I would like to know what the rectovaginal examination is for. If you are under thirty, should the doctor perform it?

The rectovaginal exam is an important diagnostic tool at the disposal of a gynecologist or nurse practitioner. For many providers, a pelvic exam is considered incomplete without it, especially with a new patient. This is because the rectovaginal exam helps a provider understand your internal anatomy more fully and look for abnormalities missed by the bimanual exam (when two fingers are put inside the vagina and the other hand presses down on the abdomen, examining the uterus, ovaries, Fallopian tubes, and other internal organs).

For the rectovaginal exam, by putting one finger inside the vagina and another into the rectum, a provider can:

• evaluate the back side of the uterus and the wall between the vagina and rectum
• check on the tone and alignment of the pelvic organs: ovaries, Fallopian tubes, and ligaments of the uterus
• determine if the uterus is retroverted (tilted)
• more thoroughly investigate complaints of pelvic or rectal pain
• feel for rectal growths, check for blood in the stool, and look for other early signs of colon cancer, especially in women over 40 years

A skilled practitioner can perform the exam with minimal discomfort to the woman patient.

For many women, the rectovaginal exam is embarrassing and awkward. The sensation as the finger is withdrawn may feel similar to that of a bowel movement, but it will pass quickly.