Bimanual (vaginal) Examination

Bimanual vaginal examination is performed for a number of different clinical indications, including unexplained pelvic pain, irregular vaginal bleeding, vaginal discharge and assessment of a pelvic mass. It frequently appears in OSCEs, most often with a mannequin, however you will still be required to demonstrate appropriate communication skills. This guide demonstrates how to perform a bimanual vaginal examination in your OSCE.

Warn patient you are now going to examine the vagina, ask if they are comfortable

Entering the vagina

Carefully separate the labia using your thumb and index finger of left hand Gently insert gloved index and middle finger of your right hand into the vagina Enter the vagina with palm facing laterally & then rotate 90 degrees so that it faces upwards


Vagina, Cervix & Fornices

Feel the walls of the vagina for any irregularity, or masses

Assess cervix:

  • Position
  • Consistency (hard/soft)
  • Os (open/closed)
  • Cervical excitation

Gently palpate fornices either side of cervix for any adnexal masses



Palpate the uterus between your hands:

  • Place left hand 4cm above symphysis pubis
  • Place right hand in posterior fornix
  • Push up with internal right hand on cervix
  • Push down on abdomen with fingers of your left hand towards the internal fingers of your right hand