Speculum Insertion

In both an exam situation and in play at home on my own, I have had a speculum inserted whilst standing. It is quite uncomfortable but also stimulatin, particularly walking around with it in.

I also like it inserted whilst lying on my side.

You were standing? Your doctor gives you th reason for the position? What was your exact position?

I have inserted a speculum with my patient on all fours, with her legs wide open, knees bent. I've noticed its much easier to find the cervix in this position.

After my breast examination, The doctor will tell me to slide down to the end of the table and put my feet into the stirrups. I am always ask to scoot down a little more until my buttocks are hanging off of the exam table. My vagina is small so he always has to work to get the speculum up inside me. I can feel his fingers spreading my vagina as he slowly inserts the speculum.

It's enough to make a girl orgasm.

The knee/chest position for gynecology is most favored by pediatricians also who need to access the adolescent vaginal cavity. In either case the comfort and possibly the modesty of the patient must be considered. Many men have told me that there is no more beautiful exam position than for a woman to have her ass in the air. Although this is a personal matter you can appreciate that several members have favored the kneeling-to-chest entry position for the speculum. Sometimes the tip or angle of the vagina allows for an easier insertion one way or the other.

Have you considered the recto-vaginal exam with the patient on all fours? The ovaries hang in a more natural position. Again, the clinician will decide and proceed.

Actually, in my practice, I find that a "seated" position (end of the table with legs bent as to squat) allows for easier and more comfortable speculum insertion, clearer visualization of the cervix, and less back discomfort for my patients. It allows gravity to assist in the exam, bringing the cervIx closer in view than lying on their back. When completed, it also allows for a more comfortable rectal exam, as you don't have to fight with the table to get a good angle for the exam.

I find it a little more cumbersome for bi-manual exams, since I'm in a

Little more awkward position. If this is necessary, I usually have them lie back on the table to allow for more access for their exam

Many of my patients have said it makes the entire exam more comfortable and they feel less exposed.

My doctor will tell me to slide down to the end of the table and put my feet into the stirrups.she sometime assists me getting my feet in the stirrups. Like others im am always ask to scoot down one to two more until she says thats fine. My vagina is usaully self lubed by now. I can feel herfingers spreading my vagina as he slowly inserts the the well lubed speculum.

I have used the speculum on my wife with her on her knees and chest on the bed. It went in rather easy and she really open wide. her cervix was very visible and i will be using this position again with her. as for her she said it was not as uncomfortable as on her back with feet in the sturrips

Just watched the bimanual examination on http://www.yourgynexam.com/performed.htm The young nurse is obviously being taught by her colleague by being examined herself and looks extremely embarrassed being both examined and filmed for this video. I suspect as a student nurse she felt under pressure to allow the filming of her examination. Other instructional videos of this nature which I use to train myself in the art of examination appear to use patients who do not appear embarrassed or whose faces are not shown but this poor young nurse looks distressed at her situation to me.

The link doesn't work..for me at any rate, goes to the page but unable play any of the videos.

After breast exam, she will ask me to ly down for vaginal exam. i just do as she says. she slowly open up and lubricate me with gloved fingers, then she insert specula. when she do i feel little uncomfort but the whole exam i enjoy. after coming home i used to have orgasm

The link doesn't work..for me at any rate, goes to the page but unable play any of the videos.

Hmmmm.... works in IE(10) but not in chrome... that has to be a first. Nice videos johncrossley - though I didn't watch the whole of the bimanual exam one.

To answer the question, my gyne exams are done in the 'frog leg' position as my doctor does not have stirrups, though I think I might find the knee-chest position more comfortable, and would never even have thought of it without reading this thread.

I like to have the patient on their back with legs spread wide open

Dr Bob

Take a look at the excellent link posted by "smith" only this morning! Around 1 minute 20 seconds into the video.

https://www.youtube.com/watch?feature=endscreen&v=EZo4fKNcvQg&NR=1

I have tried "knee chest" position a few times. It definitely allows for easier insertion of the speculum and visualization of the cervix. In fact, you may be able to use your fingers to see deep inside if your patient is sufficiently relaxed.

The exam performed in the knee holders I believe is the best position for cervical insertion.

To johncrossley: The bimanual exam you refer to is actually from a fetish porn site! At the end of the clip it says: "Copyright 2011 Stonefox Productions Inc"

http://stonefoxproductions.com/pages/whatsnew.php

So you may rest assured that the lady was paid, not "pressured" into filming! But the site may be of interest to medfet fans.

I inserted a spec on a girl who was standing and bent over

Your doctor gives you th reason for the position

I had a partner who was an RN at the local hospital. One evening, she brought home a vaginal speculum to play with. Since we were playing on the living room floor, the knee-chest position, with her butt in the air, gave me the best view of her internal anatomy. For her, using a mirror, having her back on the floor provided the best view. Once we had examined her vagina and cervix, I inserted the device into my rectum to give her a view of my insides and allow me to look up my own ass with the aid of a mirror. Her vagina and my rectum were really quite similar, both lovely and pink inside.

Now that I think of it, inserting the thing up my ass could have been dangerous. There's a possibility it could have broken off inside me had I squeezed enough.

After a play doc introduced me to it, being on all fours is my preferred position. The inability to see what the doc is doing allows me to be more relaxed and I’ve been able to have the specula opened widest in this position.

Not to mention it offers a great opportunity for a rectal thermometer to be inserted - love that “surprise.”

Unlike with other type insertions it is best to stick with the traditional insertion in the stirrups on their back

I've seen French physicians talked of the "English position" which to me seems like Sims' position: woman on the side, one knee flexed, speculum entering from behind. Apparently it is meant to be less similar to a "missionary coitus position" and less revealing than the usual approach and thus to better preserve women's dignity. I however have read that some women prefer to see what is being done to them, which is not the case in that position.

All the exams I’ve been to with my wife the speculum has always been inserted the traditional way.

I do like to experiment with different angles and positions some for comfort, some for maximum internal exposure, some for pleasure and finally stress or discomfort.

I favor on hands and knees or head down ass up. I find the vagina opens up more completely in this position.

As an additional point I favor metal speculums because they can be warmed up or made cold for varieties sake.

@Jacana The so-called “English” position that you mention was described in the book “The Women’s Choir” signed by Martin Winckler (pseudonym of Marc Zaffran).

This method was adapted by Borée who explains it:

The position is as follows: the patient lies on her side, the leg which is in contact with the examination table remains extended and only the other is folded (a little higher than in the PLS). A right-handed doctor will probably be a little more comfortable with a patient lying on her left side and vice versa. With one hand, we will then lift the buttock and the upper labia majora to release the vulva and introduce the speculum with the other hand. In fact, the speculum must rest on the posterior fork (which is not very sensitive) and move, roughly, along the axis of the body. As in the classic position, the speculum is rotated halfway before opening the valves. The cervix gently wedges itself between the two speculum blades. There you go, it’s done! At this stage you can already take a smear.

I think that this way of setting up the patient may be suitable for a general practitioner like Borée for the purpose of screening by taking a sample from the cervix.

In a gynecology office equipped with a modern examination table, I only find it useful for the insertion of an IUD. If the cervix is ​​well positioned, insertion of the device is quite easy and can sometimes be done without putting in place the Pozzi forceps so feared by patients.

I am more reserved about its use in daily practice because it requires the patient to expose her buttocks widely without having a view of the gynecologist's actions. In addition, I am convinced that the doctor's position should make it possible to monitor the patient's gaze in order to detect any signs of concern and adapt their actions.