Pelvic examination

Pelvic examination
Line drawing showing bimanual palpation as part of a pelvic exam
Specialtygynaecology
ICD-9-CM89.26

A pelvic examination is the physical examination of the external and internal female pelvic organs.[1] It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, discharge, urinary incontinence, or trauma (e.g. sexual assault).[2][3] It can also be used to assess a woman's anatomy in preparation for procedures.[4] The exam can be done awake in the clinic and emergency department, or under anesthesia in the operating room.[5] The most commonly performed components of the exam are 1) the external exam, to evaluate the vulva 2) the internal exam with palpation (commonly called the bimanual exam) to examine the uterus, ovaries, and structures adjacent to the uterus (adnexae) and 3) the internal exam using a speculum to visualize the vaginal walls and cervix.[6] During the pelvic exam, sample of cells and fluids may be collected to screen for sexually transmitted infections or cancer (the Pap test).[6]

Some clinicians perform a pelvic exam as part of routine preventive care.[3] However, in 2014, the American College of Physicians published guidelines against routine pelvic examination in adult women who are not pregnant and lack symptoms, with the exception of pelvic exams done as part of cervical cancer screening.[7][8]

  1. ^ "Examination of the Female Pelvis". Archived from the original on 2001-11-15. Retrieved 2007-12-09.
  2. ^ ACOG Practice Advisory on Annual Pelvic Examination Recommendations (30 June 2014). "The Utility of and Indications for Routine Pelvic Examination". American Congress of Obstetricians and Gynecologists. Archived from the original on 2 August 2014.
  3. ^ a b Hoffman BL, Bradshaw KD, Cunningham FG, Halvorson LM, Schaffer JI, Schorge JO (2012). Williams gynecology (2nd ed.). New York: McGraw-Hill Medical. pp. 2–6. ISBN 978-0-07-171672-7. OCLC 779244257.
  4. ^ Emery JD, Paraiso MF (2014-10-07). Office-based gynecologic surgical procedures. Springer. ISBN 978-1-4939-1414-2. OCLC 893426765.
  5. ^ "Current Procedural Terminology - Pelvic examination under anesthesia (other than local) - Classes". NCBO BioPortal. Retrieved 2018-03-02.
  6. ^ a b Bickley LS, Szilagyi PG, Bates B (2013). Bates' guide to physical examination and history-taking (11th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 978-1-60913-762-5. OCLC 801810287.
  7. ^ Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD (July 2014). "Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians". Annals of Internal Medicine. 161 (1): 67–72. doi:10.7326/M14-0701. PMID 24979451. S2CID 12370761.[Free text]
  8. ^ "Don't perform pelvic exams on asymptomatic nonpregnant women, unless necessary for guideline-appropriate screening for cervical cancer". Choosing Wisely. American Academy of Family Physicians. August 8, 2018. Retrieved 5 December 2019.