nickel

pap smears. how many of you have had one or have them once/yr like you should?

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Jenny

me

blah

hate em

but... better than cervical cancer.

Kim

Yep, every year.

Momma Kitty

Unfortunatly I do. I hate those things with a passion!!!

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Freelance Superhero

don't kill me for intruding here, but i've always wondered: what exactly IS a pap smear? i'd like to be enlightened...

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Kim

A doctor scrapes cells off your cervix to check for cancer.

guiseppewv

So why do they call it a pap smear? A pap scrape maybe but not a smear.

Sorry for the intrusion, I'm curious too. Curiosity has always gotten the better of me.

Kim

I think it is because after they scrape you, they smear the cells on a glass slide thing.

guiseppewv

Thanks. Makes more sense, now. Is it a painful process? On a 1-10 scale, where 1 is nicking your self whe you shave, 6 is a bee sting, and 10 is giving birth.

This is one of the more interesting and mature threads I have seen in a while.

Kim

I wouldn't say it's painful, just very uncomfortable. It sort of hurts when they expand the speculum, and I usually cramp a bit after ward, but it's nothing like child birth. For me, I'd say it's a 2 on the pain scale.

guiseppewv

Thanks for the info, I appreciate your candor, and that you ladies weren't pi$$ed that I posted in your thread. I have always been a little too curious for some people.

whitak24

wow, this thread went 5 posts before a guy butted in

(actually, that's far better than usual).

as for me, i know all about pap smears thanks to my GF. she absolutely and unreservedly hates them, but she does have one every year. but i've heard plenty of details about exactly how the process works

avlena

i hate the gyno's office in general... i just don't like the idea of a stranger sticking stuff up there! my first time i went in, the doc was like: "hmm... i can use the metal one, or the plastic one... " thankfully, she had pity and didn't use the cold metal thing!

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nickel

any one know a couple of things you should not do the day/night before you have a pap smear? doing so will mess up the results.

Jenny

I'm guessing have sex, get your period, douche (or whatever... never done it).

?

Anyway, for pain for me, the actual scrape really isn't painful. Uncomfortable, but.. The painful thing is like Kim said, the speculum being expanded.

nickel

bingo Jen

i found that out the hard way

speedracer120

OK, good to see that I'm not the only one to intrude, but I had a sophmore English teacher who immigrated from Hungary back when they had their "political" uprisings against the Red Commies, but anyways. His name was Pap. And all we ever had to do to piss him off was start calling him Pap Smear, or Pappy (i.e. Black Sheep Squadron).

Just thought I'd add that to this otherwise uncomfortable thread.

Freelance Superhero

thank you for the info, ladies...

hmm yeah, it doesn't sound like much fun. i know i wouldn't want any crevices in my nether regions "expanded" in any way....

jujubees

My gyno is so cool ... she told me that no vegetables were allowed the night before!

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Fas-ligand

not to offend, yet another guy joining in the thread, but I've been on the testing end of pap smears. It's really interesting seeing all the cell types under the microscope. It's pretty easy to pick out healthy patients versus unhealthy.

...and yes, the smear of pap smears has to do with the doc smearing the cells on a glass slide. Technically, and not that it makes much difference, but maybe someone wants to know, there is a new procedure that puts the cells into a solution that is mixed and a slide made from that. It's much better for diagnosing patients because it's a better representative sample, rather than selecting only the spots the doc scrapes.

my 2 cents.

nickel

ever see a sperm cell under that microscope when examining a pap smear?

Fas-ligand

Nope, can't say that I have, but while I've looked at numerous slides, I'll bet sperm cells are very small to detect and, more likely, don't appear in a cytospin often. (this is the other method I was talking about versus directly using a slide).

For info: http://yourmedicalsource.com/library...P_prepare.html

Here's a cool picture I found of what a smear looks like under the microscope. Usually there are more colors. In this picture, the more squat cells in the center are malignant cells.

cool pic

InfiniteNothing

So do you administer the test or just observe the cells. Are you a gyno? Kinda makes me want to go to medical school (The line of women waiting to spread it in front of you). Though, I can imagine alot of things are...less than pleasant.

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Fas-ligand

yeah, like any doctor, you might imagine it to be glamourous, but you really have to deal with strange cases sometimes. I think your line of women waiting aren't feeling all that happy to be getting their pap smear, in case you haven't read the above comments from women feeling uncomfortable.

...and for the record, no, I'm not a gynocologist.

Momma Kitty

He may be no gynocologist, but he has been to a few pelvic exams/pap smears. He has been on both ends of the test. I love him to death but I just don't like the fact that he thinks something I loath is really cool and interesting.

As for the pain, I have never given child birth, and I don't know why this would be but it hurts to get the scrape done. I would have to say at least a 4 or 5 on the pain scale. Maybe it is just me, but the actual scraping hurts as much as the speculum going in.

InfiniteNothing

hmm? I didn't know men had cervixes

Fas-ligand

errrrr......

in defense of myself, I have only been in the room, not getting it performed on me.

brainsmile

History of the Pap Smear


Dr. George Papanicolaou, 1883-1962
The Pap smear is called that because of the doctor who researched and published about the technique, thereby popularizing it. His research wad done with a pathologist named Dr. Herbert Traut, and it had a tremendous impact on reducing the number of deaths from uterine cancer, world-wide. At first it was hoped to catch cervical cancer in the early stages, but it has come to point out even pre-cancerous lesions that can be eliminated before sterilizing surgery would be necessary.
In this way, not only has this man prevented countless needless deaths, but also has made possible the existence of countless human beings who are the offspring of mothers who might have otherwise been sterilized by life-saving hysterectomies. He won many honors and, born in Greece, even became an American citizen.
But no Nobel Prize? What's the deal?



The colposcope
The colposcope is a stereoscopic microscope that can focus onto a cervix at the back of the vagina from a mount that sits at the end of the exam table. The examiner is still using his or her eyes, but of a greatly magnified cervix. This cannot give the detail that tissue under a slide can, but it is used to better identify lesions that can then be biopsied and then put on slides.
It was first introduced in Europe in the 1920s by Dr. Hans Hanselman. It took another 30-40 years for it to catch on in the USA, when it was popularized by Dr. Sheffey.


Techniques of Pap smear and colposcopy--the gory details

The inside of the uterus has glandular cells, and the outside of the uterus that pokes through the vagina (thereby making accessible a way out for a baby) is covered with vaginal-like cells. At some point just before the cervix ends to open into the vagina, the glandular cells are converted into the vaginal-like ones in a sort of "transformation" zone called the squamo-columnar junction (the squamous cells being the vaginal-like cells, the columnar cells being the glandular cells). In fact, most people in private practice call it the transformation zone, or TZ. Since this is the area where the columnar cells are being converted into the squamous cells, it's the area of hight metabolic activity--it's where the action is. Since cancers are wild and rapidly growing cells, it makes sense that they would pop up first wihere most of the action is taking place the fastest...the transformation zone. So getting a sample of the TZ would be the ideal retrieval of cells in a Pap smear. But a Pap is just a stick taking a swipe at the end of the cervix, so there is no way that this sloppy, loose scattering of cells on a slide can be identified as TZ cells. But if both columnar cells AND squamous cells are seen, then it can be assumed that the TZ has been adequately sampled.
That's the deal on a good Pap.
Sometimes previous treatment for cervical disease (like dysplasia) can cause a scarring effect that causes the TZ to recede up the canal, out of reach of the Pap stick--and even the brush that was introduced just for the purpose of increasing the yield from the TZ. In these cases, the Pap really isn't "complete," because it cannot be said that the TZ was adequately sampled.


The American College of Obstetricians and Gynecologists says that this is O.K. if there's been adequate TZ sampling within the last two years.


There are other designations for the columnar vs. squamous cells. For instance, sometimes they're referred to as endocervical vs. ectocervical cells. Same thing, and an incomplete Pap (no columnar cells) may read, "Endocervical cells absent."


The newer Pap technologies

Improvements in Pap technique and interpretation have been made over the years. Today's modern Pap will not only screen for dysplasia and call yeast, bacterial vaginosis, and trichomonas infections as an additional feature, but will also identify the types of HPV so that a clinician can know whether the Pap is from a woman at high risk for the malignancy-causing types of HPV or not.
Since adequate sampling of the TZ is so important, adding the "cyto-"brush as a second part of the cell retrieval has improved on sampling. This brush is actually inserted into the cervical canal itself a bit, making more likely crossing the TZ.
ThinPrep, a proprietary sampling technique, uses two improvements--increased retrieval by splashing the sampling in a fluid container instead of smearing it on a slide where it can dry and be ruined, and using computer imaging software to inspect the sampling without the "pollution" of blood, mucus, or other interference. Some insurance companies won't pay for it, and a good question would be, "Why?"

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"Nobody beats Vitus Gerulaitis 18 times in a row." - Vitus Gerulaitis on beating Jimmy Connors after 17 failed attempts.

guiseppewv

Great post brainsmile. It was a very good and interesting read.