Comparison Between Gynecological Examination Methods and Sample Collection Techniques for the Diagnosis of Endometritis in Subfertile Mares

• Published in: Journal of equine veterinary science 2022-12, Vol.119, p.104147-104147, Article 104147
• Main Authors: Teixeira-Soares, Carlos Mattos, Viana, Arabela Guedes de Azevedo, Ribeiro, Iara Magalhães, Silva, Kamilla Dias Paes, Sancler-Silva, Yamê Fabres Robaina, Machado-Neves, Mariana
• Format: Article
• Language: English
• Subjects: Animals; Endometrial cytology; Endometrial histology; Endometritis - diagnosis; Endometritis - veterinary; Endometrium - diagnostic imaging; Female; Gynecological exam; Horse Diseases - diagnosis; Horses; Infertility - pathology; Infertility - veterinary; Specimen Handling - veterinary; Uterine microbiological culture; Uterus - diagnostic imaging
• ISSN: 0737-0806; 1542-7412
• DOI: 10.1016/j.jevs.2022.104147

•Multiple findings in gynecological exam made endometritis diagnosis more accurate.•Endometritis diagnostic in subfertile mares can be influenced by gynecology exam.•Different gynecological techniques have different outcomes endometritis diagnose.•The comparison of methods and techniques showed distinct sensitivities/specificities.•Double-guarded collector was quick to perform and demonstrated the best values.•Fragment flush, new sample collection technique, was used to diagnosis endometritis.•Laboratory methods of endometritis diagnosis showed higher sensitivity/specificity. Endometritis is a relevant cause of subfertility in mares. However, the accurate diagnosis, essential for effective treatment, can be difficult due to the variability of results and interpretations resulting from different examination methods and sample collection techniques. The present work compared gynecological evaluation methods and sample collection techniques to diagnose endometritis in subfertile mares. Forty animals with a history of subfertility were selected for gynecological evaluation using clinical methodologies, such as perineal conformation, transrectal palpation and ultrasonography, vaginoscopy, and digital examination of the cervix. In addition, we performed laboratory analyses, including uterine microbiological culture and endometrial cytology and histology, of which the latter is the gold standard for the diagnosis of endometritis. Samples were collected for microbiological culture and endometrial cytological evaluations using three different techniques: a commercial cytobrush/swab collector, low-volume uterine flush, and a new tested technique, by flush the fragment resulting from the endometrial biopsy. Transrectal palpation and ultrasound showed the best results among clinical examinations. However, they were less efficient in laboratory tests of endometrial cytology and uterine microbiological culture, in which the latter showed the highest sensitivity and specificity for endometritis compared with endometrial histology. The use of multiple results from different methods has also proved to be an effective alternative for diagnosis. Among the techniques used to collect endometrial material for cytology and microbiological culture, the most effective and practical in this study was the commercial cytobrush/swab collector.