Pelvic exams are often done during an annual exam. They can also be performed at any time if a patient has symptoms or signs that warrant it. During a pelvic exam, the external genitalia are examined as well as the vagina and pelvic organs. An instrument called a speculum is inserted into the vagina so that the vagina and cervix can be seen and examined. A Pap smear or sexually transmitted infection testing can be performed during a speculum exam. To examine the pelvic organs, an exam called a “bimanual” examination is performed. Gloved fingers are inserted into the vagina while the abdomen is palpated externally with the other hand. This allows the uterus and ovaries to be felt for abnormal masses or examined for tenderness. Sometimes further testing with ultrasound is indicated to clarify findings on pelvic exam.