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What Is a Pelvic Exam?
The pelvis is the part of the body below the abdomen which includes all anatomical parts between the hips. As part of a gynecological exam, a physical examination of a woman’s pelvis is necessary to evaluate for:
- Pelvic organ abnormalities – includes the bladder, rectum, vulva, vagina, cervix, uterus, fallopian tubes and ovaries
- Tumors or new growths in or around the pelvic organs
- Infections in the vagina, including sexually transmitted diseases (STDs)
- The cause of abnormal bleeding or pain
- Evidence of sexual assault
Women’s health is evaluated further with a Pap smear or a Pap test which may be done during a pelvic exam. This test can detect any unusual growths or infections involving the cervix.
The pelvic exam may also be done as part of a woman’s routine physical exam or preventive health care.
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How Is a Pelvic Exam Done?
A thorough medical history and physical exam usually precedes the pelvic exam. Before the procedure the health professional informs the patient about the purpose and steps to be done during the examination. The patient must inform the doctor or nurse if she is pregnant and inform him/her of her other concerns.
A female nurse or assistant may stay in the room during the examination and the patient may request her partner, relative or friend to be present, too.
A doctor or nurse conducts a pelvic exam in a clinic on an examining table usually equipped with stirrups. The patient is first asked to empty her bladder in the bathroom and undress from the waist down. She is then given a gown or drape to cover her as she is positioned lying on her back with her legs raised and feet supported by the stirrups.
A lamp assists the examiner and a mirror may be positioned to allow the patient to view the procedure as it is being done.
The examination consists of the following steps:
The external examination – involves the inspection of the vulva, vagina and cervix for infections, new growths and physical abnormalities. A plastic or metal speculum which is lubricated is inserted gently into the vagina to allow inspection of the vaginal walls and cervix. A Pap test may be conducted, where the cervix is gently scraped or swabbed with a brush or spatula to allow microscopic examination of cervical cells and mucus.
The bimanual exam –the examiner inserts one or two fingers of one hand inside the vagina and uses the other hand to gently press and palpate on the lower abdomen. In this manner the doctor can evaluate the size, shape and consistency of internal structures like the uterus and ovaries. Abnormalities like tumors and tenderness in these organs may be identified.
Rectovaginal exam – the examiner inserts one finger in the vagina and another in the rectum to assess the ovaries and uterine ligaments. This is optional.
After the pelvic examination, which takes around ten minutes, the patient is allowed to wipe her vaginal area and dress up. In general the woman may feel some discomfort during the examination but she must try to relax her back and her legs by taking deep breaths and communicating with the examiner.
The examiner will inform the patient of any unusual findings and will send the Pap smear to the laboratory. Results of the Pap test may be revealed after a few days. Any unusual changes in the size, shape and consistency of the organs examined are confirmed by further examinations like imaging techniques, biopsies, and more. In addition, a breast exam may be conducted as part of the preventive health exam.
Pelvic exam information is important before a woman undergoes the test especially if it is going to be her first. Effective communication between the health provider and the patient is the best way to have a successful conduct of the exam.
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MedicineNet, “Pelvic Exam”, http://www.medicinenet.com/pelvic_exam/article.htm#do
WebMD, “Pelvic Examination”, http://women.webmd.com/pelvic-examination