Various professional organizations have weighed in on the practice utility of speculum examinations. The US Preventive Services Task Force (USPSTF), American Academy of Pediatrics (AAP), and American College of Physicians (ACP) have recommended against internal pelvic examinations in asymptomatic patients, whereas the American College of Obstetricians and Gynecologists (ACOG) has encouraged shared decision making. Although a pelvic examination can be a stressful event for adolescents, studies have shown that early discussions and performing the examination in a trusting environment can mitigate the worries and improve the patient−provider relationship. In this commentary, we discuss the literature and conclude that performing a pelvic examination in the asymptomatic adolescent and young adult patient is ultimately a matter of shared decision making. The benefits of conducting the examination in a nonthreatening environment, minimizing “exceptionalization” of the female genitalia, and strengthening the patient−provider relationship should be highlighted during the discussions.

各种专业组织都在权衡窥器检查的实践效用。美国预防服务工作组 (USPSTF)、美国儿科学会 (AAP) 和美国内科医师学会 (ACP) 建议不要对无症状患者进行内部盆腔检查，而美国妇产科医师学会 (ACOG) 则鼓励共享做决定。虽然盆腔检查对青少年来说可能是一个压力事件，但研究表明，早期讨论和在信任的环境中进行检查可以减轻担忧并改善患者与提供者的关系。在这篇评论中，我们讨论了文献并得出结论，对无症状的青少年和年轻成人患者进行盆腔检查最终是一个共同决策的问题。在讨论中应强调在无威胁环境中进行检查、最大限度地减少女性生殖器“异常化”以及加强患者与提供者关系的好处。