CERVICAL CREENING TEST

DEFINITION AND INDICATION FOR PAP SMEAR

A pap smear, also called a pap test, is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on your cervix.

RELEVENT ANATOMY

The female reproductive organs can be subdivided into the internal and external genitalia. The internal genitalia are those organs that are within the true pelvis, these include the vagina, uterus, cervix, uterine tubes (oviducts or fallopian tubes) and ovaries. The external genitalia lie outside the true pelvis, these include the perineum, mons pubis, clitoris, urethral (urinary) meatus, labia majora and minora, vestibule, greater vestibular (Bartholin) glands and per urethral area.

The cervix is the inferior portion of the uterus, separating the body of the uterus from the vagina. The cervix is cylindrical in shape, with an endocervical canal located in the midline, allowing passage of semen into the uterus. The external opening into the vagina is termed the external os and the internal opening into the endometrial cavity is termed the internal os. The internal os is the portion of a female cervix that dilates to allow delivery of the fetus during labor. The average length of the cervix is 3-5cm.

THE AGE AND PAP SMEAR FREQUENCY

 

AGE

 

PAP SMEAR FREQUENCY

 

 

< 21 Years old

 

None needed

 

21-29

 

Every 3 years

 

30- 65

 

Every 3 years or an HPV test every 5 years or a pap test and HPV test altogether every 5 years.

 

 

65 and older

 

You may no longer need pap smear tests; talk to your doctor to determine you needs.

 

PREPARATION FOR A PAP SMEAR

  1. Screening should be scheduled for when the patient is not menstruating.
  2. Avoid vaginal intercourse, douching, use of tampons, use of medicinal vaginal cream or contraceptive for 24-48 hours prior to cervical screening.
  3. Ideally, pre-existing cervicitis should be treated prior to cervical screening.
  4. Screening however, should proceed in the presence of bleeding or cervicitis, as these symptoms may be related to cervical dysplasia or neoplasm, which may be detected with cervical screening.

EQUIPMENT

  1. Examination table with foot stool supports.
  2. Examination light.
  3. Metal or plastic speculum.
  4. Examination gloves.
  5. Cervical spatula and cytobrush.
  6. Liquid-based cytology container or glass slide fixative.

POSITIONING FOR PAP SMEAR

In the event that a patient is scheduled for a pap smear, the best position to be in for the test would be a supine, dorsal lithotomy position to correctly perform a pap smear (image below).

The coccyx of the patient must be at the edge of the examination table to provide adequate visualization of the cervix once the speculum is inserted.

COMPLICATIONS

Complications from a pap smear are extraordinarily rear but may include minor bleeding and infection. Patient should also be educated on the likelihood of vaginal spotting immediately after a pap smear is performed, as this is considered normal.

COMPILED BY:

OLURIN ITUNUOLUWA 

(REGISTERED NURSE)

MERCY GROUP CLINICS, ABEOKUTA, OGUN STATE.

 

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