The best time in the patient's menstrual cycle to take a Pap is mid-cycle. The most effective technique is a combination of ectocervical and endocervical sampling. Both samples are transferred to one slide and quickly fixed with Cytospray. This is all to be placed on one slide. Starting and stopping at the 3 and 9 o'clock position ensures retention of the sample on the upper surface of the spatula.
Wooden spatulas allow good adherence of the sample for transfer to a glass slide.
There are various designs of plastic spatulas that look similar to the wooden ones except that they are harder and sharp, which can cause capillary bleeding. Transferring the sample from these plastic spatulas to the glass slide is also difficult. Data is lacking to suggest that the cytobrush is superior to or inferior to the moistened cotton swab. Both are equally effective in yielding dysplastic smears in combination with the spatula. One quarter turn with the cytobrush is sufficient for an adequate sample because the entire surface of the brush is in contact with the mucosa.