Physical Exam

Pelvic Speculum Exam

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Video coming September 2026

How to Perform

With the patient in the dorsal lithotomy position and appropriately draped, select and warm an appropriately sized speculum and lubricate it with a small amount of water-based gel compatible with any planned testing. Separate the labia and gently insert the closed speculum, directing it posteriorly toward the sacrum. Once inserted, open the blades until the cervix is fully visualized and lock the speculum in place. Inspect the cervix for color, discharge, and lesions, and obtain any indicated samples, such as cervical cytology or swabs. Unlock and slowly withdraw the speculum, inspecting the vaginal walls for color, discharge, and lesions as the blades are withdrawn.

How to Interpret

Bacterial Vaginosis

Appearance of vaginal discharge as an isolated sign

Rule in

Not helpfulNo CI

Rule out

HelpfulNo CI

Evidence:LimitedResearch in progress

References

Research in progress on one or more findings above; ratings may change.

Simões JA, Discacciati MG, Brolazo EM, Portugal PM, Dini DV, Dantas MC. Clinical diagnosis of bacterial vaginosis. Int J Gynaecol Obstet. 2006;94(1):28-32. doi:10.1016/j.ijgo.2006.04.013. PMID: 16756982.
Brunham RC, Paavonen J, Stevens CE, Kiviat N, Kuo CC, Critchlow CW, Holmes KK. Mucopurulent cervicitis — the ignored counterpart in women of urethritis in men. N Engl J Med. 1984;311(1):1-6. PMID: 6427611.
Wolner-Hanssen P, Krieger JN, Stevens CE, Kiviat NB, Koutsky L, Critchlow C, DeRouen T, Hillier S, Holmes KK. Clinical manifestations of vaginal trichomoniasis. JAMA. 1989;261(4):571-576. doi:10.1001/jama.1989.03420040109029. PMID: 2783346.
Wesley R, Sankaranarayanan R, Mathew B, Chandralekha B, Aysha Beegum A, Amma NS, Nair MK. Evaluation of visual inspection as a screening test for cervical cancer. Br J Cancer. 1997;75(3):436-440. doi:10.1038/bjc.1997.72. PMID: 9020493. PMCID: PMC2063368.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.