The 5 Reasons Why Every Doctor Needs Specula in Different Sizes
Vaginal specula have existed in some shape or form since the early Roman times. During archaeological excavations, several bronze specula were found among the ruins of Pompeii. Thomas Graves is credited with producing the modern-day speculum design in 1870. Graves tweaked an earlier design created by the controversial “Father of Modern Gynecology”, James Marion Sims. Today, Graves’ design remains largely unchanged.
Specula are used by doctors during exams and procedures to open up the vaginal canal. While it’s normal for the patient to feel pressure while a speculum is in place, it should never be painful or pinch. To provide comfortable care, doctors must use the correct size speculum. There is a range of sizes on the market today, suitable for every woman and every procedure.
The five factors that affect specula size selection are childbearing status, sexual activity, age, anatomical differences, and the type of procedure being performed. Clinicians should keep all of these factors in mind when selecting the right size specula for their patients.
Whether or not a woman has had children will determine the best size speculum for her. During vaginal birth, a woman’s vagina stretches. There can also be some vaginal stretching present in women who had a c-section but were in labor and pushed beforehand.
How long a woman pushed during labor and whether or not forceps were used during the delivery can affect the amount of stretching that occurs. How many children a woman has had, and whether or not she did pelvic floor exercises prior to birth also affects the amount of stretching that can take place.
Even under the best circumstances, many women are apprehensive about vaginal exams. Dr. Wendy Goodall McDonald uses humor in her blog, The Gyneco-(b)Logic to address specula size selection. Dr. Goodall McDonald often uses a Graves speculum for women who have had vaginal deliveries. A Graves speculum is curved and allows the cervix to be easily examined.
Whether or not a woman has been sexually active will, in part, determine which speculum size is right for her. A Huffman speculum is narrower than a Graves and is often used for young women who are not yet sexually active.
For the youngest patients, pediatric specula are available for infants and children. Dr. Goodall McDonald has also used this smaller specula size in senior women, post-menopausal women, and those who are not sexually active.
Childbearing status, sexual activity, and age aside, there are anatomical differences amongst women. Some women have longer or shorter than average vaginas. A study published by Gynecologic and Obstetric Investigation measured the vaginal lengths of 39 women. The lengths ranged from 6.86 centimeters to 14.81 centimeters.
For the comfort of the patient, the width of the vaginal opening must also be taken into consideration when choosing a speculum. The same study found that vaginal widths ranged from 4.8 centimeters to 6.3 centimeters.
Another anatomical difference is whether or not a woman still has a cervix. Women who have had a vaginal hysterectomy will have had their cervix removed. While these women don’t need to have pap tests, they may have to have other types of vaginal exams and will need an appropriate-sized speculum.
Different Procedures Require Different Exposure
Obtaining a swab of discharge or a visual examination is going to require a very different level of exposure than a vaginal hysterectomy or an IUD placement. Clinics that provide a range of gynecological services must have the right specula for each procedure.
Pap Tests or Pap Smears
During a pap test, also called pap smears, the physician uses a special brush to collect cells from the cervix. These cells are then screened for cervical cancer. A vaginal exam is often performed at the same time as a pap test.
When people think of specula, they often think of pap tests. However, there are other procedures where a speculum is required.
A vaginal exam can take place with or without a pap test. During a vaginal exam, the clinician will examine the vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for any abnormalities.
Hysterectomies can be performed a couple of different ways. In a vaginal hysterectomy, the uterus and cervix are removed through the vagina instead of an abdominal incision.
Dilation & Curettage (D&C)
During a D&C procedure, the cervix is dilated. The tissue is then removed from the inner lining of the uterus. There are several reasons for a D&C, including the removal of fibroids or infected tissue.
Intrauterine Insemination (IUI)
Intrauterine insemination is a treatment for infertility. Indeed, in IUI, sperm is placed directly into the uterus to increase the odds of fertilizing an egg.
In Vitro Fertilization (IVF)
In vitro fertilization is considered a type of assistive reproductive technology. During IVF, a viable embryo is transferred to the uterus.
Intrauterine Device (IUD) Placement
An IUD is a very small, T-shaped device that’s placed inside of the uterus to prevent pregnancy. IUDs are a long-term, reversible form of birth control.
The ER-SPEC Difference
At obp, we understand the need for having specula in different sizes. We manufacture six different sizes of disposable single-use, ER-SPEC. The ergonomic design is comfortable for both clinicians and patients. Every ER-SPEC is pre-assembled and ready for clinical to use. In addition, all ER-SPECs come with an integrated light source.
ER-SPEC is constructed out of clear plastic. Unlike reusable metal specula, ER-SPEC is transparent and allows clinicians to visually examine the entire vaginal wall while the device is in place. ER-SPEC is disposed of once the exam is over.
Learn More About Different Sized Specula
Each and every woman that walks into your clinic deserves to have a comfortable experience. When women fear unnecessary pain from a speculum, they avoid vaginal exams. In turn, they put themselves at risk for cancer and undiagnosed STIs. Women who avoid procedures like a vaginal hysterectomy or a D&C put off necessary treatment for painful conditions.