Female genital schistosomiasis (FGS): Relationship between gynecological and histopathological findings

Gertrud Helling-Giese, Aimee Sjaastad, Gabriele Poggensee, Eyrun Floerecke Kjetland, Joachim Richter, Lester Chitsulo, Newton Kumwenda, Paul Racz, Borghild Roald, Svein Gunnar Gundersen, Ingela Krantz, Hermann Feldmeier

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Schistosomiasis of the lower female reproductive tract manifests itself in a broad spectrum of clinical features. However, clinical and histopathological findings have never been studied in a synoptic manner. Based on the assumption that any type of pathology present in the female reproductive tract is the expression of a complex pathophysiological reaction towards eggs sequestered in the genital tissues, we decided to analyze colposcopic and histopathological findings in a comprehensive manner. Thirty-three women in Malawi with urinary and genital schistosomiasis were examined parasitologically and gynecologically. A thorough colposcopic examination with photodocumentation was performed and biopsies were taken from the cervix, the vagina and/or the vulva for histological sectioning and immunohistochemistry. The predominant colposcopic findings were sandy patches on the cervical surface similar to those seen in the bladder and polypous/papillomatous tumors with irregular surface on the vaginal wall and in the vulvar area. The histopathological sections of sandy-patch-like lesions demonstrated only a small cellular reaction around S. haematobium eggs in various stages of disintegration. In contrast, in the case of polyps the histology revealed a more pronounced immunological reaction characterized by a heavy cellular infiltrate. One case of invasive squamous cell carcinoma of the cervix was diagnosed. We conclude that colposcopy is a useful tool in the detection of FGS related pathology in the lower female reproductive tract and that the synoptic assessment of surface and of corresponding histological sections helped to understand the pathophysiology of S. haematobium associated disease in genital tissue.

Original languageEnglish (US)
Pages (from-to)257-267
Number of pages11
JournalActa Tropica
Issue number4
StatePublished - Dec 30 1996
Externally publishedYes


  • colposcopy
  • diagnosis
  • eo sinophils
  • female genital schistosomiasis
  • histopathology
  • pathophysiology

ASJC Scopus subject areas

  • Parasitology
  • veterinary (miscalleneous)
  • Insect Science
  • Infectious Diseases


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