Kuala Lumpur Gynae

Gynaecological Examination

The Gynaecological examination includes three components- abdominal examination, bimanual examination, and examination using a speculum. This can be distressing for a patient, so act with empathy and respect towards the patient at all times. The bimanual examination is commonly assessed during the OSCE examination, and revising the technique is important to detect clinical signs.

Introduction

  • Introduce doctor to patient
  • Wash hands
  • Explain what are the procedures and gain consent
  • Have a chaperone(preferably female) and write down who she is in the notes

General Examination

  • General appearance
  • Height and weight(BMI)
  • Any scars, distension or visible masses
  • BP, pulse and urine dipstick(including a prenancy test)
  • Body and facial hair

Abdominal Exam

Perform an abdominal exam, looking for:

  • Masses
  • Tenderness

External Genitalia

  • Prepare all the equipments which are going to use now, to minimise the amount of time the patient is exposed
  • Expose the patient
  • Examine the vulva for redness, swelling, ulceration, warts and discharge
  • Examine the urethral meatus and ask the patient to cough – looking for signs of incontinence

Speculum Examination

  • Part the labia to minimise discomfort
  • Insert the speculum sideways first, then rotating it into the correct position
  • Open the blades of the speculum carefully
  • Inspect the cervix looking for any tears, polyps, bleeding, discharge or warts
  • Perform any swabs or sweeps that you need to do
  • Carefully withdraw the speculum

Bi-manual palpation

  • Part the labia to minimise discomfort
  • Insert lubricated middle and index finger into the vagina up to the cervix
  • Put another hand on the pubic symphasis, rocking the uterus against your fingers
  • Feel the uterus for its size, shape(should be the size and shape of a small pear
  • Palpate the fornices feeling for ovarian enlargement

Completion

  • Cover the patient up and thank them
  • Dispose of used speculum, gloves etc
  • Allow the patient to get dressed before explaining findings

For more information get in touch with us at Gynae Kuala Lumpur