What does a gynecologist see when examining with a mirror? Gynecological examination: pros and cons

Examination with a gynecological speculum: types of mirrors, advantages and examination procedure

Even for adult women, examination by a gynecologist often causes fear. And to a greater extent, not because the doctor himself is so scary, but because he conducts an examination with a gynecological speculum. How is an examination performed with a gynecological speculum?

Examination by a gynecologist

Reasons for visiting a gynecologist and diagnosis of the disease

At a certain period of life, girls begin to visit a gynecologist. This often happens long before the first sexual intercourse. And all because elementary hypothermia can lead to unpleasant sensations in the abdominal area.

And in order to diagnose a particular disease, a gynecologist must conduct a full examination, which will include:

Examination of the external genitalia. To do this, the doctor simply approaches the woman, who has already positioned herself on the gynecological chair, and examines how well the external genitalia are developed and whether there are any signs of infection or damage. It is believed that this is the most harmless stage, since the doctor practically does not touch the woman
Examination with a gynecological speculum, during which the doctor examines the condition of the mucous membrane, but already inside. And although this process is unpleasant, it is very important
Palpation of the uterus. This must be done if the doctor suspects pregnancy, or the uterus does not match the size
Palpation of the appendages, during which the doctor examines the presence of cysts and growths that can cause pain, especially in young girls whose hormonal levels have not yet fully returned to normal
Taking tests. Usually, a microflora test is taken to determine the presence or absence of any infection or fungi

In fact, an examination by a gynecologist is not as scary as many people think. Yes, purely from an aesthetic point of view, it can cause a lot of inconvenience and tension, more morally. But it is necessary to undergo it, because women’s health is very important, especially her reproductive system, since the ability to give birth to a child depends on it.

Gynecological speculum

Varieties of gynecological speculum sizes

Due to the fact that the most, so to speak, scary moment during an examination by a gynecologist is manipulation of the mirror, it is necessary to dwell in more detail on the instrument itself.

So, today there are several types of mirrors, primarily differing from each other in size, since each woman has her own build. And all proportions must be strictly observed so as not to cause harm.

By size it is customary to distinguish:

Size XS. It is used in children and adolescents, since the organs are not fully formed, or rather, not formed, and their sizes are significantly smaller than those of an adult
Size S. This mirror has a diameter of 23mm. It is used mainly in girls who have not yet given birth.
Size M. This mirror has a diameter of 25 mm. It is mainly used in women who have already given birth and who are thin in build.
Size L. This mirror has a diameter of 30mm

Depending on the woman’s build, whether she has given birth or not, whether she is sexually active, etc., the choice of mirror will depend. Today, there are reusable and disposable gynecological speculums.

More information about gynecological examination can be found in the video.

Read: White mucus from the vagina: causes and symptoms, treatment methods

As for reusable mirrors, they are used in antenatal clinics and hospitals. They are made of metal and must be sterilized after each inspection. But since most women do not have much confidence in this process, they prefer to use disposable mirrors.

A disposable mirror can be purchased at any pharmacy kiosk, but the main thing is to indicate the size correctly.

The main advantages of such a mirror are that it cannot be used more than once, that is, accordingly, the risk of transmitting sexually transmitted infections is reduced, the shapes are more rounded, which makes the process itself much more pleasant.

Before purchasing a speculum from a pharmacy yourself, you should consult your doctor so that he can tell you exactly what size is needed.

What is a mirror for?

Many women wonder whether examination with a gynecological speculum is really necessary, and whether it can be avoided.

In fact, an examination is necessary, since during it the doctor can identify such abnormalities as:

Tears in the mucous membrane, which will cause not only discomfort, but will also cause infection, or rather will be a conductor for it further throughout the body
Swelling, which also causes discomfort. And if it is detected, it is necessary to establish the cause as soon as possible
Changes in the color of the mucous membrane, as well as its structure
The presence of scars that may appear after an illness or surgery

And that is not all. Examination with a mirror is necessary to examine a disease such as cervical erosion, which is very dangerous and is considered precancerous. Therefore, it is important not only to undergo such an examination, but also to pass all the relevant tests.

How is the inspection carried out?

Examination procedure by a gynecologist

Many women feel calmer when they find out how an examination is carried out using a gynecological speculum, in detail and with a list of points.

So, it consists of the following steps:

After examination of external organs. The doctor will carefully spread the labia and insert a speculum. And he will do it slowly. But there is a category of doctors who prefer to do it quickly, since such acceleration seems less painful to them
A woman must take off all her clothes to the waist, including underwear, and sit in a gynecological chair
You need to relax so that the discomfort is unnoticeable. If a woman is tense, then the muscles in the vagina are also tense, which makes examination difficult, and the girl will feel pain
Insertion of a mirror, during which the woman will feel pressure and may also develop pain, mostly due to anxiety
After introducing the speculum, the doctor will begin a full examination, during which he will review the main points
After the inspection is completed, the mirror will be removed, and also carefully, because these are the two most difficult moments

Doctors say that you should try to avoid any movements of your body during the examination, as this can lead to muscle tension, and therefore pain and a bad mood.

Preparation for inspection

And although many believe that there is no need to prepare in any way for this kind of examination, all doctors love cleanliness and order.

Therefore, if a woman is scheduled for an examination, she needs to prepare:

Try to avoid sexual intercourse for about a day or two before viewing
A few hours before the procedure you need to prepare, namely take a swim
Try not to go to the toilet several hours before the examination

The inspection isn't that scary. It's just that someone scares other women because of his pain. Examination with a gynecological speculum scares many people. And not only from the medical side, but also from the aesthetic side.

But if you prepare correctly and listen to the doctor, it will pass unnoticed.

If the woman has prepared correctly, and the doctor has completely carried out his actions as needed, then the result can be obtained in about 3 or 5 working days, but provided that the tests are taken at the clinic. If they are taken elsewhere, the result will be ready within a few hours.

Source: //DiagnozLab.com/analysis/infectious/urogenital/osmotr-ginekologicheskim-zerkalom.html

Examination of the cervix using mirrors: examination technique by a gynecologist during pregnancy

Gynecological examination includes laboratory and instrumental diagnostic methods. During the examination, the gynecologist pays the greatest attention to the condition of the cervix, assessing its appearance and size. An obligatory stage of diagnosis is examination of the cervix in the speculum and bimanual examination.

Why should women undergo gynecological examinations 1-2 times a year, and what diseases can early diagnosis prevent? How is the examination carried out, and what methods are the most informative? What are the dangers of not having regular checkups? Complete answers to all of the above questions are presented to the reader.

Main objectives of the inspection

With regular visits to the gynecologist, diseases and pathologies of the development of the female reproductive organs can be detected at an early stage. Statistical data confirms that regular examinations reduce the risk of developing gynecological cancer pathologies.

The cervix is part of a woman's main reproductive organ, which is located in the vagina. It is shaped like a thick-walled cylinder with a small passage in the center. The passage is the cervical canal. During pregnancy, it closes and blocks the exit from the uterus. During childbirth, during contractions, its full opening is ensured, under the influence of the pregnancy hormone.

The cervix is also seen as a barrier that prevents bacteria from entering the uterus from the outside environment. The bacterial action is provided by the mucus formed in the cervical canal.

Attention! The cervix is an insensitive part of the organ, so diseases are often asymptomatic.

Girls often ignore the need to visit a doctor, arguing that various symptoms and pain are absent. At the same time, insidious women's diseases, including cancer, progress at lightning speed, leaving minimal chances for recovery and preservation of reproductive function.

How often should a woman visit a gynecologist?

A gynecological examination is necessary to prevent the development and control the course of female diseases. If there are no disturbing symptoms, the menstrual cycle is not disrupted, it is enough to undergo an examination once a year. If a patient is diagnosed with a disease, the doctor needs to monitor its progress, visiting the hospital at least once every six months, and more often if prescribed by the doctor.

The examination includes the following stages:

Assessment of the condition of the external genitalia. The anus and labia are examined, the condition of the hair, skin, and mucous membranes is assessed.
A bimanual examination is performed. The doctor inserts 2 fingers into the vagina and palpates the cervix through the anterior abdominal wall. This method allows you to detect tumors.
The doctor conducts an examination in the mirrors.

Indications for examination

A vaginal examination is carried out for the treatment and prevention of pathologies of the female reproductive system. If the patient has no complaints about her health, the event is carried out once a year; if pathologies are detected, the doctor may recommend going to the hospital more often.

The list of main indications for the examination includes:

pregnancy – 38-40 weeks to control cervical dilatation;
annual medical examination - the cervix does not have nerve endings, so pain during the development of diseases does not bother the patient, examination is the only available way to identify dangerous pathologies;
constant disruption of the menstrual cycle is the main symptom indicating the development of serious disorders in the female genital organs;
bleeding not associated with menstrual bleeding, changes in cycle length and abundance of discharge on menstrual days;
impossibility of conception.

Gynecologists consider all women over the age of 30 to be at risk for developing cervical cancer. Achieving this milestone is a direct indication for an annual mirror examination. Women who have had cases of gynecological oncological pathologies in their family should pay special attention to the need for regular examination.

An unscheduled inspection is indicated in the following cases:

spontaneous termination of pregnancy;
abortion and medical termination of pregnancy;
cauterization of erosion;
natural birth or caesarean section.

In these cases, doctors recommend that the patient return for a consultation 2 months after the procedure.

Existing examination methods and technologies for their implementation

Annual preventive examination of the cervical canal and cervix includes the following activities:

inspection in mirrors;
bimanual examination;
colposcopy.

Based on the results of the data obtained, the doctor can supplement the prescription. If oncology is suspected, a laboratory examination of the biopsy specimen is required. When identifying other diseases of the reproductive system, ultrasound is indicated.

Gynecological examination and procedure for conducting it

This method is a mandatory part of every gynecological examination. The method allows you to identify various changes occurring in the cervix. The inspection proceeds as follows:

The woman takes off her clothes, puts a disposable diaper on the chair, takes a comfortable position and spreads her legs using supports.
The gynecologist cleans your hands and puts on sterile gloves.
The doctor spreads the labia and inserts a speculum into the vagina.
After the dilator is inserted to the back wall of the vagina, it is opened and the cervix is examined.
After the examination, the mirror is closed and removed.

The mucous membranes of the vagina are quite thin, so if the doctor does not follow the rules for working with a gynecological instrument, damage to its surface may occur, accompanied by bleeding. Mechanical injuries are not dangerous and do not pose a threat to women’s health; the healing period takes about 2-3 days. If the bleeding is severe, it is stopped by coagulation.

Attention! Injuries to the cervical canal and cervix can occur when using a rough brush to collect a smear.

Bimanual examination

Before the examination, the patient must empty her bladder. The assistant cleans the gynecological chair with a sterile rag, the woman takes off her clothes and lies down on a chair covered with a diaper. The legs are bent at the knee and hip joints and spread wide apart.

The doctor puts on sterile disposable gloves and inserts his right hand into the woman’s vagina, the left hand is placed on the stomach. The fingers of the doctor’s right hand are in the posterior fornix, and his left hand is in the direction of the sacrum. During the inspection, the following data is recorded:

position of the uterus;
sizes, shape;
soreness;
mobility and consistency of the cervix.

To examine the fallopian tubes and ovaries, the doctor moves the fingers of the right hand left and right (lateral fornix). The outer hand is placed in the ilioinguinal region. In the absence of pathologies, the appendages cannot be palpated.

The information obtained during the study is recorded by an assistant or nurse. After completing the examination, the doctor removes and throws away the gloves, washes his hands with soap and running water. The patient gets up from the chair, wipes the external genitalia with a napkin and gets dressed. After the examination, a conversation is held, during which the doctor gives an opinion on the state of health or prescribes additional examinations.

Colposcopy

Colposcopy is a method of examining the cervix and cervical canal using a special apparatus.

The device allows you to detect the affected areas and displays an image on the screen. The doctor can evaluate the structure of the cervix and suggest the development of pathologies.

The method provides differential diagnosis of neoplasms and allows you to take a smear or collect material for a biopsy.

In gynecological practice, there are 3 main types of colposcopy:

Simple – indicative, carried out at the beginning of the examination. Allows you to evaluate the shape and size of the cervix, determines the condition of the external pharynx, color and structural features of the mucous membranes. Allows you to visualize the vascular pattern.
Advanced - requires the use of special pharmacological solutions to assess structural changes in tissues at the cellular level.
After treating the area with a special solution, swelling of the epithelial layer appears, the cells swell, and the intensity of the blood supply decreases due to contraction of the subepithelial vessels.
Cells containing excess glycogen, after treatment with iodine-containing Lugol's solution, are painted a rich brown color; other tissues do not stain.
Chromocolposcopy - upon examination, tissues are stained with hematoxylin solution.

Extended colposcopy and chromocolposcopy make it possible to distinguish normal mucous membranes from altered ones. The peculiarity of diagnostics is that pathologically altered cells are stained, but healthy ones are not.

If a positive colposcopy result is obtained, the patient undergoes a biopsy. The advantage of the method is its safety and information content.

Colposcopy is common because it has a limited method of contraindications.

What diseases are diagnosed during examination of the cervix

The list of pathologies detected during a gynecological examination includes:

Erosion is damage to the mucous membrane. When examined in the mirrors, the doctor sees areas of redness. The diagnosis is confirmed by colposcopy. Treatment is conservative.
Cyanosis is the blueness of the cervix, which is the result of active production of progesterone.
Polyps are detected on the surface during a gynecological examination and bimanual examination.
Oncological neoplasm.
During the initial examination, the doctor sees signs of damage, but other examinations are needed to confirm the diagnosis. If the disease is detected at an early stage, the patient has a chance of full recovery.

Attention! Periodic gynecological examination is the main link that ensures early diagnosis and effective treatment of various female diseases.

If there is a delay in menstrual bleeding, if its duration exceeds 1 week, the woman should consult a gynecologist. Such deviations, with a stable cycle, indicate a probable pregnancy.

The examination technique in this case does not differ from a regular preventive examination. The doctor pays attention to the color of the cervix - under the influence of the hormone it turns blue, takes smears and assesses the condition of the internal os. When inflammatory changes are detected, treatment of the disease is provided. Biopsy and other diagnostic methods are used if absolutely necessary.

At 38-40 weeks, the doctor conducts an examination to assess the dilatation of the cervix. This condition is the main point ensuring natural delivery. If the pharynx remains closed until 41 weeks, stimulation of labor is indicated due to the risk of post-term pregnancy.

Examination with a gynecological speculum: examination procedure and proper preparation

Many women go to see a gynecologist with great reluctance, and some even with a feeling of fear and hostility. Such feelings are caused by one of the types of gynecological examination - examination with a gynecological speculum. In this article we will try to explain what this type of examination is, how it is carried out and how a woman can prepare for a visit to the doctor.

Adult women who visit a doctor, as they should, twice a year, know very well what a gynecological examination consists of. But for young girls it’s a sealed secret.

Often such ignorance becomes the reason for groundless fears.

But in any case, if a girl or woman has symptoms of a gynecological disease or just for a preventive examination, it is still necessary to contact a specialist. So what does an examination with a gynecologist consist of?

Gynecological speculum

Women and girls of different ages visit a gynecologist for the first time. Often the visit occurs at the age of puberty, when the patient has not yet had contact with a man.

There are a lot of reasons why you have to contact a specialist, but regardless of this, patients experience some fear before the examination, because a gynecological speculum is used during the procedure.

This is a special medical instrument, without which it is impossible to conduct a thorough diagnosis and determine the condition of the genital organs.

Speculums serve to expand the vagina, and if the doctor works skillfully, and if the woman is relaxed, there will be no discomfort during the procedure.

To get rid of fear, before visiting a specialist, women look for a video examination with a gynecological speculum, and this helps many.

General information

The vaginal speculum has two main components - these are specific valves that look like grooves. The tool is also equipped with a lever-type mechanism and a screw-like lock. The gynecologist's speculum has a viewing window, and to open it, you just need to squeeze the handles.

In the photo, the gynecological speculum is presented for reusable use.

Reusable medical instrument

The most widely used tools are those equipped with a self-supporting mechanism. It is thanks to this that the doctor’s hands remain free, which makes it possible to perform an examination, as well as take the necessary smears, or perform a medical procedure, for example, a mini operation.

The Cusco gynecological speculum has a rounded shape of the valves. As for the material from which the tool is made, it is either metal or polystyrene. The second type is considered more suitable for examination, since transparency makes it possible to more clearly visualize and assess the condition of the genital organs.

Thanks to the screw fixation, the doctor can set the most optimal position of the speculum and expose the cervix. The disposable gynecological speculum undergoes thorough sterilization before packaging, after which it is placed in a plastic bag. Reusable instruments can also be reprocessed, but only in a hospital setting.

The gynecological speculum shown in the photo can also be found in a doctor’s office.

Gynecological instrument according to Sims

In gynecology, the Sims vaginal speculum is also used. In its shape it resembles a spoon. The product is made from durable medical stainless steel. The product is equipped with two spoons of equal width, as well as a common handle. Used to tighten the posterior vaginal wall. It must be disinfected before and after use.

The Doyen vaginal speculum is a medical instrument for dilatation. The main working part is wide and saddle-shaped. Use it to spread edges. In gynecology it is used for laparotomy. The production material is stainless steel.

Application area

Speculum examination of the cervix has been considered an integral part of the diagnostic work of a gynecologist for many years. The range of instruments is varied and wide, which allows the specialist to choose the most suitable option, depending on the patient’s age and the scale of the examination. In most cases, a Cusco gynecological speculum with shutters is used.

When using the instrument, the doctor has the opportunity to diagnose female pathologies, as well as carry out some procedures:

Conduct an examination of the mucous membrane of the organ, during which special attention is paid to color, granularity, the presence or absence of scars and adhesions, ruptures, swelling, as well as other atypical formations;
A specialist can determine the shape of the cervix, as well as its size (these parameters indicate the presence of a particular pathology, or its absence);
Examination with a gynecological speculum allows you to diagnose erosion and detect precancerous changes in the cervix;
The doctor has the opportunity to perform some procedures, for example, take a smear or scraping from the walls of an organ, and then send the material for examination.

In each clinical case, a gynecological examination in speculum is carried out using instruments of various sizes. Not all women know that such a product is available in pharmacies in several lengths, so this issue should be studied before going to the doctor.

Size

First of all, it is worth saying why several options for speculum sizes are used in gynecology. The fact is that during the examination there may be a need to spread the vagina more widely, or, conversely, for patients who have a special body constitution, long valves may cause pain during the procedure.

Tools come in several sizes

The dimensions of gynecological speculum are as follows:

If a speculum examination is performed on a pediatric patient, an XS size instrument is used. The mirror is 23 millimeters in diameter and 70 millimeters long. Suitable for performing procedures on girls over 12 years old, those who are sexually active, and virgins (in case of emergency, so that the hymen is not damaged).
There is a gynecological speculum for nulliparous women (photos of which can be viewed on the Internet). Its size is defined as S. The diameter is the same as for children, but the length of the valves is 75 mm.
A vaginal speculum of size M is used by doctors in situations where there is no need to greatly separate the walls of the organ. In diameter and length it has parameters of 25/85 mm, respectively.
An examination by a gynecologist with a speculum of size L is carried out only when the doctor needs to greatly spread the walls of the vagina in order to thoroughly examine the organs. The diameter of the tool is 30 mm, and the length is 90 mm.

What types of gynecological speculums exist was written at the very beginning of the article. It has also been repeatedly said about disposable and reusable instruments. Let's take a closer look at what they are, especially, and whether there are any advantages.

Disposable

In gynecology, the mirror is a special assistant to the doctor. If earlier the instrument was only made of metal, now every pharmacy has products for one-time use in its assortment. Also, to complete the procedure, you can immediately buy a set of necessary accessories, which includes gloves, a diaper, glass slides, etc.

Disposable mirror

The sizes of gynecological disposable speculums are standard, which have already been mentioned, so it is necessary to figure out whether they have advantages. Such tools clearly have advantages, and they are represented by the following parameters:

Due to the fact that the material of the product is transparent, better conditions for inspection are created;
The instrument is purchased by the patient herself, and she can be sure that no one has used it before and it is completely sterile;
It is convenient and easy for the doctor to work with such a mirror, his hands remain free;
The opening area is horizontal, due to which the view is almost doubled;
There is no need to put effort into spreading the vaginal walls;
It is possible to securely fix the tool in one of six positions;
The warranty period is 5 years.

This gynecological examination mirror is made of a special material – polystyrene. Before packaging, the instrument is subjected to antiseptic treatment and sealed in a vacuum bag, compliance, the product is sterile.

Reusable

Reusable gynecological speculum is used extremely rarely in modern medicine. This is due to the fact that an increasing number of women prefer to buy a disposable instrument before visiting a doctor. It is not expensive, but at the same time it guarantees the safety of the examination and reduces to zero the likelihood of infection if hygienic standards of sterilization in the clinic are not observed.

Many people are interested in the diameter of a reusable gynecological speculum. It all depends on what kind of examination the specialist will conduct and what age the patient is. Tool sizes vary significantly not only in length and diameter, but also in area of application.

Reusable instruments are made from metal, namely stainless steel. The level of reliability of the product is very high, and it can be used for several decades. After each patient, the doctor is required to sterilize the mirror.

Children's

What a gynecological speculum is, what this instrument looks like has already been said a lot, but it is necessary to say about the existence of special instruments designed for examining little girls and young women. If the patient is over 12 years of age, the doctor conducts an examination using a product that has the same width of the working surface.

In cases where it is necessary to diagnose the condition of the genital organs of little girls under 12 years of age, a mirror is used that tapers in the area of the handle. If it is impossible to fully use such an instrument, the doctor will take a device with a special chute equipped with a lighting device.

Inspection

Examination on a gynecological chair in the mirrors is always the reason why a woman does not want to visit a doctor, because she is afraid that the specialist will hurt her or she will feel discomfort.

This psychological barrier must be overcome, because if you do not arrive on time, you can miss the development of a serious illness, which is always easier to get rid of at the initial stage of progression.

Let's look at how the cervix is examined in mirrors and the algorithm of actions:

Initially, the specialist puts on sterile medical gloves;
Then the patient needs to place a disposable oilcloth (diaper) on the gynecological chair;
Afterwards, the girl sits comfortably, throwing her legs back on special stands;
The doctor takes the instrument with his right hand, and with the help of his left hand (index finger and thumb) spreads the labia majora in different directions;
In a straight section, the mirror is inserted into the genital slit to the middle;
Next, the instrument is rotated across the incision and inserted to the posterior fornix, while the doctor gently presses on the perineum;
After this, the specialist takes the lift with his left hand;
Using a spoon-shaped speculum, it is inserted straight into the vagina to the middle, then turned across;
Next, the lift is advanced to the end of the anterior vaginal fornix, while slightly pressing on the anterior vaginal wall;
The doctor spreads the instrument and examines the vaginal wall and cervix;
After completing the procedure, the mirror is removed in the reverse order.

This algorithm allows you to understand exactly how a gynecological speculum is inserted and what is the technique for examining the cervix in the speculum. What the gynecologist sees during examination with a mirror, he will display in the medical report when making the primary and final diagnosis.

It is strictly forbidden to conduct an independent gynecological examination of the genital organs. A person without special education still cannot understand what problem a woman has, and incorrect actions can cause harm and injure the mucous membrane.

Inspection (video)

Source: //uterus2.ru/other/zerkalo-ginekologicheskoe.html

Examination of the vagina with a gynecological speculum

A gynecological examination consists of several stages, the most important of which is the internal examination of the vagina using speculum.

This procedure allows you to identify many infectious diseases, pathologies of the vagina and cervix at an early stage and prevent possible complications.

In addition, the use of modern disposable mirrors reduces the likelihood of pain and discomfort.

Vaginal examination

An annual preventive examination by a gynecologist is mandatory for all women of childbearing age, regardless of the presence of complaints. Unfortunately, many patients neglect their health due to fear of certain medical procedures, in particular, examining the vagina in mirrors.

However, modern examination methods reduce the risk of unpleasant or painful sensations to a minimum, while allowing not only to get rid of existing diseases of the reproductive system, but also to prevent the emergence of new pathologies and their undesirable complications.

Subsequence

The examination procedure in gynecology consists of several stages:

A conversation with the patient, including collection of medical history (complaints, age at menarche and onset of sexual activity, presence of chronic diseases and other information).
If necessary, measure height and weight, monitor blood pressure, visually examine and palpate the mammary glands.
Examination of the external genitalia in a gynecological chair to exclude various neoplasms, inflammatory processes, infectious diseases and other abnormalities, as well as assessment of the condition of the inguinal veins and perianal area. To do this, a woman must undress completely from the waist down. This part of the study has important diagnostic value and allows us to identify many pathologies. For example, underdevelopment of the vagina, its dryness or discoloration may indicate a hormonal imbalance, and ulcers and ulcers may indicate the presence of inflammatory diseases.
Internal instrumental examination of the walls of the vagina and cervix using gynecological speculum. When performing this procedure, the doctor pays attention to the color and structure of the mucous membrane, the nature and amount of discharge, the presence of bloody discharge, erosions, polyps, and vascular pathologies. At this stage, material is collected for laboratory research, including assessment of microflora, quantitative determination of leukocyte content, confirmation of the presence of pathogens, etc. If the gynecologist detects suspicious-looking areas in the cervical area, a colposcopy is prescribed.
Bimanual examination: palpation of the internal genital organs, allowing to assess the size and location of the uterus and its appendages, identify neoplasms, and confirm pregnancy. To do this, the doctor carefully inserts the index and middle fingers of the right hand deep into the vagina, and forcefully probes the anterior abdominal wall with the left hand. This also determines the mobility of the uterus, the condition of the pelvic muscles, the extensibility and relief of the vaginal walls.
In some cases, a vaginal-rectal examination is performed to assess the condition of the walls of the septum between the rectum and vagina, as well as to exclude the presence of adhesions and tumors. Most often, this procedure is used for women during menopause.
Ultrasound for suspected ectopic pregnancy, tumors and other pathologies of the reproductive system.
Other instrumental studies as indicated.
Prescribing additional tests, selecting contraceptives, etc.

Inspection in the mirrors

A gynecological examination in a mirror is the most important and informative procedure when visiting a antenatal clinic. There are different types of this device, differing in shape, size, and the presence of additional functions. Instruments with a lock are very convenient, allowing the gynecologist to free his hands to take smears.

The diameter of the mirror varies from 14 to 30 mm and is selected depending on the age and build of the woman. Disposable plastic instruments are often used. The examination is always carried out using sterile gloves.

The mirror is removed from the packaging immediately before use; its contact with any surfaces is unacceptable.

The doctor uses the fingers of one hand to slightly spread the labia of the patient sitting in the gynecological chair, and with the other he slowly inserts the device into the vagina, turns it at an angle of 90 degrees and fixes it in an open state. With the correct selection of the instrument size and due care of the doctor, there will be no discomfort.

Inspection of the cervix is carried out with the maximum expansion of the instrument flaps, then the latch is slightly loosened. In this position, the gynecologist evaluates the appearance of the vaginal walls and the characteristics of the discharge.

When all the necessary manipulations have been completed, the mirror doors are closed, the device is carefully removed and disposed of immediately.

Reusable steel mirrors must be sterilized immediately after use.

Speculum examination of the vagina is not carried out in the presence of a hymen. In this case, the gynecologist performs only a manual examination through the wall of the rectum.

Some patients report minor pain after the procedure.

After taking a smear, discharge that is pinkish or streaked with blood may be observed for several hours.

If, after visiting the gynecological office, heavy discharge with blood appears, the temperature rises with chills, or the general condition worsens, you should immediately consult a doctor.

Preparing for a visit to the gynecologist

If a woman has to visit a doctor, she must:

one day before the gynecological examination, exclude sexual intercourse;
stop taking medications in the form of vaginal suppositories or tablets 1-2 days beforehand (in consultation with your doctor);
stop douching, using various deodorants or scented intimate hygiene products;
2-3 hours before the examination, carry out hygiene procedures with warm water without soap;
choose comfortable clothes that allow you to expose only the lower part of your body;
empty your bladder immediately before visiting the doctor to facilitate palpation of the internal genital organs.

Excessive intimate hygiene makes it difficult to make a diagnosis, since the discharge may look different or be completely absent. In addition, frequent washing and douching disrupt the vaginal microflora and lead to various diseases.

It is not necessary to completely depilate the intimate area; it is enough to remove some hair from the labia to facilitate their visual inspection. To reduce the likelihood of pain during the insertion of a speculum, it is recommended to relax as much as possible and breathe deeply and slowly.

It is necessary to know the start date, duration and characteristics of the last menstruation.

In order for the doctor to conduct a quality examination and, if necessary, prescribe effective therapy, it is not allowed to hide any details regarding sexual life or concomitant diseases.

Young girls should remember that regular visits to the gynecologist are not only the key to women’s health, but also contribute to the birth of a healthy child in the future.

Source: //DrLady.ru/diagnostics/osmotr-vlagalishha-ginekologicheskim-zerkalom.html

What does a gynecologist see when examining with a mirror? Gynecological examination: pros and cons

The numbers clearly show how necessary it is to regularly visit a gynecologist.
According to WHO statistics, gynecological diseases affect from 30 to 50% of women. Many of these diseases cause infertility, and some are a direct threat to life. The most common diseases of the female genital organs can be divided into several groups:

Inflammatory diseases. These include adnexitis (salpingoophoritis), endometritis, cervicitis, colpitis, vulvovaginitis. Diseases of this group are more common than others: in 35% of all cases of treatment. Inflammation is caused by opportunistic bacteria, viruses, fungi, and protozoa. The development of diseases is facilitated by infections, hypothermia, weakening of the body's defenses, and hormonal imbalances. Inflammation can be acute or chronic. In the first case, the disease is usually accompanied by vivid symptoms: pain occurs in the lower abdomen, discharge appears, and sometimes the temperature rises. Chronic inflammatory diseases are often asymptomatic, but they can lead to the formation of adhesions, tubal infertility and ectopic pregnancy.
Sexually transmitted infections are a separate group of inflammatory diseases. They are caused by specific pathogens: gonococci, trichomonas, chlamydia, ureaplasma, mycoplasma, etc. As a rule, the vaginal mucosa is affected, but if left untreated, inflammation can spread to the internal genital organs. Not all infections transmitted through sexual contact are related to sexually transmitted diseases and have a pronounced clinical picture. For example, infection with the papilloma virus may not manifest itself in any way outwardly, however, some strains are recognized as oncogenic. Sexual infections increase the risk of infertility, miscarriage, and fetal malformations. WHO estimates that 357 million people worldwide become infected with STIs every year.
Endometriosis is a disease of unknown nature, manifested by the proliferation of endometrial cells outside the inner layer of the uterus (most often within the pelvis). The prevalence of the pathology is not precisely known, because due to nonspecific symptoms (constant or cyclical pain in the lower abdomen, heavy menstruation), women rarely consult a doctor. Endometriosis reduces quality of life and sometimes interferes with conception.
Benign and malignant neoplasms are more common in women over 40 years of age, although recently the disease has become “younger”. The total number of neoplasms in the structure of gynecological diseases is 18%. Benign tumors are more common, primarily uterine fibroids and ovarian cysts. Among malignant neoplasms, cervical cancer ranks first: its prevalence averages 15–16 cases per 100,000 women.
Endocrine diseases are less common than others. Many of them are hereditary and are detected at a young age. Polycystic ovary syndrome is manifested by menstrual irregularities, infertility, often obesity, acne, and excess body hair growth. Pathology is registered in 5–10% of women. The group of endocrine disorders also includes amenorrhea (absence of menstruation) of various origins and dysfunctional uterine bleeding.

Speculum: sizes XS, S, M, L

Cusco gynecological speculum is one of the key disposable devices in the field of gynecology, the most important tool for an obstetrician-gynecologist.

Not a single gynecological office can do without this device, because its functionality allows the doctor to prescribe the necessary treatment, perform medical procedures, and also perform simple operations.

Also, a distinctive quality of this device is that when using a gynecological speculum, the specialist does not need an assistant to perform gynecological manipulations, and he can do everything independently - this is due to the convenience of the technical part of the device.

But the range differs not only in the fixation mechanism and manufacturer, but also in the sizes: XS, S, M, L. Let’s take a closer look at each of the sizes and their application.

Dimensions of gynecological speculum

Despite its name, this tool has nothing in common with an ordinary household mirror. A vaginal speculum is an expanding device designed specifically for expanding the walls of the vagina, examining its vaults, and also examining the cervix.

A speculum is usually made of transparent material, which makes the examination more effective. Also, some models of the device have a special lock, which gives the doctor the opportunity to free his hands during an examination, diagnosis or operation.

It is necessary to choose a mirror that is suitable for the patient, and the gynecologist makes its choice depending on the individual physical data of the woman, namely: height, weight, age, and the number of births. An incorrectly selected instrument can harm the patient.

She may experience discomfort during the examination or even feel pain. Therefore, it is so important to choose the right and suitable tool.

Basically, disposable vaginal speculums are used in gynecological examinations because they are more convenient to use. They are otherwise called gynecological speculums according to Cusco . Firstly, disposable gynecological speculums are much cheaper and more accessible than reusable ones; they can be bought at any pharmacy.

Secondly, such mirrors are more convenient in the sense that they are already sold sterile in a separate package.

Thirdly, the use of disposable gynecological speculums is much more comfortable for the patient, because they are made of plastic (polystyrene), and their temperature, unlike metal reusable vaginal speculums, is much more comfortable for the patient.

Size S [cm Catalog]

The smallest gynecological speculums are devices for examining girls. Basically, all children's gynecological speculums have fixed parameters of the working part and a flat shape in order not to damage the vagina and hymen.

XXS size mirror is for children. This mirror has a 13 mm internal diameter of the doors and a 65 mm length of the doors.
XS size mirror is also for children. The device has a 14 mm internal diameter of the valves and a 70 mm length of the valves.
S size speculum is usually used in nulliparous patients. A mirror of this size has a 23mm internal diameter of the doors and a 75mm length of the doors.

Size M [cm Catalog]

mirror size M is used for women who have given birth. This type of mirror has a 25 mm internal diameter of the doors and an 85 mm length of the doors.

Size L [cm Catalog]

The L-size speculum is intended for examinations that require widening of the vaginal walls.
This type of mirror has a 31 mm internal diameter of the doors and a 90 mm length of the doors.

Dimensions are averaged , indicated in mm. , not see

and may vary slightly between different manufacturers.

Mirrors from all well-known manufacturers are collected in the catalogue.

Application of a gynecological speculum

How does a device such as a gynecological speculum work? This tool is used in several stages, which are described below.

First of all, the gynecologist puts on gloves and opens the package with a new gynecological speculum (if it is disposable) or takes a pre-sterilized reusable vaginal speculum.
Next, the doctor uses his fingers to spread the patient’s labia minora and insert the device inside. At this moment, the patient should not feel discomfort if the mirror is selected correctly.
At the next stage, the doctor must properly secure the instrument. If the mirror has a special clamp, then the doctor secures the mirror, expanding the device. Now the doctor can examine the organs and, if necessary, do a smear from the cervix.
At the end of the medical procedures, the doctor moves the walls of the mirror and takes it out. If the gynecological speculum is disposable, then it is immediately disposed of. If the device is reusable, the doctor will sterilize it.

Thus, the gynecological speculum is one of the most important tools in the field of gynecology. This device is truly universal, because it helps the specialist not only in examining the patient, but also allows him to carry out accurate diagnostics, treatment procedures and even some simple operations.

In this article, we talked about the technical side of this instrument, the principle of its operation, and also talked about the size of gynecological speculums and what determines their choice.

If you still have questions or want to clarify what size gynecological speculum is not found in the article, then contact us by phone or via mail. We will be happy to help you!

Source: //cordismed.ru/blog-rashodnye-materialy-dlya-ginekologii/ginekologicheskoe-zerkalo-razmery-xs-sml.html

Procedure: gynecological examination of the vagina with a mirror on a chair

Cusco gynecological speculum is one of the key disposable devices in the field of gynecology, the most important tool for an obstetrician-gynecologist.

But the range differs not only in the fixation mechanism and manufacturer, but also in the sizes: XS, S, M, L. Let’s take a closer look at each of the sizes and their application.

Complete gynecological examination

Typically, a complete gynecological examination consists of several stages:

Conversation between a patient and a gynecologist

During the conversation, the gynecologist will find out information about your health, possible complaints, the method of contraception you use, the duration of the menstrual cycle and its characteristics, and the date of your last menstruation.

If you come to a specialist for the first time, you will be asked questions about chronic and previous diseases, operations, the course and characteristics of previous pregnancies and births, if any.

Ask what diseases your closest relatives suffered; about your marital status and the health and illnesses of your husband or partner.

Examination on a gynecological chair

Examination of the external genitalia, lymph nodes
Examination in mirrors (when examined using a special sterile instrument - a vaginal speculum - the doctor will have the opportunity to examine the mucous membrane of the vagina and cervix, detect erosion of the cervix, fistulas, inflammatory diseases of the vagina and cervix, the presence of tumors, and also take a scraping of the mucous membrane of the cervix for research).
Vaginal examination
By inserting the index and middle finger of one hand into the vagina, with the other hand located in the lower abdomen, the doctor palpates the body of the uterus and appendages. It is this study that will allow the doctor to diagnose diseases of the uterus, appendages, pelvic peritoneum, and determine the presence and duration of pregnancy. Usually the process does not give the woman any unpleasant sensations - they can appear in the presence of a pathological process or if the woman is scared/excited, and therefore her muscles are tense, which can interfere with the process. In women who have never been sexually active, the gynecologist performs a rectal examination (by inserting the index finger of one hand into the rectum, with the other in the lower abdomen, the doctor palpates the body of the uterus and appendages).
In some cases, a rectovaginal examination (through the vagina and rectum simultaneously) is performed as an additional method - it is especially recommended for older women.

Ultrasound gynecological diagnostics (ultrasound)

Ultrasound diagnostics (ultrasound) of the pelvic organs in women is carried out transabdominally and transvaginally.

Transvaginal ultrasound diagnostics can perform many diagnostic tasks: from identifying benign and malignant formations of the uterus and ovaries, inflammatory processes to monitoring the follicular apparatus of the ovaries in the treatment of infertility.

Using this method, early pregnancy, the causes of dysuric disorders, urinary incontinence, and urethral pathologies are diagnosed.

To undergo transabdominal ultrasound diagnostics (ultrasound), the bladder must be well filled: 3-4 hours before the examination, you must drink 500-700 ml of any liquid.

This study is recommended to be carried out once a year and in the absence of complaints, in order to identify hidden pathology.

If gynecological pathology has already been identified, the frequency of the examination will be determined by the attending physician.

Breast examination

It is carried out without fail, since the mammary glands are a hormonally dependent organ. The gynecologist examines them in a standing and lying position, followed by palpation, assessing the shape, structure, symmetry, pain and other parameters.

Analyzes – as needed

Complete blood count; Analysis of urine; blood chemistry; coagulogram; analysis of sex and other hormones; determination of blood group, Rh factor, Rh antibodies (important during pregnancy); tests for infections, etc. (your attending physician will determine the need for testing and explain the procedure).

Other examination methods

For example, hysterosalpingoscopy, hysteroscopy, etc. – if necessary.