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Gynecologist: Is Rectal Exam Necessary?

By:
Kelly Shanahan

Question :

I feel like I've been tricked by my doctor. During a pelvic exam, she wanted to do a rectal exam at the same time. I refused, then she said it was the only way a doctor could feel and check the ovaries. After a few minutes of discussion I agreed. Now the more I think about it the madder I'm getting. I've never heard of this method for checking the ovaries. I've got a real problem thinking she might have lied to me about the reason for doing it and talking me into it. This was my first visit to this doctor. Now I don't know if I can trust her or not.

Kathi

Answer :

Rectal exams are a valuable part of the pelvic exam; some gynecologists advocate doing a rectovaginal exam (one finger in the rectum and one in the vagina) all the time, whereas others, like myself, do them routinely only in women over 40 or in situations where it will improve examination of the ovaries. Rectovaginal exam does make it easier to feel the ovaries well, but it is not the only way.

Even if I feel it is very important to do a rectal exam, I will not do it if the patient refuses. I will explain why I feel it is necessary (that is, as a screen for colon cancer in women over 40, or as a way to better feel the ovaries in someone complaining of pelvic pain) and I will document that discussion and the patient's refusal in her chart (and tell her I am doing that). I suggest that you speak to your doctor about the way you feel. If you merely leave her practice without any explanation, she won't know why you were offended and won't be able to learn from this.

 

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