Management of Pessaries During and After Pap Smear

Before the Pap Smear

The American College of Obstetricians and Gynecologists recommends removing the pessary before performing the Pap smear to ensure proper visualization of the cervix and adequate specimen collection 2, 3

The Centers for Disease Control and Prevention recommends using a combination of techniques for optimal specimen collection, and carefully removing any discharge with a saline-soaked cotton swab before obtaining the specimen if a mucopurulent discharge is present 2, 4
The Centers for Disease Control and Prevention recommends collecting the Pap smear specimen before obtaining samples for other tests such as STI screening 5

The American Geriatrics Society suggests that women using pessaries may benefit from continued Pap smear screening even after the age when screening would typically be discontinued, as pessary use has been anecdotally associated with development of cervicovaginal cancers 1
The Centers for Disease Control and Prevention recommends advising the patient to have another Pap smear within 3 months if the Pap smear shows severe inflammation with reactive cellular changes 6
The Centers for Disease Control and Prevention recommends ensuring appropriate follow-up with colposcopy if indicated for women with abnormal Pap results, which may require temporary removal of the pessary 6, 4

Approximately 15-20% of women using pessaries experience increased vaginal discharge that may require medical evaluation to exclude infection 7