Pelvic exam: What is it and why you may need one?

Speculum used in pelvic exam

 

"A pelvic exam is an examination of a woman's genital system."

 

It involves examination of the female genitals including the vulva, vagina, uterus, ovaries, and Fallopian tubes; the bladder and rectum are also usually included in the exam.

A pelvic exam begins with inspection of the external genital area and is followed with an internal visual inspection of the vaginal walls and cervix using a special instrument called the speculum to open the vaginal canal.

Pelvic exam also involves palpation, or examination by feeling the size, shape and texture of the various pelvic organs.

 

Why you may need a pelvic exam performed

A pelvic exam may be performed for a number of reasons including the few listed below:

  • As part of a regular checkup (or wellness visit)
  • To investigate causes of symptoms such as abnormal bleeding, unusual vaginal discharge, or pain and infertility.
  • As part of routine pregnancy check-ups.
  • For cervical cancer screenings, in which a sample of cells from the uterine opening (cervix) are taken for microscopic examination (known as the Pap smear or Pap test).

 

What conditions can be evaluated with a pelvic exam?

A pelvic exam can be useful in the assessment and diagnosis of multiple female medical and reproductive conditions. Here are a few examples:

  • Sexually-transmitted infections, such as gonorrhea, syphilis, chlamydia, human papillomavirus, etc.
  • Vaginal yeast infections
  • Bacterial vaginosis
  • Urinary tract infections
  • Uterine fibroids
  • Abnormal uterine bleeding
  • Ovarian masses
  • Infertility
  • Pregnancy
  • Ectopic pregnancy
  • And many more conditions

 

How is a pelvic exam performed?

No special preparation is needed for a pelvic exam.

A pelvic exam is routinely performed in the doctor's office or at the outpatient clinic of a hospital. It takes only a few minutes, and you will be awake and aware of the procedure.

If a male doctor or nurse is performing the procedure, it is standard practice to have a female assistant in the room.

Depending on the hospital/clinic policy, your consent may or may not be requested in writing before a pelvic exam is performed. Regardless, a verbal consent request is still good practice.

In undergoing a pelvic exam, you will be asked to change from your usual dress into a clinic gown and lie on your back on an examination table, covered with a sheet.

The doctor and/or nurse performing the examination will help you get in position for the speculum examination, which involves bending your hips and knees and placing your feet in metal supports on the side of the exam table (if needed).

Woman having a pelvic exam for Pap test

 

Initially, the examining doctor or nurse will inspect your external genitalia for its normal anatomy and note any discharge, bleeding, growths, rashes, or vesicular eruptions.

Next, a speculum, which is a clean or sterilized metal or plastic device is inserted into your vagina to allow for inspection of the vaginal walls and cervix.

As may be indicated, a small sample of the cells of your cervix (the entrance area to your uterus) is taken using a brush or a small spatula for a Pap test.

While there may be some discomfort, a pelvic exam should not be painful.

 

Bimanual examination

A bimanual exam is another component of the pelvic exam. This involves placement of two fingers inside the vaginal canal and pressing on the external surface of the lower abdomen with the other hand to feel the pelvic organs. A rectal exam is also often performed at this time.

The bimanual exam is performed to check for enlarged or inflamed internal pelvic organs.

 

What happens after the pelvic examination?

Upon completion of the pelvic examination, you will be cleaned up and asked to dress up. A discussion should then be had between you and the doctor or nurse regarding the pelvic examination findings and the next step.

 

 

Published: February 18, 2020

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