Size of speculum real exams

Hi,

This is more of a question has anyone else ever experience this when I got my normal pap smear the speculum didnt hurt at all they found cells so I got called back for a colposcopy the gyno used what seemed to be the same size as normal but then mid exam changed to a different size it was somewhat uncomfortable then I had a leep procedure done and it seemed like they used a bigger speculum do they change the size based on what procedure is done? Or is it just in my head?

Could very likely be a change in size or style of speculum for the procedure. Hard to know for certain, but you know your body best and would know if it felt more like a different instrument (was it cooler all over again) and/or was your anxiety building and making you less relaxed...which might make the same instrument feel slightly less comfortable.

My wife has had a similar experience with her exams.

My wife has had a similar experience with her exams.

Thanks for that insight. Thought I was going crazy for a bit, I know how much it normally opens.

I'm certainly no expert, but I imagine the size of a speculum could change based on the nature of the procedure being performed. For example, I would think an IUD placement would require a larger one than an routine pap. Speaking of that, has anyone had a doctor change speculum sizes for a routine procedure, such as a pap, when the original one would not fit?

For routine pap/pelvic exams, a medium Pedersen is used on my wife. When she has had IUD insertion/removal procedures done, either a medium or large Graves was used. (I can’t remember which one, I think it was large).

I believe that a woman’s gyn history also determines which speculum size is used for routine exams. For example, a woman that has given birth usually has a larger speculum used while a young woman with limited sexual experience usually has a smaller speculum used on her.

Yes depending on the procedure being perform , the size of the speculum used changes. For example procedures like colposcopy , IUD, Cervical and Uterine Biopsies, large speculums are used to visualize the area or to afford /accommodate the instruments used for the procedure. Even for routine PAP you may need to use a larger, longer , narrower, speculum depending on the patient's anatomy.

As previously mentioned , generally women who are virgins or not given birth traditionally have small to medium speculum used , whereas women who have given birth have medium to large speculum used. However the extent to which it can be open also plays a part as you don't need to fully open and lock the speculum in situ .

Choice of speculum either metal or plastic depends on the procedure as well , procedures like LEEP ( Loop Electrosurgical Excision Procedure ) traditionally used a metal speculum , but with the cost of autoclaving. Plastic is fast becoming the standard , as it's cheap and single use.

The type of speculum used also to some extent is determined where you live, traditionally in the US they use either Graves , Pederson or Cusco's speculums. In the UK it's been Collins speculum traditionally , but now it seems to be Cusco's speculums ( plastic ) due to cost.

Hope this helps

RN

Speaking of that, has anyone had a doctor change speculum sizes for a routine procedure, such as a pap, when the original one would not fit?

In my experience, they will start with a smaller size and move up to a larger size if they can't see what they need to. In my case, my doc started with a medium and then had to re-insert with a large due to the length of my vagina.