The Bimanual Exam

For this part of the exam, the doctor will lubricate her index and middle fingers with K-Y jelly to aid in your comfort during insertion into the vagina. The doctor will place these two fingers on the cervix while placing her other hand on your abdomen (over your uterus). She will then press down lightly, which does not feel much different from when a doctor presses on the abdomen alone. Both hands are used to get a feeling for the size of the uterus. The doctor may use the fingers inside the vagina to move the cervix around a little to check for any pain, as this would indicate pelvic inflammatory disease. The doctor will then move both her fingers inside the vagina to both the right and left sides of your cervix. She will move her abdominal hand also a little to the right and left to feel for the size of the ovaries and to try to locate any abnormalities. This whole exam may feel a little funny to you, but it won't hurt. You can try not to tighten your abdominal muscles during the procedure to minimize the discomfort. Some doctors may perform a rectovaginal exam after the pelvic exam.

The vagina and the rectum are two tube- like structures that lie on top of one another in the body. The vagina is on top, or closest to the stomach wall. Between the two tubes is a space. It is like a third tube, except it ends in a blind pouch, instead of exiting the body at the vulva or the anus, like the other two. Sometimes, problems in the pelvic organs cause cells and tissue related to the problem to collect in this pouch and the tissue below it. By inserting an index finger in the vagina and the middle finger in the rectum at the same time, the physician is able to feel for any abnormalities that may be present.