Gynecology

The genital apparatus

It is the whole of the sexual organs which include the functions of insemination, of the Fertilization, the Gestation and of parturition (natural childbirth).

See article reproductive Apparatus : Vulva, Clitoris, Large lips, Small lips, Vagina, Uterus, Fallopian tube, ovary S, Glands of Skene, Gland of Bartholin.

Means of exploration

Examination

It is typically an art of specialist. In the majority of the countries, the women must consult a general practitioner. If the circumstances require knowledge or equipment this last does not have, they are directed towards a gynecologist. However, the United States, the law and much of companies of health insurance make it possible to the gynecologists to examine in general medicine and some women choose this option.

As everywhere in medicine, the principal instruments of diagnosis are the clinical history and the examination. The gynaecological examination has this of special that being completely intimate it implies a special instrument: the speculum. This last consists of two blades with metal hinge polished, which is employed to open the vagina and to allow the examination of the cervix uteri . The gynecologists can also proceed an examination to two hands (a hand on the abdomen, two fingers in the vagina), to palpate the uterus and the ovaries. They can from time to time make a rectal examination. Gynecologists men often have a female assistant (a nurse or a coed in medicine) for this kind of examination. Abdominal ultrasounds get busy normally to confirm the examination with two hands.

The Department of Cosmetic surgery at the Medical school of the University of Virginia recommends not to use during surgical acts of the gloves powdered with talc, because of the acute problems and chronicles which can occur if this product is introduced into the abdominal cavity via the vagina. One says the same thing of the condoms on which one employs the same talc powders.

Uterus

Echography: always possible, painless and nonirradiant, can be by way endovaginale (especially for the study of the uterine collar) or pelvic, it is particularly useful during the pregnancy, to supervise the growth, morphology, the presentation of the baby.
IRM : less available than echography, the IRM gives indications of large quality, especially in research of fibromes and for certain cancers.
Hysterography: examination not very irradiant, painless, presenting an infectious risk, allowing to study the uterine cavity (less and less used, especially indicated within the framework of an assessment of infertility)
Scanner: irradiating, painless and fast, he studies general pathologies, or in the event of diagnostic uncertainty.
Hystéroscopie : examination carried out with the cabinet or under general anesthesia, allowing to see the uterine and to carry out directed biopsies, useful cavity for the diagnosis of cancer of the endometer

Vagina and cervix

The gynaecological examination of the Vagina and the collar includes/understands two stages:

vaginal examination in the search of a pain, a polyp, a cervical lesion;
installation of the Speculum appreciating the collar and the vagina, seeking a Leucorrhée, bleedings, lesions, and allowing the cervical smear.

Gynaecological pathologies

Disorders of the rules

Hypo or hyper-ménorrhée: disorders of the duration (AND frequency, according to acceptances)
Oligo or polyménorrhée: disorders of the quantity
Disorder of the frequency:

Pollakiménorrhée, lower than 24 days
Spanioménorrhée, higher than 35 days

Ménorragie: rules long and abundant (AND frequent, according to acceptances)
Métrorragie: Hemorrhage apart from the rules
Subway-menorrhagia: perpetual bleeding.
Dysmenorrhoea: this term indicates the difficulty of the flow of the rules. But one especially indicates by this word the painful rules (the term algoménorrhée would be more exact).
Amenorrhoea: absence of rules for at least 3 months apart from the Pregnancy.

Primary: at a woman of more than 18ans not having never had its rules
Secondary: at a woman having already had her rules

Disorders of the Menopause

Voir article Ménopause

turbid of the rules (irregular, abundant)
taken circulatory trouble weights
puffed out heat
psychiatric disorders
dryness of the mucous membranes
pilosity
atrophies glandular Sein
osteoporosis
coronary and cardiac risk

Pathologies of the Uterus

Fibrome : benign tumor of the uterine muscle
Polyp: outgrowth, benign formation sometimes associated with a cancer
Malformations:

Aplasia: absence of bicornuate uterus
Uterus, uterus partitioned

Pathologies of the collar

Cervicite : ignition and parasitic, microbial or viral infection declaring itself by leucorrhées (nonblood flows)
Ectropion

Pathologies of the ovary S

Cyst:

organic
functional

Syndrome of the ovaries polykystic

Standard I: primary education (Syndrome of Stein-leventhal)
Standard II: secondary with a genital infection generally (salpingite)

Pathologies of the Vagina and the Vulva

Malformations:

small stuck lips (coalescence)
vagina partitioned

Infections:

Mycoses

Traumatisms:

obstetric traumatisms
Rape

Prolapsus

The prolapsus is a failure of the pelvic structures of support and périnéales. This pathology is supported by a long or difficult childbirth, a muscular atrophy, a slimming, a hypoactivity, a congenital malformation etc

it does not present specific clinical signs but can result in a varied symptomatology which can change a patient to another:

rare pains but rather gravity or a local discomfort
dyspareunie occasional
turbid urinary varied (incontinence to see on the contrary dysurie, pollakiurie, urinary infections with repetition)
digestive disorders (final constipation)

tumé vulvar

turbid related to the exteriosation (tumefaction or " boule" with lentrée of the vagina, bleeding induced by the mechanical ulcerations created by friction…)

Endométriose

The Endométriose is a localization out of the uterine cavity of cells of the Endomètre having the same morphological and functional characteristics. Many theories were proposed, but none was still proven.

Cancer S gynaecological

See too

Obstetric Woman
Andrologie

External bonds

Summarized recent medical literature on the vaginal and uterine prolapsus. In English.

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