Does lubrication of the vaginal speculum reduce pain during a gynecologic oncology examination?

Abstract

ObjectiveTo evaluate the effectiveness of lubricant gel for reducing pain during a vaginal speculum examination (SE) in patients with gynecologic cancers. Study designThis non blind randomized controlled trial included 200 women who underwent SE for post-treatment surveillance. One-hundred patients each were allocated to the water and lubricant gel groups. All patients were asked to score their pain during speculum insertion, dilatation, and extraction using a visual analog scale (VAS). Pain intensity during speculum insertion was the primary outcome measure. ResultsThere were no statistically significant differences in demographic characteristics between the water (n=97) and lubricant gel (n=98) groups. The VAS pain scores obtained during all phases of the SE were significantly lower in the lubricant gel group compared with the water group during the insertion (3.95±1.57 vs. 5.28±1.71, P<0.001), dilatation (5.96±1.48 vs. 6.74±1.69, P<0.001) and extraction phases (2.60±1.17 vs. 3.50±1.25 P<0.001). When a separate analysis was performed for the patients who underwent radiation therapy, the mean VAS pain scores were significantly lower in the lubricant gel group during the insertion (4.46±1.45 vs. 6.22±1.79, P<0.001), dilatation (6.31±1.66 vs. 7.52±1.61, P= 0.002) and extraction phases (2.68±1.31 vs. 3.66±1.06, P=0.001). ConclusionThe use of speculum lubricant gel significantly decreased pain during the SE in gynecologic oncology patients.