Ungloved exam

I recently saw a female urologist and was very surprised when she examined my testicles with no gloves. She gloved up for the DRE but gave a thorough bare handed testicle exam. Is that normal? I wasn't complaining...

My old school urologist does the same. It is normal for older practitioners and those who learned from them. If the patient doesn't have signs of communicable disease and the examiner has intact skin, it's a non-issue.

When I was younger, genital exams were done without gloves. In the post HIV world, nobody touches you without gloves.

If your skin is intact and you wash your hands, you can't contract HIV from touching, even touching infected body fluids. The virus MUST enter your bloodstream via an open wound or contact with mucous membranes.

The hysteria about HIV was from the the early 80s, before there was real data about it's communicability. That's when AIDS and HIV patients were isolated. Even with contact, it takes a significant viral load to become infected. It's unlikely you'll ever get infected by casual contact or even breathing particulates after an HIV+ person sneezes near you.

I’d a small urologist intervention some years ago. Urologists did the exams without gloves; it’s said it gives a better feeling of the organs. On the contrary, nurses always wear gloves; they change of gloves after removing an old bandage and before doing the new one. The GP I saw before being oriented to an urologist, put gloves but did only a visual check.

She washed her hands upon entering the room and washed her hands at the end of the exam.

Its common practice as far as i know to wear gloves it kind of re assures the patient that the examiner even if they have touched someone else earlier they are taking measures to prevent any infections or problems transferring person to person

None of my Doctors worn gloves until my college physical. My pediatrician growing up would immediately wash and then start the exam. The sport/school physicals were also bare handed no gloves. The doctor sat on stool and a basin behind a privacy screen. Once behind the screen, you stood with your pants at your knees as he risen off one hand in basin. I really disliked these exams, just thinking about all the penises and balls he touched without truly washing his hands. At the end of my college physical, he said basically said "drop your boxers while I put some gloves on."

I really disliked these exams, just thinking about all the penises and balls he touched without truly washing his hands

Yes during school exams I thought exactly the same.

I never got the white glove treatment until I was about 13 or so. HIV was in its early days. In fact it was not even newsworthy.

I think its always useful to know the reasons why medical gloves are used and when they should and should not be used . This is part of our policy on our unit developed from World Health Organization Patient Safety Save Lives Clean Your Hands.

Medical gloves are defined as disposable gloves used during medical procedures; they include:

1. Examination gloves (non sterile or sterile)

2. Surgical gloves that have specific characteristics of thickness, elasticity and strength and are sterile

3. Chemotherapy gloves

Medical gloves are recommended to be worn for two main reasons:

1. To reduce the risk of contamination of health-care workers hands with blood and other body fluids.

2. To reduce the risk of germ dissemination to the environment and of transmission from the health-care worker to the patient and vice versa, as well as from one patient to another.

Inappropriate glove use:

1. The use of gloves when not indicated represents a waste of resources and does not contribute to a reduction of cross-transmission.

2. It may also result in missed opportunities for hand hygiene.

3. The use of contaminated gloves caused by inappropriate storage, inappropriate moments and techniques for donning and removing, may also result in germ transmission.

Summary indications for gloving and for glove removal:

Gloves on:

1. Before a sterile procedure.

2. When anticipating contact with blood or another body fluid, regardless of the existence of sterile conditions and including contact with non-intact skin and mucous membrane.

3. Contact with a patient (and his/her immediate surroundings) during contact precaution.

Gloves off:

1. As soon as gloves are damaged (or non-integrity suspected).

2. When contact with blood, another body fluid, non-intact skin and mucous membrane has occurred and has ended.

3. When contact with a single patient and his/her surroundings, or a contaminated body site on a patient has ended.

4. When there is an indication for hand hygiene.

Summary of the recommendations on glove use:

1. In no way does glove use modify hand hygiene indications or replace hand hygiene action by rubbing with an alcohol-based product or by handwashing with soap and water.

2. Wear gloves when it can be reasonably anticipated that contact with blood or other body fluids, mucous membranes, non-intact skin or potentially infectious material will occur.

3. Remove gloves after caring for a patient. Do not wear the same pair of gloves for the care of more than one patient.

4. When wearing gloves, change or remove gloves in the following situations: during patient care if moving from a contaminated body site to another body site (including a mucous membrane, non-intact skin or a medical device within the same patient or the environment).

5. The reuse of gloves after reprocessing or decontamination is not recommended.

So providing that the doctor washes their hands ( and don't be afraid to ask them to; they should before they begin any exam and after the exam) and you do not have any broken areas on your skin, then gloves do not have to be worn when examining a person; doing so just is a waste of resources . Also the wearing of gloves can reduce the examiners ability to detect subtle changes.

Hope this helps to clarify the use of medical gloves during an exam or procedure.

My family doctor never used gloves when I went to him as a kid. Hernia check and nut check was done barehanded. Now it seems every doctor's has a much more sterile environment, gloves included.

I'd think no gloves would be better. skin on skin contact seems like the best way to go.

My old doc usually didnt. my new doc does. I think using gloves reduces the sensation in an attempt to make it less sexual.

I've had many genital exams with the doctor being ungloved. It's just skin, like the rest of the exam.

A DRE, that's different.

Certainly my School exams and early pre employment exams, all of which involved some touching down below, were done un-gloved, that does not happen now with any of my exams, always gloved.

My pediatrician never used gloves for the genital exams. The last time I saw him for a physical was in 1991 since which time I have seen adult doctors, either family physicians or internists. Each of these doctors has gloved at the time he was going to start the genital exam. I have enjoyed the practice of having the examiner glove up because it creates a sense of drama that the area of focus and inspection is changing from the cleaner to the dirtier body parts and signals me that I am about to undergo the embarrassing parts of the exam.

When i went and saw my female urologist, we sat and chatted about my and my family's medical history before the exam began, but once she had me sit on the exam table, she pulled on gloves for the exam and did not take them off till she was done with her exam of me.

I've always thought that gloves were more of a courtesy than anything else and create a sort of barrier between the doctor and patient. My pediatrician never used gloves for genital exams when I was younger but did during my teenage years. I've never had another doctor examine my genitals ungloved.

It would seem now that glove use during any genital contact is standard anywhere.

Ignoring the possible impropriety, any exam involving a sample or culture should be gloved to avoid cross-contamination. I remember my pediatrician always wore gloves when I got throat cultures for the testing of strep throat.

Have any women here experienced an ungloved genital exam? Of course an internal exam would have to be gloved (you'd hope), but I'm talking about an external exam like at a dermatologist.

I had a hernia operation a few years ago and the surgeon did not wear gloves when I saw him before the procedure. He felt the bulse and touched my testicles but not my penis. As a child the doc always used a glove for rectal exams but not for genitals. Nurses never used a glove for rectal temps.

No gloves? Ewww. Not for me.

I'll give an ungloved exam to a sex partner, but that's it.

I had a hernia operation a few years ago and the surgeon did not wear gloves when I saw him before the procedure. He felt the bulse and touched my testicles but not my penis. As a child the doc always used a glove for rectal exams but not for genitals. Nurses never used a glove for rectal temps.

By rectal, do you mean a digital rectal exam or just a visual inspection? At my last skin exam, the dermatologist visually examined my butt and then spread my cheeks with her ungloved hands to inspect my anus.

I guess that's similar to breast exams which from what I've seen are done ungloved as well.

@liquidsky: even for a male genital exam?

Do you think it would be different if you saw known patients in a regular office?

Personally I don't think a male genital exam needs a glove. Soap and water cleans up well. I do use gloves because I think an ungloved exam is a little too intimate and makes the patient uncomfortable.

@liquidsky: I appreciate your concern about patient's comfort. But personally, I've never cared one way or the other.

Growing up, my doctor never wore gloves when examining my genitals. It wasn't until I was out of college as an adult that a doctor examined my genitals with gloves.

The doctor I was with for many years never gloved up unless it had something to do with any type of bodily fluids. He would always wash his hands when he came into the exam room. When he did the routine exams, including palpitations, the testicle check and hernia check un-gloved. When he put gloves on I knew it was time for the DRE. If I needed stitches or a biopsy etc he always gloved up. When he was done he would again wash his hands.

Since I changed medical plans, I have had female physicians. They tend to glove up for routine palpitations and exams that do not involve body fluids. I have not yet seen my new doctor so I do knot know what she will do. I recently had to go to physical therapy. One therapist gloved up when she was measuring my range of motion and then doing treatment. Another therapist took over my case and she never gloved up even though there was a lot of hands on treatment involved. I did not have any open sores, stitches etc., it was all orthopedic.

I remember when dentists did not glove up. Over the past few years, they have now started gloving up and even wearing face masks/shields. With the spray that splatters during treatments from the patients I would too if I was them.

Actually, all my exams have been ungloved.