Gynecological examination that can be detected. Gynecological tests. Gynecological examination of women and girls is different

What does a gynecologist do

A gynecologist is a doctor who diagnoses, prevents and treats women's diseases. The very direction of gynecology is closely connected with obstetrics, which studies the phenomena that occur in the female body in connection with pregnancy, starting from conception and ending with the end of the postpartum period. Therefore, most doctors specialize in obstetrician-gynecology. Prices for a consultation with a gynecologist in Moscow differ depending on the level of the medical center and the nature of the examination.

Why you need a consultation with a gynecologist

A visit to the doctor, as well as other specialists, is necessary to maintain health, prevent various diseases, and select the optimal method of contraception. Until the age of 35, a gynecologist in Moscow should be contacted at least once a year. It is advisable to visit a specialist at the beginning of the cycle, after the end of menstruation. Usually they visit a doctor before planning and during pregnancy, as well as in the presence of various complaints:

• changed discharge from the genitals;
• pain in the lower abdomen;
• bleeding;
• menstrual irregularities.

How to prepare for your visit:

• Before visiting a doctor, you need to empty your intestines and bladder.
• Take a regular shower and put on clean underwear, douching or using additional antiseptics is not worth it. It is important for the doctor to "see" the natural microflora.
• For a day it is desirable to refrain from sexual intercourse.
• Take with you a calendar that marks the menstrual cycle.

What does it include

A gynecologist's consultation in Moscow includes a preliminary conversation, at which the menstrual cycle, sexual life characteristics, the presence of complaints or unpleasant symptoms are clarified. Then there is a gynecological examination, sometimes with the use of additional tools. The doctor takes a smear for microflora, as well as for cytology. Sometimes an additional colposcope device may be required, which visually inspects the cervix for possible pathologies. In some cases, the doctor prescribes additional examinations.
The price for a consultation with a gynecologist will include all the necessary studies. In some centers, you can take laboratory tests and conduct instrumental diagnostics immediately. But you may need to visit other medical clinics.

A woman's health is, above all, the health of her children and family. In order to always control the state of her health, a woman at any age needs to undergo a planned one. Preventive visits to the doctor are recommended once a year. If a woman has previously had problems associated with the gynecological area, a visit to the gynecologist every 3-6 months is indicated.

Standard examination by a gynecologist

Don't skip your scheduled checkup! In the absence of complaints, the gynecologist usually prescribes a standard set of procedures and tests to the patient. Research methods include:

1) Bacterioscopy (general urogenital smear) is taken from the urethra, cervix and vagina with a special disposable spatula. This analysis shows the composition of the microflora, the presence of infections and inflammatory processes in the female genital organs.

2) Pap test (smear for cytology) is taken with a disposable small brush outside and inside the surface of the cervix. The cells themselves are examined directly in order to find among them atypical cells that can cause precancerous and cancerous diseases.

3) For the same purpose, colcoscopy is performed - a visual examination of the epithelium of the cervix from the side of the vagina. This study is carried out using a special device - a colposcope. The procedure is painless and lasts only 10-15 minutes.

4) Bimanual examination is a traditional type of diagnostics, which is included in the planned examination by a gynecologist. The method consists in inserting the second and third fingers into the woman's vagina in order to palpate the internal organs. A bimanual examination allows you to determine the general condition of the organs, identify inflammatory processes, the onset of pregnancy, diagnose uterine fibroids (benign tumors), adhesions, cysts, endometriosis (growth of uterine wall tissues) and a number of other diseases.

Complete gynecological examination

If during the initial examination, violations of the internal organs, a deviation from the norm in smears and cultures, or the patient has specific complaints, the doctor prescribes a complete gynecological examination, according to the nature of the problem.

Ultrasound (ultrasound) is one of the most accurate diagnostic methods. In gynecology, three main types of ultrasound are used:

- transabdominal (traditional) ultrasound examination is carried out along the anterior abdominal wall and carries some inconvenience: for better visualization of the pelvic organs, it is necessary to conduct an examination with a full bladder;

- transvaginal ultrasound is performed by introducing a special sensor directly into the patient's vagina, which allows for a more accurate diagnosis of the pelvic organs;

- Ultrasound of the ovaries is performed both with an abdominal and transvaginal sensor and allows you to fix the size, position of the ovaries relative to the uterus, existing changes and the presence of formations.

Also complete gynecological examination often includes an examination of the condition of the patient's mammary glands. The initial examination consists in palpation of the chest to detect seals, sore spots, swelling. These deviations may indicate the presence of neoplasms that occurred due to hormonal disruptions. If seals are found, the gynecologist prescribes an ultrasound of the mammary glands to the patient and a subsequent visit to the mammologist.

In the case of the presence of neoplasms in the cervix or the detection of atypical cells after a Pap test, the doctor may prescribe a biopsy - taking a small piece of tissue for detailed analysis. As a rule, anesthesia is not required during the analysis, since there are no pain receptors on the cervix.

A biopsy will determine the nature of the cells and make an accurate diagnosis. Only when all analyzes have been carried out, all risks and options have been taken into account, confirmed or refuted, can we assume that the full gynecological examination passed.

Do not forget that the best protection against any disease is a careful attitude to your health, maintaining a proper lifestyle, as well as observing elementary norms and rules of personal hygiene.

During a gynecological examination, the doctor assesses the condition of the organs of the reproductive system. A woman can undergo this procedure as part of a regular medical commission or on the recommendation of her doctor if she has specific symptoms, such as unusual vaginal discharge or pelvic pain.

A gynecological examination usually lasts only a few minutes. The gynecologist checks the vulva (external genitalia), vagina, cervix, ovaries, uterus, rectum, and pelvis for any abnormalities.

During the procedure, the doctor may also perform, that is, take a sample of cervical cells to check for cancerous or precancerous changes.

The content of the article:

Why is it necessary to undergo a gynecological examination?

A gynecological examination can be carried out as part of a regular medical commission or as a diagnostic measure if there are relevant symptoms.

A woman may need a gynecological examination in the following cases.

To assess your gynecological health. A gynecological exam is often part of the standard procedure to check for potential signs of ovarian cysts, uterine fibroids, early stages of cancer, and sexually transmitted infections. In addition, a gynecological examination is always performed during a woman's pregnancy.

When diagnosing medical conditions. A doctor may suggest that a woman undergo the procedure if she experiences gynecological symptoms such as pelvic pain, unusual vaginal discharge, changes in skin texture, vaginal bleeding, or urinary problems. A gynecological examination helps the doctor determine the cause of these symptoms. The doctor may offer the woman additional diagnostic procedures or immediately prescribe a course of treatment.

What diseases can be detected during a gynecological examination?

A gynecological examination can be used to evaluate and diagnose a number of body conditions.

A sample list of such conditions includes:

• sexually transmitted infections such as gonorrhea, syphilis, trichomoniasis, human papillomavirus and chlamydia;
• bacterial vaginitis;
• urinary tract infections;
• abnormal uterine bleeding;
• fibroids;
• ovarian cysts;
• infertility;
• polycystic ovary syndrome (PCOS);
• rectal bleeding;
• tumors on the genitals;
• genital warts;
• pregnancy;
• ectopic pregnancy.

How should I prepare for a gynecological examination?

A woman does not have to do anything special to prepare for a gynecological examination. For her own comfort, she can schedule an appointment for a day when she doesn't have one. In addition, a woman will feel more confident if she empties her bladder before starting the procedure.

If a woman has questions about the procedure or its results, she can write them down on a piece of paper, and then take it with her to an appointment with the doctor.

• sex;
• douching;
• use of tampons;
• use of contraceptive foams, creams and jellies;
• use of medical creams for the vagina.

What should you expect from a gynecological examination?

The woman lies on her back and places her feet either on the edge of the table or on special supports.

The doctor usually conducts a gynecological examination in his office within a few minutes. The woman may be asked to change her clothes. In addition, the confidentiality of the procedure can be ensured by a special shield that is placed above the waist. Before conducting a gynecological examination, the doctor can listen to how the body and lungs of the patient work. Sometimes doctors also perform a check on the abdomen, back, and chest.

What happens during a gynecological examination?

The woman lies on the table in such a way that her back remains pressed against the table, and her legs are either at the corners of the table, or rest on special stands. Then the doctor will ask the patient to move the body towards the end of the table and allow the knees to drop, exposing the genitals.

Speculum is an instrument shaped like a duck's beak. Some women complain of discomfort when it is inserted into the vagina

The following procedures are usually performed during a gynecological examination.

• External visual inspection. First, the doctor will look at the woman's vulva, checking it for irritation, redness, excessive sensitivity, ulcers, swelling, or other abnormalities.
• Internal visual inspection. The doctor will then apply a speculum, a plastic or metal instrument that resembles a duck's beak. With this device, he will take the walls of the vagina apart to see the vagina and cervix. Before insertion into the body, the doctor may slightly warm the speculum to make the procedure more comfortable for the woman. The introduction and removal of the speculum in some women causes a feeling of discomfort. In order to minimize it as much as possible, a woman should try to relax. However, if pain occurs during the insertion of the instrument, the patient should immediately tell the doctor about it.
• Papanicolaou test. If the gynecological exam includes a Papanicolaou test (Pap test or Pap smear), then before removing the speculum, the doctor will insert a small stick into the vagina to collect a sample of cells from the cervix to further study them for cancer or precancerous changes.
• Physical examination (palpation). Since the pelvic organs, including the uterus and ovaries, cannot be seen from the outside of the body, the doctor needs to feel or feel the abdomen and pelvis to check them. To do this, he inserts two lubricated and gloved fingers of one hand into the vagina, and with the other hand gently presses on the organs from the outside of the lower abdomen. As part of this procedure, the doctor will check the size and shape of the uterus and ovaries, noting any painful areas and unusual growths. After examining the vagina, the doctor will insert one lubricated and gloved finger into the rectum and check it for tenderness, masses, and other abnormalities.

A good gynecologist tells the patient what he (or she) is going to do at each step of the gynecological examination, so women usually do not encounter surprises during the examination. If the doctor is silent or laconic, the woman herself can ask him to provide detailed information.

What happens after a gynecological examination?

When the gynecological examination is completed, the woman will be able to dress. The doctor will then discuss the test results with her.

Gynecological examination results

If during the gynecological examination, the doctor reveals something unusual, he will immediately tell the woman about it. It may take a few days for your Pap smear results to come back. The doctor will discuss the next steps with the woman, suggest the necessary diagnostic methods and recommend treatment, if any.

A gynecological exam is an excellent opportunity to tell your doctor about sexual or reproductive problems. If a woman has questions about this, you can ask the doctor during the visit.

Modern methods of objective examination of gynecological patients include,

Examination methods in gynecology

Modern methods of objective examination of gynecological patients include, along with traditional ones, a number of new methods that allow you to have the most complete picture of the nature of the disease, the phase and degree of the pathological process.

Examination of the patient begins with a survey, then they proceed to her examination, after which they draw up a plan for the laboratory examination of the patient. After that, according to indications, instrumental methods of examination and special diagnostic techniques can be applied. Despite the fact that the schemes for examining gynecological patients are well known and described in textbooks and manuals, it makes sense to once again give an approximate plan and procedure for examining a patient so as not to miss any significant point that is crucial in diagnosis.

The most complete and comprehensive examination can only be carried out by professionals. If you need one of the procedures described below - do not hesitate to visit the doctors of the medical center Your Clinic and get a 10% discount!

Anamnesis

When taking an anamnesis, the age of the patient is of great importance. For example, at the age of pre- and postmenopause, as well as in young girls who do not live sexually, diseases associated with pregnancy can be immediately excluded. In addition to the main complaint, there are accompanying ones, which the woman reports after additional, leading questions. Important information can be obtained by finding out the lifestyle, diet, bad habits. When collecting an anamnesis, it is necessary to be interested in the nature of work, living conditions.

Taking into account the hereditary conditionality of many diseases, one should obtain information about mental illness, endocrine disorders (diabetes, hyper- or hypothyroidism, etc.), the presence of tumors (myoma, cancer, etc.), pathology of the cardiovascular system in relatives of the first and second generations. In addition to the usual questions regarding family history, in women with menstrual irregularities, infertility, excessive hairiness, it is necessary to find out if the next of kin has obesity, hirsutism, and whether there have been cases of miscarriage.

Information about past somatic diseases, their course, and surgical interventions is important for clarifying the nature of gynecological diseases. Particular attention is paid to infectious diseases.

For the recognition of gynecological diseases, data on menstrual, reproductive, secretory and sexual functions are of paramount importance.

Disorders of menstruation occur most often in violation of the functions of the nerve centers that regulate the activity of the endocrine glands. The functional instability of this system can be congenital or acquired as a result of damaging factors (diseases, stressful situations, malnutrition, etc.) in childhood and during puberty.

It is necessary to find out how many pregnancies the patient had, how they proceeded and how they ended. Gynecological diseases can be both the cause of reproductive dysfunction (infertility, spontaneous abortions, anomalies of birth forces, etc.), and their consequence (inflammation, neuroendocrine disorders, consequences of obstetric injuries). For the recognition of gynecological pathology, information about postpartum (post-abortion) diseases of infectious etiology is of great importance.

Pathological secretion (leucorrhea) can be a manifestation of the disease of different parts of the genital organs. There are tubal leucorrhea (emptying hydrosalpinx), uterine leucorrhea (endometritis, polyps), cervical leucorrhea (endocervicitis, polyps, erosion).

The most common are vaginal leucorrhoea. Normally, the processes of formation and resorption of the vaginal contents are completely balanced, and the symptom of the appearance of leucorrhoea, as a rule, indicates an inflammatory process.

Data on sexual function deserve attention because its disorders are observed in a number of gynecological diseases. It is known that sexual feeling and sexual desire characterize the maturity of a woman's sexual function. The absence of these indicators is observed in gonadal dysgenesis and other endocrine disorders, as well as a number of gynecological diseases.

After a correctly collected anamnesis, a diagnosis can be made in 50-60% of patients and determine the direction of further examination (the choice of diagnostic methods and the sequence of their application).

General condition assessment

Assessment of the general condition begins with an external examination. Pay attention to the height and weight of the body, physique, the development of adipose tissue, especially its distribution. Particular attention is paid to the condition of the skin. It is necessary to pay attention to the color of the skin, the nature of hair growth, acne, increased porosity, etc.

It is necessary to examine the area of ​​lymph nodes accessible for palpation. Blood pressure, pulse rate, auscultation of the lungs, percussion and palpation of the abdomen are measured. The mammary glands are carefully examined, a visual examination is performed in a standing position, then in the supine position, successive palpation of the armpits, external and internal quadrants of the gland is performed.

Gynecological examination

Gynecological examination involves a whole range of methods to study the state of the female reproductive system. Research methods can be divided into basic, used to examine all patients without fail, and additional, which are used according to indications, depending on the alleged diagnosis. This study is carried out on a gynecological chair after emptying the bladder and, preferably, after defecation. The study is carried out in sterile gloves.

Examination of the external genitalia.

Pay attention to the nature and degree of hair growth, the development of small and large labia, the gaping of the genital gap. On examination, the presence of inflammatory pathological processes, ulcers, tumors, varicose veins, discharge from the vagina or rectum is noted. The woman is offered to push, while determining whether there is a prolapse or prolapse of the walls of the vagina and uterus.

Inspection with a mirrorcal.

The study is carried out before the vaginal bimanual (two-handed) study, since the latter can change the picture of the pathological process. Folding or spoon-shaped mirrors are used. The folding mirror is carefully inserted in a closed state for the entire length of the vagina, having previously parted the labia minora with the left hand. If a spoon-shaped mirror is used, then an elevator is additionally introduced to lift the anterior wall of the vagina. Having exposed the cervix, they examine it, noting the color of the mucosa, the nature of the secret, the shape of the cervix, the presence of ulcers, scars, polyps, tumors, fistulas, etc. After a visual examination, swabs are taken for bacterioscopic and cytological examination.

Vaginal (bimanual) examination.

Conducting this study provides valuable data on the state of the internal genital organs. It should be carried out in compliance with all the requirements of asepsis and antisepsis. During the study, the fingers of the right hand should be in the vagina, and the left hand is located on the anterior abdominal wall, palm down. Consistently produce palpation of the uterus, while determining its position, displacement along the horizontal and vertical axes, consistency and size. Then the uterine appendages are palpated, for which the fingers of the right hand located in the vagina are moved to the left and then to the right fornix, and the outer hand to the corresponding inguinal-iliac region. The uterus on palpation has a pear-shaped shape, a smooth surface, is easily displaced in all directions, and is painless on palpation. Normally, the tubes and ovaries are not detected; when determining formations in this area, it is necessary to identify them as inflammatory, tumor-like, which often requires additional or special research methods.

The data of the vaginal examination allow diagnosing the presence of tumors of the uterus, formations of the fallopian tubes and tumors of the ovaries. We must not forget that for the correct diagnosis, it is important not so much the presence of individual symptoms as their detection in combination with other signs of the disease.

After questioning, examination and two-handed gynecological examination, a preliminary diagnosis is established. This allows you to draw up a plan for further in-depth examination using laboratory diagnostics, instrumental methods of examination and various diagnostic techniques. The provisional diagnosis gives the right, along with ongoing examination, to start drug treatment, depending on the nosological form of the gynecological disease.

bacterioscopic examination.

It is used to diagnose inflammatory diseases, and its results allow you to establish the type of pathogen. Bacterioscopy makes it possible to determine the degree of purity of the vagina, which is necessary before any diagnostic manipulations and gynecological operations. Material for bacterioscopic examination is taken with a Volkmann spoon from the urethra, cervical canal, posterior vaginal fornix. Before the study, it is impossible to treat the walls of the vagina with disinfectants, douche or inject drugs. It is better to take a smear before urinating. A swab is taken from the urethra with a Volkmann spoon with a narrow end or a grooved probe after preliminary massage of the urethra from back to front, pressing the urethra against the womb until a drop of discharge is obtained, which is applied to a glass slide with a thin layer marking. A smear from the cervical canal is taken after the cervix is ​​exposed in the mirrors with a Volkmann spoon with a wide end or a probe. Each smear is taken with a separate instrument, applying a thin layer on two glass slides. In accordance with the nature of the smear, there are four degrees of purity of the vaginal contents:

Idegree of purity. In the smear, single leukocytes (no more than 5 per field of view), vaginal bacilli (Dederlein sticks) and squamous epithelium are determined. The reaction is acidic.

II degree of purity. In the smear, leukocytes are determined (no more than 10-15 in the field of view), along with Dederlein sticks, single cocci and epithelial cells are determined. The reaction is acidic.

III degree of purity. There are 30-40 leukocytes in a smear, vaginal bacilli are not detected, various cocci predominate. The reaction is weakly alkaline.

IV degree of purity. There are no vaginal bacilli, there are many pathogenic microbes up to specific ones - gonococci, Trichomonas, etc. The reaction is alkaline.

I-II degrees of purity are considered the norm. All types of surgical and instrumental interventions in gynecology should be carried out in the presence of such smears. III and IV degree of purity accompany the pathological process and require treatment.

Cytological study.

Produced for the early detection of cancer. Smears are taken from the surface of the cervix or from the cervical canal. Cytological examination is also subjected to material obtained by puncture from volumetric formations, or aspirate from the uterine cavity. The material is applied to a glass slide and dried in air. A mass cytological examination, carried out during preventive examinations, makes it possible to identify a contingent of women (who have atypical cells) who need a more detailed examination to exclude or confirm cancer of the female genital organs.

Colposcopy.

The first endoscopic method that has found wide application in gynecological practice. The diagnostic value of the method is very high. This method provides an opportunity to examine the vulva, the walls of the vagina and the vaginal part of the cervix using a colposcope, which gives an increase in the object in question by 30-50 times. allows you to identify early forms of precancerous conditions, choose a site for a biopsy, and also control healing during treatment.

• Simple colposcopy. It makes it possible to determine the shape, size of the cervix, external os, color, relief of the mucosa, the border of the squamous epithelium covering the cervix and the condition of the cylindrical epithelium.
• Extended colposcopy. It differs from simple colposcopy in that before examination, the cervix is ​​treated with a 3% solution of acetic acid, which causes short-term swelling of the epithelium, a decrease in blood supply. The action lasts 4 minutes. After studying the obtained colposcopic picture, a Schiller test is performed - lubricating the neck with a cotton swab with 3% Lugol's solution. The iodine contained in the solution stains glycogen in healthy epithelial cells in a dark brown color. Pathologically altered cells in various dysplasias of the cervical epithelium are poor in glycogen and do not stain with iodine solution. Thus, zones of pathologically altered epithelium are identified and areas for cervical biopsy are indicated.

Probing of the uterus.

The method is used for diagnostic purposes to determine the patency of the cervical canal, the length of the uterine cavity, its direction, the shape of the uterine cavity, the presence and location of submucosal tumors of the uterus, the bicornuate uterus or the presence of a septum in its cavity.

Curettage of the uterine cavity.

Produced for diagnostic purposes to determine the cause of uterine bleeding, if malignant tumors of the uterus are suspected, as well as for the collection of histological material from the uterus according to indications.

Biopsy of the cervix.

It is a diagnostic method that allows timely diagnosis if there is a suspicion of a tumor process of the cervix.

Puncture through the posterior fornix of the vagina.

This is a widely used and effective research method, with the help of which it is possible to confirm the presence of intra-abdominal bleeding with a high degree of certainty, as well as to analyze the discharge obtained by puncture.

Ultrasound examination (ultrasound).

Ultrasound is a non-invasive research method and can be performed in almost any patient, regardless of her condition. The safety of the method has made it one of the main ones in monitoring the condition of the fetus. In gynecological practice, it is used to diagnose diseases and tumors of the uterus, appendages, to detect abnormalities in the development of internal genital organs. With the help of ultrasound, it is possible to control the growth of the follicle, diagnose ovulation, register the thickness of the endometrium, identify its hyperplasia and polyps. The diagnostic capabilities of ultrasound have been significantly expanded after the introduction of vaginal sensors, which improves the diagnosis of retrocervical endometriosis, adenomyosis, inflammatory formations in the uterine appendages and various forms of the tumor process.

Hysteroscopy (HS).

The main advantage of the method is the ability to detect intrauterine pathology using the optical system of the hysteroscope. Apply gas and liquid hysteroscopy. With gas HS, the uterine cavity is examined in a gaseous environment (carbon dioxide). The most commonly used liquid GS using various solutions, most often isotonic sodium chloride solution. The great advantage of this method is the ability to perform not only an examination of the uterine cavity, but also surgical manipulations with subsequent control (diagnostic curettage, polypectomy, "unscrewing" the myomatous node, separation of synechia, etc.). Expansion of the cervical canal up to № 8-9 Hegar dilators guarantees free outflow of the washing fluid and prevents endometrial pieces from entering the abdominal cavity. Indications for hysteroscopy:

• uterine bleeding in women of any age of a cyclic and acyclic nature;
• control over the therapy of hyperplastic conditions;
• suspicion of intrauterine synechia;
• suspicion of a malformation of the endometrium;
• multiple endometrial polyps, etc.

Hysterosalpingography (HSG).

HSG has long been used in gynecology to establish the patency of the fallopian tubes, to detect anatomical changes in the uterine cavity, and adhesions in the pelvic cavity. HSG is carried out in an X-ray operating room. The study is performed with water, contrast preparations (verografin - 76%, urographin - 76%, urotrast - 76%). The solution is introduced into the uterine cavity under aseptic conditions using a special conductor with a tip, after which an X-ray image is taken.

Laparoscopy.

A technique that allows you to examine the organs of the small pelvis and abdominal cavity against the background of pneumoperitoneum. The optics of the laparoscope is introduced into the abdominal cavity through a small incision, which makes it possible to directly examine the pelvic organs or, by connecting a video camera, transmit the image to the monitor. It is difficult to overestimate the diagnostic possibilities that practical gynecology has received with the introduction of laparoscopy into everyday practice. The widespread introduction of operative laparoscopy has truly revolutionized gynecology, significantly expanding the possibilities of providing highly qualified care to all groups of gynecological patients. Thanks to laparoscopy, for the first time, small forms of external endometriosis were identified, and it became possible to find out the causes of chronic pelvic pain. Using this technique, it is possible to differentiate inflammatory processes in the appendages, appendix, in a matter of minutes to diagnose an ectopic pregnancy, etc. The method is indispensable in the diagnosis and treatment of various forms of infertility, ovarian tumors, malformations of the internal genital organs, etc.

Computed tomography (CT).

The essence of the method is as follows. A thin beam of X-ray radiation falls on the investigated area of ​​the body from different directions, and the emitter moves around the object under study. When passing through tissues of different density, the intensity of the beam is weakened, which is recorded by highly sensitive detectors in each direction. The information obtained in this way is entered into the computer, which makes it possible to determine the value of local absorption at each point of the layer under study. Since different human organs and tissues have different values ​​of the absorption coefficient, the ratio of these coefficients for normal and pathological tissues can be used to judge the presence of a pathological process. With the help of CT, it is possible to obtain longitudinal images of the area under study, reconstruct sections and, as a result, obtain a section in the sagittal, frontal, or any given plane, which gives a complete picture of the organ under study and the nature of the pathological process.

Magnetic resonance imaging (MRI).

The method is based on the phenomenon of magnetic resonance, which occurs when exposed to constant magnetic fields and electromagnetic pulses of the radio frequency range. To obtain an image in MRI, the effect of absorption of electromagnetic field energy by hydrogen atoms of a human body placed in a strong magnetic field is used. Next, the received signals are processed, which makes it possible to obtain an image of the object under study in different planes.

The method is harmless, since magnetic resonance signals do not damage cellular structures and do not stimulate pathological processes at the molecular level.

You need to contact the gynecologist:

• for regular preventive examinations once or twice a year to detect and prevent possible diseases;
• with violations of menstruation;
• with vaginal bleeding, as well as unusual discharge;
• with the appearance of pain in the lower abdomen;
• with the appearance of burning, itching in the genitals;
• when planning a pregnancy.

At the beginning of the examination, the doctor determines the features of the patient's figure, the amount of hair on the body, which can tell about the hormonal status of the body or its violation. By asking general questions about working conditions, sexual relations, partner, experience and the nature of menstruation, the doctor chooses diagnostic methods. That is why it is important to clearly state the purpose of the visit - routine check-ups, postnatal visits, tests for infections, etc.

Gynecological studies

The following procedures can be carried out in the gynecological office:

• Manual research. The position, condition of the uterus, fallopian tubes, ovaries is determined. Thus, uterine fibroids, inflammation of the appendages, ovarian cysts, normal or ectopic pregnancy are diagnosed. For a more detailed analysis of the pelvic organs, ultrasound may be performed.
• Looking in mirrors. The doctor using a special mirror examines the walls of the vagina, the cervix.
• Swab sampling for flora. With a special swab, the doctor takes the discharge of the mucous membrane of the cervical canal, vagina, urethra and applies it to the glass. In the laboratory, it is possible to detect an inflammatory process under a microscope (by the number of leukocytes), bacterial and fungal infections.
• Sampling of material for the diagnosis of infections. With the help of a mini-brush, on the bristles of which there are epithelial cells with bacteria living in them, material is taken from the cervical canal. For the diagnosis of herpes, chlamydia, mycoplasmosis, ureaplasmosis, papillomatosis, the polymerase chain reaction (PCR) method is used. PCR analysis is carried out in specialized diagnostic centers where the collected material is delivered.
• Colposcopy. Examination of the cervix with a colposcope with magnification allows you to detect erosion, leukoplakia, papillomatosis, and tumor changes. If necessary, they take a biopsy (a small piece of tissue) or a scraping of cells from the wall of the cervix and send it for a histological examination, which gives accurate information about the state of the cells in the “problem” place.
• ultrasound . An important diagnostic procedure that helps to collect data on the condition of the uterine mucosa, the size and location of organs, clarify or refute the initial diagnosis made manually. An external (transabdominal) ultrasound is performed through the abdomen (anterior abdominal wall with a filled bladder. In an internal (transvaginal) examination, when the device's sensor in a disposable condom is inserted into the vagina, adhesive processes can be detected, the condition and size of the ovaries, the amount of endometrium lining the uterus is determined , maturation and passage of the egg.This study is contraindicated in late pregnancy, as it can provoke a miscarriage.

Also, a gynecologist can additionally prescribe the following procedures.

• ELISA blood test- determines the level of antibodies to a specific infection and allows you to accurately determine in what form - acute or chronic - the disease proceeds;
• Culture/antibiotic susceptibility prescribed for frequently recurring infections. Material from the vagina or cervical canal is placed in a nutrient medium, bacteria are grown on it. According to the study of the "harvest", the most effective antibacterial drugs are selected.
• Blood test for hormones. The cyclicity of monthly changes in a woman's body is due to fluctuations in the level of hormones in the blood, which depends on the menstrual cycle. Analyzes are taken on certain days cycles. If the results reveal hormonal disorders, then additional studies are carried out - computed tomography, x-ray of the skull to collect data on the state of the pituitary gland, which regulates the production of hormones that control the reproductive system.
• Medical genetic studies are recommended for those women who are planning a pregnancy or have suffered miscarriages, non-developing pregnancies, the birth of children with abnormalities.

When diagnosing serious diseases of the female genital area, instrumental studies and mini-surgical interventions can be prescribed:

• The study of the patency of the fallopian tubes - in the diagnosis of infertility. The method of kymographic pertubation involves the introduction of air or gas into the uterus, tubes and abdominal cavity, after which contractions of the fallopian tubes are graphically recorded.
• Hysterosalpingography - a special substance is let into the uterine cavity, after which an x-ray is taken.
• Hysteroscopy . The endoscope is passed into the uterus through the cervix to detect intrauterine pathologies. A biopsy is taken from the suspicious area.
• Laparoscopy . An endoscope is inserted into the abdominal cavity through a small incision in the abdominal wall. It is carried out with the diagnosis of infertility, ectopic pregnancy, endometriosis.

Not a single analysis shows a complete picture of the state of health or pathology of a woman, and therefore more often the gynecologist prescribes several tests at the same time. The information obtained with their help, of course, helps to make a more accurate diagnosis.

Breast examination

The primary examination of the breast is also within the competence of a gynecologist - whether it is monotonous in composition, whether there are seals, tumors, secretions. For a more detailed study, the gynecologist will refer the patient to an ultrasound of the mammary gland, to a mammologist.

About choosing a clinic and a doctor

A good doctor can make the most unpleasant procedure for the patient as easy as possible by talking and explaining the need for his actions. He takes into account the emotional state of the woman, never says that she invented the symptoms. A female doctor knows from her own experience what childbirth, menstruation, infections, gynecological examinations and mammograms are - something that cannot be subtracted from books. Maximum comfort - a chair covered with material, comfortable lighting, cloth, not paper napkins - are provided in private clinics. There are practically no queues and tedious waiting.