Foreword

vii

Preface

ix

Acknowledgments

xi

PART I

INTRODUCTION TO THE GYNECOLOGIC EXAM

Introduction

1

1

Conducting the Interview and Taking a Gynecologic and Sexual History

3

2

Abdominal Exam

17

3

Vulvar Exam

23

4

The Speculum Exam

39

5

The Bimanual Exam

57

6

The Rectal Exam

67

PART II

APPROACH TO EXAMINING SPECIAL POPULATIONS

Introduction

75

7

Specific “Challenges”

77

8

Examining the Patient With Anxiety, History of Sexual Abuse, or Vaginismus

85

9

Examining Virginal Women and Premenarchal Children

99

10

Techniques Useful When Examining Overweight, Multiparous, or Physically Challenged Women

107

11

Special Considerations When Examining the Menopausal and Elder Woman

119

12

Care of the Woman Who Has Experienced Female Genital Mutilation

131

PART III

IN-OFFICE DIAGNOSTIC TESTING

13

Performing In-Office Diagnostic Tests

141

APPENDICES

A

Common Pelvic Examination Problems and Interventions

149

B

Vaginal Microscopy Flow Sheet

151

C

Vaginal Microscopy: Flow Sheet Instructions

152

D

Vulvar Care Guidelines for Patient Education

154

References

157

Abbreviations

161

Index

163