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Speculum Examination
Description
Speculum examination of the vaginal canal and cervix is a vital part of any gynecologic examination. The use of a speculum also facilitates a number of gynecologic processes, including obtaining cervical cytology or cultures, colposcopy, intrauterine contraceptive device placement and removal, hysteroscopy, and others. When used properly it is an invaluable tool; when used artlessly, its use can result in pain, trauma, and lost information.
Indications
Any time the tissues of the external genitalia or vaginal canal must be retracted for inspection or access, a speculum is used.
Contraindications
Pelvic examinations are intrinsically an invasive procedure. As such, they require the specific or implied permission of the patient except under emergency conditions. Risk (though small) must always be exceeded by benefit; if the speculum examination is unlikely to yield information that will alter patient management, it is contraindicated.
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