How does the gynecologist decide which speculum to use?

I just had a routine exam at a new gynecologist and he used a kristeller speculum which he asked me to hold. I was never examined with one of those and I was wondering if it’s decided which speculum to use based personal preference or if there are guidelines? What do you think?

I was definitely weirded out a bit by holding the upper blade myself lol

I have no real idea, never experienced that before but maybe the gyno wanted you to feel more involved and in control? Is it more comfortable than a regular speculum?

@Patientlywaiting could be! But no, I definitely felt more pressure than usual

@Lina98 I had never heard of that type, went online to see pictures and don't even understand how they work!

@Jacana how I learned today it’s two blades that are being inserted one after the other. The first one is pulled down (towards the anus) and the other one up. I was holding the upper one

@Lina98 Maybe this choice is motivated by putting the patient more in control?

Kristeller Vaginal speculum is a hand held speculum used to examine the walls of the vagina during pelvic examination, cervical examination, pap smears, cervical cytology and vaginal biopsy. It allows better visualization and manipulation than a traditional metal or plastic speculum.

So in answer to your question , its partly personal choice as a sims speculum could also have been used, but as stated it does allow better visualization of the walls of the vaginal canal than a traditional speculum so its fit for purpose ( well equipped or well suited for its designated role or purpose.)

@Jacana The Kristeller vaginal speculum and retractor is a single blade not self-retaining speculum. The advantage of Kristeller vaginal Speculum is that it gives more exposure of the vaginal cavity than self-retaining specula and therefore is preferred for gynecological procedure. The disadvantage of Kristeller vaginal speculum is that, being it not self-retaining, one assistant's help is need to keep the speculum in place.

@Lina98 For a routine exam the health care provider decides which speculum to use based in personal preference. I prefer for gynecological routine exams the self-retaining Cusco vaginal speculum.

All I know is that from now on, I’m reminding drs that both of my babies were born via c-section and I have a tight pelvic floor. No thank you to big speculums.

Brings a whole new perspective to the phrase "I want you to open wide for me" @Lina98

To be honest I was never curious enough to ask. I prefer plastic ones just because it isn’t as cold as the metal one, and that’s the one she always uses.

They decide by the body type and shape of a woman

To be honest I was never curious enough to ask. I prefer plastic ones just because it isn’t as cold as the metal one, and that’s the one she always uses.

I always thought women preferred metal speculums...

@HunnyBuns The use of disposable vaginal specula is associated with increased greenhouse gas equivalents compared with reusable alternatives with no significant difference in clinical utility.