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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).
The external genitalia is examined first, looking for abnormalities like lesions, ulcers, warts and color changes. The elements of this exam include the vulva, which contains the mons pubis , of which there are two longitudinal folds of skin forming the labia majora; then the labia minora and hair follicles.
The pelvic examination may include any of the following components, alone or in combination: assessment of the external genitalia, internal speculum examination, bimanual palpation, and rectovaginal examination. The USPSTF found inadequate evidence on the accuracy of pelvic examination to detect a range of gynecologic conditions. [6]
A study done in 2003 found that 90% of Pennsylvania medical students had done pelvic exams on anesthetized patients during their gynecology rotation. [5] One medical student described performing them "for 3 weeks, four to five times a day, I was asked to, and did, perform pelvic examinations on anesthetized women, without specific consent, solely for the purpose of my education."
Female assessment starts with a full medical history (anamnesis) which provides details of the woman's general health, sexual history and relevant family history. [12] A physical examination will also take place to identify abnormalities such as hirsutism, abdominal masses, infection, cysts or fibroids.
The historic taboo associated with the examination of female genitalia has long inhibited the science of gynaecology. This 1822 drawing by Jacques-Pierre Maygrier shows a "compromise" procedure, in which the physician is kneeling before the woman but cannot see her genitalia. Modern gynaecology no longer uses such a position.
Dr. Rachel Rubin, a board-certified urologist and sexual medicine specialist, says historically, medical textbooks focused on male genitalia, while female genitalia was more of a “sidebar ...
A primary care physician will also generally examine the male genitals but may leave the examination of the female genitalia to a gynecologist. With the clues obtained during the history and physical examination the healthcare provider can now formulate a differential diagnosis, a list of potential causes of the