Speculum: What is it? Types, Uses and Complications Related to the Use of This Instrument

It is a duck-billed device that doctors use to see inside a hollow part of your body.

It is used to diagnose or treat diseases.

A common use of the speculum is for vaginal exams. Gynecologists use it to open the walls of the vagina and examine the vagina and cervix.

Types of specula

A speculum is made of stainless steel or plastic. Metal devices are reusable. The plastic ones are disposable.

Vaginal specula

Vaginal specula have one, two, or three blades.

Bivalve Speculum (Cusco Speculum)

The two-bladed or bivalve speculum is the most common type of instrument gynecologists use to examine the vagina and cervix.

The doctor inserts the speculum into the vagina and opens the blades, exposing the inside of the vagina and cervix.

Vaginal specula come in different sizes. The type of speculum your doctor chooses will depend on your age and the length and width of your vagina.

Pediatric speculum

Gynecologists use this shorter version of the speculum to examine the vagina in infants and children.

Huffman speculum

This long, thin speculum is narrower than a regular speculum. It is used in adolescent girls who have not yet been sexually active.

Pederson speculum

Doctors use the Pederson speculum on teens who have been sexually active. Its leaves are narrower than those of a regular adult speculum, but larger than the leaves of a Huffman speculum.

Graves speculum

The Graves speculum has the widest blades of any speculum. Gynecologists use it to examine adult women. It comes in a larger size for those with an especially long vagina.

Anal speculum

An anoscope is a tube-shaped instrument that widens the opening of the anus. Doctors use it to diagnose diseases of the anus and rectum.

Ear speculum

This funnel-shaped device allows your doctor to examine your eardrum and ear canal. It is attached to a lighted instrument called an otoscope, which the doctor uses to look into your ear.

Nasal speculum

This two-bladed instrument is inserted into the nostrils. Allows doctors to examine the inside of the nose.

Uses of specula

There are several reasons why your doctor might use a speculum.

Pelvic exam

Gynecologists do a pelvic exam to check for problems with the vagina, cervix, and other reproductive organs. The speculum opens the vaginal canal so the doctor can see these organs more easily.

During this test, the doctor may use a special brush to remove some cells from the cervix. This is called a Pap test or Pap test.

The cells go to a laboratory, where they are checked for early signs of cervical cancer.

Cell samples can also be taken from the vagina and cervix to screen for sexually transmitted diseases (STDs).

Doctors also use a speculum for procedures like these:

Vaginal hysterectomy

This procedure removes the uterus through the vagina.

Dilation and curettage

This procedure opens (dilates) the cervix and removes part of the lining of the uterus.

Intrauterine insemination (IUI) and in vitro fertilization (IVF)

These procedures help women with fertility problems to get pregnant.

Placement of the intrauterine device (IUD)

IUDs are a reversible form of birth control that is placed inside the uterus.

Anal examination

Doctors use an anal speculum to diagnose and treat conditions such as:

  • Hemorrhoids.
  • Abscesses
  • Tears in the anus (anal fissures).
  • Growths in the lining of the rectums called polyps.
  • Some cancers.

Ear exam

An ear speculum allows an ear, nose and throat (ENT) or a primary care physician to examine the inside of your ear. It is used to search for problems such as:

  • Swimmer’s ear.
  • Perforation of the eardrum.
  • Wax buildup in the ear.
  • Foreign objects in the ear.
  • Acute ear infection (otitis media).

Nasal examination

A nasal speculum widens the opening of the nose to help the doctor diagnose a disease or perform procedures such as:

  • Fixation of a deviated septum (septoplasty).
  • Remove foreign objects from the nose.

Complications related to the use of the speculum

Pelvic exams can be a bit uncomfortable when your doctor places the speculum inside your vagina and opens it. However, there are few risks involved as long as the speculum is sterile. If it hurts, you can ask your doctor to use a smaller speculum.

The speculum may feel like it’s stretching your vagina, but it only temporarily opens the vaginal canal. It will not widen or loosen your vagina. A speculum must not cause damage or injury when used by a trained physician.

Preparing for your first pelvic exam

Most young women should have a pelvic exam before age 21.

It’s normal to be nervous about your first pelvic exam. Remember that this test is just one way for your doctor to check your reproductive system. It should be quick, and it shouldn’t be painful.

Let your gynecologist’s office know that this is your first exam. The doctor and nurse should explain the process to you and answer any questions you have.

In the two days before your exam, avoid the following:

  • Vaginal creams
  • Suppositories.
  • Showers

During the exam, you will first tell the nurse about your medical history. The nurse may ask you when you started having your periods and if you have any symptoms such as itching or burning in the vagina. Your weight and blood pressure will also be checked.

You will then change into a hospital gown or undress from the waist down and cover yourself with a curtain.

During the pelvic exam, you will move to the end of the table, bend your knees, and place your feet in supports called stirrups.

Your doctor will first examine the outside of your vulva. The doctor will then insert a speculum into the vagina to view the inside of the vagina and cervix. You may feel a little pressure when the speculum is opened, but it shouldn’t be painful.

Using a small brush, your doctor may remove a sample of cells from your cervix, called a Pap smear. The doctor will also insert a gloved finger into your vagina to check your ovaries, uterus, and other pelvic organs.

The entire exam should take between three and five minutes. Your doctor will inform you if there are any problems with your reproductive tract.