A rectovaginal examination is a type of

gynecological examination A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, di ...

used to supplement a

pelvic examination A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, dis ...

. In the rectovaginal examination, a doctor or other health care provider places one finger in the

vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...

and another in the

rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...

to assess the

rectovaginal septum The rectovaginal fascia (often called rectovaginal septum or sometimes fascia of Otto) is a thin structure separating the vagina and the rectum. This corresponds to the rectoprostatic fascia in the male. Clinical significance Perforations in ...

. The examiner will look for any scarring or masses that may indicate cancer or another disease. Typically, a rectovaginal examination is performed to assess pelvic pain, rectal symptoms, or a pelvic mass. It can also provide a sample for

fecal occult blood Fecal occult blood (FOB) refers to blood in the feces that is not visibly apparent (unlike other types of blood in stool such as melena or hematochezia). A fecal occult blood test (FOBT) checks for hidden (occult) blood in the stool (feces). The ...

testing. Usage as a screening test in asymptomatic women * The rectovaginal examination has marked limitations despite the controlled circumstances of the operating room including general anaesthesia, an empty bladder and ideal patient positioning. As suspected, the specificity of the rectal examination is high due to the low prevalence of disease. However, the sensitivity of the rectovaginal examination is very low, limiting its capacity as a screening test. Both sensitivity and positive predictive value of the rectovaginal examination for detecting uterosacral nodularity were zero. * The pelvic examination may include any of the following components, alone or in combination: assessment of the external genitalia, internal speculum examination, bimanual palpation, and ''rectovaginal examination''. The USPSTF found inadequate evidence on the accuracy of

to detect a range of gynecologic conditions. * Although the digital rectal exam (DRE) is commonly used as a way to obtain a stool sample for a FOBT (

fecal occult blood test Fecal occult blood (FOB) refers to blood in the feces that is not visibly apparent (unlike other types of blood in stool such as melena or hematochezia). A fecal occult blood test (FOBT) checks for hidden (occult) blood in the stool (feces). ...

) in an office based setting, ''this is an insufficient way of screening for colorectal cancer and is not recommended.'' A single office-based FOBT (fecal occult blood test) performed following a digital rectal examination (DRE) is not an adequate screen due to low sensitivity for advanced tumor and colorectal cancer. A paper published in the

Journal of Internal Medicine The ''Journal of Internal Medicine'' is a monthly peer-reviewed medical journal covering all aspects of internal medicine. It was established in 1863 and is published by Wiley-Blackwell on behalf of the Association for the Publication of the Jou ...

states, "While FOBT done appropriately (taken home and used according to the instructions) is an important screening option, in-office FOBT may be worse than no screening at all because it misses 95% of cases of advanced tumor, giving many patients a false sense of reassurance."

References

{{reflist Female genital procedures