Name of the Procedure:

• Common Name(s): Pap Smear, Pap Test
• Medical Term: Screening Papanicolaou Smear (Q0091)

Summary

A Pap smear is a routine screening procedure used to test for cervical or vaginal cancer. During the procedure, a healthcare provider collects cells from the cervix or vagina and sends them to a laboratory for analysis.

Purpose

• Conditions Addressed: Pre-cancerous or cancerous cells in the cervix or vagina, human papillomavirus (HPV) infection.
• Goals/Outcomes: Early detection of cervical or vaginal cancer, allowing for prompt treatment and better outcomes.

Indications

• Symptoms/Conditions: Irregular menstrual bleeding, unexplained pelvic pain, or history of HPV infection.
• Patient Criteria: Women aged 21 and older, sexually active women, and those with a history of abnormal Pap smears.

Preparation

• Pre-procedure Instructions: Avoid douching, intercourse, or using vaginal medicines 24-48 hours before the test. No fasting required.
• Diagnostic Tests/Assessments: No additional testing generally required beforehand.

Procedure Description

1. The patient will lie on an exam table and place her feet in stirrups.
2. A healthcare provider inserts a speculum into the vagina to visualize the cervix.
3. Using a small brush or spatula, the provider collects cells from the cervix and/or vaginal walls.
4. The cell sample is placed on a glass slide or in a liquid-based solution for laboratory analysis.

• Tools/Equipment: Speculum, cervical brush or spatula, glass slides or liquid-based cytology vial.
• Anesthesia/Sedation: None required.

Duration

• Procedure Time: Typically 5-10 minutes.

Setting

• Location: Outpatient clinic, gynecologist's office, primary care physician's office.

Personnel

• Healthcare Providers: Nurse, Medical Assistant, Gynecologist, or Primary Care Physician.

Risks and Complications

• Common Risks: Mild discomfort, slight bleeding or spotting post-procedure.
• Rare Risks: Infection, severe bleeding.

Benefits

• Expected Benefits: Early detection of cervical or vaginal abnormalities, which can lead to timely and effective treatment.
• Realization of Benefits: Usually within a couple of weeks, once lab results are available.

Recovery

• Post-Procedure Care: Patients can resume normal activities immediately; minimal or no restrictions.
• Recovery Time: Immediate.
• Follow-Up: Depending on results; if abnormal, further diagnostic testing or treatment may be required.

Alternatives

• Other Options: HPV testing, combination HPV and Pap testing.
• Pros and Cons: HPV testing also detects high-risk strains that can lead to cancer, potentially providing earlier intervention.

Patient Experience

• During Procedure: Slight discomfort during speculum insertion and cell collection; usually quick.
• After Procedure: Minor cramping or spotting; over-the-counter pain relief if necessary; otherwise, normal activities can be resumed immediately.