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Pelvic Examination

A physical exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. NIH - National Cancer Institute

About the Pelvic Examination

A physical exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. First, the area outside the vagina is checked for signs of disease. A speculum is then inserted into the vagina to widen it so the vagina and cervix can be checked for signs of disease.

Cell samples may be taken for a Pap test, or to test for sexually transmitted diseases or other infections. The doctor or nurse then inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand to feel for lumps and check the size, shape, and position of the uterus and ovaries. The rectum may also be checked for lumps or abnormal areas. Also called internal exam. NIH - National Cancer Institute

What works? Research summarized

Evidence reviews

Simulation training for breast and pelvic physical examination: a systematic review and meta-analysis

BACKGROUND: Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges.

The reliability of clinical examination in detecting pelvic fractures in blunt trauma patients: a meta-analysis

This review found that clinical examination is able to detect relevant fractures of the pelvis, and that fractures that are missed tend not to require immediate treatment. Although these findings appear reliable, they should be interpreted with some degree of caution given the possibility of publication bias, differences between the studies and the failure to adequately assess study quality.

Heavy Menstrual Bleeding

Heavy menstrual bleeding (HMB) has an adverse effect on the quality of life of many women. It is not a problem associated with significant mortality. Many women seek help from their general practitioners and it is a common reason for referral into secondary care.

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Summaries for consumers

Diagnosis: Endometriosis

Period (menstrual) pain is very widespread: About half of all women have it. Some women have such severe pain that every month, for one to three days they are unable to pursue their daily activities. Often, normal doses of painkillers do not help anymore. If this is the case with you, you could have endometriosis.

Limited symptom relief is available for women with chronic pelvic pain

Chronic pelvic pain in women is a common problem. Symptoms include lower abdominal pain, and pain before and during sexual intercourse. Specific causes are difficult to identify and treatment is often limited to relief of symptoms. An ultrasound or internal examination using a laparoscope is done to rule out serious conditions and to provide reassurance. The review of trials found that a multidisciplinary approach helps alleviate symptoms. A high dose of progestogen therapy using medroxyprogesterone acetate also helps but goserelin has a longer duration of benefit. There is an indication of benefit from writing therapy for some patients.

Feedback or biofeedback in addition pelvic floor muscle training for urinary incontinence in women

Women of all ages are affected by urinary incontinence. A common treatment is pelvic floor muscle exercises (also called pelvic floor muscle training) where the pelvic floor muscles are squeezed and lifted then relaxed several times in a row, up to three times a day. The exercises can help strengthen the muscles, improve muscle endurance (so the muscle tires less easily), and improve coordination (so the muscle squeezes hardest when the risk of leaking is greatest, e.g. with a cough or sneeze).

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Terms to know

Cells
The basic subunit of any living organism; the simplest unit capable of independent life. Although there are some single-celled organisms, such as bacteria, most organisms consist of many cells that are specialized for particular functions.
Cervix
The lower, narrow end of the uterus that forms a canal between the uterus and vagina.
Fallopian Tubes
A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.
Infection
The invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or other microorganisms.
Ovaries
The ovaries are a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
Papanicolaou Test (Pap Smear)
A procedure in which cells are scraped from the cervix for examination under a microscope. It is used to detect cancer and changes that may lead to cancer. A Papanicolaou test can also show conditions, such as infection or inflammation, that are not cancer.
Rectum
The last several inches of the large intestine closest to the anus.
Speculum
An instrument used to widen an opening of the body to make it easier to look inside.
Uterus (Womb)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called womb.
Vagina
The muscular canal that goes from the uterus to the outside of the body. During birth, the baby passes through the vagina.

More about Pelvic Examination

Photo of an adult woman

Also called: Pelvic exam, Internal exam, Manual pelvic examination

Other terms to know: See all 10
Cells, Cervix, Fallopian Tubes

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