Method Of Exam

• Preparation
  • Have patient empty bladder
  • Always do pelvic exam chaperoned.
  • Wear a pair of clean gloves and warm them with running warm water
  • Inquire for latex allergy
  • Drape patient with sheet to form a "tent" over her knees
  • Have PAP and culture material ready
  • Describe and explain each step to patient prior to performing them
• Inspect followed by palpation of the external genitalia,
  • Mons pubis
    • Pubic hair character and distribution
  • Labia majora
  • Labia minora
  • Clitoris: less than 2 cms
  • Urethral orifice: Gently palpate intravaginal portion and milk looking for discharge.
  • Introitus
  • Perineum.
  • If possible, identify the opening of the periurethral (Skene's)and Bartholin's gland.
    • Check for the Bartholin's gland by palpating with the index finger in the vagina near the posterior part of the labia majora. Normal pea size.
• Exam of pelvic relaxation
  • Ask the patient to strain down to evaluate the support of vaginal outlet. Observe for
    • Stress incontinence
    • Anterior walll of vagina
    • Posterior wall of Vagina