Vaginal lubricant gel as an artefact on a Pap smear

Abstract

After reading some articles on the issue of whether the use of lubricant gel may have any effect on cervicovaginal smears, both in conventional cytology and in liquidbased preparations, in our opinion, the authors’ conclusions seem contradictory. Here is an image corresponding to a routine conventional cervicovaginal Pap smear from a young female sex worker. It shows a violet-shaded amorphous material smeared in a wave-like pattern. This material covers both the background and epithelial cells (Fig. C-1), which obscures a large portion of the smear. Some infectious agents such as actinomyces-like organisms (no filamentous structures were observed) and processes like vaginal bacteriosis (absence of the typical ‘‘clue cells’’ and coccobacilli) were discarded as differential diagnosis. As a possible artefact caused by some vaginal cream was suspected, the patient was asked about the use of some product for the genital zone. She answered that she usually put on vaginal gel to provide lubrication during sexual intercourse. Due to painful coituses, vaginal dryness may constitute an important problem, especially when psychological or physiological alterations (menopause, breastfeeding, diabetes, etc.) exist. Therefore, additional lubricants for sexual intercourse are commonly used. Because this type of products may cause artefacts on smears, cytotechnicians and cytologists should be alert when screening is exercised.