Use of vaginal speculums in lower rectal and anal conditions

Abstract

Background: Ano-rectal conditions are one of the common diseases attended by General practitioners and Surgeons at the outpatient clinics and in-patients. Visual inspection of the anal canal and rectum using different instruments such as anoscope and sigmoidoscope which require light sources is essential to assess the site, the extent of the lesion as well as to take biopsy or provide surgical treatment to small or minor lesions. This paper describes our experience with use of common vaginal vaginal speculums (Graves and Sim’s speculum) as an alternative to anoscopes (which require light sources and are unavailable in other centers).
Methods: Adult patients with different anal complaints were seen, investigated and treated by the authors using Graves, Pederson and or Sims vaginal speculum in two hospitals- Muhimbili national and Tumaini hospitals in Dar-es-Salaam July 2003 and December 2004.
Results: A total of 27 adult consecutive patients with different types of anal and lower rectal conditions were managed using the vaginal speculums between. The age range of the patients was between 10 – ≥ 51years. There were 19 males and 8 females. Most of them (70.3%) had fissure and fistula- in – anal and haemorrhoids. The instruments provided excellent results both in the diagnosis and treatment of such conditions.
Conclusion: These speculums can be used as alternatives in places where the recommended instruments are not available.