Yale Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT.
Yale Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, Connecticut.
J Pediatr Adolesc Gynecol. 2021 Dec;34(6):783-786. doi: 10.1016/j.jpag.2021.07.004. Epub 2021 Jul 17.
Various professional organizations have weighed in on the practice utility of speculum examinations. The US Preventive Services Task Force (USPSTF), American Academy of Pediatrics (AAP), and American College of Physicians (ACP) have recommended against internal pelvic examinations in asymptomatic patients, whereas the American College of Obstetricians and Gynecologists (ACOG) has encouraged shared decision making. Although a pelvic examination can be a stressful event for adolescents, studies have shown that early discussions and performing the examination in a trusting environment can mitigate the worries and improve the patient-provider relationship. In this commentary, we discuss the literature and conclude that performing a pelvic examination in the asymptomatic adolescent and young adult patient is ultimately a matter of shared decision making. The benefits of conducting the examination in a nonthreatening environment, minimizing "exceptionalization" of the female genitalia, and strengthening the patient-provider relationship should be highlighted during the discussions.
各种专业组织都对阴道镜检查的实际应用进行了评估。美国预防服务工作组（USPSTF）、美国儿科学会（AAP）和美国医师学院（ACP）建议无症状患者避免进行内部盆腔检查，而美国妇产科医师学会（ACOG）则鼓励共同决策。尽管阴道检查对青少年来说可能是一个有压力的事件，但研究表明，早期的讨论和在信任的环境中进行检查可以减轻担忧并改善医患关系。在这篇评论中，我们讨论了相关文献，得出的结论是，对无症状的青少年和年轻成年患者进行盆腔检查最终是一个共同决策的问题。在讨论中，应该强调在非威胁性环境中进行检查、最小化女性生殖器的“特殊化”以及加强医患关系的好处。
