Sequence of Pelvic Examination Affects Patient-Reported Pain

Rinko, Rebecca; Yu, Ian; Bakillah, Emna; Alper, Lauren; Delaney, Colleen; Su, Marisa; Dawson, Melissa; Gracely, Edward J.; Whitmore, Kristene

doi:10.1097/spv.0000000000000515

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…O exame da genitália interna deve ser iniciado pelo exame especular (48) . Usa-se o espéculo bivalvar, que pode ser de Collins ou Collins e Graves, estéril, de aço ou material descartável, de tamanho adequado sem lubrificação prévia.…”

Section: Exame Da Genitália Internaunclassified

Semiologia ginecológica: uma atualização no atendimento da mulher na atenção primária à saúde Gynecology semiology: an update of the care of women in primary health care

Silva

Hildebrand

Botogoski

et al. 2020

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: O presente trabalho se constitui como artigo de atualização acerca do tema semiologia ginecológica, visando oferecer subsídios para a consulta ginecológica, realizada por médicos da atenção primária à saúde e por médicos ginecologistas. Objetivo: dar subsídios teóricos ao profissional da saúde, de modo a agregar recursos para a compreensão de queixas das pacientes, abordagem de temas como a atenção a sinais de violência contra a mulher, buscando auxiliar no estabelecimento de vínculo médico-paciente estável, pautado no respeito, na segurança e na individualização do cuidado, assim como oferecer recurso esquemático para a otimização do momento da consulta e assertividade do médico examinador. Metodologia: Através do acesso de literatura disponível em bases de dados como PubMed, Scielo e BVS, foram definidos tópicos imprescindíveis à consulta ginecológica, dando base à formulação de uma ficha clínica ambulatorial, que define o roteiro do atendimento ginecológico no ambiente da atenção primária à saúde. Conclusão: Parte-se da compreensão da consulta ginecológica como pilar fundamental do atendimento à saúde da mulher, com ampla aplicabilidade médica e com possibilidade de refletir em decisões futuras da paciente a respeito de sua saúde ginecológica, sexual e reprodutiva, causando impacto em questões inerentes à saúde pública. Nesse contexto, pode-se concluir que estabelecer um roteiro de atendimento contribui de forma significativa na efetividade e resolutividade da consulta ginecológica no âmbito da atenção primária à saúde.Palavras-chave: Ginecologia, Anamnese, Exame Ginecológico, Atenção primária à saúdeABSTRACTIntroduction: The present paper constitutes an update article about the gynecological semiology, aiming to offer subsidies for gynecological consultation, carried out by doctors from the primary health care and by gynecologists. Objective: The aim of this study is to provide theorical support to the health professional in order to add resources for understanding the patients complains, including theme such as signs of violence against women, seeking to establish a stable doctor-patient bond, based on respect, safety and individualization of care, as well as offering a schematic resource to optimize the medical approach. Methodology: Through the access to the literature available in the online database such as PubMed, Scielo and BVS, essential topics to the gynecological consultation were defined, based in the formulation of a ambulatory clinical form, which defines a script for gynecological care in the primary health care environment. Conclusion: It is understood that the gynecological consultation is a key pillar of women’s health care, with wide medical applicability and with the possibility of reflecting on future decisions of the patient regarding her gynecological, sexual and reproductive health, directly impacting on inherent to public health. In this context, it can be concluded that establishing a schematic clinical record contributes significantly to the effectiveness and resolution of gynecological consultation in the context of primary health care.Keywords: Gynecology, Medical history taking, Gynecological examination, Primary health care

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Section: Exame Da Genitália Internaunclassified

Semiologia ginecológica: uma atualização no atendimento da mulher na atenção primária à saúde Gynecology semiology: an update of the care of women in primary health care

Silva

Hildebrand

Botogoski

et al. 2020

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Examen pelvien en gynécologie et obstétrique : recommandations pour la pratique clinique

Deffieux,

Rousset-Jablonski,

Gantois

et al. 2023

Gynécologie Obstétrique Fertilité & Sénologie

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Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial

Rinko

Spector

Cook

et al. 2021

Female Pelvic Med Reconstr Surg

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Objective The purpose of this study is to determine the optimal sequence in performing a pelvic examination to reduce discomfort in patients with baseline vaginal pain. Methods A randomized controlled trial of women presenting for a new appointment at the Drexel Vaginitis Center was conducted. Women were assigned to either group A, a Q-tip touch test, speculum examination, then bimanual examination, or group B, a Q-tip touch test, bimanual examination, then speculum examination. The primary outcome was visual analog scales to assess pain at baseline and after each portion of the examination. Secondary outcomes were responses to questionnaires for self-esteem, quality of life, and sexual function. Results Two hundred women were enrolled in the trial. For both group A and group B, each portion of the examination was similarly scored regardless of whether the speculum examination was performed before or after bimanual examination. Pain during the speculum examination was higher than pain during the other components of the examination, although not significant (P = 0.65). When looking at reported pain outcomes, outcomes did not differ as a whole or between groups in relation to sexual activity, sexual orientation, and previous hysterectomy. The data were not significantly different between groups for self-esteem scores, sexual dysfunction, or quality of life scores. Conclusion In women with baseline vaginal pain, there was no difference in pain scores between the different components of the pelvic examination, nor is there a significant difference in pain during the examination compared with their baseline pain. Most patients reported minimal pain during each component.

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Sequence of Pelvic Examination Affects Patient-Reported Pain

Abstract: Pain associated with the speculum examination was lower in those undergoing speculum before bimanual examination. Speculum pain was greater than bimanual pain in both groups. Most patients reported minimal or no pain during the different portions of the examination.

Cited by 3 publications

References 13 publications

Semiologia ginecológica: uma atualização no atendimento da mulher na atenção primária à saúde Gynecology semiology: an update of the care of women in primary health care

Semiologia ginecológica: uma atualização no atendimento da mulher na atenção primária à saúde Gynecology semiology: an update of the care of women in primary health care

Examen pelvien en gynécologie et obstétrique : recommandations pour la pratique clinique

Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial

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