Sitting on your fists during PAP?

To our female posters: have you ever had to sit on your fists or otherwise boost up your butt during a PAP smear? My SO apparently had to as the nurse practitioner couldn't see her cervix.

Not at all. and i never heard of that either..I have to say that would feel really uncuffy i would think.

To our female posters: have you ever had to sit on your fists or otherwise boost up your butt during a PAP smear? My SO apparently had to as the nurse practitioner couldn't see her cervix.

ABSOLUTELY NEVER.

Was your SO on a real gyno exam table or was her NP totally inexperienced?

They may ask you to scoot down the table, but that's it.

You just lay back, spread your legs, the speculum goes in, and voila. . . there's the cervix.

I have had to do that. It was at a real exam, of course. The doctor said that because my uterus/cervix was tilted (?) she found it very hard to see. It was a bit uncomfortable, but otherwise did not last very long.

Not during a PAP smear but for a transvaginal ultrasound i had to make fists under my buttocks.

It was uncomfortable.

I have never had this happen. I guess this would change the angle though so it does not actually seem that strange. It probably depends on anatomy, to some degree. Interesting though.

I never had to do that and I have a tipped uterus. Perhaps you did not scoot all the way down or the stirrups were not in the proper position.

I would mention it to the doctor that his NP may need more training.

I'm going to agree with lil on this one...I also have a very tilted uterus and never have to help my doctor find my cervix!

I have never been asked to do that and I do have a tilted uterus.

My wife has a tilted uterus and for a exam by a general care doctor she has had to do it because the exam table would not raise to allow a good view but not in the gynos office but he has exam tables that raise higher to allow him to view her cervix better

Never had that experience. My doctor uses a larger speculum if he can't visualize my cervix. Sitting on your fists doesn't seem very professional to me...

They often have difficulty locating my partner's cervix but she has never had this experience. I do not think that she would be impressed if asked to do so. Personally I cannot see why it would be necessary - simpler more patient friendly options are available.

I've never even heard of this happening! Yikes! Maybe in a play exam

I've never had to do that. But, I've had my mom, or a nurse, hold my legs during exams when I was younger. I'm very petite and a regularly sized exam table was too uncomfortable for me to hold my legs wide apart for any length of time.

The uterus may tip either forward (anteverted) or backward (retroverted). Rarely on a flat exam table not equipped with stirrups or to provide better comfort for the patient, raising the hips either with a wedge cushion or fists to tilt the pelvis may allow better visualiztion of a retroverted cervix that may otherwise be difficult and uncomfortable to locate.

One of my close female friends sometimes finds the speculum uncomfortable, so during one of her well woman checks with BUPA the nurse told her to put her fists under her bottom as that might make it more comfortable.Of course if stirrups are used then that's a different ball game, but here in the UK they are very rarely used apart from during more evasive or surgical procedures

I often put a pillow under the woman's bottom during a play exam as I find it makes the cervix much easier to locate. One of my 'patients', a real nurse, gave me that tip some years ago.

Dr Philip - The UK Play Doctor.

One time when my wife was pregnant with our son, we thought her water had broken so we went to the hospital. The nurse came in to do a pelvic and she brought a bed pan with her. She had my wife pick her bottom up off the bed and the nurse slid the upside down bed pan under her butt. Then she pulled out a speculum and performed the pelvic.

Ellena is absolutely correct. If the cervix is very posterior, sometimes having the patient sit on her fists brings it forward slightly and may allow it to be visualized or palpated. It doesn't always work but sometimes it does.

This happened to my friend and the doctor couldn't locate her cervix for the pap so she had her sit on her fists.

I am surprised to see that not a single response has been made mentioning the pelvic tilt feature which most North American exam tables such as Ritter, Midmark and UMF offer. Most have a two piece sectional top and while most people are familiar with the back tilt feature which allows an inclined to almost upright sitting position, they may not be aware that the seat portion of the top is also hinged and may be elevated. Most have a preset angle of approximately 15 to 30 degrees from prone, and if the head is elevated to the same degree or higher, the patient will not have the sensation of "blood running to their head".

While I appreciate the UK standard of the frog-leg position on a flat couch may require a patient with a retroverted uterus to have her hips elevated on a pillow (fists??? Really!), any physician using one of the more common North American exam tables found in most GP and GYN offices who suggests such a move is probably not aware of the feature.

And my friends occured in the US. Thanks for the input DrJ58!

I've never had to do that, the end of the table tilts up, shouldn't that take care of it?