This is followed by the gynecological examination. While the doctor prepares the necessary materials and prepares the examination room, the patient undresses in a small separate area or changing room. Afterwards she sits on the gynecological chair in the so-called lithotomy position.
The woman is in a half-sitting, half-lying position with spread and slightly bent legs. The doctor will now first inspect the genital region from the outside and look for changes in the skin, swelling, redness or discharge. He will then palpate for lymph nodes in the groin area and palpate the lower abdomen from the outside for pressure pain and other abnormalities.
This is followed by a vaginal examination. For this, the doctor requires a preheated speculum, which he inserts into the vagina and then opens. This expands the vagina and the cervix can be assessed.
For general cancer screening, the doctor now takes a kind of cotton swab and takes a smear from the portio, the lower part of the uterus where the cervix is also located. The swabbed cells are spread on a microscope slide. The doctor then takes a small brush with which a smear is taken from the cervix.
This can be somewhat uncomfortable for the woman. These cells are also spread out on a microscope slide for later evaluation in the laboratory. The speculum can now be removed again.
A vaginal palpation examination follows. The doctor carefully inserts two fingers and simultaneously palpates with the other hand from the lower abdomen towards the inserted fingers. The bladder, uterus and ovaries can be palpated.
In doing so, the doctor will check, for example, whether the patient feels pain at any point. Finally, the gynecological examination includes a rectal examination in which the anal region is palpated with one finger. Afterwards, the patient can put her clothes back on underneath, but now takes off her top so that the palpation of the breast can still be performed.
The doctor palpates both breasts as well as the lymph nodes in the neck and armpit area for abnormalities. Depending on whether the patient has any complaints, the gynecological examination can be extended by various aspects. For example, an ultrasound scan can be performed from the abdomen or through the vagina in order to assess the uterus and ovaries more precisely.