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The Effect of Lubricant on Cytology Specimens

In the medical community, evidence guides practice and new research is conducted all the time to test theories and challenge current best practice to pave the way for tomorrow’s best practice. The art of medicine and science is ever-evolving and researchers dedicate themselves to testing theories and proving methods. For decades, medical lubricating jelly was used to make invasive procedures more comfortable. In the late 1990s, however, this practice was challenged and many practitioners discontinued the practice of lubing speculums prior to insertion out of concern that the lubricant may affect the integrity of cytology specimens. In today’s post, we will review some of the literature to determine if these beliefs were founded and establish best practice methods.

Medical lubricant is used to make invasive medical procedures more comfortable for patients. For procedures like cervical exams and Papanicolaou (Pap) smears, water-soluble medical lubricants have been preferred over oil-based lubricants to reduce the wear and tear on plastic speculums and, more importantly, to reduce the effects on cytology specimens.

While this has been an accepted practice for the better part of a century without incident, it wasn’t until the 1990s when research was conducted to test the hypothesis that water-based lubricating jellies had little effect on lab specimens. One study used a sample population across five different clinics In a random, double-blind trial that lasted six months, water-based lubricant or plain water was used as lube during Pap smears. The results were an astonishing dead tie. Both the water and the water-based lubricant caused negative effects in less than 1.4% of the samples tested.

In another, similar, study performed the following decade, more than 5,500 samples were tested. With the use of water-based gel lubricants, the cytology error rates caused by unsatisfactory samples was a mere 1.1% as opposed to the 1.5% of samples solicited using plain water as a lubricant. The difference in the results is not statistically significant enough to draw conclusions or make the claim that using a water-based lubricant yields better results than using water, but it is significant enough to confidently state that it does not negatively affect samples or pose a threat to the integrity of Pap smear procedures.

With these results in mind, it would be irresponsible to remove medical lubricant from the procedure. Not only does medical lubricant make invasive vaginal procedures like a Pap smear more comfortable for the patient, making them more likely to follow-up on routine preventative appointments, but it also reduces vaginal tearing, shearing, or tissue damage caused by friction of the speculum. Additionally, water-soluble medical lubricants including HR Lubricating Jelly offer not only premium viscosity that directly translates to patient comfort and safety, but also include bacteriostatic properties that reduce the risk of infection caused by invasive procedures.

HR Lubricating Jelly is paraben and glycol-free and doesn’t contain additives that cause sensitivities to patients or damage to instruments. HR Lubricating Jelly has been the go-to medical lubricant for gynecologists and obstetricians for more than 80 years, and for good reason. If you perform vaginal exams or Pap smears in your clinic, be sure to keep your storage rooms fully stocked with the lubricant that makes your job easier and your patients’ visit more comfortable. Browse our entire collection online today.

For more information and to review the results of more similar studies, visit these online resources.

Lubrication of The Vaginal Introitus and Speculum Does Not Affect Papanicolaou Smears

Association of Speculum Lubrication with Pain and Papanicolaou Test Accuracy 

Effect of Lubricating Gel on Patient Comfort During Vaginal Speculum Examination: A Randomized Controlled Trial

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