Stirrups-Free Pap Smear May Be a Welcome Option

Mar. 23 -- FRIDAY, June 22 (HealthDay News) -- Women who know they should get regular Pap smears but dread the stirrups that go along with the test may finally get a reprieve.

New research shows that Pap results are just as accurate when the screen is performed with the patient keeping her feet on the examining table.

There was a real bonus in terms of comfort, too.

"There's about a 50 percent reduction in physical discomfort if women did not use the stirrups," said lead researcher Dr. Dean Seehusen, a family physician at the Eisenhower Army Medical Center at Fort Gordon, in Augusta, Ga. Women also said they felt psychologically less vulnerable, he said.

Seehusen, who published his findings recently in the British Medical Journal, remains hopeful that the practice of giving women a choice -- stirrups or no stirrups -- will catch on.

It could even boost women's health by inspiring them to have the exam more regularly, he added.

Seehusen said he had long suspected that one reason some women avoid potentially lifesaving Pap smears, and the accompanying pelvic exam, is due to the anxiety and discomfort of the stirrups position.

It can raise real anxiety in some women, he said, because "when your feet are in the stirrups you cannot easily get out." Women with mobility problems can also have an especially difficult time, he said. On top of those issues, many stirrups are cold to the touch, as well.

The study involved 197 women, ages 18 and up, who had come to the medical clinic for their annual pelvic exams. They were assigned to undergo the Pap test either in the stirrups or not.

After the tests, the women answered questions about their physical comfort, as well as their psychological sense of vulnerability and loss of control.

The result: The quality and accuracy of the Pap smears were similar, regardless of whether stirrups were used or not.

Seehusen's advice: "If a woman thinks she wants to try this method, she should ask her provider," he said.

Another women's health expert agreed.

"If a doctor can do without using the stirrups and you are more comfortable, by all means ask," said Dr. Celeste Robb-Nicholson, editor-in-chief of the Harvard Women's Health Watch and assistant professor of medicine at Harvard Medical School, Boston.

"If this alternative is offered," she said, "it could result in higher screening rates" for pap smears.

But your doctor may still prefer to do some exams with the stirrups, for better stability, she cautioned. While a simple Pap test may be no problem to perform when a woman's legs are not in the stirrups, more complicated procedures -- such as getting an endometrial biopsy -- might be better conducted with a woman's legs stabilized by the stirrups, Robb-Nicholson explained.

And some doctors may still prefer to do the Pap smear while a woman's feet are in stirrups.

But for those women who are uncomfortable in the stirrups, "It is reasonable to ask" to skip them, Robb-Nicholson said.

More information

There's more on the Pap smear at the National Women's Health Information Center.

SOURCES: Dean Seehusen, M.D., M.P.H., family physician, Eisenhower Army Medical Center, Fort Gordon, Augusta, Ga.; Celeste Robb-Nicholson, M.D., editor-in-chief, Harvard Women's Health Watch and assistant professor, medicine, Harvard Medical School, Boston; July 22, 2006, British Medical Journal.