A vaginal speculum is a medical instrument used to gently separate the walls of the vagina to allow for clear visualization of the vaginal canal and the cervix (the opening to the uterus)

Standard Procedure for a Pelvic Exam with a Speculum

1. Preparation:

The patient is positioned on the exam table, lying on their back with feet placed in stirrups (lithotomy position).

The provider will explain the procedure and often use a water-based lubricant on the speculum for comfort.

The speculum may be warmed (often with a warming pad) to reduce the shock of cold metal (if not using disposable plastic).

2. Insertion and Opening:

The provider gently separates the labia with one hand.

With the other hand, the closed speculum blades are inserted into the vagina at a downward angle (following the natural angle of the vagina), usually with mild pressure.

Once fully inserted, the provider uses a thumb lever or screw mechanism to slowly open the blades, spreading the vaginal walls apart until the cervix comes into view.

3. Examination and Sampling:

The provider locks the speculum in the open position (if it has a locking mechanism).

They then visually inspect the vaginal walls and cervix for color, texture, discharge, or any abnormalities.

If a Pap smear is needed, they use a small brush or spatula to gently collect cell samples from the cervix.

4. Removal:

The speculum is unlocked and slowly closed to release the vaginal walls, ensuring not to pinch any tissue.

It is then gently withdrawn along the same angle it was inserted.