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Indications for Pelvic Examination
- To evaluate symtoms
A pelvic examination is indicated to evaluate complaints referable to the female genital tract (e.g., vaginal itching, discharge, dysfunctional ding, or pain). It should also be done on any woman complaining of lower abdominal or pelvic pain.
- To prepare for a Papanicolaou (Pap) smear
A speculum examination must be done before a Pap smear can be collected for evalution of cervical cytology. Click here to review the indications for a Pap smear.
- To prepare for collection of vaginal or cervical secretions
A speculum examination must be done to visualize the cervix and vaginal fornices so that specimens can be collected for examination or culture.
Click here to review the indications for examination of vaginal
secretions.
- As a routine screening test
The role of the pelvic examination (as opposed to the Pap smear) for screening is controversial. Women who do not require annual Pap smears may still benefit from regular pelvic examinations. Although elderly women are at increased risk for ovarian and uterine cancer, the U.S. Preventive Services Task Force does not recommend screening pelvic examinations.
This is because most ovarian cancers are well advanced by the time they are detected. Also, many benign adnexal masses are found on pelvic examination; these are considered "false positive" findings when screening for malignancy (USPSTF). However, the examination may be helpful in detecting less dire but uncomfortable and treatable conditions such as pelvic prolapse, atrophic vaginitis, and incontinence. This may be particularly true in the geriatric
population.
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