speculum

This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (September 2007)

The disposable bivalved plastic vaginal speculum is used in office gynecology

A speculum (Latin for "mirror") (plural specula or speculums) is a medical tool for investigating body cavities, with a form dependent on the body cavity for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra.^[1] Like an endoscope, a speculum allows entry into a body cavity, endoscopes, however, tend to have optics while a speculum is intended for direct vision.

Vaginal and anal specula were used by the ancient Greeks and Romans,^[2] and speculum artifacts have been found in Pompeii.^[3] A vaginal speculum, developed by J. Marion Sims, consists of a hollow cylinder with a rounded end that is divided into two hinged parts, somewhat like the beak of a duck. The speculum is inserted into the vagina to dilate it for examination of the vagina and cervix.

Specula come in a variety of shapes based on their purpose, in any case the tube or blade(s) of the instrument allow the operator a direct vision of the area of interest and the possibility to introduce instruments for further interventions such as a biopsy. The best-known specula are the bivalved vaginal specula; the two blades are hinged and are "closed" when the speculum is inserted to facilitate its entry and "opened" in its final position where they can be arrested by a screw mechanism, so that the operator is freed from keeping the blades apart.

A specialized form of vaginal speculum is the weighted speculum, which consists of a broad half tube which is bent at about a 90 degree angle, with the channel of the tube on the exterior side of the angle. One end of the tube has a roughly spherical metal weight surrounding the channel of the speculum. A weighted speculum is placed in the vagina during vaginal surgery with the patient in the lithotomy position. The weight holds the speculum in place and frees the surgeon's hands for other tasks.

Vaginal specula are also used for anal surgery, although several other forms of anal specula exist. One form, the anoscope, resembles a tube that has a removable bullet shaped insert. When the anoscope is inserted into the anus, the insert dilates the anus to the diameter of the tube. The insert is then removed, leaving the tube to allow examination of the lower rectum and anus. This style of anal speculum is one of the oldest designs for surgical instruments still in use, with examples dating back many centuries. The sigmoidoscope can be further advanced into the lower intestinal tract and requires an endoscopic set-up.

Ear or aural specula resemble a funnel, and come in a variety of sizes.

Nasal specula have two relatively flat blades with handle. The instrument is hinged so that when the handles are squeezed together the blades spread laterally, allowing examination.

All specula were formerly made of metal, and sterilized after use. However, many, especially those used in Emergency Departments and Doctor's offices, are now made of plastic, and are sterile, disposable, single-use items. Those used in surgical suites are still commonly made of metal.

Vaginal and anal specula are also sometimes used as sex toys.

Contrary to some previously held opinions, the speculum does not cause damage to the vaginal opening, as many gynecological teachers will attest. In very few states in the United States, vaginal specula are illegal for personal use^{[citation needed]}, but since there was a popular cervical self-examination component to the second-wave feminist movement, many states are either much more lenient or have completely relinquished restrictions on speculum use. However, distributors still face specific guidelines about which specula may or may not be sold.

Glass specula

Types of specula

Vaginal use

Tubal shape

• Fergusson
• Glass speculum

One blade

The one-bladed Sims' speculum is still in use today

Two blades (bivalved)

Duckbill shape of a two-bladed speculum

Ear specula are funnel-shaped

Three blades

Rectal use

Tubal shape

• Aniscope

One blade

• Czerny

Two blades

Three blades

• Alan Park
• Cook
• Mathieu

Nasal use

Aural use

See also

• Endoscope
• Luce Irigaray, writer of Speculum of the Other Woman (1974)

Notes

Wikimedia Commons has media related to: speculums