Effect of cervical wiping with sterile cotton on the quality of pap-smear

ABSTRACT

There are conflicting reports about the effect of wiping cervix with cotton on Pap-smear results. Therefore, we aimed to do a research about this subject. 234 eligible women attended to have Pap-smear at an educational hospital in Rasht, Iran, from July to September 2011, were allocated by block randomization into two groups. In the intervention group, we cleaned cervix with a sterile cotton rotating 360 degrees and obtained samples using spatula for exocervix and cytobrush for endocervix. This method was performed without cleaning the cervix on the control group. Data collection, vulvovaginal examination, laboratory assay were done by investigators masked to the group allocation. Participants were also blind. The data were analyzed using logistic regression in SPSS-13. Rate of sufficient endocervical cell of the slides in the intervention group was significantly higher than in the control group [70.3% vs. 57.8%, p=0.03]. In the intervention group 42.4% of the slides were satisfactory and 57.6% had limited quality for interpretation. These figures in the control group were 37.1% and 62.9%, respectively. This difference was not statistically significant. Also, there was no significant difference between the groups on rate of slides with inadequacy of squamous cells and obscuring 75% or more of the slides with inflammatory exudate or blood [p>0.05]. There were no significant differences between the groups on some quality indicators of the smears. However, frequency of smears with sufficient endocervical cells was higher in the group with cervical wipping. Therefore, it is recommended to clean cervix before obtaining the smears