Gynecologic Pelvic Examination

Excerpt

The gynecologic examination is a critical component of comprehensive women's healthcare. The pelvic exam traditionally includes a careful inspection of the external genitalia and a speculum and bimanual exam to assess the internal genitalia. Under some circumstances, a rectovaginal examination may also be appropriate to better characterize the posterior pelvis. The gynecologic examination is a critical diagnostic tool, enabling healthcare providers to assess and diagnose a broad spectrum of gynecological conditions, such as abnormal bleeding or discharge, pelvic pain, sexually transmitted infections (STIs), benign or malignant tumors, cysts, and anatomical abnormalities. Additionally, the exam can be part of obstetric and routine screening evaluations. An appropriate exam can help identify abnormalities, assess patients before performing procedures (eg, intrauterine device [IUD] insertion), and monitor women during their reproductive years.

The gynecologic pelvic examination can pose several challenges for healthcare professionals. First, these are sensitive exams, often used to assess very private concerns that can cause patients to feel vulnerable, embarrassed, and/or physically uncomfortable. For this reason, excellent communication with the patient is essential, and the healthcare professional must be able to effectively explain the procedure and obtain informed consent while respecting a patient's concerns. Additionally, due to the sensitive nature of the procedure, it can be harder to practice and gain competence in this crucial skill.