Effect of Lubricant Use on Cervicovaginal Cytology – What's the Evidence?

 

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Abstract

Objective To determine if the use of lubricating gel on the speculum during the cervicovaginal cytology examination interferes with the results obtained, as well as whether it reduces reported discomfort in patients.

Data sources A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, with a search in the Pubmed/Medline, Scielo, Cochrane Library, Embase databases of articles published between January 2011 and May 2022. The keywords used were cytology, speculum, lubricant, result, and pain.

Selection of studies The initial search resulted in 306 articles, of which were excluded three because they were duplicates, 257 after reading the title and abstract and 41 after reading the full text. Thus, five articles were selected for the study: four randomized clinical trials and one metanalysis.

Data collection The selection of articles was performed by two investigators. The 5 selected articles were read in full and submitted to a comparative analysis.

Data synthesis Screening through cervicovaginal cytology allows for early diagnosis and reduction of associated mortality, but the procedure can be associated with pain. A small amount of aqueous lubricating gel in the speculum can be used to reduce the discomfort associated with performing cervicovaginal cytology.

Conclusion The use of lubricating gel in the speculum does not seem to be associated with a change in the cytology result and reduces the discomfort associated with its insertion into the vagina.

Resumo

Objetivo Determinar se o uso de gel lubrificante no espéculo durante o exame de citologia cervicovaginal interfere com os resultados obtidos e se diminui o desconforto relatado por pacientes.

Fontes de dados Foi realizada uma revisão sistemática segundo as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), com pesquisa nas bases de dados Pubmed/Medline, Scielo, Cochrane Library, Embase, de artigos publicados entre janeiro de 2011 e julho de 2022. Utilizaram-se as palavras-chave citologia, espéculo, lubrificante, resultado e dor.

Seleção dos estudos A pesquisa inicial resultou em 306 artigos, dos quais foram excluídos três por se encontrarem duplicados, 257 após a leitura do título e do resumo e 41 após a leitura integral. Assim, foram selecionados cinco artigos para o estudo: quatro ensaios clínicos aleatorizados e uma metanálise.

Coleta de dados A seleção dos artigos foi realizada por dois investigadores. Os cinco artigos selecionados foram lidos na íntegra e submetidos a uma análise comparativa.

Síntese dos dados O rastreio através da citologia cervicovaginal permite um diagnóstico precoce e redução da mortalidade associada, mas a sua realização pode estar associada a dor. Uma pequena quantidade de gel lubrificante aquoso pode ser utilizada no espéculo para diminuir o desconforto associado à realização da citologia cervicovaginal.

Conclusão A utilização de gel lubrificante não está associada a alteração do resultado da citologia e diminui o desconforto associado à sua introdução na vagina.

Publication History

Received: 27 July 2022

Accepted: 14 August 2023

Article published online:
29 November 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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