Screening Pelvic Examination in Adult Women
Authors: Carol Bates, Jennifer Potter
Journal: Annals of Internal Medicine (2014)

Letters16 December 2014Screening Pelvic Examination in Adult WomenCarol Bates, MD and Jennifer Potter, MDCarol Bates, MDFrom Beth Israel Deaconess Medical Center, Boston, Massachusetts.Search for more papers by this author and Jennifer Potter, MDFrom Beth Israel Deaconess Medical Center, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5035-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We greatly appreciate Qaseem and colleagues' guideline (1) and the associated evidence review (2) but would argue that the degree to which the speculum or bimanual examination is the primary source of the discomfort associated with pelvic examinations has not been sufficiently determined. Traditional teaching has recommended doing the speculum examination first without any lubricant other than water; one might imagine this to be the most uncomfortable aspect of a sequential examination. We now know that water-based lubricant does not interfere with cytologic assessment or evaluation for vaginal or cervical infection.Speculum examinations may be uncomfortable at ...References1. Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD; Clinical Guidelines Committee of the American College of Physicians.. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161:67-72. [PMID: 24979451] doi:10.7326/M14-0701 LinkGoogle Scholar2. Bloomfield HE, Olson A, Greer N, Cantor A, MacDonald R, Rutks I, et al. Screening pelvic examinations in asymptomatic, average-risk adult women: an evidence report for a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161:46-53. [PMID: 24979449] doi:10.7326/M13-2881 LinkGoogle Scholar3. Bates CK, Carroll N, Potter J. The challenging pelvic examination. J Gen Intern Med. 2011;26:651-7. [PMID: 21225474] doi:10.1007/s11606-010-1610-8 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Carol Bates, MD; Jennifer Potter, MDAffiliations: From Beth Israel Deaconess Medical Center, Boston, Massachusetts.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0520. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening Pelvic Examination in Adult Women: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Linda L. Humphrey , Russell Harris , Melissa Starkey , Thomas D. Denberg , and Screening Pelvic Examination in Adult Women Samuel Metz and Debra Gussman Screening Pelvic Examination in Adult Women Thomas D. Denberg , Russell Harris , Linda L. Humphrey , and Amir Qaseem Screening Pelvic Examination in Adult Women Thomas D. Denberg , Russell Harris , Linda L. Humphrey , and Amir Qaseem Screening Pelvic Examination in Adult Women Samuel Metz and Debra Gussman Metrics 16 December 2014Volume 161, Issue 12Page: 925-926KeywordsCervixConflicts of interestDisclosure ePublished: 16 December 2014 Issue Published: 16 December 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...