Effects of Gel Lubricant on Cervical Cytology

Abstract

To determine whether the use of lubricating gel during vaginal speculum examination affected cytologic interpretation in the conventional Pap smear.Two consecutive cervical smears were obtained from 1334 patients undergoing Pap smear screening. The first smear (uncontaminated) was obtained using the routine collection technique. The second smear (gel-contaminated) was taken after applying a 1- to 1.5-cm ribbon of lubricating gel onto the external cervical os. Adequacy of Pap smear and discordance in diagnosis between the paired smears were examined.The proportion of unsatisfactory smears was significantly higher in the gel-contaminated smears, 12.1% vs. 1.7% (p < 0.01). This difference was consistent across all reproductive groups. For patients who had smears satisfactory for cytologic evaluation, the discordance in cytologic diagnosis between the gel-contaminated and uncontaminated smears from the same patient was 0.3%.Lubricating gel contamination of the cervix can adversely affect adequacy and cytologic diagnosis in the conventional Pap smear.