PAPSMEAR                                                            

Papanicolaou test                                                                    

Definition                                            

A microscopic examination of cells scraped from the cervix.

How the test is performed   

You will be asked to lie on your back with your feet in the stirrups. A pelvic examination will be done, and a speculum (an instrument used to open the walls of the vaginal canal in order to examine the interior) will be inserted into your vagina and opened slightly. A sample of cells from the outside and the canal of the cervix is taken by gently scraping the outside of the cervix with a wooden or plastic spatula (shown at the left), then inserting a small brush that looks like a pipe cleaner into the canal. The cells are placed on a glass slide and sprayed with a fixative, or put in a bottle containing a preservative, then sent to the lab for examination.

How to prepare for the test   

The health care provider should be notified of a prior abnormal Pap smear, if you might be pregnant, and you are taking any medications or birth control pills. You should avoid douching, using tampons, having intercourse, and tub bathing 24-hours before the test. Empty your bladder just before the test.

How it feels   

There may be some discomfort and a feeling of pressure during the procedure. A small amount of bleeding may occur after the test.

Risks   

There are no risks involved.

Why the test is performed    The Pap smear can detect cancerous or precancerous conditions of the cervix.

For recommendations on the frequency of having this test done, see also the information on cervicitis.

Normal values   

The test is negative, meaning there are no abnormal cells present.

What abnormal results mean   

The current system of reporting divides the results into three main areas: benign or non-cancerous, pre-cancerous or showing some abnormal cell changes, and malignant or possibly cancerous. A report in the latter two categories will usually lead to a follow-up examination, including a repeat Pap smear and possibly other tests. If you have never had an abnormal Pap smear before, and the result indicates a mild abnormality, the Pap test is repeated in 6 months. If the test result suggests a sever abnormality or cancer, you should undergo immediate colposcopic evaluation with biopsies. If you have had an abnormal Pap test in the past, or have had treatment for a precancerous change, you should have an immediate colposcopy.

Special considerations   

The following drugs may affect the Pap smears:

• Colchicine
• Estrogen
• Podophyllin
• Progestins
• Silver nitrate