Depending on the issue, there are a number of other examinations. Their use depends on the various complications or concerns of the patient.
Examination Methods
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Sonography: ultrasound plays an important role in gynecological practice – especially during pregnancy, but also, among other things, when a child is wanted or a tumor is suspected. It can be inserted through the vagina (vaginal sonography) or moved over the abdomen (abdominal sonography) or breast (mammary sonography).
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Smears and biopsies: during speculum examinations, cells from the cervix and cervical canal can be obtained for cancer screening (“PAP examination”) or small tissue samples from suspicious districts can be obtained and examined under a microscope. In most cases, these samples are sent to the laboratory for evaluation. The pH value can be determined from the vaginal secretion – if it is less acidic than normal, this is a first indication of colonization with pathogens. If the vaginal secretion then develops a fish-like odor when it is coated with potassium hydroxide solution on a slide (amine test), this suspicion is confirmed. Bacteria or fungi may then be detected under the microscope. In this case, the vaginal secretion is sent to the laboratory for more detailed microbiological examination (eg, cultivation of the germs and test which antibiotics work against them).
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Urine examination: this is part of the routine examination during pregnancy; otherwise, it is performed, for example, if there is a suspicion of cystitis.
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Cycle and hormone diagnostics: If there is a suspicion of hormonal disorders or should cycle irregularities or an unfulfilled desire to have children to be clarified, in addition to the above-mentioned methods still others are used. For example, various hormone concentrations can be measured in the blood or the so-called cervical factor can be determined in the secretion of the cervix. This means that by means of various factors such as appearance and consistency is tested, how the secretion reacts to the different hormones during the menstrual cycle.
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Endoscopy: In children and virgins, a narrow endoscope can be inserted through the vagina instead of the speculum examination (vaginoscopy). In certain situations (e.g., infertility, bleeding from the uterus), the uterine cavity can also be examined with an endoscope – under local anesthesia (hysteroscopy). For diagnostic and often directly therapeutic purposes, an endoscope can also be introduced through small incisions in the abdominal wall (laparoscopy).
