Gynecology Department

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The Gynecology Department

 

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Most girls will start going for gynecological care when they are having any abnormal symptoms (such as vaginal discharge), if they have just started having sex (or are planning to start), or even if they haven't yet become sexually active but have reached the age of 18. Here is a step-by-step breakdown of exactly what is going to happen during the exam.

First off, the patient should make sure that she schedules her appointment during the middle of her menstrual cycle. If it gets too close to menstruation, the uterus will start to shed cells, which can interfere with the Pap smear results. If the patient feels that she may want someone to be in the exam room with her during the exam for support, she should ask what the doctor's policies are on this subject while making her appointment. Also during the scheduling, the patient should make it known that it is her first visit and exactly why she will be coming for the visit. Secondly, the patient should not put anything into her vagina for 2 days before the appointment, as this can cause an abnormal Pap smear. This means that the patient should not have intercourse, douche, or put dildos, tampons, or fingers into her vagina.

It is helpful for the patient to write down any specific questions, symptoms, or anything else she may be wondering about and take it to the exam. If considering birth control, the patient should think about her preferences before her visit. The patient will be asked about any current medications, so be sure to bring the bottles for any current medications and also any old medical records if uncertain about the details of any previous procedures. Also, waits at the doctor's office may be long, so if nervousness is going to be a problem, make sure to bring a good book or something else to do that can provide a distraction.

Before the nurse takes the patient back to the examining room, she may ask the patient for a urine sample in order to diagnose urinary tract infections or pregnancy. Even if a sample is not requested, it is a good idea to empty the bladder to aid in avoiding feelings of discomfort during the exam. Once back in the exam room (which will be set up with a tray for the various tests), the patient will have to give her medical history. She will be asked about such issues as family history of cancer of the female reproductive organs, past operations or hospitalizations, and any medications that the patient may be using.

Before doing the external pelvic exam, your doctor will probably do a breast exam. During the pelvic exam you値l be lying on your back with your bottom at the very end of the table and your heels resting in metal supports called stirrups. The doctor sits at the end of the examination table so that he or she can examine your external and some internal organs. The doctor will wear exam gloves during all parts of the examination.

Your doctor will do an external examination of your genitals.

The bimanual exam is performed when your gynecologist inserts two fingers into your vagina and places the other hand on top of your lower abdomen, while feeling for any abnormalities that might have occurred since your last pelvic exam. During this part of your examination, your doctor checks the size, shape, and mobility of your uterus. Changes in your ovaries, such as ovarian cysts may be detected during the bimanual exam, as well as other uterine changes including endometriosis, fibroid tumors, or other common uterine conditions.

Your doctor will do a bimanual and rectovaginal exam to evaluate for any abnormal masses.

A speculum is a metal or plastic instrument that looks somewhat like a duck's bill. The "bills" are inserted into the vagina and opened in order to spread the vaginal walls and visualize the cervix. After the speculum has been opened, a cervical brush and then a spatula will be used to rub a sample of cells off the cervix. This may cause you to experience some spotting after the exam, but it will not hurt. The sample of cells is spread onto a slide and this is the Pap smear. Any samples for testing for infections will be collected. Some doctors screen for sexually transmitted diseases routinely. However, most tests will only be done if there is a reason. The speculum is then closed and removed from your vagina. There will be some clicking noises during the locking and unlocking of the speculum; these noises are routine, so there is no need to be concerned by them.

Your doctor will do a speculum exam to do obtain a pap smear.

    
       

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