The bimanual exam is performed when your gynecologist inserts two fingers
into your vagina and places the other hand on top of your lower abdomen, while
feeling for any abnormalities that might have occurred since your last pelvic
exam. During this part of your examination, your doctor checks the size, shape,
and mobility of your uterus. Changes in your ovaries, such as ovarian cysts may
be detected during the bimanual exam, as well as other uterine changes including
endometriosis, fibroid tumors, or other common uterine conditions.
In some patients, particularly those with difficult to feel pelvic masses, a
combined rectovaginal exam is useful. After changing gloves the doctor will
lubricate your rectim and then insert one finger into your rectum and your index
finger into your vagina. The rectovaginal exam is helpful in feeling the
uterosacral ligaments, a common site of endometriosis involvement.
On completion of the rectal exam, stool can be checked for the
presence of occult blood.