Sensitive Exams

A sensitive exam is one that involves the genitalia, rectum or female breast. This includes:

  • Pelvic exams
  • Clinical breast exams
  • Rectal exams
  • Urogenital exams (penis and scrotum)

Sensitive exams are very common and can help detect, diagnose and treat several health conditions, like colorectal cancer, cervical cancer and breast cancer. It is normal for patients to find sensitive exams stressful or distressing. At Bronson, we are committed to ensuring our patients feel safe and heard at all times. This is why we have chaperones available for sensitive exams.

What is a Medical Chaperone?

A medical chaperone is an observer who assists patients and providers during sensitive examinations, treatments, procedures or upon request. Chaperones protect both patients and providers by helping create a neutral, safe, respectful environment. Their main role is to:

  • Provide emotional comfort, as needed, to the patient
  • Provide gowns/sheets to ensure privacy
  • Help the patient understand all instructions
  • Ensure continuing consent throughout the exam

A chaperone is a trained health professional or Bronson staff member. We will make every effort to ensure the chaperone is the gender in which the patient is most comfortable with. Family members and friends of adult patients may not serve as a chaperone, but may be present during chaperoned appointments if the patient wishes.

Chaperones are offered for sensitive exams and procedures and will be present unless you decline to have one present. Providers may also request the presence of a chaperone. If you would like to have a chaperone, let the office know during e-check in or when you arrive at the office. If you ask for a chaperone at any time during your visit, your provider will not proceed until a chaperone is available.

View Bronson's Chaperone Policy

What to Expect During a Sensitive Exam?

It is normal to feel slight discomfort or pressure during a sensitive exam. However, it should not feel painful. If you experience pain, tenderness or excessive pressure during a sensitive exam, it is important to tell your provider immediately. You are in charge. If you have any questions or concerns during your exam, please speak up.

Adult Sensitive Exams

Female Exams

Breast Exams

A breast exam is usually performed if you have concerns such as pain, discharge or a lump in the breast region. It may also be performed as a screening tool for cancer.

Breast exams require you to remove clothing from the waist up. You will be provided a gown and cover sheet. They are not painful. If you become uncomfortable, tell your provider immediately.

The exam includes:

  • A visual examination of the breast skin for rashes, dimpling or other abnormal signs. Your provider will ask you to raise your arms over your head to allow them to see differences in shape or size.
  • A manual examination. The provider will use the pads of their fingers to lightly press lightly over the breast tissue, underarm and up to the collarbone to check for lumps. Nipples may be checked for any discharge when squeezed.

Pelvic Exams

Most providers suggest a first pelvic exam by age 21 or if you experience pain or vaginal discharge, whichever comes first.

A pelvic exam requires you to remove clothing below the waist. You will be provided a gown and sheet. During the exam, you will be lying down on the exam table with your legs open and in stirrups. During a pelvic exam, you may feel pressure or slight discomfort, but it should not be painful. If you become uncomfortable, experience pain, tenderness or too much pressure, tell your provider immediately.

A pelvic exam includes:

  • An external check of the labia, clitoris, vagina and rectal opening. This includes both visual inspection and palpation (light pressing with fingers).
  • An internal exam using of a duck-bill shaped instrument known as a speculum. The speculum is gently inserted into the vaginal canal to provide visual access of the vagina and cervix. Your provider may gently move the speculum as needed to see the cervix. During the internal exam, your provider may collect a specimen for a Pap or STI test. They will use a thin, plastic applicator to collect cells from the cervix to send to the lab.
  • A bi-manual exam may be performed if you have pain or other symptoms in the lower abdomen. During a bi-manual exam, your provider will insert one or two gloved fingers into the vagina while palpating points on the abdomen with the other hand. They are checking the ovaries, uterus and pelvic floor muscles for any abnormalities.

Rectal Exams

If you have complaints of pain in the lower abdomen, blood in your stool, or other gastrointestinal symptoms, your provider will do a rectal exam. It is done either kneeling or lying on an exam table. It should not be painful. If you become uncomfortable, tell your provider immediately. It is not uncommon to have a sense of needing to urinate or defecate during the exam. This sensation usually passes quickly, but if it does not, ask the provider to stop the exam.

This type of exam may include:

  • An external visual exam in order to look for rashes, lumps or sores.
  • Specimen collection, which involves inserting a cotton swab about one inch into the rectum and rotating it gently to get a sample.
  • An internal digital exam, where your provider will insert one gloved, lubricated finger into the anus. They will palpate any lumps or abnormalities.

It may be necessary to perform an anoscope. This is an exam with the use of a scope that is lubricated and gently inserted into the anus, getting a visualization of the rectal canal. Your provider may ask you to tense and relax your muscles during the exam. It should not be painful. If you become uncomfortable, tell your provider immediately.

Male Exams

Exams of the penis and scrotum are performed to check for hernias, or if you are experiencing pain, swelling or discharge. This type of exam is not painful, but if you become uncomfortable, tell your provider immediately. Some patients may develop an erection during the exam. This is a normal reaction. Erections can be caused by anxiety, temperature changes, or a reaction to touch.

Pubic/Groin Exam

The exam includes:

  • A visual exam of the groin.
  • Palpation of the scrotum, groin and hip crease to check for abnormalities such as hernia, lumps, testicle and spermatic cord issues.
  • During a hernia exam, your provider will place their fingers through the scrotum while you are standing.

Penile Exam

If you have concerns such as pain or sores, your provider will perform a visual and manual exam of the penis. If you are uncircumcised, the provider may ask you to retract the foreskin so they are able to examine all surfaces. They may palpate the area. They will examine the opening of the urethra and many use a swab to collect a specimen for lab testing. They may squeeze the shaft of the penis and muscles to check for scarring.

Rectal Exams

If you have complaints of pain in the lower abdomen, blood in your stool, or other gastrointestinal symptoms, your provider will do a rectal exam. It is done either kneeling or lying on an exam table. It should not be painful. If you become uncomfortable, tell your provider immediately. It is not uncommon to have a sense of needing to urinate or defecate during the exam. This sensation usually passes quickly, but if it does not, ask the provider to stop the exam.

This type of exam may include:

  • An external visual exam in order to look for rashes, lumps or sores.
  • Specimen collection, which involves inserting a cotton swab about one inch into the rectum and rotating it gently to get a sample.
  • An internal digital exam, where your provider will insert one gloved, lubricated finger into the anus. They will palpate any lumps or abnormalities. Your provider may put pressure on the prostate gland to check for pain or tenderness.

It may be necessary to perform an anoscope. This is an exam with the use of a scope that is lubricated and gently inserted into the anus, getting a visualization of the rectal canal. Your provider may ask you to tense and relax your muscles during the exam. It should not be painful. If you become uncomfortable, tell your provider immediately.

Pediatric Sensitive Exams

A chaperone is always available at the request of a patient, family member or provider during a pediatric sensitive exam. Chaperones are intended to create a safe environment for both patients and providers. Parents may decline the presence of a chaperone for a patient under the age of 13. Adolescent patients (ages 13-17 years) must participate in the decision to have a chaperone present.

Well Child Exams

Childhood is a time of rapid growth and body changes. The goal of a well child visit is to assess your child's growth and development and to identify or prevent future health concerns. The visit includes two parts:

  1. Basic health screening: This includes checking height and weight, BMI, blood pressure (if over age 2), hearing and vision. The provider will also talk to you and your child about safety, sleep, immunizations and growth and development.
  2. Physical exam: This includes listening to heart, lungs and stomach with a stethoscope, testing reflexes on arms and legs, and looking in eyes and ears and mouths with a scope.

    Another important part of the physical exam includes checking the sexual maturity of the child. This standard assessment helps ensure normal growth and development and allows for the recognition of any problems that may need referral. This part of the exam may be different based on age and development of each individual child.

Pediatric Female Exam

A pediatric female exam is one that involves examining the genital area. This requires that the patient remove all clothing from the waist down. It can also include a breast exam, which requires clothing from the waste up be removed or moved aside. A gown will be provided.

During these types of exams, the provider is looking for the stage of pubic hair growth and breast development. If there is a concern about a mass, the provider may need to examine and palpate the breast more closely.

Pediatric Male Exam

A pediatric male exam is one that involves examining the genital area. This requires that the patient remove all clothing from the waist down.

During this type of exam, the provider is looking for the stage of pubic hair growth and genital development. The provider will manually verify the testes have descended by palpating the scrotum. Sometimes, the testes withdraw and are difficult to palpate. This is a normal reaction that can be caused by anxiety, being ticklish, temperature changes, or a reaction to touch. The provider may then need to gently push the testicle down from the upper part of the scrotum. In uncircumcised boys, the provider may gently pull on the foreskin to see if it is retractable.

Sensitive Tests/Procedures

EKG

During an EKG, the chest must be exposed. This allows your provider to place patches on your skin. You will be given a gown and/or cover sheet during the procedure. For females receiving this test, your breast may need to be lifted or moved to place the EKG leads in the correct place.

Osteopathic Manipulative Treatment (OMT)

OMT is a procedure where a physician, using their hands, moves a patient's muscles and joints. They use techniques that include stretching, gentle pressure and resistance. Physicians that do OMT evaluate you and perform these techniques while you are fully clothed. Depending on the area of your body they are evaluating and working with, the physician’s hands may be close to sensitive areas of your body such as the breasts or genital area. For example, OMT on your hip or lower back may require hand placement close to the buttock, groin or genital area. Or, OMT on your shoulder may require hand placement on the rib cage close to the breast. Your provider will talk to you about where they are about to touch you ahead of time. If you feel any discomfort, please tell your provider immediately.

Physical Therapy

Some treatments may require your provider to place their hands on skin or over clothing on areas such as rib cage, axilla, abdomen, thighs or buttocks. For example, treatment for the shoulder may require mobilization which occurs in the axilla or along the rib cage. Your therapist will talk to you about where they are about to touch you ahead of time. If you feel any discomfort, please tell your provider immediately.