1, how to check the gynecological examination?
Consultation room for gynecological examination: Compared with other departments, gynecology needs a long-term fixed private doctor. After all, such a personal matter, I don't want to tell strangers every time.
You need to know the doctor's situation before choosing a doctor. Some doctors are only good at a certain field, such as female menopause or uterine tumors. You can ask the doctor himself or the clinic. Only a few doctors like to brag. In the subsequent diagnosis and treatment, if the doctor thinks your question is too professional, she will also recommend other doctors to you.
The doctor will ask:
Most of the doctor's questions will revolve around your menstruation and pregnancy. You must know the time of menarche, menstrual cycle, last menstruation and menstrual flow. Sometimes during the examination, the doctor will ask some irrelevant questions. She probably thinks you're too nervous. I hope you care about something else and learn about your medical history for your reference.
Women who really cherish themselves have a body diary. Including body temperature records, menstrual conditions, sexual life and contraception, and even emotional changes. In this way, you can know more about your body, and it is easy to find out when there are abnormalities.
Gynecological examination room
Examination room: after consultation, go to the examination bed behind the partition and take off your clothes for gynecological examination. At this time, don't be embarrassed if you have a feeling of urine. A full bladder will directly affect the examination. Lie on the examination table with your legs apart. If you feel nervous, don't forget to tell the doctor that besides taking a deep breath to adjust yourself, she will also help you divert your attention.
hole
Objective: To check whether the vulva skin is smooth, the color is normal, and whether there are ulcers, dermatitis, vegetation and hypopigmentation.
Normal vulva: pubic hair downward, triangular distribution, pigmentation of labia majora, reddish labia minora, clitoris 2.5cm long, and pale pink mucosa around urethral orifice.
After that, a deeper examination is needed, and a speculum is needed, which is usually disposable or sealed after disinfection. The doctor will warm it in hot water, then apply vaseline, and then put the closed duckbill into the female private parts, so that the examination is more tolerable. When the duckbill is opened, the inner wall of the female private parts that are usually stuck together is opened, and the doctor can clearly see the female private parts and cervix.
Female private parts
Objective: To check whether the mucosal surface of female private parts is smooth, whether the texture is normal, whether there is bleeding point, and whether the characteristics and smell of female private parts secretion are normal.
Normal female private parts: the mucosa of female private parts is pale pink with wrinkles, without ulcers, vegetation, cysts and congenital malformations. The secretion is egg white or white paste, without fishy smell, and the amount is small, but it increases during ovulation and pregnancy. If you want to check leucorrhea, the doctor will take the specimen at this time.
neck
Objective: To observe whether there are tumors, ulcers, erosions and polyps on the cervix, whether the size of the cervix is normal, whether the surface is smooth, whether the texture is excellent, and whether there is uterine prolapse.
Normal cervix: the periphery is raised and there is a hole in the middle. The parturient is round and I-shaped, tough, fleshy and smooth. If you want to do a smear examination of cervical cancer, the doctor will take samples at this time.
The doctor took out the speculum, put on a pair of thin rubber gloves, coated with vaseline, slowly put one or two fingers into the female private parts, and put the other hand on the lower abdomen to press down hard. This is an examination of the uterus and accessories. This will make you nervous again, even a little painful. No way, relax, stare at the ceiling and think about "Fei Xian". If you are fat, you should relax yourself more. Fingers will feel pain when touching the bottom of the uterus, but the time is not long, 1 minute or so.
Uterus and adnexa
Objective: To understand the position, activity and texture of uterine fundus. If the uterus is enlarged, hardened and the surface is not smooth, it is abnormal and needs further examination.
Normal uterus: inverted pear-shaped, 7 ~ 8 cm long, 4 ~ 5 cm wide and 2 ~ 3 cm thick, most of which are forward-bent, with medium hardness and good fluidity. Ovary and fallopian tube are collectively called "attachments", which can move and feel slight pain after touching. Normal fallopian tubes should not be touched.
Gynecological examination laboratory
Although some examinations are graded, this is only the examination result of this part of the tissue extracted at the moment, and the specific diagnosis needs the comprehensive judgment of doctors combined with other examinations. For example, when checking the cleanliness of women's private parts, the first degree is normal and the second degree is within the normal range, but the doctor will judge whether there is mild infection according to the specific situation during the inspection. It is recommended that women have a physical examination once a year for three years after sexual activity.
Routine examination of leucorrhea
Objective: Leucorrhea is a mixture of mucous membrane secretion, cervical canal secretion and endometrial gland secretion of female private parts, and its formation is related to the role of estrogen. Used to check whether there are trichomonas and candida in female private parts, and also used to determine the cleanliness of female private parts.
Operation: No special operation is required. Doctors only need to take a little secretion from women's private parts.
List of laboratories-including 5 items
The normal pH value is about 4.5. Women's private parts are weakly acidic, which is self-purification of women's private parts and can prevent the reproduction of pathogenic bacteria. If you have trichomonal or bacterial female genital inflammation, the pH value will increase, which can be greater than 5 ~ 6.
The cleanliness of female private parts is divided into four degrees, I ~ II is normal, and III ~ IV is abnormal leucorrhea, indicating that female private parts have inflammation.
After leucorrhea treatment of mold and trichomonas, whether trichomonas or mold exists can be found under the microscope. If there are trichomonads or molds, indicate them with "+". This symbol can only show that you have been infected with trichomonas or mold, but it can't show the severity of the infection.
Amine test for detecting bacterial female genital diseases. The diagnosis can be made if the amine test in leucorrhea is positive.
Method of clue cell examination for female bacterial vaginosis. Many bacteria condense around epithelial cells in women's private parts, making their edges blurred. This is a clue cell, which is the most sensitive and specific sign of bacterial female privates diseases.
Cervical anti-cancer smear
Objective: To observe the morphology of exfoliated cells and screen female private parts for cervical infection, cervical lesions and cervical cancer. At the same time, we can also know the estrogen level indirectly.
Operation: Doctors scrape cells and secretions from the junction of squamous epithelium and columnar epithelium of cervical cancer, and then evenly smear the removed secretions on glass slides, or store them in liquid specimen bottles and send them to the laboratory for cytological examination.
List of laboratories: Pap grading method and TBS grading Pap level 1: completely normal.
Pap Ⅱ: It is more common in postmenopausal women or women of childbearing age, accompanied by cervical inflammation, which means that individual nuclei have obvious heterogeneity, but do not support malignancy.
Papanicolaou Ⅲ: Suspected cancer, requiring further diagnosis immediately. There is about a 10% chance of developing cancer.
Pap grade ⅳ: severe suspected cancer, comprehensive examination.
Pap V: Cancer diagnosis.
Pap's five-level classification has many subjective factors, and there is no strict objective standard among all levels, so it is gradually being replaced by TBS classification. The latter is more accurate and sensitive, but it needs professional doctors to understand.
Human papillomavirus test
Objective: To detect human papillomavirus. It is usually performed at the same time as the anti-cancer smear examination.
Operation: Brush a sample on the cervix with an umbrella brush, and then separate the impurities in the collected sample with "cell preservation solution" to form a clear cell smear, so as to detect whether it is infected with human papillomavirus.
Laboratory test report
active
1. After being infected with human papillomavirus, 20 ~ 30% of patients can develop condyloma acuminatum, and can also cause cervical diseases, including cervicitis, cervical erosion and even cervical cancer. There are 70 ~ 80% people who do not have any sensory lesions, which is equivalent to hepatitis B virus carriers. Their own resistance is strong, and there is no virus to take advantage of, but they need to pay close attention.
2. HPV infection leads to cervical diseases, which need to be treated as soon as possible. After the cure, check it regularly to prevent the virus from lurking in the body.
Negative If you are over 30 years old, the test result is negative, and there is no lesion in the anti-cancer smear, then you don't need to do this test for the next 3 to 5 years.
Suspicious anomaly plus two tests
Endoscopy of female private parts
This test is usually performed when the results of Pap test are abnormal. It only takes a few minutes for a woman to have a private part examination, and it won't hurt. Use 10 ~ 40 times binocular magnifying glass to directly observe whether there are signs of cervical cancer. If suspicious areas are found, directly and accurately locate the next biopsy.
biopsy
Generally, specimens are obtained from the most abnormal parts for examination, including vulva, female private parts, cervix and endometrium, which are most commonly used for the diagnosis of endometrial cancer and cervical cancer. Whether anesthesia is needed depends on the examination site.
b ultrasonic room
B-ultrasound examination is painless and non-invasive, and it is the most relaxing examination. It is generally necessary to check under the condition of holding urine, and it is best to start drinking water after entering the hospital. If there are too many people, be sure to tell the doctor and try to check in advance.
Objective: To check whether there are uterine tumors, endometriosis, uterine malformations, ovarian tumors, pelvic inflammatory masses or abscesses.
Surgery1-Conventional ultrasound: This method is the most common. Put the B-ultrasound probe in the lower abdomen to observe the pelvic cavity, focusing on the uterus, appendages and pelvic cavity.
The doctor's advice:
1. From half an hour before the examination to 1 hour, you need to drink about 1000 ml of water to hold your urine to the maximum. Because only when the bladder is filled to a certain extent can the uterus be squeezed from the depths of the pelvic cavity to the lower abdomen, and the uterus and ovaries can be observed by B-ultrasound. So it is best to carry a water bottle with you and replenish it in time.
2. There will be a little swelling and pain after urinating.
Operation 2-Transvaginal ultrasound: add a probe to the ultrasound machine and attach a film. The doctor or patient will put the probe into the female private parts for examination, with emphasis on the cervix and endometrium.
The doctor's advice:
1. This method does not need to hold urine, and because it is close to uterus and ovary, the image is clear, the resolution is high, and the examination results are more accurate.
2. Women who are not suitable for bleeding in private parts, such as menstrual period, irregular bleeding in female private parts. It is also not suitable for people with infectious diseases, such as female genital inflammation and sexually transmitted diseases. Other patients with cervical, female private parts and vulvar diseases should also be carefully selected to prevent infection and bleeding.
2. Can a virgin have a gynecological examination?
Problem analysis: Virgins can have gynecological examination, such as female private parts secretion examination, or B-ultrasound examination, but they can't have finger diagnosis, and they can't enter the cervix or uterus through female private parts, because this examination is likely to lead to hymen rupture.
Opinions and suggestions: Most obstetricians and gynecologists are female doctors, which is also to protect women's privacy.