For Easier Pap Smears: Condom vs Glove

I read with interest Dr Adam Breinig’s Practical Pointer, “For Easier Pap Smears, Use a Condom” (CONSULTANT, August 2009, page 488). I agree that this is an excellent way to retract the lateral vaginal walls during the speculum examination in an obese patient. However, I have also had good results using the finger of an examination glove (with the tip cut off) as a sleeve for the speculum. The glove finger has 2 advantages over a condom. First, I do not have to worry about spermicide on a condom interfering with any tests I might need to perform. Second, I can use a finger from a latex-free glove for a patient with latex allergy.
-- Dale Reddish, CRNP
Salisbury, Md

The glove finger is a good idea, but I think condoms are a better choice. A condom is designed to stretch more than an examination glove; thus, it will give you a greater degree of flexibility without breaking. Also, I think condoms-which are packaged individually- are more sterile than gloves. Note that you can use condoms without any spermicide or lubricant (these are the type I choose). However, I agree that a latex-free glove finger would be a good alternative for any patient with latex allergy.
-- Adam Breinig, DO
Charleston, WVa