- Position the patient
- Ask the patient to lie in the lithotomy position
- Ensure privacy and dignity throughout the procedure
- Provide a sheet or gown to cover the lower body
- Inspect external genitalia for any visible lesions, inflammation, or discharge
- Warm and insert the speculum
- Lubricate lightly with warm water (avoid gel lubricants as they may interfere with cytology)
- Gently separate the labia and insert the closed speculum angled downward initially
- Rotate horizontally and open the blades slowly to visualize the cervix
- Adjust as needed for full view of the external os
- Collect the sample
- Use a broom-type device (or Ayre’s spatula and endocervical brush)
- With broom: insert into cervical os and rotate 5 times
- With spatula: rotate 360° around the ectocervix
- Then with endocervical brush: insert into the canal and rotate 1/4 to 1/2 turn gently
- Avoid contaminating the sample with vaginal walls
- Transfer the sample
- If using liquid-based cytology: rinse the device in the collection vial by swirling or snapping it off
- If using a glass slide: smear the sample evenly and fix immediately with cytology spray