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Editing Pelvic Examination with intent to add more information about an accessible exam for individuals with disabilities
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Medical guidelines[edit]
Previous to July 2014, the benefits of routine pelvic examinations were not clear and there was no consensus.[1] Since then, American College of Physicians (ACP) issued a guideline that recommended against performing this examination to screen for conditions in asymptomatic, nonpregnant, adult women. (The guideline did not consider Pap smears.) The ACP said that there was no evidence of benefit in support of the examination, but there was evidence of harm, including distress and unnecessary surgery. This was a strong recommendation, based on moderate-quality evidence.[2] In 2018, the American College of Obstetricians and Gynecologists (ACOG) issued a committee opinion that pelvic exams should be performed for 1) symptoms of gynecologic disease, 2) screening for cervical dysplasia, or 3) management of gynecologic disorders or malignancy, using shared decision-making with the patient.[3] ACOG concluded there is inadequate data to support recommendations for or against routine screening pelvic examination for asymptomatic, non-pregnant women with average risk for gynecologic disease.[3]
Annual "well-woman exams" are an occasion for gynecologists to recognize issues like incontinence and sexual dysfunction, and discuss patient concerns, and an exam can be done if indicated by the clinical history.[4]
As Edited:
Medical guidelines[edit]
Traditionally, the benefits of routine pelvic examinations were assumed in the field of gynecology, and were a recommended part of the initial gynecology visit, annual visits, and as needed for treatment.[5] In 2014, the American College of Physicians (ACP) published a review of the benefits and the risks of the exam and issued a guideline that recommended against performing this examination to screen for conditions in asymptomatic, nonpregnant, adult women, concluding that the potential harms outweighed the demonstrated benefits and that screening pelvic exams in asymptomatic women did not reduce mortality or morbidity rates. The guideline did not consider the necessity of frequency of Pap smears.) This was a strong recommendation, based on moderate-quality evidence.[2] In 2018, the American College of Obstetricians and Gynecologists (ACOG) issued a committee opinion that pelvic exams should be performed for 1) symptoms of gynecologic disease, 2) screening for cervical dysplasia, or 3) management of gynecologic disorders or malignancy, using shared decision-making with the patient.[3] ACOG concluded there is inadequate data to support recommendations for or against routine screening pelvic examination for asymptomatic, non-pregnant women with average risk for gynecologic disease.[3]
Annual "well-woman visits" are an occasion for gynecologists to recognize issues like incontinence and sexual dysfunction, and discuss patient concerns, and an exam can be done if indicated by the clinical history and using a model of shared decision-making.[4] ACOG reinforced the potential value of pelvic examinations in allowing clinicians to explain a patient’s anatomy, reassure her of normalcy, and answer specific questions, thus establishing open communication between patient and clinician.
- ^ Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, et al. (March 2017). "Screening for Gynecologic Conditions With Pelvic Examination: US Preventive Services Task Force Recommendation Statement". JAMA. 317 (9): 947–953. doi:10.1001/jama.2017.0807. PMID 28267862.
- ^ a b Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD (July 2014). "Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians". Annals of Internal Medicine. 161 (1): 67–72. doi:10.7326/M14-0701. PMID 24979451. S2CID 12370761.[Free text]
- ^ a b c d "ACOG Committee Opinion No. 754 Summary: The Utility of and Indications for Routine Pelvic Examination". Obstetrics and Gynecology. 132 (4): 1080–1083. October 2018. doi:10.1097/aog.0000000000002896. PMID 30247359. S2CID 52342353.
- ^ a b ACOG Practice Advisory on Annual Pelvic Examination Recommendations (30 June 2014). "The Utility of and Indications for Routine Pelvic Examination". American Congress of Obstetricians and Gynecologists. Archived from the original on 2 August 2014.
- ^ Berek and Novak's Gynecology (15th ed.). Philadelphia PA: Lippincott, Williams, and Wilkins. 2012. p. 11. ISBN 978-1-4511-1433-1.
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