[Physical diagnostics--bimanual vaginal examination]

Bimanual examination is frequently done for the evaluation of internal female genitals in gynaecologic and obstetric patients. Reliability of bimanual examination is influenced by several factors such as the woman's age and physique, but also by the experience of the examiner. Additional transvaginal sonographic assessment increases both the sensitivity and specificity of the diagnostic procedure, especially where the ovaries are concerned. However, transvaginal sonography is not an alternative to bimanual examination. In obstetrics, bimanual examination is an essential diagnostic procedure at parturition. Bimanual examination is unpleasant for most patients and not without risks. This underscores the importance of adequate skills in performing the technique, and the importance of accurate consideration of the necessity of the procedure.