A modest amount of gel applied to the blades of a Disposable Vaginal Speculum before insertion will not affect test results but will alleviate the patient’s discomfort. A 24-year-old lady arrives for her annual appointment, which includes a Pap smear and sexually transmitted disease tests (STD). She tells you how unpleasant her last speculum exam was and how concerned she is about having another one. Should you apply lubricating gel or water to the speculum before inserting it into her vagina?
Disposable Vaginal Speculum
Physiology teaches us that lubrication is required for vaginal entrance. Yet, conventional wisdom holds that using lubricating gel on a Disposable Vaginal Speculum can interfere with the findings of a Pap smear and chlamydia tests. Pelvic exams without lubricating gel on the speculum can cause severe discomfort, which may deter some women from undertaking recommended screening procedures.
We have Just Seen How Prison Tests Affect The Results:
Tests comparing lubricating gel and water have conclusively demonstrated that a modest amount of gel applied to the exterior of the Disposable Vaginal Speculum blades does not interfere with Pap testing or Chlamydia trachomatis detection. However, one liquid-based cytology producer advises against using lubricants containing “carbomers” or “carpool polymers,”. But claims that water-based lubricants have not been observed to interfere with Pap smear results. Till now, no studies have examined lubricants from the standpoint of patients
Lubricant Gel Relieves Discomfort
The Hill and Lamvu study was a 6-month, single-blind, randomized experiment of women ages 18 to 50 who sought care at an obstetrics and gynecology facility in Orlando. Florida for issues needing Disposable Vaginal Speculum examination. The study excluded women who were menopausal, pregnant, or within 6 weeks of giving birth had dyspareunia, vaginitis, vulvar pain, or vulvar lesions. Were undergoing a procedure or had never had vaginal intercourse. Ladies who did not speak English fluently were also barred.
The study comprised 120 women who were randomly assigned to one of two groups with no discernible demographic differences. All speculum exams were performed by a single examiner using a consistent technique and a medium-sized Graves speculum. Before inserting the speculum, the examiner applied 0.3 mL of water-based lubricating gel to one set of women and 3 mL of water to the other.
Patients were given a visual analog scale and informed to indicate the intensity of pain after insertion. Using a scale of 0 (no pain) to 10 (extreme pain) immediately after the speculum was inserted and opened before the examiner attempted to observe the cervix (the worst pain imaginable). The gel group experienced less pain during speculum insertion than the water group. A statistically significant difference of 0.74. Twenty of the 59 patients (33.9%) in the gel group assessed their pain as 0, compared to six of sixty (10%) in the water group (P=.002). Although the primary endpoint of the trial was pain rather than sampling quality. The authors also reported that all of the women who had Pap screening (73) had sufficient cytology.
It is Time to Make Lubrication a Standard Method:
This is the first trial to investigate Disposable Vaginal Speculum lubrication from the standpoint of the patient. It demonstrates that women suffer less pain when lubricating gel, rather than water, is put on the speculum. This information, together with earlier research demonstrates. If a tiny amount of water-based lubricating gel does not affect liquid-based cytology or chlamydia test findings. Should make use of lubricating gel standard practice when doing speculum examinations.
We Notice no Disadvantages:
The study’s exclusion criteria were designed to identify women who had changed pain perception, which could distort study results. Those who met the exclusion criteria, on the other hand, may benefit from a pelvic exam with gel lubrication. We see no danger in inspecting them with a small quantity of lubrication as well.
Also, the study did not examine different types and sizes of Disposable Vaginal Speculum. We see no reason why the advantage of a gel lubricant should be confined to the type of speculum used by the examination. A 0.9 mean difference was considered “clinically relevant” in studies in emergency departments. That utilized visual analog scales to quantify therapies to reduce pain.
7,8 According to such standards, the 0.74 difference seen in this study is not clinically significant. However, one in every three patients in the gel group indicated 0 on the pain scale. Indicating no discomfort, compared to one in every ten in the water group. We feel that the larger proportion of women having no pain and the mean difference on the pain scale of 0.74 (both statistically significant). Together with the lack of danger associated with the use of a water-based lubricant. Make this a clinically effective practice changer.