Question: Is the gynecological examination on a flat table versus on a gynecological couch with supporting leg stirrups equally effective? Is there any evidence that patients have better tolerance -experience when they are examined flat or not?
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Answer: Seehusen et al have reported a randomised controlled trial including 197 adult women undergoing routine gynaecological examination and cervical smear, either with or without stirrups. They found that: "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."
(Evidence level Ib)
Reference:
Seehusen DA, Johnson DR, Earwood JS, Sethuraman SN, Cornali J, Gillespie K, Doria M, Farnell E, Lanham J. Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial. BMJ (Clinical research ed.) 2006 VOL: 333(7560):171
Search date: April 2011
Classification of evidence levels
Ia Evidence obtained from meta-analysis of randomised controlled trials.
Ib Evidence obtained from at least one randomised controlled trial.
IIa Evidence obtained from at least one well-designed controlled study without randomisation.
IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.
III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.
IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
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