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Adequate pap smears on large, obese womenFrom: Ann Diehl, ARNP (fdiehl@pionet.net)Sun Jun 21 13:06:01 1998
I work in a hospital based Primary Care unit basically serving the indigent and/or underinsured population. Our budget is limited as to equipment. Have been having problems with adequate visualization of the cervix in some of the larger, obese patients. We have small and regular sized plastic speculums and access to large metal specs. I often use a condom cut off at the end, over the speculum to prevent the vaginal walls folding in when the speculum opens. This helps a lot. However I occasionally examine women for whom any of our speculums seem long enough to adequately get the cervix in view for a proper exam and pap. This is especially a problem when the cervix tips to the back. Any suggestions for me and my colleagues? I have in two instances recently referred these women to our Gyne Dept at an off site location which fills the Gyne schedule and causes an inconvenience for the patient. Thanks in advance for your reply.
-- Annabelle Diehl, ARNP
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