Original researchLubrication of the vaginal introitus and speculum does not affect Papanicolaou smears
Section snippets
Materials and methods
The Arrowhead Regional Medical Center Institutional Review Board approved this study. Women presenting to the Arrowhead Regional Medical Center Women’s Health Clinic who would have Papanicolaou smears as part of their visits were invited to participate. Patients with known untreated cervical cancer or active bleeding were excluded. The study was carried out between July and October 1999. All patients gave informed consent and were seen by the regularly assigned residents and faculty. A
Results
After we finished studying the first 182 patients of 200 attending our clinic (91.5% participation), we reviewed our data because we realized that we rarely got an unsatisfactory reading. Therefore, we would need 10,000 patients to demonstrate some statistical but clinically meaningless difference. Demographic data regarding age, gravidity, parity, and ethnicity are shown in Table 1. No gross lubricant was seen on the slides. The low numbers of unsatisfactory slides were similar in both groups
Discussion
The move to evidence-based practice supports challenging dogma such as the avoidance of lubricant before performing a Papanicolaou smear. The ACOG technical bulletin Cervical Cytology: Evaluation and Management of Abnormalities1 falls short of condoning use of lubricant, stating that “care should be taken to avoid contaminating the slide with lubricant.” Lubrication of the introitus and speculum facilitates speculum insertion without impairing smear quality.
Patient comfort and satisfaction are
References (1)
Cervical cytologyEvaluation and management of abnormalities. ACOG technical bulletin no. 183
(1993)