title: Routine bimanual pelvic examinations: practices and beliefs of US obstetrician-gynecologists.
abstract: OBJECTIVE
  Less-than-annual cervical cancer screening is now recommended for most US women, raising questions about the need for routine annual bimanual pelvic examinations. Little is known about clinicians' bimanual pelvic examination practices, their beliefs about its importance, or the reasoning underlying its performance in asymptomatic women.
  
  
  METHODS
  We conducted a nationwide survey of US obstetrician-gynecologists. Respondents (n = 521) reported their examination practices and beliefs based on vignettes for asymptomatic women across the lifespan.
  
  
  RESULTS
  Nearly all obstetrician-gynecologists perform bimanual pelvic examinations in asymptomatic women across the lifespan, although it is viewed as less important for a newly sexually active 18-year-old. Reasons cited as very important included adherence to standard medical practices (45%), patient reassurance (49%), detection of ovarian cancer (47%), and identification of benign uterine (59%) and ovarian (54%) conditions.
  
  
  CONCLUSIONS
  Obstetrician-gynecologists perform bimanual pelvic examinations in the vast majority of asymptomatic women, but the importance placed on the examinations and reasons for conducting them vary.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA 94118, USA.
authors.forename: Jillian T
authors.initials: JT
authors.lastname: Henderson
authors.forename: Cynthia C
authors.initials: CC
authors.lastname: Harper
authors.forename: Sarah
authors.initials: S
authors.lastname: Gutin
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Chapman
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
mesh_terms: D000328:Adult; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000517:prevention & control; D058869:Gynecological Examination / Q000706:statistics & numerical data*; D006176:Gynecology / Q000592:standards*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States