Vaginal cancer physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

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Complete pelvic examination is performed. During the speculum examination, the vagina should be inspected thoroughly, including visualization of the entire circumference and the fornices by moving the position of the speculum. Any abnormal areas or masses should be biopsied. The bimanual examination should include palpation of the vaginal walls for masses and evaluation for other pelvic masses. The groins should be palpated to assess for enlarged lymph nodes.

Physical Examination

  • The lesion may be missed on initial examination if it is small and situated in the lower two-thirds of the vagina[1].
  • During visual examination of the vagina, the anterior and posterior blades of the speculum obscure this area, so the tumor may be missed unless the vagina is inspected as the speculum is removed or the lesion is palpated on bimanual examination.
  • Rectovaginal exam should also be performed to assess for parametrial and pelvic sidewall involvement and possible rectal involvement.
  • The posterior wall of the upper one-third of the vagina is the most common site of primary vaginal carcinoma.
  • The lesion may appear as a mass, a plaque, or an ulcer[2].
  • Focused physical examination is performed to assess for metastatic disease[3].
  • The inguinal area should be examined for enlarged lymph nodes[4].


  1. Shrivastava SB, Agrawal G, Mittal M, Mishra P (2015). "Management of Vaginal Cancer". Rev Recent Clin Trials. 10 (4): 289–97. PMID 26411952.
  2. Rajaram S, Maheshwari A, Srivastava A (August 2015). "Staging for vaginal cancer". Best Pract Res Clin Obstet Gynaecol. 29 (6): 822–32. doi:10.1016/j.bpobgyn.2015.01.006. PMID 25847318.
  3. Ng QJ, Namuduri RP, Yam KL, Lim-Tan SK (August 2015). "Vaginal metastasis presenting as postmenopausal bleeding". Singapore Med J. 56 (8): e134–6. doi:10.11622/smedj.2015127. PMC 4545142. PMID 26311914.
  4. Lee IO, Lee JY, Kim S, Kim SW, Kim YT, Nam EJ (July 2017). "Sentinel lymph node mapping with indocyanine green in vaginal cancer". J Gynecol Oncol. 28 (4): e29. doi:10.3802/jgo.2017.28.e29. PMC 5447138. PMID 28541627.