-
Animal Reproduction Mar 2020Gynecological examination is essential to assess the reproductive tract of mares and can provide important information about the uterine environment. It includes...
Gynecological examination is essential to assess the reproductive tract of mares and can provide important information about the uterine environment. It includes physical, vaginal, and rectal examination, ultrasound, cytology, culture, and endometrial biopsy. The present study aimed to perform gynecological examination and fertility to assess the fertility prognosis of Pantaneiro mares that have not been reproductively active and to determine their reproductive ability. Eight mares underwent ultrasound and gynecological examination and artificial insemination. Ultrasound revealed changes only in one mare. Histopathological findings were mild, such as periglandular and perivascular inflammatory cell infiltrates, fibrotic areas, glandular dilation, glandular island formation, and edema due to the phase of the estrous cycle. One animal was classified in category I and the others in category IIA. Cytological changes were found in only one mare. Endometrial culture from five mares resulted in isolation of and Only four mares resulted pregnant through artificial insemination, using the same stallion with fresh semen, which has been proving fertility. Thus, mares with better uterine conditions will not always become pregnant and those with mild changes will not always be barren.
PubMed: 32399064
DOI: 10.21451/1984-3143-AR2019-0031 -
Journal of General and Family Medicine Nov 2022Pelvic inflammatory disease (PID) is not a mere transient infection. PID can lead to chronic pain, ectopic pregnancy, and infertility. Although the Centers for Disease...
BACKGROUND
Pelvic inflammatory disease (PID) is not a mere transient infection. PID can lead to chronic pain, ectopic pregnancy, and infertility. Although the Centers for Disease Control and Prevention have established minimum diagnostic criteria, including pelvic examination, the diagnostic value of pelvic tenderness has recently garnered controversy. Our meta-analysis aimed to confirm whether pelvic tenderness, cervical motion tenderness, and adnexal tenderness can help diagnose PID.
METHODS
We searched for studies reporting the diagnostic test accuracy of pelvic tenderness, cervical motion tenderness, and adnexal tenderness among female patients at risk for PID, using MEDLINE, EMBASE, CENTRAL, CINAHL, Google, and Google Scholar through May 25th, 2022. After quality assessment using QUADAS-2, we performed data synthesis using a bivariate random effect model and Bayesian hierarchical summary receiver operating characteristic model. We then conducted sensitivity analysis excluding studies with non-PID cases.
RESULTS
The literature search produced 6769 articles. After quality assessment, 14 studies and their 2808 participants were eligible for synthesis on pelvic tenderness. Laparoscopy, either alone or in combination, was the most frequent reference standard. The main results for pelvic tenderness sensitivity and specificity were 0.81, 95% confidence interval (CI) [0.67-0.90] and 0.40, 95% CI [0.25-0.57], respectively. Sensitivity and specificity were 0.72, 95% CI [0.57-0.83] and 0.50, 95% CI [0.34-0.66], for cervical motion tenderness, and 0.87 [0.64-0.96] and 0.27, 95% CI [0.12-0.52] for adnexal tenderness, respectively.
CONCLUSIONS
Our meta-analysis suggests that pelvic tenderness assessed by pelvic examination may be useful for PID examination with moderate-to-high sensitivity, whereas clinicians should be aware of the diagnostic significance of pelvic tenderness.
PubMed: 36349207
DOI: 10.1002/jgf2.572 -
Women's Health (London, England) Jul 2014The value of pelvic examination for healthy asymptomatic women has been called into question given the lack of benefit for ovarian and endometrial cancer screening, the... (Review)
Review
The value of pelvic examination for healthy asymptomatic women has been called into question given the lack of benefit for ovarian and endometrial cancer screening, the ability to screen for sexually transmitted infections without a pelvic examination, and the uncoupling of the procurement of contraception with a pelvic examination. Still, there are indications for performing pelvic examinations in symptomatic women and in some high risk women. How do we as clinicians apply current evidence and expert opinion to our medical practice? Our recommendation to consider a pelvic examination at 3-5-year intervals with cervical cancer screening to elicit gynecologic and sexual health concerns offers a compromise between continuation of unnecessary annual pelvic examinations and complete elimination of these examinations.
Topics: Contraception; Female; Guidelines as Topic; Gynecological Examination; Humans; Risk Factors; Sexually Transmitted Diseases; Uterine Cervical Neoplasms; Vaginal Smears; Women's Health
PubMed: 25259899
DOI: 10.2217/whe.14.30 -
Obstetrics & Gynecology Science Mar 2023Pelvic organ prolapse (POP) is a significant public health concern in women and a common cause of gynecological surgery in elderly women. The prevalence of POP has...
Pelvic organ prolapse (POP) is a significant public health concern in women and a common cause of gynecological surgery in elderly women. The prevalence of POP has increased with an increase in the aging population. POP is usually diagnosed based on pelvic examination. However, an imaging study may be necessary for more accurate diagnosis. Translabial ultrasound (TLUS) was used to assess diverse types of POP, particularly posterior-compartment POP. It is beneficial to distinguish between true and false rectocele, and detect the rectocele as clinically apparent. TLUS can also establish whether the underlying cause is a problem of the rectovaginal septum, perineal hypermobility, or isolated enterocele. TLUS also plays a role in differentiating POP from conditions that mimic POP. It is a simple, inexpensive, and non-harmful diagnostic modality that is appropriate for most gynecologic clinics.
PubMed: 36575051
DOI: 10.5468/ogs.22227 -
Canadian Urological Association Journal... Jun 2017Pelvic organ prolapse (POP) results from weakness or injury of the pelvic floor supports with resulting descent of one or more vaginal compartments (anterior, apical... (Review)
Review
Pelvic organ prolapse (POP) results from weakness or injury of the pelvic floor supports with resulting descent of one or more vaginal compartments (anterior, apical and/or posterior). Women typically become symptomatic from the bulging vaginal wall or related organ dysfunction once this descent reaches the introitus. POP is a common condition, affecting more than half of adult women. Many women presenting to an urologist for stress urinary incontinence or overactive bladder will have associated POP; therefore, it is important for urologists who treat these conditions to be familiar with its diagnosis and management. While POP is part of the core urology training curriculum in some jurisdictions, it is not in Canada.1 This article reviews the diagnosis of POP, including pertinent symptoms to query in the history, important facets of a systematic pelvic examination, and the appropriate use of ancillary tests. Treatment options are also discussed, including conservative measures, pessaries, and various reconstructive and obliterative techniques.
PubMed: 28616110
DOI: 10.5489/cuaj.4634 -
Cureus Jun 2023Introduction Gynecological teaching associates (GTAs) are trained to teach the pelvic exam using themselves as models, and it has been hypothesized that their use can...
Introduction Gynecological teaching associates (GTAs) are trained to teach the pelvic exam using themselves as models, and it has been hypothesized that their use can improve learners' confidence and interpersonal skills. This study aims to gain greater insight into whether the use of GTAs is associated with increased medical students' confidence when performing the pelvic exam during clinical rotations. Methods An email survey was distributed to medical students in two different classes at a single United States Medical Licensing Examination (USMLE)-accredited medical school: one that learned the pelvic exam using GTAs and one that did not. A Fisher's exact test was performed to determine associations between the use of GTAs and confidence in performing the pelvic exam, with a p-value of <0.01. Results Out of the 85 survey participants, 68 had performed a pelvic exam in the clinical setting and thus rated their confidence level. Of the 38 students who learned using a GTA, 66% (p<0.0024) reported a confidence level of four or five (out of five) compared to 50% of the 30 students who were not able to practice using a GTA. There was a statistically significant difference in the confidence levels of students who practiced on GTAs compared to those who did not. Discussion Our findings demonstrated that students who were able to learn the pelvic exam using GTAs reported higher confidence levels when subsequently performing a pelvic exam in a clinical setting. Conclusion Our findings support investment in GTA programming for teaching the pelvic exam in medical school curricula.
PubMed: 37469809
DOI: 10.7759/cureus.40601 -
CMAJ : Canadian Medical Association... Jul 2021
Topics: Canada; Female; Gynecological Examination; Humans; Patient Preference; Physician's Role; Respect; Sex Offenses; Transgender Persons
PubMed: 34281967
DOI: 10.1503/cmaj.210331 -
NCHS Data Brief Jun 2019Pelvic examination has been commonly performed as part of a physical examination for women in the United States. However, the value of routine pelvic examinations has... (Review)
Review
Pelvic examination has been commonly performed as part of a physical examination for women in the United States. However, the value of routine pelvic examinations has been questioned recently (1,2). In 2012, the American College of Obstetricians and Gynecologists (ACOG) recommended annual pelvic examinations for women aged 21 and over as part of the well-woman visit (3). In 2018, ACOG advised that pelvic examinations be performed when indicated by medical history or symptoms (4). Using National Survey of Family Growth (NSFG) data through 2017 for women aged 15-44, this report describes trends overall and by age since 1988 in the receipt of pelvic examinations in the past year, and differences by Hispanic origin and race, education, poverty status, and health insurance status for 2015-2017.
Topics: Adolescent; Adult; Age Factors; Ethnicity; Female; Gynecological Examination; Humans; Surveys and Questionnaires; United States; Young Adult
PubMed: 31442190
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Nov 2020To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in...
OBJECTIVE
To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination.
METHODS
A longitudinal study was conducted with 4 year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated.
RESULTS
Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders.
CONCLUSION
The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.
Topics: Adult; Brazil; Breast; Education, Medical, Undergraduate; Female; Gynecological Examination; Gynecology; Humans; Male; Physical Examination; Self Concept; Simulation Training; Students, Medical; Surveys and Questionnaires; Young Adult
PubMed: 33254269
DOI: 10.1055/s-0040-1718433