Health Self-Exam for Women How to Perform a Bimanual Pelvic Examination

About the way to give a bimanual pelvic self-exam for women, health and gynecology information.

HOW TO PERFORM A BIMANUAL PELVIC EXAMINATION

You will need surgical gloves and K-Y jelly, not vaseline.

Before the procedure, the woman to be examined should urinate, since a full bladder may make the uterus more difficult to locate.

1. The woman lies down with knees drawn up and wide enough apart to expose genitals.

2. The examiner puts on surgical glove, lubricating index and middle fingers of gloved hand.

3. The 2 lubricated fingers in a "pistol position" are inserted into the vagina.

4. Gentle exploration will locate the cervix. It feels hard, like the end of a nose. The 2 inserted fingers are placed under the cervix and held there to keep it firmly in place.

5. With the other hand, the examiner presses down on the lower abdomen. This firm external pressure should locate the uterus. Unusual uterine position, obesity, or lack of sufficient external pressure may make it difficult to find. The normal uterus is commonly the size of a lemon. Although some women may normally have a large uterus, if the uterus you are feeling is as large as an orange or a grapefruit the possibility of a tumor or pregnancy should be considered.

6. After noting the size, wiggle the uterus gently to see that there is no pain when the attached structures are moved.

7. With hands in the same position, the examiner feels at the sides of the abdomen for the Fallopian tubes and the ovaries. When the woman feels a slight twinge, the ovaries have been located. They are almond-sized and should not be hard, enlarged, severely painful, or more painful on one side than the other. The tubes may not be felt, but if they are located they will be soft and about the thickness of a pencil. If they are hard, enlarged, or painful to the touch, something is wrong.

8. After the examination, the women may exchange roles. The examiner may want to draw a picture of what she has felt with her hands during the examination.

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