Level 1: Likely reliable evidence

AND MAY NOT AFFECT CERVICAL-SMEAR QUALITY

Level 2: Mid-level evidence

A randomized trial evaluated the use of stirrups in 197 women undergoing a routine gynecologic exam and cervical smear (BMJ. 2006;333:171; full text available online free of charge at: www.bmj.com/cgi/content. Accessed June 12, 2007). Participants were randomized to an exam using stirrups vs. an exam with feet on the edges of the exam table extension. The mean scores on a 100-mm visual analog scale were 13.1 vs. 23.6 for sense of vulnerability (P <.05), 17.2 vs. 30.4 for physical discomfort (P <.05), and 17.7 vs. 23.1 for sense of loss of control (not significant). There were no significant differences between groups for cervical-smear quality: 0 vs. 2 smears were inadequate for evaluation and 15 vs. 16 smears did not contain endocervical cells.