Effects of using lubricant during the speculum examination for Pap smear collection

Abstract

Objective To evaluate the effect of using lubricant during speculum examination for Pap smear collection. Methods A cross‐sectional study was conducted involving 83 patients attending a medical school clinic. Participants were allocated into two groups: Group 1—Lubricant using; Group 2—No lubricant using. All patients were submitted to two successive collections and after were asked about their level of discomfort. Differences between groups regarding quality, artifacts, cytology, and level of discomfort were observed through chi‐squared test. Odds ratios and 95% confidence intervals were also estimated. Statistical significance was set at P < .05. Results No significant differences between groups regarding quality, presence of artifacts, and cytological results were observed. Significant lower discomfort level in Group 1 (lubricant using). Conclusion The use of vaginal lubricant did not affect the results of cytology and could be a useful tool to reduce the discomfort during Pap smear collection.

Effect of Lubricant Use on Cervicovaginal Cytology – What's the Evidence?

“…In Brazil, Nunes et al 4 performed a double-blind randomized clinical trial between August 2012 and June 2013, with the objective of evaluating the effect of the use of lubricating gel in the speculum during cervicovaginal cytology examination. It included 83 women aged between 15 and 44 years, randomly divided into two groups: group 1 (cervicovaginal cytology was first performed with a dry speculum and later with a small amount of liquid petroleum jelly) and group 2 (both cervicovaginal cytology exams were performed with a dry speculum).…”

“… 2 As for Hill et al and Nunes et al's RCTs, they included only women of childbearing age and concluded that the use of lubricating gel decreases the pain felt, without altering the CVC result. 3 4 Finally, the metanalysis by Pergialiotis et al concluded that the use of aqueous lubricant on the speculum does not interfere with the result of conventional CCV nor does it significantly alleviate the discomfort felt.…”

“…Cervicovaginal cytology (CVC) is an effective screening test for early diagnosis of cervical cancer, allowing a marked reduction in associated mortality. 1 2 3 4 According to the literature, most of the women who died from cervical cancer did not undergo cervical cytology during the previous 5 years. 3 The discomfort caused by the introduction of the speculum can decrease the rate of adherence to screening.…”

“…Theoretically, the use of lubricant while introducing the speculum can minimize this discomfort and, thus, increase adherence rates for this test. 1 3 4 The Family Doctor has a key role in the prevention of disease in Primary Health Care. However, this approach is controversial, and many studies have assessed the possible effects of lubricants on cytology results.…”

“…However, this approach is controversial, and many studies have assessed the possible effects of lubricants on cytology results. 4 5 In this sense, it was considered relevant to review the existing scientific evidence on the use of lubricating gel in the speculum during the performance of cervicovaginal cytology, as well as its influence on the results obtained and patients' reported discomfort during the test.…”