Unusual Vaginal Discharges

June 2019 (Update of template for December 2018 version)

This medical protocol concerns symptomatic, sexually active women presenting unusual vaginal discharges with or without pre-menstrual/post-menstrual spotting or post-coital bleeding and asymptomatic persons identified as sexual partners of women with Trichomonas vaginalis vaginitis, as established through a laboratory test.

The contents of the protocol and of the related prescription have been transferred to new frameworks that are now being used at INESSS.

An amendment has been made, however. Measuring the pH and looking for an amine odour with a KOH solution are part of the treatment indication of bacterial vaginosis and vulvovaginal candidosis in the protocol. This point-of-care testing (POCT) must be supervised by institutional laboratories; however, a number of laboratories are not able to offer the oversight and support needed to carry out these tests. INESSS’s protocol cannot therefore be applied in its original version.

POCT is recommended by a number of authorities as a clinical manifestation supplement to help guide a diagnosis. Nevertheless, POCT is not essential because the vaginal secretion samples will be forwarded to the laboratory for microbiological analysis. Consequently, measuring the pH and looking for an amine odour with a KOH solution for the treatment indication of bacterial vaginosis and vulvovaginal candidosis in the Medical Protocol on Unusual Vaginal Discharges are now optional. The protocol and algorithm have been modified.

Note: If you are using the earlier version of the medical protocol (December 2018), you do not need to obtain a new signature for a prescription that was approved by the Council of Physicians, Dentists and Pharmacists (CPDP) or the signatory physicians, provided that your prescription makes reference to INESSS’s medical protocol.

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