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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).
A rectovaginal examination is a type of gynecological examination used to supplement a pelvic examination. In the rectovaginal examination, a doctor or other health care provider places one finger in the vagina and another in the rectum to assess the rectovaginal septum. The examiner will look for any scarring or masses that may indicate cancer ...
Cul-de-sac hernias are the most difficult to diagnose during physical examination, and to distinguish from anterior rectocele or enterocele. [2] Furthermore, rectocele and cul-de-sac hernia may occur together. [3] Combined vaginal and rectal digital palpation may be used (examiner's thumb in vagina, index finger in anal canal). [11]
The procedure begins by gently scraping or sampling the cells of the cervix using a special spatula, brush or swab. Some women experience temporary bleeding from this procedure. The scrapings are placed on a slide, covered with a fixative for later examination under a microscope to determine if they are normal or abnormal. [19]
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Gynecologic hemorrhage represents excessive bleeding of the female reproductive system. [1] [2] Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive.
Another procedure is posterior colporrhaphy, which involves suturing of vaginal tissue. Surgery may also involve insertion of a supporting mesh (that is, a patch). [8] There are also surgical techniques directed at repairing or strengthening the rectovaginal septum, rather than simple excision or plication of vaginal skin which provides no support.
Posterior enterocele (develops in the rectovaginal space, also termed the pouch of Douglas or the cul-de-sac). [2] Anterior enterocele (develops in the vesicovaginal space). [2] Retains the full thickness of the anterior vaginal wall. [2] Lacks vaginal wall (or very thin and ulcerated vaginal wall). [2] Anterior enterocele is rare. [2]