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Limitations of the pelvic examination for evaluation of the female pelvic organs
Author(s) -
Padilla L.A.,
Radosevich D.M.,
Milad M.P.
Publication year - 2005
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.09.015
Subject(s) - medicine , pelvic examination , laparotomy , gynecological examination , adnexal mass , laparoscopy , body mass index , physical examination , gynecology , obstetrics , surgery
Objective To assess factors influencing an accurate pelvic examination under the best possible circumstances. Methods Before undergoing laparoscopy or laparotomy, 84 women under general anesthesia underwent pelvic examinations by an attending gynecologist, a gynecology resident, and a medical student blinded to the indication for surgery. Surgical findings were compared with the examiners' findings. Dependent variables (uterine size, uterine contour, and presence of adnexal masses) and effect modifiers (examiner experience and body mass index) were analyzed. Results The overall pelvic examination was accurate 70.2% of the time for attending gynecologists, 64.0% for residents, and 57.3% for medical students. The sensitivity to detect adnexal masses was much lower than the sensitivity to assess uterine size or uterine contour. Obesity noticeably reduced detection of adnexal masses. Conclusion The bimanual examination appears to be a limited screening test for the female upper genital tract even under the best possible circumstances. Uterine assessment appears to be more accurate than adnexal assessment.