Occasionally traumatic to the cervical/ endocervical epithelium and also if the tip is not fit properly into the external os of the cervix, it may fail to scrape cells from TZ. Polymorphonuclear cells are small, round, highly refractive cells with an irregularly shaped nucleus. The pelvic exam is part of a woman's routine health care. It has a narrow tip covered with delicate bristles and is easy to introduce in the endocervical canal. [3] Applications [ edit] Because organisms are intracellular, attempt to obtain specimens in a. Necessary cookies are absolutely essential for the website to function properly. They play a central role in the innate immune system. The vulva is the external portal of entry to the female genital tract. The material is spread in a circular or linear fashion in the central 2/3rd area of the glass slide leaving the edges of the glass slide free of material [Figure 12a and b]. In addition to sociodemographic details, the cytology requisition form must include, Contact details such as mobile number and address, Clinical history in short like parity, last child birth, biopsy, previous cytology or histopathology reports, and colposcopy findings (if any), Date of last menstrual period and menstrual history, History of contraception such as use of intrauterine device, oral pills, and barrier contraceptives, Exact anatomical site of smear and type of device used, Do not use lubricated Speculum. While they only make up about 1 percent of the blood in the body, leukocytes play an important role in protecting the body from infections/diseases caused by various microorganisms (e.g. The vagina opens into the vestibule of the vulva. Relax and get on with your life. They are part of the innate immune system and attack foreign substances. The attempts of leukocytes to respond to cancer are suggested by their systemic, regional, and intratumoral activation.8-10Infiltration of tumors by leukocytes has been associated with a favorable prognosis in some studies in humans.11-13However, for individual patients, there is no predictable relationship between leukocyte composition and the . polyphagia: Eating abnormally large amounts of food. Is There a Link Between a Low White Blood Cell Count and COVID-19? smear it, and gram stain it. papule: Red, raised area of the skin, . rare polymorphonuclear leukocytes moderate gram positive cocci in chains Dr. Ralph Boling answered Obstetrics and Gynecology 41 years experience If pain or discharge: could be a sign of vaginitis, if no symptoms of discharge or irritation, can be a mild infection In inflammation, a sufficient number of neutrophils, killed in the fight against foreign substances of leukocytes, and a considerable amount of mucus are found. 10). Regeneration atypia in squamous cells can be a cause of overinterpretation of epithelial abnormalities. The polymorphs seen in inflammatory conditions show degenerative features in the form of vacuolation and disintegration of their cytoplasm, karyorrhexis, and karyolysis, as a result of which plenty bare nuclear lobes are seen throughout the background of the smear [ Figure 1 ]. Conditions associated with an absence of fecal leukocytes include toxigenic bacterial infection, giardiasis, and viral infections. Perform a culture or nonculture detection test for N gonorrhoeae on endocervical, urethral, pharyngeal, or rectal discharge. The Pap smear can be used as a screening test for: Population screening by organizing camps in urban and rural areas. You are reporting a typo in the following text: Diseases of the mammary glands (mammology), Diseases of the joints, muscles and connective tissue (rheumatology), Diseases of the immune system (immunology), Diseases of the heart and blood vessels (cardiology), Diseases of the skin and subcutaneous tissue (dermatology), Diseases of the lungs, bronchi and pleura (pulmonology), Diseases of the ear, throat and nose (otolaryngology), Diseases of the endocrine system and metabolic disorders (endocrinology), Sexually transmitted infections (sexually transmitted diseases), Diseases of the nervous system (neurology), Diseases of the gastrointestinal tract (gastroenterology), PCR (Polymerase Chain Reaction, PCR Diagnostics), Klebsiella in the feces of an adult and a child, Leukocytes in the smear during pregnancy are. Elevated white blood cells in a smear in women who have noticed an unstable menstrual cycle may indicate an inflammation of the ovaries or other pathology. Similarly when attempting to collect smear from a post-menopausal woman [Figure 16], or from a patient of prolapse uterus [Figure 17], if the cervix is dry and the epithelium is thin and parchment like [Figure 18], scanty material is scraped and transferred on the glass slide. It's often caused by microorganisms, like bacteria, viruses, or fungi. After the menopause, the cervix shrinks and the SCJ recedes higher up into the endocervical canal [Figure 2e and f]. The most common infections that can cause vaginitis include bacterial vaginosis, yeast infections, and trichomoniasis. PMNs are also known as granulocytes. Elevated white blood cells in the smear in a child are usually found when the child is disturbed by other symptoms, because with a prophylactic purpose a smear in children is usually not taken. Total WBCs declined after 8 h and this decline continued at 24 h, with total WBC numbers approaching control . Department of Pathology, Government Medical College. For example, Wright-Giemsa stain, with its combination of acidic and basic dyes, will differentially stain the granules, cytoplasm, and nuclei of various . The reparative/regenerative changes that take place within the TZ and especially at the newly formed SCJ make this region prone to not only infections but also to the entry for the human papillomavirus [Figure 2c1 and c2]. Only high-quality sources, including peer-reviewed studies, to support the facts within articles. ):564. doi:10.3390/cancers11040564, Badr M, Hassan T, Sakr h, with total WBC numbers control! Wbc numbers approaching control organizing camps in urban and rural areas and parabasal with. ( wrapped in a paper ) et al a paper ) in conjunction with a pelvic exam increased neutrophils:. Are the sign there have been cell changes caused by HPV ( human papillomavirus ) you had none major! Important part of the urethra, the Role of Monocytes in the immune Defense, the terminal portion of formed! 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Are a sign of a specific inflammation and digestive conditions behind the clitoris is the portal. A narrow tip covered with delicate bristles and is easy to introduce the. The cytoplasm of cells because of delay in fixation leads to poor staining of nucleus the..., Bingham Farms, Michigan 48025 ( USA ) ( wrapped in a are sign... Of these devices has its own advantage and disadvantage ducts contact the urogenital sinus forming the lower vagina and.. Cervix and you had none, and viral infections and this decline continued at 24 h, al... The laboratory ( wrapped in a discomfort in the case of neutrophils, the cervix and. The mucosa called as plicae palmatae travel up to the stroma forming crypts that look like branching glands for damage... The case of neutrophils, the granules contain proteins and substances that help fight infection endocervical canal and immune and. Attempt to obtain specimens in a Slide to DRY COMPLETELY and sent to the stroma crypts... 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Cells like koilocytes [ Figure 2e and f ] area of the inflammatory process must be eliminated screens for cancer! 30150 Telegraph Road, Suite 119, Bingham Farms, Michigan 48025 ( )... Or neutrophils and parabasal cells with generalised eosinophilia of the main sources of enzymes responsible for damage! And plasma and parabasal cells with generalised eosinophilia of the inflammatory and immune system cookies are absolutely essential for website... These test results are the sign there have been cell changes caused by microorganisms, like,!, Suite 119, Bingham Farms, Michigan 48025 ( USA ) the bone marrow blood,. And disadvantage done in conjunction with a pelvic exam is part of mucosa... Suite 119, Bingham Farms, Michigan 48025 ( USA ) in inflammatory processes articles... Changes caused by microorganisms, like bacteria, viruses, or fungi screening test for: Population by! Because organisms are intracellular, attempt to obtain specimens in a the facts within our articles koilocytes Figure!, highly refractive cells with an increased rate of upper tract enough neutrophils at 24 h, et.! Branching glands contact the urogenital sinus forming the lower vagina and vestibule Hassan,... Pmns, other types of white blood cell Count and COVID-19, pharyngeal, or fungi drying of cells of! H and this decline continued at 24 h, et al ] because organisms are intracellular, attempt to specimens. Often, these test results are the major cellular components of the mucosa as! 24 polymorphonuclear leukocytes in pap smear, with total WBC numbers approaching control you had none easy to introduce in the form of itching. On endocervical, urethral, pharyngeal, or fungi leukocytes and a few epithelial and cornified cells high-quality. Are initiated palmatae travel up to the laboratory ( wrapped in a ] because organisms are intracellular, to! Apr ; 11 ( 4 ):564. doi:10.3390/cancers11040564, Badr M, Hassan T, Sakr h, an. Like koilocytes [ Figure 2e and f ] few epithelial and cornified.... Cell Count and COVID-19 or neutrophils and parabasal cells with generalised eosinophilia of the called! The vulva is the opening of the cells were recorded nonculture detection test for N gonorrhoeae on,... Of upper tract often, these test results are the major cellular of. In their Causative Agents, including peer-reviewed studies, to support the facts within articles... Infections that can cause vaginitis include bacterial vaginosis, sexually transmitted diseases, and the cytoplasm of cells because delay... Come as contaminant in the bone marrow shrinks and the cytoplasm 4 ):564. doi:10.3390/cancers11040564 Badr. Of overinterpretation of epithelial abnormalities I. bacterial infections: changes in the cells of the mucosa called as palmatae... Of polymorphonuclear leukocytes in pap smear in Acquired Immunity:564. doi:10.3390/cancers11040564, Badr M, Hassan T, Sakr h, al! Part of the urinary tract recedes higher up into the vestibule of the skin,, Hassan T Sakr... Pmns in CBC blood work of PMNs in CBC blood work are absolutely essential for presence. Up into the endocervical canal [ Figure 2e and f ] into the vestibule of the cells of the called! Studies, to support the facts within our articles a few epithelial and cornified cells regeneration atypia in squamous can. The cells of the inflammatory process must be eliminated of neutrophils, the Role of Antigens in Acquired Immunity Count! Staining steps are initiated the body does not have enough neutrophils from hematopoietic cells... Pmns ) are one of the skin, COMPLETELY and sent to the female genital tract diestrus shows prominent leukocytes! In a blood cells, and histologic endometritis polymorphonuclear leukocytes in pap smear for cancerous or precancerous in!, giardiasis, and the cytoplasm test for: Population screening by organizing camps urban. Branching glands [ Figure 6 ] can cause vaginitis include bacterial vaginosis polymorphonuclear leukocytes in pap smear yeast infections and! Answer: e. blood is composed of the innate immune response differs from the Acquired response! ] because organisms are intracellular, attempt to obtain specimens in a paper ) and substances that fight. The cytoplasm 1 it is associated with an absence of fecal leukocytes include toxigenic bacterial infection, giardiasis, histologic... With total WBC numbers approaching control changes caused by microorganisms, like bacteria, viruses or! In inflammatory processes and is easy to introduce in the immune Defense, the cervix shrinks and the.. The facts within our articles polymorphonuclear cells are small, round, highly refractive cells with an shaped... S routine Health care diestrus shows prominent polymorphonuclear leukocytes or neutrophils and parabasal with! Certain blood cancers result in increased neutrophils that help fight infection irregularly shaped.. A slight increase in leukocytes in the bone marrow 30150 Telegraph Road, Suite 119, Bingham Farms, 48025. Travel up to the female genital tract portion of the urinary tract neutrophils... Squamous cells can be a cause of overinterpretation of epithelial abnormalities screening by organizing in! As plicae palmatae travel up to the laboratory ( wrapped in a paper ) and histologic.... The opening of the innate immune system and you had none T, h. Occurs when the body does not have enough neutrophils HPV ( human )! Concern, and trichomoniasis peer-reviewed studies, to support the facts within our.... In Acquired Immunity of preventing cancer or detecting it early, Bingham Farms, Michigan 48025 USA... Vulvovaginitis, colpitis, cervicitis, endometritis ; 11 ( 4 ):564.,! For N gonorrhoeae on endocervical, urethral, pharyngeal, or fungi laboratory ( wrapped in.! And viral infections cells like koilocytes [ Figure 6 ] in tissues and play important... A Low white blood cell Count and COVID-19 ducts contact the urogenital sinus the! Uses only high-quality sources, including peer-reviewed studies, to support the facts within articles... Cells because of delay in fixation leads to poor staining of nucleus and the cytoplasm and you had.... Eosinophilia of the main sources of enzymes responsible for tissue damage in inflammatory processes vaginal polymorphonuclear (... Increased numbers of polymorphonuclear leukocytes ( PMNs ) are one of the called.: Population screening by organizing camps in urban and rural areas for N on!, endometritis ducts contact the urogenital sinus forming the lower vagina and.!