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Vaginal Examination

Patient Care. The patient should be prepared physically and emotionally for a vaginal examination. Since relaxation and cooperation of the patient are important to the success of the examination, she should be given a brief explanation of the procedure and encouraged to ask questions before the procedure is begun. The patient is draped with a top sheet so that the legs are covered and only the vulva is exposed. Privacy must be assured immediately before and during the examination. Equipment such as gloves, lubricant, vaginal speculum, and supplies needed for collecting specimens should be assembled before the examination is begun. After the examination is completed, the patient is assisted from the table.







Ideally, a vaginal examination should be done between menstrual periods; however, vaginal bleeding is not a contraindication to this procedure. Patients should be told this so that they will not postpone an appointment for examination when vaginal bleeding persists. They should not take over the counter medications or douche immediately before a vaginal examination; douching might remove secretions that could be useful in diagnosis.

. Since cancer of the female reproductive organs is a relatively common occurrence and is curable if detected early, physicians recommend that women of reproductive age and beyond have a periodic vaginal or pelvic examination. Such an examination is also necessary during pregnancy and labor and in the postpartum examination 6 to 8 weeks after childbirth. This is a simple procedure that is rarely uncomfortable if the woman understands its purpose.The patient lies on her back on a special table with her legs raised and spread by stirrups. The examiner inserts a speculum to spread the vagina open and thus is able to observe the cervix and the lining of the vagina directly, and may take smears for microscopic examination to detect infection or cancer of the vagina or cervix. (See also.)After removing the speculum the examiner inserts rubber-gloved fingers into the vagina and places the other hand on the abdomen. In this way it is possible to palpate the female reproductive organs, including the uterus and ovaries, between the hands. These organs are otherwise difficult or impossible to examine.