MedFet | Jill's Rectal Examination

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Jill's Rectal Examination

After a careful gynecological and urological work up on Jill (which I noted that she seemed to enjoy thoroughly), I informed her that I thought that it would be prudent to do a complete rectal examination, as well.

Although I could tell from the expression on her face that no coaxing or explanation would be necessary to obtain consent, I began to explain that the examination would be preceded by a large volume retention enema, administered with a nozzle that had an inflatable cuff on it's end to preclude accidental expulsion. I then proceeded to show Jill the nozzle and demonstrate how the cuff inflated to hold the nozzle in place. I told Jill that I would administer the enema slowly, while she lay on her left side with her right knee drawn up against her chest to expose her rectum for treatment and examination. The enema would consist of 2500cc of warm (slightly above body temperature) saline solution. I assured Jill that I would pause anytime she began to feel uncomfortable as the enema was administered.

I then went on to tell Jill that after the enema she would be placed in a nylon web sling, that passed over her shoulders to her ankles. As I showed her the sling, I explained that this sling would comfortably hold her her knees well back and apart without any straining on her part. I also explained that she would be on her back, knees flexed back almost against her chest and well apart. I continued to explain that, in that position, the sling would also help to immobilize her for the procedure to which she was about to submit.

Jill seemed interested to learn that the exam would start with a very deep and protracted Digital Rectal Examination (DRE) during which I would stimulate her "G" spot with my well lubricated and gloved index finger directly through the recto - vagina wall while using a small vibrator to gently stimulate her exposed clitoris. She seemed relieved when I assured her that, it was quite common for patients to become aroused by this procedure and, therefore, there was really no cause to be embarrassed by it.

I then showed Jill the Proctoscope, a stainless steel instrument about 6 inches long and about an inch in diameter. The instrument looked like a long tube with a pointed end and a pistol grip handle. I demonstrated how, once lubricated and fully inserted in her rectum, the bullet shaped tip could be withdrawn through the barrel of the instrument allowing the full length of her rectal lumen to be carefully examined as the instrument was slowly withdrawn from, moved about and maneuvered within her. I also showed her how, after this examination, a small vibrator would be inserted into the bore of the instrument to turn it into a long, vibrating, rectal stimulator. I explained that the pulsating instrument would be manipulated to stimulate her "G" spot, again while a another small vibrator was used on her clitoris.

I assured Jill that the insertion would be careful, slow and gentle and would, at worst, be only slightly uncomfortable, and even then only momentarily.

To illustrate the last procedure that I would be performing, I showed Jill the three billed Cook Rectal retractor which would be used to finish her rectal exam. I explained that the three bills would be lubricated and then gently inserted into her anus and very slowly separated to expand her anal sphincter to a diameter of perhaps two - three inches to allow me complete access to finish the survey of her lower rectal lumen and anal sphincter muscle. I did advise Jill that it would help if she could stay calm and relaxed, as I performed this portion of the examination. I offered to help her do so by gently massaging her clitoris while the exam was proceeding. She seemed to like this idea and accepted readily.

With that, as I pulled on a latex exam glove, I asked Jill to roll over onto her left side for me, pull her right knee up against her breast and take a deep breath. As she did so, I applied a glob of KY to the tip of my index finger and placed it at her sphincter and entered just an inch of so. I then asked her to exhale slowly for me and she did so, my finger began it's invasion of her rectum....

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