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Date Posted: 12:47:30 10/16/16 Sun
Author: Knuit Holt
Subject: Pelvic examinations of children and teens during routine physicals steadily more common

Mandatory Pelvic Examinations in Children


What is becoming standard for those two age levels for both boys an girls are somewhat like this.

- The day before the child gets laxatives and only liquids so that the digestive system is clean when going to the health center, or the parents are instructed to give a small enema to help the child get clean the day of the exam.

- When arraving the child will be asked to go to the toilet once more, to undress and lay down on a stretcher with a blanket to cover the body. There the child will get some stuff to be relaxed and drowsy which can be administered in various ways epending on the policy of the health center.

- After this the colon of the child will be flushed several time with an automatic machine or the colonic type to make it totally clean, while the child lies in a sedated state.. The exact methods of colon cleansing before the exam, varies conciderably from setting to setting and will also depend on the thorroughnes of the exam planned. Big enemas of the old fashioned type is seldome done any more.

- Then the child is wheeled into the examination room and placed in appropriate positions, which will vary according to the differnt exams done. Some kind of stirrups or equipment to hold the legs spread and fixed will typically be used for both girls and boys. Exams done will typically be these:

- A general assessment of the hip joints and the musculature in the pelvic floor, by which a finger may be inserted in the anus.

- Inspection of the belly zone and hip joints with an ultrasound sond. For both boys and girls a hernia check with the aid of the ultrasound sond.

- A neurological exam with touching or electronic sonds to stimulate reflexes and physiological reactions, but one will by all means avoid this test to be interpreted as sexual stimulation. On the other hand, the reactions in the pelvic zone during these stimulations will be used to assess wether the child has been sexually exploited by someone.

- For boys a visual inspection of the genital organs, with retraction of the foreskin, spreading of the urethral opening and palpation of the scrotum with testicles. Specimen taking with a swab or sond from the urethral opening.

- For girls a visual inspection and palpation of the outer parts of the vulva. After that separation of the vulvar lips with inspection of the inner contents, including urethral and vaginal opening. Specimen taking from the urethral opening and the outer vagina with a swab or sond.

- Testicular ultrasond inspection of boys.

- Inspection with specimen taking in the vagina with a thin scope, and not a speculum for younger girls, possibly a speculum for girls in full puberty.

- Vaginal ultrasond inspection for girls.

- An inspection of the urethra of boys in all its length with a thin ultrasond sond.

- An inspection of urethra and bladder with a cystoscope, an exam that has become very easy to do without much disconfort due to the technical development.

- Catheter inserted in the bladder to instill contrast fluid and then examination of the bladder region with an ultrasound probe. The catheter is thereafter let stay in the bladder to drain urine and to serve as a marker during the rest of the exam.

- Inspection and probe taking in the anus using a speculum.

- Inspection of the pelvic area with an ultrasound sond inserted into the anus.

- Anoscopy or sigmoidoscopy with probe taking.

- A possible functional test of the bladder and urethra by fluid pumped in and by a special catheter that can be pumped up, and uscular reactions and pressure monitored.

- A possible functional test of the anus and lower colon with insertion of a tube that is inflated at several points and reaction monitored.

The exact sequence of these exams will vary, from clinic to clinic, and depending of the technology used, two or more of these examinations will often be perfromed in one handling only.

A parent will in some clinics be allowed and even required to stay with the child during the exam and help the child though, but some clinics prefere to give the child deeper sedetion to hide the particular for both the child and the parents.

Some clinics will at the end of the exam teach the caregiver about regular checks they can do or even are required to do on the child and how to report findings. Other clinics will regard such teaching as an invitation to child abuse, and even worn parebts against close handlings of the childs body.

Before this special exam, the child has typically already had a general physical with examination of the whole body, with blood tests and all other standard tests.


What will the doctor look for during the extensive pelvic checkups.

The purpose of these exams is to assess the exact development status of the child or teen or to get aware of pelvic problems that needs attention or treatment. This information shall then be used by parents, teachers, sport coaches and other with responsibility for the child during school activities, sport activities and daily routines.

Children and teen also have frequent pelvic problems that usually are overlooked, and the purpose is to catch up such problems so that they can be resolved, or managed during appropriate support.

Some of the things one will look for in girls are:

Development of the shape of clitoris, genital lips and vagina.

Symptoms of hernias that can be seen in the vulva

Imperforate hymen in girls.

Infections of presens of unwanted microbes in the vagina.

Vaginal secretion

Signs of first menstruation

Some of the things one will look for in boys are:

Testicular and scrotal development

Secretion from the prostate and signs of testicular activity

Prostate development, which tells a lot about maturation stage in boys.

Patological processes in the testicles and prostate

Inguinal hernias and similar problems

Narrow foreskin

Urethral valves - flaps of connective tissue where the urethra joins the bladder that partly hinders the flow of urine and can cause urination trouble and infection. Most often affecting boys

Things they will look for in both boys and girls are:

Uretero-pelvic reflux -Ineffective valves where the channels from the kidneys join the bladder, which can cause urine to be pressed up against the kidneys and cause injure and infection in the kidneys. Both boys and girls.

Abnormal placement of the urethral opening and narrow urethra.

Infection or presens of microorganisms in the urethra and anus.

Neurological or functional problems in the bladder, lower colon, rectum or anus, or changes caused by such problems.

Too small bladder capacity.

Signs of chronic inflammatory processes in the digestive system.

Orthopedic problems and rheumatic diseases afflicting the hip joint and the muscles in the pelvic area.

Areas in the urethra, anus or lower colon that are too narrow or abnormally shaped.

Symptoms in the pelvic region caused by problems in other body areas.


In addition to the beneficial reason for these exams, there are other more murky and usually secret incitement for these becoming routine:

- Authorities in a area require these exams to be done and reports issued regarding each child.
- A general suspicion of parent of sexual abuse.
- A general surveillance of the population and their intimate habits, including sexual.
- Scientific projects.

A reason that I have abundant evidence for, but that surprised me in the beginning is this: Some primary schools, usually private ones, cooperate with athletic schools and dance academies to find suitable candidates for these schools, and use these exams to find children that are physically suited for these schools.

If they are found suited, subsequent exams of this type under sedation are done more often, an the child is typically manipulated to delay the puberty, enhance flexibility, and control the growth during these exams, to make them suited as dancers and gymnasts.


By Knut Holt
For more health information, please visit:


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