Pelvic Exam and Pap Test

The entire exam lasts just a few minutes and includes three steps:

Step 1: the external genital exam

Step 2: the speculum exam - which includes a Pap test

Step 3: the bimanual exam

Step 1: the external genital exam

A clinician will visually examine the vagina to check for signs of irritation, discharge, cysts, genital warts or other visible condition.

Step 2: the speculum exam

A clinician inserts a speculum into the vagina. When opened, it separates the walls of the vagina, so that the cervix can be seen. Once in place, the clinician checks for any irritation, growth or abnormal discharge from the cervix. Tests for many sexually transmitted infections may be taken by collecting cervical discharge on a cotton swab. These tests may not be done unless you have a concern about infections. It is important to discuss this with your clinician about any concerns or symptoms before the exam.

Usually a small spatula or tiny brush is used to gently collect cells from the cervix for a Pap test. The cells are tested for abnormalities – the presence of precancerous or cancerous cells. The cell sample will be sent to a laboratory. The results will be sent back to the clinician within a few weeks.

Step 3: the bimanual exam

Wearing an examination glove, the clinician inserts one or two lubricated fingers into the vagina. The other hand presses down on the lower abdomen. The clinician can then feel the internal organs of the pelvis between the two fingers in the vagina and the fingers on the abdomen. The clinician examines the internal organs with both hands to check for:

• Size, shape and position of the uterus
• An enlarged uterus, which could indicate a pregnancy or fibroids;
• Tenderness or pain which might indicate infection;
• Swelling of the fallopian tubes;
• Enlarged ovaries, cysts or tumors.

It is important to tell the clinician if you feel pain or discomfort during the exam.

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