88142 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision

Name of the Procedure:

Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision.

Summary

This procedure involves collecting cells from the cervix or vagina using a special preservative fluid. The cells are then prepared in a thin layer using automated technology, and a pathologist manually screens the sample under physician supervision to check for abnormalities.

Purpose

The procedure is primarily performed to screen for cervical or vaginal cancer, precancerous conditions, and other infections or abnormalities. The goal is to detect any issues early, allowing for timely and effective treatment.

Indications

• Abnormal vaginal bleeding
• Postmenopausal bleeding
• Routine cervical cancer screening (Pap smear)
• Monitoring of previously identified abnormalities
• Follow-up after cancer treatments

Preparation

• Avoid sexual intercourse, douching, or using vaginal medicines or spermicidal products 48 hours prior to the test.
• Schedule the procedure when not menstruating.
• Inform the healthcare provider of any medications or current health conditions.

Procedure Description

1. The patient lies on an examination table and places her feet in stirrups.
2. A speculum is gently inserted into the vagina to allow access to the cervix.
3. A brush or spatula is used to collect cells from the cervix and/or vaginal walls.
4. The collected cells are placed in a vial containing preservative fluid.
5. The sample is processed using automated thin layer preparation technology to create a slide.
6. A pathologist manually examines the slide under a microscope, supervised by a physician.

Duration

The cell collection part of the procedure typically takes about 5-10 minutes.

Setting

The procedure is performed in an outpatient clinic or a gynecologist's office.

Personnel

• Gynecologist or physician
• Medical assistant or nurse
• Pathologist for sample examination

Risks and Complications

• Slight discomfort or cramping during the procedure
• Minimal risk of infection or bleeding
• Rare risk of an inadequate sample that may require a repeat procedure

Benefits

• Early detection of cervical or vaginal cancer
• Identifies precancerous changes or infections
• Guides treatment decisions and follow-up care

Recovery

• Most patients can resume normal activities immediately.
• Minor spotting or cramping may occur.
• Follow-up appointments may be scheduled based on results.

Alternatives

• Conventional Pap smear: uses direct smear technique instead of a preservative fluid and automation.
• HPV testing alone or combined with Pap smear for more comprehensive screening.

Patient Experience

• Patients may feel slight discomfort during sample collection.
• Mild cramping or spotting is possible afterward.
• Pain management is usually not necessary due to the minor discomfort involved.

Comfort measures like a calm environment and clear communication from healthcare providers can help ease patient anxiety.