The effect of vaginal lubrication on unsatisfactory results of cervical smears.
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.


METHODS
We searched MEDLINE (1966- 2013), Scopus (2004-2013), Clinicaltrials.org (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.
First Department of Obstetrics and Gynecology, Athens University, Alexandra Hospital, Athens, Greece.
Vasileios
V
Pergialiotis
Dimitrios G
DG
Vlachos
Alexandros
A
Rodolakis
Nikolaos
N
Thomakos
Dimitrios
D
Christakis
Georgios D
GD
Vlachos
D005260:Female; D006801:Humans; D054327:Lubricants / Q000008:administration & dosage* / Q000009:adverse effects*; D008153:Lubrication / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000379:methods*
D054327:Lubricants