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Paperchase 2: Decreasing Discomfort in the Speculum Exam

Andrew Buelt, DO and Joe Weatherly, DO
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No me gusta!

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Do you use gel during speculum exams? If not, it may be that you were taught gel would interfere with Pap results. This paper suggests that is not the case.

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Paul B. -

Rumor has it that gel interferes with the results of GC/Chlamydia testing. Any insight into that?

Joe W. -

Great question! Urine GC/C testing of course is not believed to be affected by the speculum exam with or without gel.
From a practical standpoint, reasonable amount of gel wiped on the bill of the speculum should be dispersed over the labia/vaginal walls or canal on the speculums brief journey. Little if any actually comes into contact with the cervix and when it does, it does not appear to affect testing [Contraception 2005;72(1):60–4] using any of the 3 common NAATs. (Different labs use polymerase chain reaction (PCR), transcription-mediated amplification, and strand displacement amplification) Theses tests perform consistently with or without gel with sensitivities around 95% and specificity between 80-90% depending on the NAAT. Ann Intern Med. June 7, 2005;142:914–25
Urine testing is very reasonable alternative for the DIY type patients and would likely not involve gel if there are any questions. Hope this helps!

--Your Paper...and question chasing team.

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