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Lubricants

Lubricant Introduction

As an aid for patient comfort, lubricants are frequently used during the pelvic examination. However, usage of lubricant is not recommended by published guidelines (CLSI (Formerly NCCLS) Document GP15-A3, ACOG Practice Bulletin, no. 45, November 2008) because their use can adversely affect the Pap result in many ways including:

  • Abundant lubricant on the cervical face will require removal with swabbing of the cervix which theoretically could remove exfoliated diagnostic cells.
  • Residual lubricant could interfere with the endocervical brush and spatula or cervical broom in the acquisition of cervical cells.
  • Residual lubricant could create a potential immiscible interface in alcohol based liquid Pap solutions leading to potential agglutination and cellular loss.
Hologic, Inc. has evaluated a variety of popular lubricants and found that those containing an ingredient known as "carbomers" or "carbopol polymers" are prone to interfere with popular liquid based Pap Tests.

Lubricant Gallery

Cytologists may be asked to evaluate the cause of "unsatisfactory" Pap samples. The following photographs illustrate the appearance of the different lubricants as seen in ThinPrep® Pap Test (TPPT) preparations.

A TPPT vial containing epithelial cells of moderate to high maturation and devoid of visible lubricant was identified for use in this comparison presentation. The TPPT vial was divided equally into five new TPPT vials with subsequent addition of a lubricant.
Image 5
Lubricant F 10x
Lubricant F
10x
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Lubricant G 10x
Lubricant G
10x
Image 5
Lubricant H 10x
Lubricant H
10x
Image 5
Lubricant I 10x
Lubricant I
10x
Image 5
Lubricant J - Image 1 10x
Lubricant J - Image 1
10x
Image 5
Lubricant J - Image 2 10x
Lubricant J - Image 2
10x
Image 5
Lubricant K - Image 1 10x
Lubricant K - Image 1
10x
Image 5
Lubricant K - Image 2 40x
Lubricant K - Image 2
40x
Image 5
Lubricant K - Image 3 40x
Lubricant K - Image 3
40x
Image 5
Lubricant L 10x
Lubricant L
10x
Image 5
Lubricant M - Image 1 10x
Lubricant M - Image 1
10x
Image 5
Lubricant M - Image 2 10x
Lubricant M - Image 2
10x
Image 5
Lubricant N 10x
Lubricant N
10x

Although Hologic does not recommend the use of lubricants, if one must be used due to patient discomfort or use of a plastic speculum, it should be done sparingly with care to avoid the tip of the speculum. This will decrease the possibility of suboptimal slide preparation due to excessive lubricant.

Download the ThinPrep Customer Lubricant Letter

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