Rectal exam during pelvic?
My mom made me an appointment with her male doctor for a full exam, she explained in detail what would happen and she said that the last part of the exam is a digital rectal exam.
After reading a bunch of answers on here my question is should I refuse that part or since it is a normal part of the exam should I let him do it?
I am 22 and have had a pelvic exam before but, I had never been offered or even heard of a rectal exam until my mom told me about it.
Honestly, I work at an OB/GYN office and our doctors don’t do rectal exams unless you have a problem in that area that you need checked out. You doc will do a bimanual exam, where he will insert a finger into your vagina while pressing down on your abdomen. This is done to check the size and shape of your uterus and ovaries.
If the office you go to does do rectal exams normally, you do have every right to refuse that part of the exam. You don’t say how old you are, but young women usually don’t need a rectal exam as rectal problems are more common in older women.
August 24th, 2009 at 6:01 am
Honestly, I work at an OB/GYN office and our doctors don’t do rectal exams unless you have a problem in that area that you need checked out. You doc will do a bimanual exam, where he will insert a finger into your vagina while pressing down on your abdomen. This is done to check the size and shape of your uterus and ovaries.
If the office you go to does do rectal exams normally, you do have every right to refuse that part of the exam. You don’t say how old you are, but young women usually don’t need a rectal exam as rectal problems are more common in older women.
References :
Certified Medical Assistant at an OB/GYN office.
August 24th, 2009 at 6:15 am
Firstly, let me say that no health professional can "force" you to do anything. It is your body, and so if you wish to decline having a pelvic examination performed, it is entirely within your right to do so.
Secondly, there is no scientific evidence to support the necessity for a pelvic examination of an asymptomatic
woman requesting hormone therapy, or attending for a sexual health check. The literature does not support this practice, and as such I do not know why it continues in the United States. It is certainly not the practice here in Australia (where I work as Clinical Nurse Consultant in Primary Health Care).
Additionally, many countries do not advocate having an annual pelvic exam as is the case in the United States. For example:
-The Royal Australian and New Zealand College of Obstetricians and Gynecologists suggest every 2 years in Australia (as it is the Australian Government national policy) and every 3 years in New Zealand (as it is the New Zealand Government national policy)
-The College of Family Physicians of Canada suggests every 3 years
-The Nordic Federation of Societies of Obstetrics and Gynecology suggests every 3 years
-The Royal College of Obstetricians and Gynecologists suggests every 3 years up until age 50, and then every 5 years till age 64
-The Alliance for the Prevention of Cervical Cancer suggests 3 – 5 yearly intervals
Keep in mind that it is widely acknowledged that most cases of cervical cancer take up to 10 years to develop.
To specifically answer your question regarding the digital rectal exam. Some doctors perform this as part of a pelvic exam. Campbell KA, Shaughnessy AF (1998) found that out of 272 rectal exams ZERO diagnostic findings were made. They did however discover incidental findings in seven patients (hemorrhoids, stool in rectum, and vaginal scar), and one confirmatory finding of colitis. They concluded that a digital rectal examination should not be included as part of a routine gynecological examination unless a specific diagnosis or condition is suspected.
Finally, ovarian cancer is relatively rare, and only likely to be detected during a pelvic examination in its more advanced stages. As such, the literature concludes that using a pelvic examination as screening tool is of little to no diagnostic value.
References :
http://www.racgp.org.au/Content/NavigationMenu/Publications/AustralianFamilyPhys/2006issues/afp200611/20061103stewart.pdf
http://www.rcog.org.uk/resources/public/pdf/WP_GynaeExams4.pdf
Campbell KA, Shaughnessy AF. Diagnostic utility of the digital rectal examination as part of the routine pelvic examination. J Fam Pract 1998; 46:165-7