title: Does lubrication of the vaginal speculum reduce pain during a gynecologic oncology examination?
abstract: OBJECTIVE
  To evaluate the effectiveness of lubricant gel for reducing pain during a vaginal speculum examination (SE) in patients with gynecologic cancers.
  
  
  METHODS
  This non blind randomized controlled trial included 200 women who underwent SE for post-treatment surveillance. One-hundred patients each were allocated to the water and lubricant gel groups. All patients were asked to score their pain during speculum insertion, dilatation, and extraction using a visual analog scale (VAS). Pain intensity during speculum insertion was the primary outcome measure.
  
  
  RESULTS
  There were no statistically significant differences in demographic characteristics between the water (n = 97) and lubricant gel (n = 98) groups. The VAS pain scores obtained during all phases of the SE were significantly lower in the lubricant gel group compared with the water group during the insertion (3.95 ± 1.57 vs. 5.28 ± 1.71, P < 0.001), dilatation (5.96 ± 1.48 vs. 6.74 ± 1.69, P < 0.001) and extraction phases (2.60 ± 1.17 vs. 3.50 ± 1.25 P < 0.001). When a separate analysis was performed for the patients who underwent radiation therapy, the mean VAS pain scores were significantly lower in the lubricant gel group during the insertion (4.46 ± 1.45 vs. 6.22 ± 1.79, P < 0.001), dilatation (6.31 ± 1.66 vs. 7.52 ± 1.61, P = 0.002) and extraction phases (2.68 ± 1.31 vs. 3.66 ± 1.06, P = 0.001).
  
  
  CONCLUSIONS
  The use of speculum lubricant gel significantly decreased pain during the SE in gynecologic oncology patients.
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey. Electronic address: maidenkemal@yahoo.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Gungorduk
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozdemir
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gökçü
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sancı
mesh_terms: D000328:Adult; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D058869:Gynecological Examination / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008153:Lubrication; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D013525:Surgical Instruments
keywords: Gynecologic malignancy; Lubricating gel; Speculum examination