Harvard Women's Health Watch

Gynecology news: New study suggests alternative to stirrups for pelvic exams

Gynecology news

New study suggests alternative to stirrups for pelvic exams

No matter how many pelvic examinations a woman has had, she's not ever likely to feel at ease about being asked to perch her unclothed hips at the edge of the exam table and place her feet up in metal stirrups. This indelicate position — known in medical parlance as the dorsal lithotomy position — is an integral part of the pelvic exam and Pap screening, which involves widening the vagina with a speculum and obtaining cells from the cervix. The stirrups position is thought to afford the best view of the vulvovaginal area and facilitate proper placement of the speculum.

Most of us understand the value of pelvic exams and learn to live with the indignities. But for some women, the feelings of embarrassment, exposure, discomfort, and even pain during speculum exams are potential barriers to screening. The question is, couldn't there be some acceptable, less vexing alternative? According to the findings of a study, the answer is yes. In a randomized trial of stirrups versus no stirrups for routine gynecological exams, researchers in Georgia found that the women who were allowed to keep their feet on the examining table felt significantly less vulnerable and more comfortable than those whose feet were placed in stirrups. The results were published in the July 22, 2006, British Medical Journal (BMJ).

The study demonstrates that it's possible to perform pelvic exams and obtain cervical smears without using stirrups. It also suggests that many women might find the experience less stressful if they had the option of keeping their feet on the table.

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