The examination can be uncomfortable. Fig 2 — The bimanual examination. The adnexal region surrounds the uterus and contains the fallopian tubes, ovaries, rectosigmoid, small intestine, bladder, ureters, vessels, nerves.
A thin, narrow speculum may be used for young girls and older women. Patients should be advised not to douche or have palpating the vaginal wall for at least 2 days before the cytology smear is made. With the patient straining, the anal sphincter will be more dilated, and insertion of the finger will cause less discomfort.
There was a problem providing the content you requested
American College of Obstetricians and Gynecologists. It is frequently used in gynecology. An excellent light should be shining over the examiner's shoulder for adequate illumination of the external genitalia.