Most doctors recommend women have a yearly pelvic exam. This gives healthcare providers an opportunity to examine the pelvic area and make sure everything is OK.
A pelvic exam consists of four parts: the external genital exam, the speculum exam, the bimanual exam and the rectovaginal exam.
The rectovaginal exam is a diagnostic tool that helps doctors to more fully examine the internal pelvic anatomy and check the vaginal and rectal areas for abnormalities.
How is it done? It involves the doctor inserting one lubricated, gloved finger into the vagina and a second finger (from the same hand) in the rectum at the same time. This is happening while he or she is pressing on the lower abdomen with the other hand. This procedure allows the healthcare provider to feel deep in the pelvis to determine where and how large the pelvic organs are.
Doctors can feel for signs of tumors that might be located behind the uterus, on the lower walls of the vagina or in the rectum.
The procedure lets doctors evaluate the tissue between the uterus and vagina, the tone and alignment of the pelvic organs (like the ovaries and fallopian tubes) and the ligaments that hold the uterus in place. It can even help diagnose a tilted uterus.
This exam is also a chance for doctors to check for rectal bleeding or growths, as well as any other early warnings of colon cancer. This is especially true for women over age 40.
For women experiencing rectal or pelvic pain, a rectovaginal exam may help pinpoint the source of the pain.
This exam can be a bit uncomfortable and often makes many women feel as if they need to have a bowel movement. However, it doesn’t last long—typically they run one to five minutes. It should not cause any pain. Women need to tell their doctor if it hurts when their organs are touched or moved.
A rectovaginal exam is not the same as a rectal exam. During a rectal exam, the doctor only inserts a finger into the rectum. It is similar to a bimanual exam, which is where the healthcare provider inserts one or two lubricated, gloved fingers into the vagina, while the other hand gently presses on the lower abdomen.