The general process of gynecological examination

Many female friends are not so clear about the process of gynecological examination. In fact, gynecological examination includes a lot of examination items. If you want to confirm what kind of gynecological disease you have, you must complete a comprehensive gynecological examination to make an accurate judgment. Generally speaking, you must first take a systemic examination, such as blood, blood pressure, breathing and other items. These examinations are considered to be relatively routine.

1. Full body examination

This includes measuring body temperature, pulse, respiration, blood pressure, and, if necessary, height and weight. Other examinations are the same as other internal medicine examinations.

2. Abdominal examination

It is an important part and should be systematically performed including inspection, palpation, percussion and auscultation before pelvic examination. Observe the shape of the abdomen to see if there is a dragon or frog belly, and whether there are scars or varicose veins on the abdominal wall. The outpatient department checks the softness and tension of the abdominal wall, whether there is tenderness, rebound pain or muscle tension, and whether a mass can be palpated. Palpate the liver, spleen, kidneys, etc. to see if they are enlarged or tender. During percussion, pay attention to the presence of shifting dullness.

3. Pelvic examination

(1) Vulvar examination: Observe the development of the vulva and the amount and distribution of pubic hair. In a normal vulva, the pubic hair is distributed in a triangular shape with the tips pointing downward. There are no ulcers, dermatitis, growths or hypopigmentation in the perineum. The mucosa around the urethral opening is light pink and free of growths. Married women have old cracks in their hymen, and pregnant women have old cracks in their hymen and perineum, or there may be incision scars in the perineum. If necessary, the doctor will ask the patient to hold his breath and look for bulging of the anterior and posterior vaginal walls, uterine prolapse, or urinary incontinence. Any abnormalities will be recorded in detail.

(2) Vaginal examination using a speculum: Be gentle and try to avoid bleeding caused by friction. The normal vaginal wall mucosa is light pink in color, with wrinkles, and is free of ulcers, growths, cysts, vaginal septum, double vagina, and other congenital malformations. Normal vaginal discharge is egg white-like or white paste, has no fishy smell, and is in small amounts, but increases during ovulation and pregnancy.

(3) If there are any abnormalities, the patient may experience local itching, burning sensation, etc. If there is abnormal leucorrhea, the secretions can be removed at this time for smear testing for Trichomonas, Candida, Gonorrhea and clue cells, and bacterial culture can be performed if necessary. Leucorrhea is a mixture of vaginal mucosal exudates, cervical and endometrial gland secretions, and its formation is related to the action of estrogen.

In general, the cleanliness of leucorrhea can be divided into 4 levels:

Grade I: A large number of vaginal epithelial cells and vaginal bacilli are seen under the microscope.

Grade II: Vaginal epithelial cells, a small amount of white blood cells, some vaginal bacilli, and a small amount of miscellaneous bacteria or pus cells are seen under the microscope.

Grade III: A small amount of vaginal bacilli, a large number of pus cells and miscellaneous bacteria are seen under the microscope.

Grade IV: No vaginal bacilli are seen under the microscope, and except for a small amount of epithelial cells, there are mainly pus cells and miscellaneous bacteria.

Note: Grades Ⅰ to Ⅱ are normal, and grades Ⅲ to Ⅳ are abnormal leucorrhea, indicating vaginal inflammation.