Sheathed versus standard speculum for visualization of the cervix

    Authors

    D. A. Hill; M. L. Cacciatore;G. Lamvu

    Comments

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    Abbreviated Journal Title

    Int. J. Gynecol. Obstet.

    Keywords

    Bivalve; Cervix; Gynecologic examination; Speculum; Vaginal sidewall; RANDOMIZED-CONTROLLED-TRIAL; VISUAL ANALOG SCALE; BIVALVE SPECULUM; VAGINAL SPECULUM; Obstetrics & Gynecology

    Abstract

    Objective: To determine whether modifying a plastic speculum with a flexible sheath would improve visualization and decrease pain during vaginal examination. Methods: We conducted a prospective randomized controlled trial of 136 women undergoing vaginal speculum examination at an outpatient obstetrics and gynecology faculty practice. Patients underwent examination via a standardized technique with either a medium-sized plastic speculum (standard) or an identical speculum modified with a flexible polypropylene sheath (sheathed). Investigators recorded the percentage of the cervix visualized. After speculum insertion, patients recorded pain using a 10cm visual analog scale. Results: There were no substantial demographic differences between the standard (n = 67) and the sheathed (n = 68) groups. Investigators were able to visualize a significantly greater percentage of the cervix using the sheathed speculum compared with the standard speculum (95.1% +/- 8.2% vs 78.2% +/- 18.4%; P < 0.001), representing a 21.6% improvement in visualization, and were able to visualize the entire cervix in 42 (61.8%) patients when using the sheathed speculum compared with 11 (16.4%) patients undergoing standard speculum examination (P < 0.001). Patients undergoing examination with the sheathed speculum reported a nonsignificant decrease in pain scores (1.0 vs 1.2; P = 0.087). Conclusion: A sheathed speculum significantly improves visualization of the cervix, without compromising patient comfort. (c) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

    Journal Title

    International Journal of Gynecology & Obstetrics

    Volume

    125

    Issue/Number

    2

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    116

    Last Page

    120

    WOS Identifier

    WOS:000335279300006

    ISSN

    0020-7292

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