Speculum Type During Pap Smear/Pelvic

I've had metal and plastic speculums used in exams. I prefer metal ones to the plastic.

I have always had metal speculums used on me, Graves type.

If I am doing a play exam I always start with a graves metal speculum , and I also use a collins speculum as well

Plastic disposable graves. Wish it was a stainless steel one instead!

My real doc usually uses the plastic Graves speculums. After my last child, I went in for an IUD insertion and he used metal that time - that was wonderful!

For play, I prefer metal because it can be cold or warm depending on the scenario. ?

Traditionally in the UK , most of the GPs, Gynecologists, Obstetricians and Nurse practitioners have used a metal Collins Speculum which was then autoclaved either in their surgery or at the local hospital. However over the last few years almost all have opted for the use of single use plastic speculums , more specifically the Cusco type speculum.

Its down simply to the cost of the speculums , disposable plastic are cheap to buy and since efficiency savings is the mantra in the NHS, this will and is the norm. We still have some metal speculums , but they are mainly used in theaters or for specific gynecological procedures

Can the type of plastic used to produce speculums be recycled?

I'm sure it could be recycled, but as with any business it all boils down to cost. I suspect it just cheaper to produce new one that recycle the old ones.

Back in 1972 when I had my first gynecology exam she used a metal speculum to open my vagina and a flash light for illumination. It looked like stainless steel? I don't know the brand but they were sterilized and used again on another patient. It was not uncomfortable at all. I'd say until around year 2000, a metal speculum was used for me during paps and pelvic exams. Soon after it was all plastic disposable with reusable Welch Allyn illumination. For my at home exams and paps my Patton four blade was and still is my favorite. A small clip on light is used for illumination. The Patton affords a beautiful view! I also have Skylar stainless steel in medium and large sizes. Off speculum illumination is used. Plastic is also used at times with Welch Allyn illumination.

My wife's current obgyn uses a small plastic graves speculum. This was the same for her previous obgyn but before that the obgyn she went to used a metal speculum which she didn't know the style or size.

Plastic for me. I’ve had the metal ones, but thankfully find the plastic versions a little more comfortable (and less cold).

My current gyn uses plastic as does my GP. It's been many years since I've seen a doctor use a steel one. Which I find sad, as it means much more plastic going into landfills.

Just googled the Patton! Wow! That is quite a speculum!

I've been using plastic for many years. I intend to purchase a Collins, Xlarge if possible. I so enjoy viewing to the very depths of her vagina.

Ok. So, gyno in their practise often used disposable plastic Graves speculum. As talk, @RN1993 and @Rockdoc. Also, I think that utilization this waist are much cheaper and saved time. Gyno could haven't autoclaved and spend time to done this sterilization process. They must done some probes that this speculum (or other tools) are properly cleared what is costed. What is more, this type of speculum are transparent and they can see all vagina walls and they not allergic. In hospitals doctors used Graves one but made of steel. Currently, my doctor used a Kristeller blades.

I've only had the up and down type. The side to side one looks really exciting to me. I imagine it must stretch you much wider.

In real life, always plastic, always Graves.

For play... I have only gotten to experience metal graves and metal collins. Would really love to experience the trellat and the single blade one.... not sure of name. Oh and I'd also like to try the weighted one, but I'm a little nervous about trying that one!

Girlfriend and I use a stainless steel Graves size medium because that is what is used on her at the gynecologist

My OB uses a plastic light up graves. I think they are all one size.

My old gyno (now retired) always used a metal Sims speculum. I was shocked the first time he did that...usually my real doctors use the plastic Welsh-Allyn specs. My play doctor would start with the plastic then move onto metal Graves.

Back in the day, metal Graves or Pedersen speculums were the standard type for routine pelvic examinations in the US. Nowadays, disposable plastic speculums are the mainstay. Some speculums have built in disposable light sources. I am not sure how long this will last at least in California where you can't even get a plastic straw. I suspect plastic speculums will be the next to be banned.

For play exams, I use Simms, Collins, and Graves. I also use a self lighted plastic speculum with a mirror for teaching.

Have only had the plastic ones and Graves

A Comparative Carbon Footprint Analysis of Disposable and Reusable Vaginal Specula

Background: Healthcare systems in the United States have increasingly turned toward the use of disposable medical equipment in an attempt to save time, lower costs, and reduce transmission of infections. However, the use of disposable instruments is associated with increased solid waste production and may have negative impacts on the environment, such as increased greenhouse gas emissions. Objective and study design: To inform this discussion, we apply life cycle assessment methods to evaluate the carbon footprints of three vaginal specula: a single-use acrylic model and two reusable stainless steel models. The functional unit of the study was defined as the completion of 20 gynecologic exams by either type of speculum. The greenhouse gas emissions (e.g. carbon dioxide, methane, nitrous oxide) across all life cycle stages, including material production and manufacturing, transportation, use and reprocessing, and end-of-life, were analyzed using SimaPro life cycle assessment software and converted into carbon dioxide equivalents (CO2e). Results: The reusable stainless steel grade 304 speculum was found to have a lesser carbon footprint over multiple model scenarios (different reprocessing techniques, autoclave loading/efficiency, and number of uses) than either the reusable stainless steel grade 316 or the disposable acrylic specula. The material production and manufacturing phase contributed most heavily to the total life cycle carbon footprint of the acrylic speculum whereas the use and reprocessing phase contributed most to the carbon footprints of both stainless steel specula. Conclusion: The use of disposable vaginal specula is associated with increased greenhouse gas equivalents compared to reusable alternatives with no significant difference in clinical utility. These findings can be used to inform decision-making by healthcare systems, as they weigh a wide range of considerations in making final purchase decisions, and that similar analytic methods can and should be applied to other components of health systems' waste streams.

My wife's first Doctor, her family doctor, always used a Medium Graves and it was always really painful for her. once when he was absent, she saw a different doctor in the group, and he used a Pederson and my wife said it was much more comfortable going in.

the next time she saw her regular doctor we told him of the last experience with the Pederson and he just ignored us and used a Graves medium.

a few doctors have used a Graves Large. once for an endomitrial biopsy, and once just cause that's what the doctor used. i dont know why.

she is very small and tight and even a Pederson does not really slide in easy. And opening any of them makes her wince.

My wife's gyn has always used a metal medium pederson or graves speculum on her.

Most doctors I’ve had including my GP use plastic graves speculums.

Personally, I prefer to use a stainless steel speculum.

Insertion is always easier than with plastic material, there is often less risk of pain.

To introduce a plastic speculum you risk having to lubricate it beforehand and it is forbidden if you want to take a smear. The lubricating agents pollute the collected cells.

Regarding the model, I choose the Collin which exposes the cervix better in my opinion

I had a young female coworker, half my age, who shared that she was going to her annual exam. I asked her if she preferred metal or plastics speculums. I'm sure she wasn't expecting that question. I told her my preference was metal because it seems more clinical. She appreciated that conversation.

Personally, I prefer to use a stainless steel speculum.

Insertion is always easier than with plastic material, there is often less risk of pain.

To introduce a plastic speculum you risk having to lubricate it beforehand and it is forbidden if you want to take a smear. The lubricating agents pollute the collected cells.

Regarding the model, I choose the Collin which exposes the cervix better in my opinion

@Franklin58200 Please see the following studies on the effect of using lubricant on speculae:

https://pubmed.ncbi.nlm.nih.gov/12423847/

https://pubmed.ncbi.nlm.nih.gov/12423848/

There are other studies available, if you care to look for them. But they all conclude that there is no significant adverse effect on the quality of the Pap Smear sample by using water soluble lubricant on the posterior blade of the speculum.

I also prefer to use a stainless Collin speculum, for the same reason as you. A Collin provides a better view of the cervix and anecdotally is less uncomfortable than the more commonly used Graves or Pederson.

@Deviant1

Thank you for this bibliography.

In my post, I just expressed the position of the faculties of medicine in France and the prescriptions of the French Society of Colposcopy and Cervico Vaginal Pathology