Pelvic examination is essential to clinical care
I have contemplated the issue of the routine screening pelvic exam now for several years. But for the last year, I have found various problems in many “asymptomatic women.” For example: The 18-year-old who was “not sexually active” but who had Chlamydia. Or the 84-year-old who denied itching or other vulvovaginal symptoms who had either vulvar cancer or lichen sclerosis so severe her vagina was almost closed; a 30-minute review of her outside records revealed recurrent urinary tract infections requiring more than 5 courses of antibiotics in 6 months for what was actually contaminants from a urine specimen that passed through the vagina first. I think the move away from actually touching patients has completely gotten out of hand! It is appalling how many women I have seen who visited an emergency department for pelvic or abdominal pain and never had a hands-on examination. If we do not examine the part of the body that many completely ignore we may as well lose our specialty!
Christine Kneer-Aronoff, MD
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