Presentation
Occult cervical pathogens may be present in these patients. Copyright 2010 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Acta Obstet Gynecol Scand 2003 82 1030 6 ,, ,, ,. et al Distress and pain during pelvic examinations: effect of sexual violence. [doi.org]
Relax as much as possible to ease discomfort, but tell your doctor if you're in pain. Pap test. [mayoclinic.org]
- Asymptomatic
METHOD: This project explored the attitudes of GPs regarding the performance of pelvic examinations in asymptomatic women. [ncbi.nlm.nih.gov]
The review focused on asymptomatic gynecologic conditions commonly identified by clinicians as a reason for performing the screening pelvic examination, conditions for which detection of early-stage disease in asymptomatic patients is biologically and [doi.org]
- Swelling
After the speculum is in place, the doctor or nurse practitioner will shine a light inside the vagina to look for anything unusual, like redness, swelling, discharge, or sores. [kidshealth.org]
First, your doctor looks at your vulva, checking for irritation, redness, sores, swelling or other abnormalities. Internal visual exam. [mayoclinic.org]
This examination will detect any growths, abnormalities, swellings, or areas of tenderness in the pelvic area. [irishhealth.com]
- Inflammation
The presence of tearing, inflammation and swelling is noted. Thinner and smaller labia minora are an expected finding in older women. The clitoris is assessed for size, position, symmetry, and inflammation. The urethral opening is inspected. [en.wikipedia.org]
Gonorrhea or chlamydia may also cause inflammation to the urethral meatus or the external opening of the urethra. These, in addition to bacterial infections, can also cause inflammation of the Skene's glands, Bartholin's glands, and vulva. [encyclopedia.com]
The walls of the vagina are checked for growths, inflammation and abnormal discharge. A Pap test may be done. The speculum is then removed. [cancer.ca]
Check the walls of your vagina and your cervix for damage, growths, inflammation, unusual discharge, or discoloration. [myhealth.alberta.ca]
- Pathologist
Pap smear — liquid-based technology Originally the Pap test consisted of using a small wooden spatula to sample the outermost cell layer of the cervical os (the opening to the womb inside the vagina), then smearing the sample onto a glass slide for a pathologist [womenshealthnetwork.com]
Now use Bethesda system (2001) which incorporates important changes: -Pap smear analysis considered medical consult -Pathologist responsible for making dx -Referring physician provides hx -Must have a statement of adequacy Recs regarding f/u made by pathologist [quizlet.com]
Sometimes, pathologists practice both anatomical and clinical pathology, a known as general pathology. [wikivisually.com]
Cardiovascular
- Hypotension
Speculum examination is indicated in those presenting with severe bleeding or hypotension as removal of obstructing endocervical products can be a crucial resuscitative measure. [ncbi.nlm.nih.gov]
Urogenital
- Vaginal Discharge
Of these women, 185 (87.7%) were asymptomatic, and 26 (12.3%) reported vaginal discharge. No other concerns were elicited. [ncbi.nlm.nih.gov]
Your doctor might suggest a pelvic exam if you're experiencing gynecological symptoms such as pelvic pain, unusual vaginal bleeding, skin changes, abnormal vaginal discharge or urinary problems. [mayoclinic.org]
But if you have a new vaginal discharge or new or increasing pelvic pain, a pelvic exam may be done while you are having your period. Do not use douches, tampons, vaginal medications, or vaginal sprays or powders for at least 24 hours. [brooklyngynplace.com]
The doctor might take a sample of your vaginal discharge to test for infection. [womensaidcenter.com]
- Sexual Dysfunction
“In my experience, that is frequently a woman who has an experience of sexual abuse of some kind, and she almost for sure is having sexual dysfunction but may be reluctant to discuss the issue unless I raise it with her,” says Levy. [nbcnews.com]
ACP advises that the pelvic examination is appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems, or sexual dysfunction. [sciencedaily.com]
(Jason Merritt/Getty Images) Westhoff published a medical journal article in 2011 questioning the need for the annual pelvic exam in the absence of any symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction [nydailynews.com]
Through their research, the team found that the common procedure, performed on 63.4 million U.S. women in 2008, is only helpful in cases where women have symptoms such as abnormal bleeding, pain, urinary problems, sexual dysfunction, or vaginal discharge [medicaldaily.com]
Workup
Diagnostic workup however is needed to ascertain the underlying cause of the anemia. (1-5) History and physical examination Diagnosis begins with a detailed history and physical examination. [news-medical.net]
[…] included conditions (including but not limited to abnormal bleeding, pelvic pain, incontinence, and infertility); quality of life KQ 2: Sensitivity, specificity, likelihood ratios, positive and negative predictive values KQ 3: Unnecessary diagnostic workup [uspreventiveservicestaskforce.org]
Current standard of care requires further workup of any abnormality found on Pap. -this usually consists of screening for HPV, colposcopy, and bx of cervical samples. Decreases the incidence and mortality of cervical CA. [quizlet.com]
Available evidence reports false-positive rates for ovarian cancer of 1.2% to 8.6% and false-negative rates of 0% to 100%. 4 Pelvic examination screening also could result in unnecessary diagnostic workup and treatment. [doi.org]
Ultrasound
- Enlargement of the Liver
A detailed physical examination entails examination of the abdomen for enlarged spleen or liver. Signs of jaundice, kidney disease or cancers are looked for. Severe anemia may lead to heart failure. [news-medical.net]
Treatment
METHODS: The SNAP-IT (Smooth National Adaptation and Presentation of Guidelines to Improve Thrombosis Treatment) method was used to determine whether the ACP guideline was consistent with CTFPHC standards and could be adapted or adopted. [ncbi.nlm.nih.gov]
Your doctor might suggest additional diagnostic testing or treatment. How you prepare You don't need to do anything special to prepare for a pelvic exam. [mayoclinic.org]
No studies evaluated the effectiveness of early diagnosis and treatment of screen-detected, asymptomatic gynecologic conditions compared with the diagnosis and treatment of symptomatic gynecologic conditions. 4 It is also unknown whether performing screening [doi.org]
If an STI or pelvic in ammatory disease (PID) is confirmed and she still wants an IUD, it may be inserted as soon as she finishes treatment, if she is not at risk for reinfection before insertion. 1. [fphandbook.org]
Prognosis
Acute myeloid leukemia with myelodysplasia-related changes usually occurs in older adults and has a poor prognosis. [cancer.gov]
Epidemiology
[…] impact of our findings, we think there is a pressing need for improving patient counseling concerning this exam,” said senior author Miriam Kupperman, PhD, MPH, a UCSF professor in the departments of Obstetrics, Gynecology and Reproductive Sciences, and Epidemiology [ucsf.edu]
“Stories are very powerful, but they are the antithesis of epidemiological evidence,” Sawaya said. “The focus should be on symptoms, and on how to keep people healthy, not to turn healthy people into patients.” [khn.org]
More information on the burden and epidemiology of the numerous gynecologic conditions potentially detected by pelvic examination is available in Table 1 of the accompanying systematic evidence review. 2 Scope of Review The USPSTF commissioned a systematic [uspreventiveservicestaskforce.org]
More information on the burden and epidemiology of the numerous gynecologic conditions potentially detected by pelvic examination is available in Table 1 of the accompanying systematic evidence review. 4 The USPSTF commissioned a systematic review to [doi.org]
The amount of epidemiologic and physiologic information about contraceptives has grown enormously, and the methods have evolved toward safer formulations; today's oral contraceptives, for example, contain much lower doses of contraceptive hormones than [guttmacher.org]
Prevention
It has been suggested that to address every preventive service recommended by the U.S. [aafp.org]
Perdue, MPH US Preventive Services Task Force USPSTF Recommendation: The Screening Pelvic Examination US Preventive Services Task Force; Kirsten Bibbins-Domingo, PhD, MD, MAS; David C. Grossman, MD, MPH; Susan J. Curry, PhD; Michael J. [jamanetwork.com]