BMJ  2006;333:158-159 (22 July), doi:10.1136/bmj.333.7560.158

Editorial

Vaginal speculum examinations without stirrups

US clinicians wonder if it will work

The first 150 words of the full text of this article appear below.

The pelvic examination using a vaginal speculum is one of the most common medical procedures performed by doctors and experienced by women. About 55 million smear tests are performed in the United States every year.¹ The article in this issue by Seehusen and colleagues is a provocative one for US clinicians, raising basic questions about how pelvic examinations are performed.² American medical schools uniformly teach a single way to position a woman for pelvic examinations—in the dorsal lithotomy position with feet in stirrups.^{3 4} The article raises the possibility that the standard use of stirrups may not be best for patients, and that other positioning options should be considered. Most clinicians I spoke with (admittedly, an unscientific sample) shared my initial reaction to the article's suggestion of performing a speculum exam without stirrups—how would that work? Given this reaction among providers of family medicine in the northeastern part of the . . . [Full text of this article]

Beth Israel Residency in Urban Family Medicine, Institute for Urban Family Health, Albert Einstein College of Medicine, New York, NY 10003, USA
(wbarr@institute2000.org)

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Relevant Article

Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial

Dean A Seehusen, Dawn R Johnson, J Scott Earwood, Sankar N Sethuraman, Jamie Cornali, Kelly Gillespie, Maria Doria, Edwin Farnell, IV, and Jason Lanham
BMJ 2006 333: 171. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• (2006). Women Prefer Pelvic Exams Without Stirrups. JWatch Emergency Med. 2006: 5-5 [Full text]  

Rapid Responses:

Read all Rapid Responses

Stirups in the labour ward

Patji Alnaes-Katjavivi
bmj.com, 22 Jul 2006 [Full text]

Vulnerability and comfort during vaginal speculum examination

Keith R Stewart
bmj.com, 24 Jul 2006 [Full text]

Routine gynaecological examination does not require stirrups

Jai B Sharma MD MRCOG, et al.
bmj.com, 8 Aug 2006 [Full text]

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