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The Effect of Vaginal Lubrication on Unsatisfactory Results of Cervical Smears

Pergialiotis, Vasileios MD, PhD, MSc; Vlachos, Dimitrios G. MD; Rodolakis, Alexandros MD, PhD; Thomakos, Nikolaos MD, PhD; Christakis, Dimitrios MD, MSc; Vlachos, Georgios D. MD, PhD

Journal of Lower Genital Tract Disease: January 2015 - Volume 19 - Issue 1 - p 55–61
doi: 10.1097/LGT.0000000000000037
Original Articles: Vulva and Vagina

Objective Speculum lubrication with water-based gels before cervical smear sampling has been investigated and commented on thoroughly during the last decade. The present meta-analysis was based on randomized and quasi-randomized control trials and evaluated its impact on unsatisfactory cytologic results. We also assessed its efficacy in producing lower pain scores during speculum insertion.

Materials and Methods We searched MEDLINE (1966– 2013), Scopus (2004–2013), (1997–2013), Popline (1973–2013), Cochrane Central Register of Controlled Trials (CENTRAL) (1999–2013), and Google Scholar (2004–2013) engines for published randomized control trials, as well as the reference lists from all the included studies.

Results Five randomized trials and 2 quasi-randomized trials were included in the present review involving 8,717 women. Unsatisfactory results based on conventional cytology did not statistically differ among procedures performed with lubricated speculums and those without (odds ratio = 0.94, 95% CI = 0.64–1.37). Consequently, pain scores also did not differ significantly among the 2 groups (odds ratio = −0.37, 95% CI = −1.10 to 0.36). Only 2 studies evaluated unsatisfactory results on liquid-based cytology, precluding firm results.

Conclusions It seems that speculum lubrication does not interfere with the rates of unsatisfactory results when examination is based on conventional cytology. Conversely, however, the limited number of studies evaluating speculum lubrication on liquid-based cytology precludes firm conclusions.

Standard water-based gel lubricants do not interfere with conventional cytology on rates of unsatisfactory results of cervical smears.

First Department of Obstetrics and Gynecology, Athens University, Alexandra Hospital, Athens, Greece

Reprint requests to: Pergialiotis Vasileios, MD, 6, Danaidon St, Chalandri 15232, Athens, Greece. E-mail:

The authors have declared they have no conflicts of interest.

Copyright © 2015 by the American Society for Colposcopy and Cervical Pathology