Due to recurrent issues with hemorrhoids caused by some other medical issues, I have been subjected to examination by anoscope several times. I have had it done by my PCP, by the surgeon who did my banding, and by a nurse practitioner.
The ones from my PCP were the most private. It was just her in the room. The exams from the surgeon were most “public” as there was often at least one med student or resident observing and sometimes a nurse helping (usually when he was doing a banding). The one with the nurse practitioner was the one that stuck out as it was the only one with a chaperon present and it was the one where I had the most explanation of what she was going to do a head of time.
The one with the nurse practitioner was the one that sticks in my memory the most.
It had been a few years since my last hemorrhoid banding and they bleeding more and more frequently. It was getting close to the point where it was annoying enough that it was time for another banding. I called to arrange an appointment, but it had been long enough since I had seen him last that I didn’t have “current patient status”, so I was going to have a wait for an appointment. Since it was going to be a while, I put myself on the wait list.
Not too long after, I was notified that an appointment was available with one of the nurse practitioners in the practice. Since it was a long wait for my regular surgeon, I took it.
The day of the appointment came and after the normal eternity in the waiting room. (OK, probably 10 or 15 minutes.) The nurse practitioner, a young brunette woman in a face mask, brought me back to an exam room and explained that she would do an evaluation at this visit and that we would decide treatment from there. (Pretty normal.)
I should describe the room. It was a large exam room with an attached bathroom and a proctologist exam table, the kind that you kneel on and are then raised and rotated so that you are bent over in a butt up position.
After I explained my history, she told me that she needed to do an exam. She said that she was going to look at my anus first, then she would use a lubricated finger to feel inside my anus, and then she would insert the anoscope. She went into detail and used her hands to show what she was going to do. I think that she even showed me the disposal anoscope.
Then she told me that she was going to leave the room to let me undress and get in position and that she would come back shortly with a chaperon for the exam. She gave be a paper drape and told me to lower my pants and underwear, kneel on the shelf of the table, and to cover with the drape.
I did as instructed. I felt a little silly covering up just to be uncovered. It was also a little awkward as the head of my penis would bump against the table if I wasn’t careful.
She came back in with an older nurse as the chaperon. She then uncovered my butt and raised and rotated the table so that my ass is in the air at what felt like eye level (probably wasn’t that high) and I am kind of draped over the table.
She then told me that she was going to look first. I felt her spread by buttocks wide and spent a minute just looking. She was keeping up a running commentary telling me what she was doing and pointing out things to the chaperon.
Then she warned my that she was going to insert a finger into my rectum to feel the hemorrhoids. She seemed to do an in and out thing where she would insert her finger all the way, then mostly withdraw it, rotate her hand, and then reinsert it. At least that is what it felt like.
She then told me that she was going insert the anoscope and that I would feel a lot of pressure. And did I. It is hard to describe but it is much more intense than a rectal thermometer or a finger. She did the same thing that she did with her finger. She would insert the scope, remove the opturator, look, put the opturator back, partially withdraw it, turn it, and reinsert. All the time she was commenting on what she saw to me or to the chaperon.
Finally, she withdrew the scope all the way and left the room so that I could get cleaned up and dressed. After she came back, we discussed her findings and my treatment options. I particularly remember her referring to the hemorrhoid at the bottom of my anus “nearest your scrotum”. I ended up deciding to try some steroid suppositories that she prescribe and put off the banding for a few more months.
It was the most thorough and memorable hemorrhoid examination that I have had.