Genital examination of women with reduced mobility

For many women, the lithotomy position traditionally employed for pelvic examination is either unachievable, or so uncomfortable that it amplifies the usual baseline dread and avoidance. A simple method is described, involving supine abduction of the hips without flexion of hips and knees or external rotation of the hips, whereby one performs a limited but effective examination without need for the positioning that constitutes such a barrier. Foremost among the advantages of this alternative is enhanced patient comfort, both physical and mental. The chief loss is of speculum examination and thus of Papanicolau smear. Very often, traditional examination is "deferred" by physician or patient because of discomfiture. Thus the realistic comparison of this method is that of performing no pelvic examination at all, and this modification thus has the potential to reveal many crucial and salient findings.