Effective reduction in inadequate Pap smears by using a saline-lubricated speculum and two glass slides

Abstract

Objective: The aim of the study was to propose a method using saline lubrication and two glass slides to reduce the proportion of inadequate Pap smears. Materials and methods: This was a retrospective study of patients at a medical center in eastern Taiwan that performs 5000–6000 Pap smears annually. The extracted data only detailed the number and percentage of inadequate Pap smears. We applied two modifications to the conventional Pap smear technique. The first modification was lubricating the speculum with normal saline instead of jelly. The second modification was performing the smear on two glass slides instead of just one. We used the modified technique beginning in January 2017. Therefore, we collected data from 2016 (before the modified technique was employed) and 2018 (after the modified technique was employed). The categorical data are presented as numbers (percentages). The differences in the number and percentage of inadequate smears resulting from both techniques were assessed using the Chi-square test. Results: During 2016 and 2018, 28 and 2 women received inadequate Pap smears among the total of 594 and 613 women who received Pap smears, respectively. The proportion of inadequate Pap smears was 4.71% and 0.33% in 2016 and 2018, respectively (P < 0.001). Conclusions: The use of this modified technique effectively reduced the percentage of inadequate Pap smears.

Keywords

• Pap smear
• Saline lubrication
• Glass slide
• Inadequate smear
• Insufficient cellularity