Table of ContentsView AllTable of ContentsPurpose of a Rectovaginal ExamWhy It Is PerformedWhat a Rectovaginal Examination InvolvesOther Rectal ExamsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Purpose of a Rectovaginal Exam
Why It Is Performed
What a Rectovaginal Examination Involves
Other Rectal Exams
Frequently Asked Questions
A rectovaginal examination is a manual physical examination of the rectum and thevagina. While it is not generally a standard part of a medical or gynecological evaluation, it may be done if there are concerns about issues, such as rectal involvement of endometriosis, a rectovaginalfistula(an abnormal connection between the rectum and vagina), or rectal or vaginal cancer.
It is different than a pelvic exam. Apelvic examis typically recommended to evaluate symptoms such as irregular bleeding or discharge and screening for malignancy (cancer).Components of a pelvic exam can include aspeculumexam, bimanual exam, and rejctovaginal exam.
Read on to learn more about the rectovaginal exam and everything it entails.
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A rectovaginal exam can allow your healthcare provider to examine and identify abnormalities in your pelvic area, including thecervix,uterus,ovaries, fallopian tubes, anus, and rectum.
The rectovaginal exam is not a particularly accurate screening exam. It is usually reserved for people who either have rectal or pelvic pain or are experiencing symptoms related to the genitourinary tract (such as pain, urinary urgency, or abnormal bleeding).
Other reasons for the exam can include:
Although a pelvic exam is considered important for identifying and treating cancer,sexually transmitted infections (STIs), and other genitourinary tract disorders, a rectovaginal exam offers uncertain benefits.
Can a Rectovaginal Exam Detect Cancer?According to a 2016 review of studies in theJournal of the American Association of Nurse Practitioners,a rectovaginal exam has a low sensitivity in detecting uterosacral nodules, rectal compression, cervical involvement of endometrial cancer, and colorectal cancer. This means it misses many of these problems.
Can a Rectovaginal Exam Detect Cancer?
According to a 2016 review of studies in theJournal of the American Association of Nurse Practitioners,a rectovaginal exam has a low sensitivity in detecting uterosacral nodules, rectal compression, cervical involvement of endometrial cancer, and colorectal cancer. This means it misses many of these problems.
Your healthcare provider might consider doing a rectovaginal exam if you have pain, discomfort, or pressure that seems like it is coming from the anal or rectal area. They might also do this exam if they detect a possible growth or abnormality in or near your rectum while doing other parts of your pelvic exam.
In general, a rectovaginal exam is considered when symptoms or other examination findings raise the possibility of a problem involving both the rectum and the vagina. Your healthcare provider will discuss this part of the exam and why it is being done.
The American Congress of Obstetricians and Gynecologists (ACOG) guidelines include the following recommendations:
Usually, there is no special preparation needed before having a rectovaginal exam. As with any pelvic exam, you should not engage in sexual intercourse (including anal sex) for 24 hours before your appointment. Sometimes, your healthcare provider may advise you to take a laxative beforehand.
A rectovaginal exam typically lasts for less than a minute, but it may last longer if your healthcare provider finds something concerning.
There are no risks involved with a rectovaginal exam. It can be a little uncomfortable but should not be painful. Deep breathing and relaxing your pelvic muscles can help. Let your healthcare provider know if you feel any pain.
To do your rectovaginal exam, your healthcare provider will:
During this procedure, your healthcare provider will evaluate the tissues in your rectum and vagina, the tone and alignment of your pelvic organs, including the ovaries and fallopian tubes, and the ligaments that hold the uterus in place.
Besides a rectovaginal exam, there are other types of rectal exams, typically for evaluation of gastrointestinal problems.
Generally, one of the most common reasons for a rectal exam is testing for blood in the stool. Tell your healthcare provider if you see blood streaks in the toilet, blood on the toilet paper, have black tarry stools, experience unexplained weight loss, vomiting blood, or diarrhea.
Additionally, you might have a rectal exam if you have experienced stool incontinence or cannot control your stool. In this case, your healthcare provider would do a rectal exam to check your anal sphincter tone, which can affect control over your stool.
Summary
A rectovaginal exam is an exam in which the rectum and vagina are manually examined. It can also provide valuable information for your healthcare provider about your pelvic structure and if any issues are going on. If you’re nervous about the rectovaginal exam, ask what it involves and discuss your concerns with your healthcare provider. They may be able to provide you with relaxation techniques, use extra lubricant, or possibly do an alternative exam.
A Word From Verywell
Gynecological examinations are often needed for screening or evaluating symptoms. These physical examination techniques can help your healthcare provider decide the next steps in your diagnostic evaluation or treatment plan.
If you have any questions or are hesitant about any part of your exam, talk about it with your healthcare provider or someone on your medical team until you feel that your concerns and questions have been addressed to your satisfaction.
Frequently Asked QuestionsYou may need a rectovaginal exam if you have an abnormal appearance, sensation, or control of your rectal and vaginal areas.During this exam, your healthcare provider checks for tenderness, structural irregularities, discharge, blood, and altered muscle tone.You do not have to agree to any exam you don’t want. Instead, discuss alternate approaches that might help in diagnosing your problem.It shouldn’t hurt, but it can be uncomfortable or even painful if you have a medical problem affecting your rectum or vagina.
You may need a rectovaginal exam if you have an abnormal appearance, sensation, or control of your rectal and vaginal areas.
During this exam, your healthcare provider checks for tenderness, structural irregularities, discharge, blood, and altered muscle tone.
You do not have to agree to any exam you don’t want. Instead, discuss alternate approaches that might help in diagnosing your problem.
It shouldn’t hurt, but it can be uncomfortable or even painful if you have a medical problem affecting your rectum or vagina.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Song L, Xing A, Li Q, Wang G.High-grade serous carcinoma resulting from rectal endometriosis and complicated with ovarian cancer.Front Oncol.2019;9:1252. doi:10.3389/fonc.2019.01252American College of Obstetricians and Gynecologists.The utility of and indications for routine pelvic exam.Nishikawa J.An evidence‐based review of the rectovaginal examination during well‐woman visits.J Am Assoc Nurse Practitioners.2016;28(5):237-240. doi:10.1002/2327-6924.12316Elfassy L, Lasry A, Gil Y, Balayla J.Prevalence threshold of screening tests in obstetrics and gynecology.Eur J Obstet Gynecol Reprod Biol.2021;259:191-195. doi:10.1016/j.ejogrb.2021.02.015
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Song L, Xing A, Li Q, Wang G.High-grade serous carcinoma resulting from rectal endometriosis and complicated with ovarian cancer.Front Oncol.2019;9:1252. doi:10.3389/fonc.2019.01252American College of Obstetricians and Gynecologists.The utility of and indications for routine pelvic exam.Nishikawa J.An evidence‐based review of the rectovaginal examination during well‐woman visits.J Am Assoc Nurse Practitioners.2016;28(5):237-240. doi:10.1002/2327-6924.12316Elfassy L, Lasry A, Gil Y, Balayla J.Prevalence threshold of screening tests in obstetrics and gynecology.Eur J Obstet Gynecol Reprod Biol.2021;259:191-195. doi:10.1016/j.ejogrb.2021.02.015
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Song L, Xing A, Li Q, Wang G.High-grade serous carcinoma resulting from rectal endometriosis and complicated with ovarian cancer.Front Oncol.2019;9:1252. doi:10.3389/fonc.2019.01252American College of Obstetricians and Gynecologists.The utility of and indications for routine pelvic exam.Nishikawa J.An evidence‐based review of the rectovaginal examination during well‐woman visits.J Am Assoc Nurse Practitioners.2016;28(5):237-240. doi:10.1002/2327-6924.12316Elfassy L, Lasry A, Gil Y, Balayla J.Prevalence threshold of screening tests in obstetrics and gynecology.Eur J Obstet Gynecol Reprod Biol.2021;259:191-195. doi:10.1016/j.ejogrb.2021.02.015
Song L, Xing A, Li Q, Wang G.High-grade serous carcinoma resulting from rectal endometriosis and complicated with ovarian cancer.Front Oncol.2019;9:1252. doi:10.3389/fonc.2019.01252
American College of Obstetricians and Gynecologists.The utility of and indications for routine pelvic exam.
Nishikawa J.An evidence‐based review of the rectovaginal examination during well‐woman visits.J Am Assoc Nurse Practitioners.2016;28(5):237-240. doi:10.1002/2327-6924.12316
Elfassy L, Lasry A, Gil Y, Balayla J.Prevalence threshold of screening tests in obstetrics and gynecology.Eur J Obstet Gynecol Reprod Biol.2021;259:191-195. doi:10.1016/j.ejogrb.2021.02.015
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