An evidence-based review of the rectovaginal examination during well-woman visits

Women's health promotion and disease prevention has experienced considerable transformation over the past decade. This includes introduction of the Human Papillomavirus (HPV) vaccination, updated recommendations for mammography screening, Papanicolaou smear and HPV testing, and pelvic examinations. Despite significant literature about these subjects, one area that has not been reviewed is the rectovaginal examination (RVE). This article will examine available evidence regarding the RVE and make evidence-based recommendations that nurse practitioners (NPs) can integrate into practice

An electronic search was completed using PubMed, CINAHL, National Guideline Clearinghouse, and Cochrane Data Bases. Medical Subject Heading terms and keywords included Physical Examination, Vagina, Rectum, Digital Rectal Examination, Gynecological Examination, and Rectovaginal Examination in combination with Well-Woman, Screening, and Pelvic Examination.

Available literature shows the RVE to have low sensitivity in detecting uterosacral nodularity, rectal compression, cervical involvement of endometrial cancer, and colorectal cancer.

This critical review of available literature found no evidence to support the use of the RVE in well-woman visits. NPs should limit the use of the RVE to patients presenting with rectovaginal or pelvic complaints.