Pap Smear Video

Researched and Presented by Anthony
Description: Obtaining a pap smear from the cervix and cervical canal.
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This is how a pap smear is done, however, for a complete summary of information, here are the things you need to know about the procedure.

What is a Pap Smear?

A Pap smear (also known as the Pap test) is a medical procedure in which a sample of cells from a woman's cervix (the end of the uterus that extends into the vagina) is collected and spread (smeared) on a microscope slide. The cells are examined under a microscope in order to look for pre-malignant (before-cancer) or malignant (cancer) changes.

A Pap smear is a simple, quick, and relatively painless screening test. Its specificity - which means its ability to avoid classifying a normal smear as abnormal -- while very good, is not perfect. The sensitivity of a Pap smear - which means its ability to detect every single abnormality -- while extremely good, is also not perfect. Thus, a few women develop cervical cancer despite having regular Pap screening.

In the vast majority of cases, a Pap test does identify minor cellular abnormalities before they have had a chance to become malignant and at a point when the condition is most easily treatable. The Pap smear is not intended to detect other forms of cancer such as those of the ovary, vagina, or uterus. Cancer of these organs may be discovered during the course of the gynecologic (pelvic) exam, which usually is done at the same time as the Pap smear.

How is a Pap smear done?

A woman should have a Pap smear when she is not menstruating. The best time for screening is between 10 and 20 days after the first day of her menstrual period. For about 2 days before testing, a woman should avoid douching or using spermicidal foams, creams, or jellies or vaginal medicines (except as directed by a physician). These agents may wash away or hide any abnormal cervical cells.

A Pap smear can be done in a doctor's office, a clinic, or a hospital by either a physician or other specially trained health care professional, such as a physician assistant, a nurse practitioner, or a nurse midwife. With the woman positioned on her back, the clinician will often first examine the outside of the patient's genital and rectal areas, including the urethra (the opening where urine leaves the body), to assure that they look normal. A speculum is then inserted into the vaginal area (the birth canal). The speculum is an instrument that allows the vagina and the cervix to be viewed and examined. A cotton swab is sometimes used to clear away mucus that might interfere with an optimal sample.

A small brush called a cervical brush is then inserted into the opening of the cervix (the cervical os) and twirled around to collect a sample of cells. This sample, because it comes from inside the cervix, is called the endocervical sample ("endo" meaning inside). A second sample is also collected as part of the Pap smear and is called the ectocervical sample ("ecto" meaning outside). These cells are collected from a scraping of the area surrounding, but not entering, the cervical os. Both the endocervical and the ectocervical samples are gently smeared on a glass slide and a fixative (a preservative) is used to prepare the cells on the slide for laboratory evaluation.

A bimanual (both hands) exam usually follows the collection of the two samples for the Pap smear. The bimanual examination involves the examiner inserting two fingers of one hand inside the vaginal canal while feeling the ovaries and uterus with the other hand on top of the abdomen (belly).

The results of the Pap smear are usually available in 2 to 3 weeks. At the end of Pap smear testing, each woman should ask how she should expect to be informed about the results of her Pap smear. If a woman has not learned of her results after a month, she should contact her clinician's office.

What are the possible recommendations for follow-up after a Pap smear?

Once the final diagnosis has been made, the follow-up recommends what the appropriate next step(s) might be. For example, if the final diagnosis states that the smear was "within normal limits," the appropriate follow-up might be "recommend routine follow-up."

An abnormal Pap smear is one in which the laboratory interprets the cellular changes to be different from those normally seen on a healthy cervix. There are a number of possible follow-up scenarios for an abnormal Pap smear.