Many patients wonder about the rectal exam performed by an OBGYN. This part of a gynecological visit, while potentially causing apprehension, serves a specific purpose in assessing overall pelvic health. This article clarifies why these exams are performed and what they involve.
Understanding the Role of the Rectal Exam
The rectal exam, often part of a comprehensive pelvic assessment, allows for a more complete evaluation of organs and structures in the pelvic region. During a rectovaginal exam, the provider can palpate structures challenging to assess with a vaginal exam alone, such as the posterior uterus, ovaries, and uterosacral ligaments.
This technique helps assess the pelvic floor and the rectovaginal septum, the tissue between the rectum and vagina. The rectal exam provides a different angle for palpation, offering additional insights into the condition of these internal organs.
Diagnosing with the Rectal Exam
The rectal exam can help detect specific conditions or issues that might not be apparent during other parts of a gynecological examination. Physicians use this method to assess for masses, tenderness, or other irregularities in areas such as the cul-de-sac, the deepest part of the pelvic cavity between the uterus and the rectum. Accumulation of abnormal fluid or growths in this area can indicate various conditions.
This examination can aid in evaluating conditions like endometriosis, often causing nodules or tenderness in the uterosacral ligaments. It can also help identify pelvic inflammatory disease (PID) or certain types of pelvic masses, including some ovarian or uterine cancers, which might be palpable through the rectal wall. While not a primary screening tool for colorectal cancer, a rectal exam can sometimes detect hemorrhoids, polyps, or other anal/rectal issues that are relevant to overall health.
What to Expect During the Exam
A rectal exam is typically a quick part of a gynecological visit, often performed after the vaginal examination. The procedure involves the insertion of a gloved, lubricated finger into the rectum, often with another finger in the vagina or a hand on the lower abdomen. Patients may be asked to lie on their back with feet in stirrups, or on their left side with knees bent.
During the exam, it is common to experience sensations of pressure or a brief urge to have a bowel movement. While generally not painful, some discomfort can occur. Open communication with your provider is important; if discomfort is significant, it is helpful to let them know. Relaxing the abdominal and rectal muscles can help minimize any unpleasant sensations.
Discussing Your Concerns
Patients have the right to understand any procedure performed during their medical appointments, including the rectal exam. If you have concerns about the necessity of the exam for your specific situation, it is important to openly discuss these with your OBGYN. Asking questions about why it is being recommended, or if there are alternatives, fosters a collaborative approach to your care.
While the rectal exam is a valuable diagnostic tool, its inclusion depends on individual health history, symptoms, and age. Your provider can explain how this examination contributes to your overall health assessment. Engaging in dialogue ensures you feel informed and comfortable with your healthcare decisions.