Gynecologic Pap Smear, Two Slides, and Maturation Index w/ Reflex*

Diagnose primary or metastatic neoplasma; diagnose genital infections with herpesvirus, Candida, Trichomonas vaginalis, cytomegalovirus, and Actinomyces; aid in the diagnosis of vaginal adenosis, cervicovaginal endometriosis, human papillomavirus (HPV), lymphogranuloma venereum; aid in evaluating hormonal function (maturation index); evaluate cellular composition of the surface layers of vaginal squamous epithelium, which reflects balance of estrogen and progesterone effects upon this target tissue; diagnose conditions producing abnormal cytohormonal balance (ie, pituitary dysfunction, ovarian dysfunction, feminizing tumor, and virilizing tumor).

Failure to obtain adequate ectocervical, endocervical, or vaginal cell population renders the specimen suboptimal for evaluation. Excessive use of lubricating jelly on the vaginal speculum will interfere with cytologic examination and may lead to unsatisfactory Pap results. All powder should be wiped off gloves before spatulas are handled since presence of starch granules will make interpretation of slides difficult. Inflammatory reaction may preclude hormonal evaluation. A very significant proportion of adenocarcinomas of endometrium are not detected by this means. Occasionally, highly differentiated adenocarcinomas of endocervix can be missed. Occasional aggressive lesions of squamous epithelium of cervix can be missed, especially if patient has only a single examination.

Patient should avoid douches 48 to 72 hours prior to examination. Specimen should not be collected during or shortly after menstrual period. Excessive use of lubricating jelly will interfere with cytologic examination.