Method Of Exam
Author: A. Chandrasekhar, MD
Consultant: P. Tomich, MD
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