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Welch-Allyn Vaginal Speculum

 

Women's health is an important subject as it encourages women of all ages to see their obstetricians or gynecologists regularly in order to manage, detect, or prevent various problems. These exams or diagnostic processes often rely on the vaginal speculum for better access.

Welch-Allyn is among the most reliable manufacturers of diagnostic tools and other pieces of equipment necessary in healthcare. The vaginal speculum is among those tools. In this post, we are going to focus closely on Welch-Allyn's vaginal speculum and shed more light on its function and other useful info you need to know.

What is Welch-Allyn Vaginal Speculum?

A vaginal speculum is a medical device a gynecologist uses to open a patient's vaginal walls. Hinged or shaped like a duck's bill, a vaginal speculum is usually made of plastic or metal.

Today, a vaginal speculum is the standard piece of equipment in a gynecologist's office, but these devices had a long history through which they evolved into tools we know today. The history of the vaginal speculum leads us back to ancient times. Rome, more specifically!

In Pompeii, before the eruption of Vesuvius, physicians used a medical tool that is considered to be the first vaginal speculum. The tool was excavated in 1770 from Pompeii ruins at a site called The House of the Surgeon. The site got its name due to all sorts of medical instruments excavated there.

Historical records show primitive vaginal specula originated around 97 A.D. They featured dovetailed valves that opened or closed during the exam. The device was operated by a corkscrew. The design was quite similar to the specula used today.

The vaginal speculum didn't mark some dramatic evolution in the Middle Ages. Remember, in this era, an inspection of a female body and its private parts was taboo and sinful. This area of medicine stagnated for a while. In the 1800s new, updated versions of speculum appeared. Giuseppe Cannella, an Italian surgeon, created a speculum with a knife in 1821. This hybrid tool served to amputate the cervix in cases of uterine prolapsed and cancer. Don't worry; Cannella never used this tool on actual, living women.

Physicians from the 19th century were usually male and were discouraged from observing a naked female patient. Most of their examinations were performed blindly.

Marie Anne Boivin, a French midwife, created a vaginal speculum that users could screw into place and examine the cervix closely. She invented her device in 1825. Boivin's invention evolved into the modern vaginal speculum. Several other physicians contributed to the evolution of the speculum. This area will experience a boom in the late 20th century with the rise of feminism and the sexual revolution.

James Marion Sims, the American physician, also gave his contribution to the development of vaginal speculum. Also known as Father of Gynecology, Sims created a double-bladed tool to examine the cervix and vagina. He developed the instrument from a pewter spoon. Even though the surgeon from Alabama contributed immensely to gynecology, he was also one of the most controversial figures among physicians.

What is Welch-Allyn Vaginal Speculum used for?

The vaginal speculum is primarily used for Pap tests and pelvic exams in women.

Pap smear (Papanicolau test) is a diagnostic procedure whose main objective is to test for cervical cancer in women. The test focuses on collecting cells from a patient's cervix. Early detection of cervical cancer increases the chance of successful treatment.

According to the American Cancer Society, approximately 14,480 cases of cervical cancer will be diagnosed in U.S. women in 2021. During this year, it is estimated 4290 women will die from this serious disease

Pap smear complements tissue biopsy. It is performed widely primarily because this test is inexpensive, fast, simple to obtain and process. Additionally, the Pap test produces no damage to the vaginal tissues, thus allowing for frequent repetition of cellular sampling.

Gynecologists perform Pap tests in conjunction with a pelvic exam. In patients older than 30, a Pap smear can be combined with a test for HPV (human papillomavirus), a common STI that may cause cervical cancer.

Doctors recommend patients start getting their Pap test at 21 years of age every three years. Women older than 30 who do Pap test with HPV tests can get their exam every five years. You need your Pap test more frequently if you have precancerous cells or cervical cancer, HIV, a weakened immune system, or if you're a smoker.

A pelvic exam is performed to evaluate bleeding, pain, and vaginal discharge, but also to screen for sexually transmitted infections and cervical cancer. This examination is a part of a regular checkup, but it may be recommended by a doctor if a patient is experiencing various symptoms that point to the presence of a condition affecting the reproductive or genital area.

Patient education is necessary to encourage women to get their pelvic exams regularly. One study showed that about half of subjects didn't know the purpose of pelvic examination, but others believed it carries a certain value, such as assurance of normalcy. Physicians need to communicate with patients more effectively in order to educate them about the importance of pelvic tests and what to expect.

The pelvic exam lasts a few minutes, in most cases. It includes the external and internal visual exam. The external exam involves checking the vulva for irritation, sores, and other abnormalities. Internal exam relies on the use of vaginal speculum to inspect the vagina and cervix. A pelvic exam may also include a Pap test and physical exam. The latter includes feeling or palpating the abdomen and pelvis to check for the size of the uterus and ovaries. This is done to detect unusual growths and tender areas.

What are the features Welch-Allyn Vaginal Specula?

The vaginal speculum made by Welch-Allyn has useful features that make the whole examination process more effective. These instruments are disposable, meaning they could be safer than non-disposable metal instruments.

Why?

Non-disposable specula need to be cleaned thoroughly, sterilized, and decontaminated between patients. These processes come with certain risks. There's always a possibility you haven't sterilized or decontaminated the instrument well enough. Additionally, there is also a risk of decontamination agents coming into contact with the sensitive vaginal tissue of the patient. Since single-use plastic specula eliminate these risks, they are considered a much safer option. Disposable specula help save on time and expenses that you would need to dedicate to handling metal, reusable instruments.

It is worth mentioning there are several types of specula, and Welch-Allyn has Pederson speculum. Pedersen specula have a narrower blade. It is a double-bladed instrument that features a screw mechanism to keep the blades open after their insertion into the vaginal canal.

For example, Welch-Allyn Vaginal Speculum Kleenspec 590 Series Pedersen comes with a wider handle for better balance and improved maneuverability. The cordless light source provides a homogenous spot and eliminates glare. That way, the light is projected forward. Since the instrument is made of acrylic, it is smooth and doesn't pinch vaginal tissue.

Some specula are clear, while others have a clear and blue design. The instrument allows for a stronger grip, and it is more flexible than many alternatives on the market.

Additionally, Welch-Allyn Kleenspec LED Vaginal Speculum comes with a built-in light source that provides visualization necessary for improved patient outcomes. This speculum is particularly suitable for emergencies, including labor.

What are the different sizes of the Welch-Allyn Vaginal Speculum?

Welch-Allyn vaginal speculum comes in three different sizes: small, medium, and large. The availability of different sizes of specula is one of the greatest advantages of Welch-Allyn instruments. Every doctor needs different sizes of these tools in order to perform the exam adequately. There is no "one size fits all" rule when it comes to the speculum. Different factors influence the size of the instrument the doctor should use during the exam.

These factors include:

•     Childbearing status - the biggest factor that determines the size of speculum you need to utilize is a woman's childbearing status. Vaginal childbirth stretches the vagina, but C-section can do the same, particularly if a woman was in labor and pushed before the procedure. The extent of stretching is largely influenced by how long a woman is pushed during labor. The use of forceps during delivery also affects the amount of stretching. Other factors include the number of children a patient has had, whether or not she did pelvic floor exercises before labor.

•     Sexual activity - narrower or smaller speculum is often necessary for women who are not sexually active.

•     Age - smaller speculum is often used for younger patients, while larger instruments for older patients.

•     Anatomical differences - not all women have the same genital and reproductive area. For that reason, anatomical differences apply in the selection of the speculum for the exam. One study enrolled 39 women and assessed their anatomical differences. Results showed the lengths of vaginas ranged from 6.86cm to 14.81cm significantly different vaginas, and healthcare professionals need to keep this in mind during the exam. Yet another anatomical difference to consider is whether a woman has a cervix or not. Women who have undergone vaginal hysterectomy also had their cervix removed and need an appropriate-sized instrument.

•     Type of procedure performed - the choice of a speculum partly depends on the type of procedure a healthcare professional is going to perform. A speculum is usually associated with a pap test, but other procedures may include vaginal exams, intrauterine insemination, among others. Different procedures may call for a different size of the instrument.

Generally speaking, there is no specific standard for speculum size. The sizes of instruments may vary from one manufacturer to another. Healthcare professionals take into consideration the abovementioned criteria to determine the right size of tool for each patient. While a wider speculum may produce greater discomfort, the narrower instrument may limit visualization. Many healthcare professionals choose the smallest speculum that provides optimal visualization and thereby reduces discomfort.

Welch-Allyn Vaginal Speculum is of Pederson kind whose dimensions are:

•     Small - 7.5cm x 1.5cm

•     Medium - 10cm x 2.5cm

•     Large - 11.5cm x 2.5cm

Pederson medium accommodates most patients.

How to handle Welch-Allyn Vaginal Speculum?

Not only is the vaginal speculum one of the most frequently used gynecological tools, but it is also simple and easy to handle.

At the very beginning, it's useful to ensure a patient has an empty bladder to make the whole process a lot less uncomfortable. Before insertion, the speculum should be lubricated. At this point, it's convenient to warn the patient they're going to feel mild discomfort.

Using the left-hand part of the patient's labia and insert the speculum gently with the right hand. You need to insert the speculum completely, ensuring blades are vertical and the screw is facing sideways. During insertion, rotate the speculum 90 degrees. As you do this, the screw will face upwards, and the blades will reach a horizontal position.

Then, it is necessary to open the blades of the speculum slowly for inspection of the cervix. To keep the speculum open and in place, you need to tighten the screw. Now you're ready to obtain swabs, perform an examination, or do a biopsy.

Undo the screw to remove the vaginal speculum. This will allow the blades to close but keep them slightly open to avoid pinching the vaginal wall. Rotate the device 90 degrees and remove it from the patient's vagina.

When we're talking about handling vaginal speculum, it's useful to mention lubrication. Vaginal entry requires lubrication which is why the exam with speculum can cause discomfort. Traditional recommendations suggested warm water is enough to do the trick. The prevalent belief was that lubricants could interfere with infection tests and Pap smears. However, evidence shows the modest lubrication of the speculum's external surface doesn't impair infectious or cytologic evaluation of the cervix.

Studies reveal water-based lubricants don't affect cervical cytology specimens, regardless of where the lubricant is applied. These placements include the outer or inferior speculum bill, distal superior or inferior bills of the speculum, and vaginal introitus in addition to the speculum. On the flip side, lubricants that contain carbomers and carbopol polymers could interfere with prep Paps. For that reason, they should be avoided. Scientists recommend the use of the dime-sized amount of water-based lubricant during the bimanual examination.

Are any risks associated with Welch-Allyn Vaginal Speculum?

A vaginal speculum is a safe tool to use and will not harm a patient. The biggest risk associated with the use of vaginal speculum during the pelvic exam is discomfort. Some patients may tense their muscles during the exam, which could make it more uncomfortable for them. It's important to explain to patients they need to stay relaxed as much as they can to reduce discomfort. One way to avoid tension is to instruct a patient to take deep and slow breaths.

To patients, it may seem like a vaginal speculum is stretching out their vagina. Healthcare professionals can help patients feel better by informing them about the process. It is useful to elaborate speculum temporarily opens the vaginal canal and will not loosen or widen the vagina. When used by a trained professional, the vaginal speculum does not cause injury or damage.

Keep in mind the tool should be sterile, which only adds to its safety in the pelvic exam.

Where to buy Welch-Allyn Vaginal Speculum?

Welch-Allyn is a reputable brand, so it's not that difficult to find vaginal specula they make. They don't sell the equipment via the official website. However, you can enter your email address and country to find distributors.

Probably the easiest way to obtain vaginal speculum by Welch-Allyn is at BettyMills.com. You see, Betty Mills is a company that offers a wide spectrum of medical supplies and devices, both non-prescription and prescription. Several factors make this distributor stand out, including useful discounts, quick delivery, and incredibly helpful customer support.

Betty Mills offers many other pieces of equipment you may need. The site is also safe to use and make orders from, meaning your information and privacy are protected at all times.

How much does Welch-Allyn Vaginal Speculum cost?

It would be difficult, nearly impossible, to pinpoint a specific price of Welch-Allyn Vaginal Speculum Why? It's simple - several factors are involved. The costs of this gynecological tool depend on the size and quantity, primarily.

Additional features may also play a role. These include illumination, material, and even overall design. The manufacturer may also influence the price. Generally speaking, specula made by reputable brands also have better quality and are more sought after than devices created by unknown manufacturers.

The best thing to do is to check out the manufacturer's website or Betty Mils site to get informed about specific costs of specula that match your needs.

Conclusion

The vaginal speculum is one of the most frequently used instruments in gynecology. Welch-Allyn is among the top brands in this industry. Their Pedersen specula are available in different sizes, from small to medium and large, and are reusable. Acrylic material and disposable nature make these specula less uncomfortable and a lot safer for patients. As the top distributor of these and many other tools and instruments, Betty Mills is all about convenient discounts, outstanding customer experience, and versatile offers. It stands as the most reliable distributor of Welch-Allyn vaginal speculum.

References



[i] Cancel M. (2017). The vaginal speculum: from its unearthed secrets to our modern times. Sklar. http://research.sklarcorp.com/the-vaginal-speculum-from-its-unearthed-secrets-to-our-modern-times

[ii] Wall L. L. (2006). The medical ethics of Dr. J Marion Sims: a fresh look at the historical record. Journal of medical ethics32(6), 346-350. https://doi.org/10.1136/jme.2005.012559

[iii] Key statistics for cervical cancer. American Cancer Society. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

[iv] Naib ZM. Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition. Chapter 178 Pap Test https://www.ncbi.nlm.nih.gov/books/NBK287/

[v] Norrell, L. L., Kuppermann, M., Moghadassi, M. N., & Sawaya, G. F. (2017). Women's beliefs about the purpose and value of routine pelvic examinations. American journal of obstetrics and gynecology217(1), 86.e1-86.e6. https://doi.org/10.1016/j.ajog.2016.12.031

[vi] Pendergrass PB, Reeves CA, Belovicz MW, et al. (1996). The shape and dimensions of the human vagina as seen in three-dimensional vinyl polysiloxane casts. Gynecologic and Obstetric Investigation, 42(3),178-182. https://doi.org/10.1159/000291946

[vii] Harmanli, O., & Jones, K. A. (2010). Using lubricant for speculum insertion. Obstetrics and gynecology116(2 Pt 1), 415-417. https://doi.org/10.1097/AOG.0b013e3181e750f1

[viii] Bates, C. K., Carroll, N., & Potter, J. (2011). The challenging pelvic examination. Journal of general internal medicine26(6), 651-657. https://doi.org/10.1007/s11606-010-1610-8