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Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial.
Female Pelvic Med Reconstr Surg. 2020 Apr 21 [Online ahead of print]FP

Abstract

OBJECTIVE

The purpose of this study is to determine the optimal sequence in performing a pelvic examination to reduce discomfort in patients with baseline vaginal pain.

METHODS

A randomized controlled trial of women presenting for a new appointment at the Drexel Vaginitis Center was conducted. Women were assigned to either group A, a Q-tip touch test, speculum examination, then bimanual examination, or group B, a Q-tip touch test, bimanual examination, then speculum examination. The primary outcome was visual analog scales to assess pain at baseline and after each portion of the examination. Secondary outcomes were responses to questionnaires for self-esteem, quality of life, and sexual function.

RESULTS

Two hundred women were enrolled in the trial. For both group A and group B, each portion of the examination was similarly scored regardless of whether the speculum examination was performed before or after bimanual examination. Pain during the speculum examination was higher than pain during the other components of the examination, although not significant (P = 0.65).When looking at reported pain outcomes, outcomes did not differ as a whole or between groups in relation to sexual activity, sexual orientation, and previous hysterectomy. The data were not significantly different between groups for self-esteem scores, sexual dysfunction, or quality of life scores.

CONCLUSION

In women with baseline vaginal pain, there was no difference in pain scores between the different components of the pelvic examination, nor is there a significant difference in pain during the examination compared with their baseline pain. Most patients reported minimal pain during each component.

Authors+Show Affiliations

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Bon Secours Mercy Health, St Francis Hospital Health System, Greenville, SC.Drexel University College of Medicine.Drexel University College of Medicine.Drexel University College of Medicine.Dornsife School of Public Health.Drexel Vaginitis Center, Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32332423

Citation

Rinko, Rebecca, et al. "Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: a Randomized Clinical Trial." Female Pelvic Medicine & Reconstructive Surgery, 2020.
Rinko R, Spector C, Cook E, et al. Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial. Female Pelvic Med Reconstr Surg. 2020.
Rinko, R., Spector, C., Cook, E., Mancenido, B., Gracely, E. J., & Nyirjesy, P. (2020). Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial. Female Pelvic Medicine & Reconstructive Surgery. https://doi.org/10.1097/SPV.0000000000000791
Rinko R, et al. Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: a Randomized Clinical Trial. Female Pelvic Med Reconstr Surg. 2020 Apr 21; PubMed PMID: 32332423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sequence of Pelvic Examination Does Not Affect Patients With Baseline Vulvovaginal Syndromes: A Randomized Clinical Trial. AU - Rinko,Rebecca, AU - Spector,Chelsea, AU - Cook,Ellen, AU - Mancenido,Briana, AU - Gracely,Edward J, AU - Nyirjesy,Paul, Y1 - 2020/04/21/ PY - 2020/4/26/entrez JF - Female pelvic medicine & reconstructive surgery JO - Female Pelvic Med Reconstr Surg N2 - OBJECTIVE: The purpose of this study is to determine the optimal sequence in performing a pelvic examination to reduce discomfort in patients with baseline vaginal pain. METHODS: A randomized controlled trial of women presenting for a new appointment at the Drexel Vaginitis Center was conducted. Women were assigned to either group A, a Q-tip touch test, speculum examination, then bimanual examination, or group B, a Q-tip touch test, bimanual examination, then speculum examination. The primary outcome was visual analog scales to assess pain at baseline and after each portion of the examination. Secondary outcomes were responses to questionnaires for self-esteem, quality of life, and sexual function. RESULTS: Two hundred women were enrolled in the trial. For both group A and group B, each portion of the examination was similarly scored regardless of whether the speculum examination was performed before or after bimanual examination. Pain during the speculum examination was higher than pain during the other components of the examination, although not significant (P = 0.65).When looking at reported pain outcomes, outcomes did not differ as a whole or between groups in relation to sexual activity, sexual orientation, and previous hysterectomy. The data were not significantly different between groups for self-esteem scores, sexual dysfunction, or quality of life scores. CONCLUSION: In women with baseline vaginal pain, there was no difference in pain scores between the different components of the pelvic examination, nor is there a significant difference in pain during the examination compared with their baseline pain. Most patients reported minimal pain during each component. SN - 2154-4212 UR - https://www.unboundmedicine.com/medline/citation/32332423/Sequence_of_Pelvic_Examination_Does_Not_Affect_Patients_With_Baseline_Vulvovaginal_Syndromes:_A_Randomized_Clinical_Trial L2 - https://doi.org/10.1097/SPV.0000000000000791 DB - PRIME DP - Unbound Medicine ER -
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