Gynecological examination
A regular gynecology examination includes a pelvic exam to determine the position, consistency and regularity of reproductive organs. It also enables the doctor to determine the presence, position and sensitivity of possible pathological growths, and to establish their impact on surrounding organs. This exam can also reveal the discomfort and soreness which indicate the inflammation of the genitourinary system, or the cervical soreness in the case of an ectopic pregnancy.
A speculum examination enables a detailed visualization of external genitalia, as well as a thorough examination of the vagina and the cervix. The observation of the cervix and ectocervix allows the physician to rule out the presence of pathological lesions and growths. It can also be used to diagnose a possible infection by examining the appearance of the vagina and vaginal discharge. During this exam, the doctor will usually take a Pap smear for cytological analysis, and cervical smears for microbiological analysis, which determine the degree of purity of vaginal flora.
We are dedicated to making our patients feel comfortable, and all examinations in our office are conducted extremely gently and attentively.
Two-dimensional (2D)ultrasound examination
The conventional two-dimensional ultrasound exam can be performed either transvaginally or transabdominally. The latter is used with patients who have not had intercourse yet or find the vaginal exam extremely discomforting. The patients are required to have a full bladder, as this allows a thorough examination of all internal organs. Ultrasound exams are a supplement to the full gynecological exam, since they enable a better visualization of internal genitalia, detailed imaging of the organs and detection of possible pathological changes.
The transvaginal transducer of our ultrasound is maximally reduced in size, to minimalize the discomfort to our patients.
Three-dimensional (2D)ultrasound examination
Three-dimensional ultrasound exam is a significant advancement for the diagnostic purposes in gynecology. Although the 3D ultrasound has greatly improved the diagnostics of all gynecological conditions, such as the polycystic ovary syndrome or endometriosis, it is predominantly used to evaluate congenital uterine anomalies, most commonly the uterine septum. This ultrasound examination has become the golden standard in diagnosing, localizing and categorization of gynecological anomalies, and a valuable preoperative tool to help the surgeon remove the anomaly successfully.
It should be noted that the 3D ultrasound examination causes no additional discomfort to the patient in comparison to the standard 2D ultrasound exam.
Color doppler ultrasound examination
Color Doppler ultrasound exam is a supplement to the traditional ultrasound exam, which enables a more detailed examination of the bloodstream in the genital system. This examination shows the distinction between arterial and venous blood flow, and enables the analysis of parameters that distinguish between normal and irregular blood flow in a particular organ. Color Doppler is an essential part of ultrasound examination of all suspicious cystic growths, and it can be applied with both the standard 2D ultrasound, and the more advanced 3D ultrasound imaging.
The application of Color Doppler imaging does not cause any additional discomfort in patients, in comparison to standard ultrasound examination.
Follicular monitoring
Ultrasound follicular monitoring is a vital component in all methods of infertility treatment, as well as the best way to monitor a menstrual cycle in all women who wish to learn more about what goes on in their body in each stage of the cycle. The examination is conducted in various phases of the menstrual cycle, with the aim of monitoring basal follicular growth, ovulation and the regular generation and function of the corpus luteum. This examination is performed several times in the course of a menstrual cycle, mainly with the purpose of adequately timing sexual intercourses in order to conceive. This method is particularly effective for women with polycystic ovary syndrome, who often have irregular and less frequent ovulations. Besides tracking changes in the ovaries, this method can be applied to track changes of the uterine lining during the menstrual cycle.
Follicular monitoring consists of a series of relatively short ultrasound examinations in 2D ultrasound technique, which last the maximum of 15 minutes.
Cervical smears
The microbiological analysis of cervical smears is an essential diagnostic procedure used to detect inflammation in the female genitourinary system. The smears are taken gently from the outer cervical layers during the speculum examination with sterile swabs, and further sent for microbiological analysis. This procedure is recommended if the patient experiences symptoms indicative of genitourinary infection or the gynecological exam reveals signs of potential inflammation, such as hyperemic vaginal mucous membrane or abnormal vaginal discharge. The microbiological analysis of cervical smears is used to determine the precise antibiotic treatment of urogenital infection.
The procedure is very similar to the Pap test sample collection, and thus causes no additional discomfort to the patient. It should be emphasized that cervical smear samples should be collected at least ten days after completing treatment with antibiotics. The patients are also advised not to use vaginally applied medicine, creams, powders, douches and deodorants up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure.
Vaginal wet mount
Vaginal wet mount is an alternative method to the microbiological analysis of cervical smears. The sample for this examination is collected within the regular gynecological exam, if the doctor suspects a vaginal inflammation. The results of the test are obtained within minutes in the doctor’s office, which is the main advantage of this method. The collected sample is smeared on a microscopic glass slide, stained with special dyes and observed under a microscope to check for the signs of inflammation. Based on key parameters, the smear is graded on the scale 1 to 3, and the doctor will prescribe therapy if necessary.
The patients are strongly advised not to use vaginally applied medicine, creams, powders, douches and deodorants up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure. It should be noted that this sample collection procedure does not cause any additional discomfort to the patients.
Urethral smears
Urethral smear is an additional method used to detect the causes of urogenital infections. This method is usually applied when cervical smears and urine culture tests have not revealed the causes of infection, or the patient still experiences symptoms upon completing the therapy. The sample for urethral smear is collected with a thin cotton swab, which is inserted into the urethra at a depth of 2 to 3 centimeters and gently rotated. The sample is then sent to microbiological analysis to determine the exact cause of the infection. The doctor will prescribe targeted therapy upon receiving test results.
It should be emphasized that the sample for the urethral smears ought to be collected at least ten days after completing treatment with antibiotics. The patients are also advised not to use vaginally applied medicine, creams, powders, douches and deodorants up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure.
Endometrial biopsy
This exam is performed by inserting a thin suction tube into the uterus to collect a tissue sample of the uterine lining (mucous membrane), which undergoes cytological and pathohistological evaluation and screening for cell abnormalities. The sample can also be used for microbiological analysis in case of infertility, multiple miscarriages or severe infections of the genitourinary system in women. Some patients tend to experience more discomfort during this exam in comparison to a regular Pap smear, whereas most patients have not reported the same.
It should be emphasized that the sample for the microbiological analysis should be collected at least ten days after completing treatment with antibiotics. The patients are also advised not to use vaginally applied medicine, creams, powders, douches and deodorants up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure.
Pap test
Pap test or smear (named after the Greek doctor Papanikolau) is a simple, noninvasive exam of collecting vaginal and cervical cells, which are examined for precancerous and cancerous changes. In addition, Pap smears can be used to detect causes of inflammatory changes. Every sexually active woman should do a Pap test once a year, since regular testing reduces the cervical cancer mortality rates by 90 percent. The samples are best collected between the 10th and 20th day of the menstrual cycle. You will be delivered the test results within several working days, accompanied with treatment recommendations in case of any abnormalities.
The patients are advised not to use vaginally applied medicine, creams, powders and douches up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure.
HPV typing
HPV typing is a diagnostic method applied to prove the presence of HPV viruses on the molecular level. This procedure is commonly conducted together with the Pap smear test or separately, but it certainly provides a more precise reading of the Pap smear test results. It should be noted that the prevalence of HPV infection among people is relatively high. However, this does not necessarily mean that every positively tested woman will develop cervical cancer; the infection often clears spontaneously, especially in young women. HPV typing is used primarily to determine low and high risk types of the virus that might cause malignant cell changes.
The patients are advised not to use vaginally applied medicine, creams, powders and douches up to three days prior, as well as to abstain from vaginal intercourse two days prior to the procedure.
Colposcopy
Colposcopy is an examination of the cervix with a magnifying instrument. The procedure is commonly carried out if the results of Pap smear reveal abnormalities, since it enables a precise collection of the bioptic sample for a more detailed histopathological analysis. The cervix can be observed under normal conditions or intentionally stained with special washes for better detection of cell abnormalities. Contemporary colposcopes enable the use of green filters, which better reveal abnormalities in the blood vessels. The patient lies in a standard (lithotomy) position for most gynecological exams; the examination lasts for around 30 minutes and does not usually cause discomfort.
Cervical biopsy
Cervical biopsy is a method essentially applied to precisely determine the stage of abnormal changes caused by HPV. This diagnostic procedure is usually conducted parallel to colposcopy, since this enables precise sample collection of the affected area. The examination is performed with the help of a small instrument, and local anesthetic is administered if necessary.
Sample collection for cervical biopsy is best taken four to five days after the period. Patients are advised to rest for the day after the procedure and abstain from sexual intercourse for several weeks.
Diagnostics and treatment of various gynecological conditions
Our practice offers medical consultation regarding all gynecological conditions, as well as a detailed analysis of all previous medical reports and test results, and we issue a comprehensive specialist and sub-specialist opinion and recommendations. We particularly treat endocrinological conditions, such as the polycystic ovary syndrome and premature menopause. We apply a holistic approach to the preservation of gynecological health of adolescents, family planning and prevention of unplanned pregnancy, as well as the treatment of postmenopausal ailments, where we devote special attention to improving quality of life in menopause.
