Pelvic Examinations & Pap Smear

DEFINITION

Examination of the female external and internal genitalia. The Pap smear (cervical smear), carried out during the pelvic examination, is a laboratory study used to detect cancerous or precancerous cells on the cervix. Annual pelvic examination with a Pap smear is recommended for most women and more often for those in high-risk categories.

REASONS FOR PROCEDURE

  • Routine diagnostic check.
  • Investigate the cause of abdominal or pelvic pain.
  • Unexpected vaginal bleeding or discharge.
  • Bladder problems.
  • A general check before prescribing any form of contraception.
  • Pain during intercourse.
  • Suspected sexually transmitted disease.
  • In pregnancy, to assess the position of the baby.
  • Screening test for cancer.

RISK

None expected.

DESCRIPTION OF PROCEDURE

  • Do not douche before the examination.
  • The examination is performed in the examiner’s office.
  • On the examining table, you will lie on your back with knees bent and legs apart (legs are usually placed in stirrups) for support.
  • The external genital organs will be examined visually for lumps, sores, skin discoloration, inflammation and qualities suggesting the general hormonal status.
  • A speculum is placed inside and opened. The speculum is an instrument that holds the vaginal walls apart and allows the examiner to see the cervix and vagina and check for inflammation, infection, scars or growths. There may be some feeling of pressure on the bladder or rectum with the speculum in place.
  • With a swab, a sampling of cells is taken from the cervix and placed on a glass slide for the Pap smear test. If you have an infection or there are signs of infection present, a sample of vaginal or cervical discharge may be taken for laboratory analysis also.
  • After the speculum is removed, the examiner will place two fingers in the vagina and the other hand on top of the abdomen to check placement of the uterus and ovaries and to assess their size, shape, consistency and tenderness.

This procedure may cause some discomfort.

  • Usually there is a rectal examination, where the examiner places one finger in the rectum (often, one finger is placed in the vagina at the same time) to check the rectum itself and other nearby structures.

EXPECTED OUTCOME

There are no aftereffects expected from the examination. In routine examinations, the results are usually normal.

POSSIBLE COMPLICATIONS

None expected from the examination. The findings may indicate a disorder to be treated or a condition requiring further diagnostic testing.

POSTPROCEDURE CARE
GENERAL MEASURES

  • There may be some slight vaginal discharge following the examination. Use a tissue to wipe or place one in the underpants temporarily. If there is bleeding (rare), a sanitary pad may be necessary.
  • Any findings from the physical examination or further diagnostic testing recommendations will be discussed with you by the examiner.
  • The results of the Pap smear testing may take several days or more. They will be reported to you during your follow-up visit Be sure you and the doctor follow up on any abnormalities that are detected.