January 27, 2023
In the context of recent complaints of rape in the gynecological setting, the CNGOF is issuing new recommendations concerning the conduct of the consultation. The pelvic examination no longer has to be performed at each consultation.
The National College of French Gynecologists and Obstetricians (CNGOF) has just issued new recommendations concerning the course of the gynecological consultation. Main announcement: the pelvic examination, that is to say the observation of the organs of the pelvis by a vaginal examination or the installation of a speculum, should no longer be carried out systematically.
Why ?
The reason given is that “Some women fear or even avoid gynecological consultation because of this examination”, explained Professor Xavier Deffieux, obstetrician gynecologist at Antoine-Béclère (Clamart, AP-HP) to the Daily Doctor this Wednesday, January 25. According to the practitioner “You have to determine in which situations it is useful, avoid unnecessary touches and reassure on the merits of the treatment. »
Specifically, these exams “are not essential for a prescription of hormonal contraception and its monitoring or during pregnancy monitoring for an asymptomatic woman, without risk factor”. However, they remain important in various cases, such as for the insertion and follow-up of an IUD, in the screening for cervical cancer or in the event of suspected endometriosis.
Essential consent
The College of Gynecologists stresses the importance of putting these recommendations into context. “It is often a compromise between the objective of doing well, the safety of women and the means available”, believes Xavier Deffieux. Which does not forget to recall the importance of the patient’s consent. Because “we must not forget that it is the woman who accepts or not the recommendation that is proposed”adds Professor Deffieux.
The CNGOF thus advises in particular to ask patients regarding the existence of violence before considering a pelvic examination. Because in this case, the examination would be “lived less well (anxiety, discomfort, pain, embarrassment, shame)”.
To note : Across the Atlantic, theAmerican College of Physicians and the Canadian Task Force on Preventive Health Care have been recommending for several years “not to perform a pelvic examination to screen for non-cervical cancers, pelvic inflammatory disease or other gynecological conditions in asymptomatic women”.
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Source : CNGOF – Le Quotidien du Médecin – Canadian Task Force on Preventive Health Care
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Written by : Dominique Solomon
