Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial

Abstract

Objectives: To determine if a standardised method of leg positioning without stirrups reduces the physical discomfort and sense of vulnerability and increases the sense of control among women undergoing speculum examination as part of a routine gynaecological examination.

Design: Randomised clinical trial.

Setting: Family medicine outpatient clinic.

Patients: 197 adult women undergoing routine gynaecological examination and cervical smear.

Intervention: Examination with or without stirrups.

Main outcome measures: Women's perceived levels of physical discomfort, sense of vulnerability, and sense of control during the examination, measured on 100 mm visual analogue scales.

Results: Women undergoing examination without stirrups had a reduction in mean sense of vulnerability from 23.6 to 13.1 (95% confidence interval of the difference - 16.6 to - 4.4). Mean physical discomfort was reduced from 30.4 to 17.2 (- 19.7 to - 6.8). There was no significant reduction in sense of loss of control.

Conclusion: Women should be able to have gynaecological examinations without using stirrups to reduce the stress associated with speculum examinations.

Trial registration: US Army Central Investigation Regulatory Office. Trial No DDEAMC 05-11.

Fig 1

Patient flow through the study

Fig 2

Positioning of women with draping for examination without stirrups (drawn by Jordan Mastrodonato)