Pelvic exam

Overview:

A pelvic exam is done to examine the pelvic organs of women which include reproductive and excretory organs. The pelvic examination helps in identifying abnormalities like infections, growths, and any diseases. This can be done as a part of an annual health checkup or in case of any disease. 

Anatomy of the Pelvic area: 

The reproductive organs include external genitals like the vulva (includes labia, clitoris, and vaginal opening), and internal organs like the vagina (a tube extending from the vulva to the uterus), cervix (tube connecting the uterus and the vagina), uterus (a sac-like structure where the baby grows), fallopian tubes (tubes that carry eggs to the uterus), and ovaries (glands producing eggs). The excretory organs include the rectum (chamber that opens to the anus to poop), and bladder (bag holding the urine to pee). 

Indications: 

A pelvic examination is done as a routine check-up to check the health and disease of the pelvic area. It is indicated when an individual develops any symptoms of infections or growth. It is also indicated in pregnancy as part of the prenatal care visits. It is also done to identify conditions like unusual bleeding from reproductive or excretory parts, urinary issues, pain during sex, abnormal discharge from the vagina, and changes in the tissues around them. 

It is also indicated as a part of any pelvic procedures like biopsies or placing any intrauterine devices. It is also indicated when there is a family history of cervical or ovarian cancers. A pelvic exam should be done for women aged 21 to 65 years of age and those who are female at birth but became male with surgery (transgender male). If a transgender male is having female organs still it is better to get a pelvic examination till they are present to avoid any disease conditions. 

Contraindications:

Pelvic examination is not indicated when an individual is getting birth control other than intrauterine devices. It is also not indicated in young adolescents unless very necessary. 

Advantages: 

Regular pelvic examinations have many advantages: 

• Early detection of abnormalities like cervical cancers, sexually transmitted infections, and tumors. 
• Early treatment possibilities 
• Understanding one’s own sexual and reproductive health 

Before Pelvic exam:

Before pelvic examination history regarding reproductive health will be asked by the HCP. Previous medical history medication, surgeries, or previous tests should be informed to the HCP. It is always advisable to inform before any previous sexual trauma. One has to pee to avoid discomfort during examination. 

Make sure to schedule the examination on a day when there are no periods. Menstruation is not a contraindication for pelvic examination but if an individual is not comfortable, they can always postpone it. Pelvic examinations are done by a healthcare professional along with an assistant. One can also request a partner, friend, or family member to stay with them during the examination. One can also ask for a mirror to be involved more during the examination. 

During the procedure:

A pelvic examination is done in a doctor’s office by wearing comfortable clothing provided by the hospital. An individual is made to lie on an examination table with knees bent or legs hanging over rests called stirrups. Knees should be open as wide as possible for convenience of the examination. 

• External examination: The pelvic examination includes an external examination where the HCP visually examines the genitalia for any abnormalities, size, shape, and color of the pelvic parts. 
• Speculum examination: A special tool called a speculum is used to open the vagina wide for better clinical examination. One should relax the body as much as possible to avoid discomfort during the examination. An HCP will examine the internal parts for any abnormal discharge or growth. 
• Physical examination: To examine the internal organs like the uterus, the HCP uses a gloved finger and runs along the walls to examine for any discharges, growths, swellings, or tears. They will also examine the size and shape of the uterus. Later examination of the excretory parts is done using the gloved fingers into the rectum. This is called rectal examination. 
• Pap smear test: This is done as a part of routine pelvic examinations to screen for cervical cancer. Using a speculum the vagina is opened widely, then using a small brush cells are collected from the cervix. The collected cells are transported to the laboratory to check for any abnormal cells. 

Pelvic examination may cause minor discomfort but should not cause severe pain during the procedure. Relaxing the muscles of the shoulder, stomach, and leg muscles and slow deep breaths reduces the discomfort. One can inform the HCP if there is any severe pain during the procedure. 

After the procedure: 

After the examination, there might be mild discomfort and spotting which subsides over time. One can return to routine activities after a pelvic exam. The HCP will discuss the observations and results. 

Interpretation:

Any abnormal findings will be informed to the patient. Suspicious lesions will be confirmed by subjecting the patient to additional tests to confirm them. 

Risks and contraindications: 

A pelvic examination can cause fear, anxiety, pain, and mild discomfort. There will be mild bleeding called spotting. If the bleeding is severe it is better to inform the healthcare professional. 

Conclusion: 

Pelvic examination is a routine procedure to assess the health of the pelvic organs in women. It helps in the early diagnosis of potentially life-threatening diseases like cervical cancer. Even though it causes mild discomfort it offers significant health benefits by early detection, diagnosis, and treatment.  

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