While there is a large body of evidence on the effectiveness of Pap smears for cervical cancer screening and on screening for cervical gonorrhea and Chlamydia, there is sparse evidence to support other portions of the pelvic examination and little guidance on examination logistics. Maximizing comfort should be the goal; lubrication use and careful speculum selection and insertion can ease this intrusive procedure. This is particularly important in adolescent and menopausal women, sexual minorities, obese women, women with disabilities, and women with a history of trauma or prior instrumentation affecting the genitalia. We review the evidence and provide guidance to minimize physical and psychological discomfort with pelvic examination. Pelvic examinations are performed to evaluate pain, bleeding, and vaginal discharge and to screen for cervical cancer and sexually transmitted infections.
What You Need to Know About the Speculum
Speculum - wikidoc
A speculum is a duck-bill-shaped device that doctors use to see inside a hollow part of your body and diagnose or treat disease. One common use of the speculum is for vaginal exams. Gynecologists use it to open the walls of the vagina and examine the vagina and cervix. A speculum is made from stainless steel or plastic.
Why a Rectovaginal Exam Is Performed
A speculum is a medical tool for investigating body cavities, with a form dependent on the body cavity for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra. Vaginal specula were used by the Romans, and speculum artifacts have been found in Pompeii. Marion Sims, consists of a hollow cylinder with a rounded end that is divided into two hinged parts, somewhat like the beak of a duck.
An annual pelvic exam is recommended for all women and can consist of some or all of the following procedures: the external genital exam, the speculum exam, the bimanual exam, and the rectovaginal exam. Gynecologists will sometimes perform a rectovaginal exam in addition to a normal pelvic exam. To do this, your doctor will insert a gloved, lubricated finger into the vagina and another from the same hand into the rectum. They will then palpate examine by feeling the abdomen with the free hand.