A Survey of Women Undergoing a Pelvic Examination

Abstract

This study attempts to evaluate patients' satisfaction with certain aspects of a first visit antenatal or gynaecological consultation and the reaction to and preferences during a pelvic examination. Embarrassment and apprehension were emotions experienced by at least half those surveyed and the speculum examination was uncomfortable to more women than the bimanual examination. However, less than 10% found the pelvic examination worse than they had anticipated.

Experience of the first pelvic examination

“…Similarly, in an Australian study 13 It is important to remember that simple guidelines cannot always be extrapolated to individual consultations. The tone of the pelvic examination is very much affected by the clinician's gentle and considerate manner 12 , as well as the clinician being carefully responsive to signals from the patient 14 .…”

Attitudes towards pelvic examination in a random sample of Swedish women

“…The present study has a point in that it may be regarded as representative of women in general within the age strata selected. Other studies published have been based on women just facing a PE or just examined (5,6,18,19). Such circumstances may influence the results.…”

“…Vella (19) found that women perceived the inspection of their genital tract with the help of a speculum as worse than the bimanual palpation procedure. In a questionnaire study, Broadmore and coworkers (20) reported that 60 per cent of the C Acta Obstet Gynecol Scand 77 (1998) women examined in a family planning clinic had experienced pain or discomfort.…”

Creating a more positive patient experience of pelvic examination

“…Pap sampling from the vaginal pool became obsolete after Ayre (1947) described a modified technique whereby the Pap sample was collected from the ectocervix rather than the vaginal pool. Although Ayre's technique is still used today, recent studies have refuted the belief that use of a small amount of aqueous vaginal lubricant, applied either on the vaginal speculum or vaginal introitus, contaminates the interpretation of cervical cytology, or hampers the detection of cervical human papillomavirus (HPV), Chlamydia trachomatis, and Neisseria gonorrheoeae or bacterial vaginosis (Amies, Miller, Lee, & Koutsky, 2002;Griffith, Stuart, Gluck, & Heartwell, 2005;Hathaway, 2006;Kozakis, Vuddamalay, & Munday, 2006;Sawaya et al, 2008;Vella, 1991). Harmanli and Jones (2010) reported that there is level 1 evidence that a small amount of vaginal lubricant on the external surface of the speculum does not interfere with interpretation of cervical cytology or culture specimens collected from the cervix.…”