Complete gynecological exam

The gynecological examination even in the absence of disorders is useful to prevent diseases and control of the female reproductive system health. Prevention means indeed to regularly take care of one’s well-being, as well as following a correct lifestyle made of a healthy diet, physical exercise and compliance with hygiene rules. If you are over 18 years old and sexually active, even if occasionally, the advice is to do a gynecological examination per year.

As in every other examination, during a gynecological examination the specialist needs to spend some time asking questions to his/her patient (pre-existing illnesses, allergies, current problems, but also lifestyle, medications, interventions and pregnancies, family pathologies), useful to gain the information needed to assess medical history and an accurate picture of the current state of patient’s health, before proceeding to the pelvic exam: an examination of the internal female genitals (vagina, uterus and ovaries) and external (vulva), through visual inspection, manual scan and the aid of a speculum. The visit usually does not cause any pain and it is important that the patient does not have fear.

In my medical practice clinic in Florence, I can complete the gynecological examination by collecting samples of the patient’s blood and urine for screening tests (such as Pap test) to be sent to the laboratory for analysis, and / or by performing painless transvaginal ultrasound (to exclude the presence of fibroids, ovarian cysts, endometrial polyps and other vagina, uterus and ovaries pathologies), or by analysis and preparatory tests to IVF (in vitro fertilization).

As a gynecologist, during the visits I perform in Florence, I try to empathize with my patient, to put her at ease, I act gently and with patience during the manual examination, as well as I intend to be scrupulous and thorough when listening or when providing medical explanations.

Below is a list and description of the most important gynecological diagnostic techniques, the ones available during my gynecological examinations are specified. For all other tests I collaborate with a team of specialists and dedicated structures, to which I can refer my patients if they need.

Diagnostic techniques and the most important gynecological tests

Pap Test: it is a screening test which consists in collecting a sample of cells from the cervix and the inside of the cervical canal with special tools (spatulas and brushing). The material is placed in a special test tube and analyzed under the microscope. This method is an important screening test for the prevention of cervical cancer. Test I perform in my medical practice.

Microbiological tests: vaginal swab, endocervical and intraurethral to search for common germs, chlamydia, ureaplasmas, mycoplasma, gonococcus, trichomonas. Test I perform in my medical practice.

Vulvoscopy: consists in the observation of the vulva with a magnifying glass, to highlight certain diseases and injuries (lichen sclerosus, vulvar warts etc.). Exam to be performed in dedicated structures.

Colposcopy: consists in the observation of the mucosa of vagina and cervix with a colposcope. In presence of an abnormal Pap Test or when suspicious areas are observed with the speculum, a colposcopy is recommended. It is also necessary during the colposcopy to swab gently with a cotton ball, soaked in acetic acid and subsequently in an iodine solution (Lugol’s solution), the surfaces to be examined. Those substances, applied on the mucous membranes under analysis, have the property of highlighting abnormal areas that may be present. Exam to be performed in dedicated structures.

Ultrasound: can be transabdominal, performed with a full bladder, and transvaginal, with a particular probe that is inserted into the vagina and allows a closer and more detailed visualization of pelvic organs. Exam I perform in my clinic.

SIS or sonohisterography: is an exam that allows the ultrasound visualization of the uterine cavity and fallopian tubes; the procedure is held in out-patients’ clinic, and involves the injection of a few cc of saline solution into the uterine cavity through a small catheter placed transcervically in the uterus. The solution distends and enlarges the endometrial cavity, so that it can be studied with transvaginal ultrasound, allowing the assessment of the tubal patency. Exam I perform in my clinic.

Hysterosalpingography: is a test that allows a morphological analysis of the uterus and fallopian tubes. Consists in the injection of a contrast medium into the uterine cavity by transcervical catheterization, and then in the execution of some X-rays to visualize the uterine cavity and the fallopian tubes, thus obtaining a negative image of these structures. Exam to be performed in dedicated structures.

Hysteroscopy: consists in the observation the uterine cavity through the introduction of a rigid instrument, called hysteroscope, into the cervical canal and uterus. The examination is carried out in case of suspicion of pathology within the uterus cavity. Exam to be performed in dedicated structures.

Diagnostic videolaparoscopy: is a test performed in very particular conditions, it is surgery in fact. It consists in the introduction of an optic fiber probe inside the abdomen, having done a small incision at umbilical level. Exam to be performed in dedicated structures.

Mammography: nowadays, still the best screening method for malignant breast lesions. It allows to identify not yet palpable cancerous lesions. The radiation absorbed during the examination are negligible, especially when compared to the advantages. The breast ultrasound is indicated for the study of the breast when the woman has less than forty years and is used to complete the mammography or for the biopsy of previously detected lesions. Exam to be performed in dedicated structures.

Computerized Bone Densitometry: is the reference method for the diagnosis of osteoporosis because it measures the mineral wealth of the skeleton, mainly consisting of calcium, and helps to assess small changes in bone mineral density over time. Exam to be performed in dedicated structures.