A bimanual exam is a common component of a comprehensive pelvic or gynecological examination. Healthcare providers routinely perform this procedure to assess the internal pelvic organs and evaluate the health of reproductive structures.
Understanding the Bimanual Exam
A bimanual exam involves the healthcare provider using two hands to physically assess the pelvic organs. One hand is placed externally on the patient’s lower abdomen, while two lubricated, gloved fingers are inserted into the vagina. This technique allows the provider to gently palpate the size, shape, and position of the uterus, ovaries, and fallopian tubes. Qualified healthcare providers, such as gynecologists, family physicians, or nurse practitioners, perform this examination.
Why a Bimanual Exam is Performed
The bimanual exam helps identify abnormalities within the pelvic cavity. It can detect conditions such as non-cancerous uterine fibroids or fluid-filled ovarian cysts. The exam also allows for the detection of tenderness, which could indicate inflammation or infections like pelvic inflammatory disease (PID). Additionally, it can help pinpoint sources of unexplained pelvic pain. This examination is a routine part of wellness checks, aiding in the early detection and monitoring of pelvic health, even when a patient does not report any symptoms.
What to Expect During the Exam
Before the bimanual exam, patients are typically asked to empty their bladder to enhance comfort. The patient then lies on an examination table, usually on their back with feet in stirrups, a position that allows the healthcare provider optimal access. The provider inserts one or two lubricated, gloved fingers into the vagina while simultaneously pressing gently on the lower abdomen with their other hand. Patients often experience a sensation of pressure or mild discomfort, rather than sharp pain, during this examination. Communicating any discomfort or concerns to the provider during the procedure is important.
Interpreting Results and Next Steps
During the bimanual exam, the healthcare provider interprets findings by assessing the size, shape, consistency, mobility, and tenderness of the pelvic organs. Normal findings indicate healthy pelvic organs, suggesting no palpable masses or areas of unusual tenderness. Conversely, abnormal findings might suggest the presence of a mass, such as a fibroid or cyst, or indicate inflammation.
If abnormalities are detected, the healthcare provider may recommend further diagnostic tests, which could include an ultrasound to visualize the organs, blood tests, or magnetic resonance imaging (MRI). A referral to a specialist might also be suggested for further evaluation or management. The bimanual exam remains a component of a comprehensive approach to gynecological health, guiding subsequent care decisions.