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A pelvic examination includes a complete physical examination of a woman's external genitals by a health professional.
Pelvic examination also helps a health professional evaluate the size and position of a woman's pelvic organs. It is an
important part of preventive
health care for all adult women. Pelvic examination is done to help detect genital cancers, infections,
sexually transmitted diseases (STDs), or other genital and vaginal abnormalities.
Pelvic examination includes:
An external exam
of the genital area around the external genitals (called the vulva).
An internal exam
with an instrument called a speculum. A Pap test is done during the internal exam.
A bimanual internal exam. This exam is done by inserting one or two gloved, lubricated fingers into
the vagina while pressing on the abdomen with the other hand.
A rectovaginal exam (or digital rectal exam). This exam is done by inserting the lubricated,
gloved first finger of one hand into the vagina and inserting the lubricated second finger of the
same hand into the rectum while pressing on the abdomen with the other hand.
Pelvic Examination Results
Pelvic examination
Normal:
The uterus, fallopian tubes, and ovaries
are normal in size and location. The uterus can be moved slightly without causing pain.
No sores, signs of infection,
inflammation, or abnormalities of the vagina and cervix are present.
Glands around the opening of your vagina (Bartholin's glands) or urethra (Skene's glands) are not swollen or inflamed.
On the Pap smear, no abnormal cells are seen.
If cultures
are taken, results are negative for
yeast infections, chlamydia, bacterial vaginosis, and sexually transmitted
diseases (STDs). However, further testing may be necessary to rule out the presence of an STD.
No masses (nodules) of abnormal tissue are felt in the area between the uterus and rectum (cul-de-sac)
or in the strong bands of tissue (ligaments) that attach to the uterus to hold it in place.
No fibroids are felt during the bimanual pelvic or rectal exams.
No pelvic pain
or tenderness is present.
No hardening of tissue (induration) is felt.
Abnormal:
Sores, signs of infection,
inflammation, or abnormalities of the vagina and cervix are present. Signs of a sexually transmitted disease (such as
genital herpes, genital warts, or syphilis) may be present. Additional testing will be required to determine the cause.
The glands around the vagina (Bartholin's glands) or urethra
(Skene's glands) are swollen or inflamed.
Abnormal cells are
present on the Pap test, which may indicate the presence of cervical cancer.
Abnormal results
of a Pap smear may also indicate the presence of genital infections or endometriosis
of the cervix and vagina.
The uterus cannot be moved (even slightly) during the
exam. This may mean that scar tissue (adhesions), possibly caused by endometriosis, is present and may be
holding the uterus in place.
Pain or tenderness is felt when the uterus
is moved slightly or when the area between the uterus and rectum (cul-de-sac) is touched. The uterus is
pushed away from the midline of the abdomen.
The ovaries are painful when
touched, are enlarged, or are not movable (fixed). This may indicate that adhesions may be holding the ovaries
in place.
An ovarian mass is present or a mass that was detected during
a previous gynecologic exam is still present or has grown larger.
Small
masses (nodules) of abnormal tissue are felt near the uterus or in the cul-de-sac.
Fibroids are felt during the bimanual pelvic or rectal exam.
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