I prefer to have my patient strip to just her panties for the exam and put on a gown. That way, I get to slowly uncover her as I proceed through the exam - head, back, chest, tummy, legs, then finally the pelvic area. At that point I remove her panties and usually question her about the wetness problem - how often is she this moist, does she have to use anything like pantyliners on a daily basis, does she ever have any odor problems. I will then closely examine the wet spot in her panties as she watches me.
Very clinical, yet very embarrassing.