Indications for a vaginal examination

• Surveillance for cervical carcinoma

Vaginal discharge

Postmenopausal bleeding

• Symptoms of uterine prolapse

• Unexplained urinary tract obstruction

• Suspected tubal pregnancy

Examination sequence

P Ask the patient to empty Ihe bladder.

□ Position the patient comfortably either on her back or in the left lateral position with her head on a pillow, hips and knees flexed and thighs abducted.

P Use a lamp to illuminate the vulva adequately.

P Use suitable gloves and lubricate the examining fingers.

P Separate the labia minora with the forefinger and thumb of the left hand, bringing into view the clitoris anteriorly, then the urethra, the vagina and the anus posteriorly.

Normal

Hydrocele

Spermatocele

Normal

Hydrocele

Spermatocele

Spermatocele

Spermatocele Picture

Epididymitis

Varicocele

Tumour of testicle

Epididymitis

Varicocele

Tumour of testicle

Fornix Vaginal
Fig. 5.19 Swellings of the scrotum.
Posterior Fornix
Fig. 5.21 Vagina! examination.

O Palpate each lateral fornix in turn bimanually.

O Note any tenderness or swelling of the Fallopian tubes or ovaries (adnexae), the bladder anteriorly and the pouch of Douglas posteriorly.

□ Supplement digital examination by inspection of the vagina and uterine cervix using a vaginal speculum.

Using a vaginal speculum and taking a cervical smear

□ Gently insert a lubricated, warmed speculum into the vagina; do not use a lubricant other than water if a cervical smear is being performed.

□ Rotate the blades through 90 degrees pointing the handles anteriorly if the patient is supine and posteriorly if in the left lateral position.

□ Gently open the blades and identify the cervix.

□ Use the notched end of a spatula and rotate through 360 degrees to scrape off a cytological sample from the cervical os.

□ Spread the sample thinly onto a labelled, cleaned glass slide and fix immediately with a 50/50 mixture of alcohol and ether.

□ Swab any discharge from the urethra, vagina and cervix.

□ Send one specimen for culture and smear another on to a glass slide for direct microscopy: unstained smears arc helpful to confirm trichomona! infection and stained smears to confirm gonorrhoea or thrush.

Fig, 5.20 MRI scan showing the contents of the female pelvis.

(Courtesy of Dr Andrew R. Wright.)

□ Look for any evidence of discharge, ulceration or abnormalities of Bartholin's glands.

□ Inspccl the vaginal walls for prolapse by asking the patient to strain down and then to cough.

□ Note the position and degree of any vaginal prolapse and the occurrence of any involuntary urinary incontinence on coughing.

□ Insert the index and middle fingers of the right hand into the vagina and rotate palm-upwards (Fig. 5.21). Use only one finger if vaginismus (spasm of the vaginal muscles) or atrophic vaginitis makes examination painful.

□ Palpate the cervix; the normal cervix points downwards and slightly backwards and feels like the tip of the nose.

□ Note any tenderness on movement of the cervix (.cervical excitation).

□ Now perform bimanual palpation: with two fingers in the anterior fornix, place the left hand flat on the abdomen above the pubis. \

□ Identify the size, position and surface characteristics of the uterus between the hands.

□ If the uterus is not palpable, palpate with the fingers in the posterior fornix as the ulerus may be retroverted.

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

Get My Free Ebook


Responses

  • maura
    How to examine per vaginum of pouch of Douglas?
    8 years ago
  • Gale
    What are the indications for vaginal examination?
    7 years ago
  • ren
    What are the indication of vaginal examination?
    3 years ago
  • Jessica
    What are the indications of per virgina?
    3 years ago
  • elle
    What are the indications of vaginal examinination?
    3 years ago
  • EVELYN
    What are the indications of vaginal exam?
    3 years ago
  • Tesmi
    What are indications of vaginal exaination?
    3 years ago
  • futsum
    What is the indication of vagina?
    3 years ago
  • Kevin
    What are the indications of vagina examination?
    3 years ago
  • reuben
    What are the indications for vaginal examintion?
    3 years ago
  • welde
    What are indication fot vagina examinatiom?
    3 years ago
  • Clinton
    What are the indication of vaginal examiation?
    3 years ago
  • tekle yemane
    What are the indications of Vaginal examinations?
    2 years ago
  • quirico
    What are the indication for vagina examination?
    2 years ago
  • jasmine
    What are the indications of vaginal examination in a woman?
    2 years ago
  • lucas white
    What are the indication of conducting vaginal examination in a woman?
    2 years ago
  • Sayid
    What are six indication to performing vaginal examination.?
    2 years ago
  • DEMSAS NASIH
    What are the indications for speculum examination?
    2 years ago
  • Fethawi
    What are the indication of vagina examination during labour?
    2 years ago
  • fabrizia
    What are the indications of digital vaginal examination?
    2 years ago
  • ercole milanesi
    What is vaginal examination and what are indications,contraindications and procedure?
    2 years ago
  • adriana
    What are indication of pv examinations?
    2 years ago
  • amelie
    What are the indications for performing vaginal examination?
    2 years ago
  • Anselmo
    Is per vagina examination contraindicated in preeclampsia?
    2 years ago
  • ruben
    When is vaginal examination contraindicated?
    2 years ago
  • fatimah medhanie
    What arecontra indication for vaginal examination during labour?
    2 years ago
  • weronika
    What are the indications for conducting a vaginal examination in a woman?
    2 years ago
  • Morgan
    What is are th indications for a virginal examination?
    2 years ago
  • ernesta
    What are the indication of pv during pergnacy?
    2 years ago
  • Alex Burns
    What is virgina indication?
    2 years ago
  • Samantha
    What are the indication of vagina examination in pregnancy?
    2 years ago
  • elvio
    What are the indications for high vaginal swab?
    2 years ago
  • sanni
    What are the indications for vaginal examination in pregnancy?
    1 year ago
  • MANTISSA
    What are nain indication of vaginal examination?
    1 year ago
  • juliane
    What are the indications for viginal examinatuon?
    1 year ago
  • savanna
    What are q indications for conducting vaginal examination in women?
    1 year ago
  • Vladimiro Napolitano
    What are the indications for vaginal axamination during labour?
    1 year ago
  • iona
    What are the indication of pelvic examination(pdf)?
    1 year ago
  • Piera
    What is the sequence of indication?
    1 year ago
  • bonnie
    What are indications foe vagina examination during labour?
    1 year ago
  • virginia
    What are the indication of pv for normal prgnant women?
    1 year ago
  • Angelo
    What indications for speculum vaginal examination?
    1 year ago
  • Helen
    What are the indications of vaginal examinations in labour?
    1 year ago
  • steve
    What are the indication of take cervical swab?
    1 year ago
  • Pentti
    What are the indications for vaginal toileting?
    12 months ago
  • nadine
    What are the conra indication of vaginal?
    11 months ago
  • alyx
    What are indication and contra indication of per vagina and physical examination?
    10 months ago
  • jasmine
    What is cotra indication of pv?
    10 months ago
  • Andrea
    What are the contraindication for vaginal exmination?
    6 months ago
  • riitta
    What are the indications of viginal examination?
    4 months ago
  • Aurora
    What is the procedure for conducting a vaginal speculum examination?
    2 months ago

Post a comment