88174 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision

Name of the Procedure:

Cytopathology, Cervical or Vaginal (Any Reporting System), Collected in Preservative Fluid, Automated Thin Layer Preparation; Screening by Automated System, Under Physician Supervision

Common Names: Pap Test, Pap Smear, Cervical Cytology

Summary

A cytopathology test where cells from the cervix or vagina are collected, preserved in a special fluid, prepared into thin layers, and screened using an automated system supervised by a physician. It helps in detecting abnormal or pre-cancerous cells.

Purpose

The procedure aims to screen for cervical cancer and other abnormalities in the cervix or vagina. It helps in the early detection of potential issues, enabling prompt and effective treatment.

Indications

• Routine screening for cervical cancer.
• Investigation of abnormal vaginal bleeding.
• Follow-up for previously detected abnormalities.
• Women aged 21 and above, as per guidelines.

Preparation

• Avoid sexual intercourse, douching, or using vaginal medications for at least 48 hours before the test.
• Schedule the test when you are not menstruating.

Procedure Description

1. Patient Positioning: You will lie on an exam table with your feet in stirrups.
2. Speculum Insertion: A speculum is gently inserted into the vagina to allow visibility.
3. Cell Collection: Cells are collected from the cervix using a small brush or spatula.
4. Preservation: Collected cells are placed in a preservative fluid.
5. Laboratory Processing: The sample is processed into thin layers using automated technology.
6. Automated Screening: An automated system screens the samples to detect abnormal cells, under the supervision of a physician.

Duration

The procedure takes about 10-20 minutes.

Setting

Typically performed in an outpatient clinic or a gynecologist's office.

Personnel

• Gynecologist or trained healthcare provider.
• Laboratory technologist and pathologist (for sample preparation and analysis).

Risks and Complications

• Mild discomfort or cramping during the procedure.
• Light spotting post-procedure.
• Rare risk of infection or injury to the cervix.

Benefits

• Early detection of cervical cancer and other abnormalities.
• Reduction in cervical cancer mortality with regular screening.
• Quick and effective analysis through automated systems.

Recovery

• Resume normal activities immediately after the procedure.
• Follow any specific post-procedure instructions provided by your healthcare provider.
• Schedule follow-up appointments as recommended based on the results.

Alternatives

• HPV testing as a primary screening method.
• Visual inspection with acetic acid (VIA) in low-resource settings.
• Pros: HPV testing can directly detect high-risk viruses, and VIA is low-cost.
• Cons: Pap smear provides cellular-level analysis, which can detect non-viral abnormalities.

Patient Experience

• You may feel slight discomfort or pressure during the insertion of the speculum.
• Light spotting or cramping may occur but is typically short-lived.
• Pain management is generally not necessary, but discussing concerns with your provider is recommended.