The cursed evil plastic vaginal speculum! I don’t allow them used for my exams.
The use of plastic specula is indeed not unanimous.
It appears that their insertion is less comfortable than for stainless steel material.
In addition, they essentially exist in the Cusco form and they often only exist in 3 sizes, small, medium and large, while our "old-fashioned" specula are available in several widths and lengths. Moreover their opening screw system lacks flexibility.
As a general rule, the only interest of plastic instruments is their single use and the absence of any cleaning and sterilization obligation.
I understand that they are preferred by general practitioners who have little opportunity to practice gynecology on a daily basis.
On the other hand, for a specialist consultation, I think it is desirable to keep the classic instruments which offer more diversity in the offer and are more practical. For cleaning, we put all the material of the day in the evening in the autoclave and the next day we leave with clean and sterile material.
I am surprised to read that bimanual palpation will no longer be systematically practiced, yet it is a basic practice in gynecology.
Would you imagine letting a patient go without seeing her breasts examined ?
In my opinion, one of the greatest advances is indeed endovaginal ultrasound. Indeed, before its appearance in the 90s, it was a real torture for some patients to find themselves in the waiting room with an irresistible need to pee.
The other "revolution" is now the detection and typing of HPV which supplants the classic Papanicolaou test and is better in terms of predicting the risks of cervical cancer.
We could also mention vaccination against HPV but I am not a fanatic.