Gynecological Examination and Diagnosis

With gynaecological examination, the condition of the genital organs and gynaecological problems are evaluated.

Underwear must be removed for gynaecological examination, a special apron or cover is given to make the person feel comfortable. To provide a suitable position for the examination, the patient is asked to sit on the gynaecological examination chair, lean back and put his legs on the side legs. In this way, the patient's examination position is called the “lithotomy position” in the medical language. Then, whether there is lymph node enlargement in the groin areas is determined by manual examination.

Check whether there is redness, irritation, cyst, wart in the external genital area (vulva). In this position, leaving the person alone makes the examination process very easy. This process, which takes a very short time, does not cause any pain. After the external genital organ examination, pelvic examination is started. Pelvic examination is done when the bladder is empty. For the examination to be painless and complete information about the genital system, you need to relax your abdomen and fully rest your waist on the table. You may wait a while if you need to relax. When this relaxation occurs, the examination will be completely painless. Later, external lips, clitoris, urethra entrance, hymen pathologies and damage during birth are detected.

Then, if you are not a virgin, the device called vaginal speculum (it can be metal or plastic) is gently inserted into the vagina. In the meantime, the doctor gets the opportunity to examine the vagina completely. Whether the current is colour, texture, foamy, smell… is evaluated. Then the cervix is observed. Here, erosion (wound), birth-related rupture (emmet rupture) and signs of infection are examined. Meanwhile, a sample of cells is collected from the cervix with a pap-smear brush. The sampling process for pap-smear takes place using various sticks to change from doctor to doctor. This procedure is always painless. In some cases, you may have a few drops of bleeding after sampling. This is considered completely normal unless your doctor says otherwise.

During the pelvic examination, if there is no bleeding, pap-smear is routinely taken even if no pathology is detected. In cases where infection is suspected during the examination, a sample can also be taken for culture. Vaginal and cervical culture is the process of sampling a cotton swab by touching the various areas of the vagina and the cervix. The speculum is then slowly removed from its location. The degree is evaluated if there are developed sagging due to births such as bladder sagging (cystocele) or large intestine sagging (rectocele) during removal.

Sampling with PAP Smear stick in gynaecological examination

The final stage of the pelvic examination is a manual examination. The doctor inserts the index finger and middle finger of one hand into the vagina and presses the other hand to the lower abdomen. In this examination, the size of the uterus, the consistency of the uterus and the position of the uterus (forward, inverted) are noted first. At this stage, the doctor moves his cervix back and forth and to the side, and assesses whether this movement causes pain (Meanwhile, a small amount of pain may be considered normal, but excessive pain may be a sign of infection or convexity). Learn about the right and left ovaries and the surrounding soft tissues from the side wall of the vagina. Here, it is checked whether there is a mass in the area during the examination. Excessive pain in the area by pressing can be a harbinger of infection. The same procedure is repeated in the left ovary region and the pelvic examination is completed.

In some cases, in manual examination, the doctor evaluates by placing one finger in the vagina and the other finger in the rectum area. This examination, called a rectovaginal evaluation, is an examination performed in case of serious infection or cancer. Some doctors routinely perform this examination.

Examination in virgins; A virgin comes to the gynaecological examination even more hesitantly. Some women even investigate whether this doctor made an assessment by ultrasonography instead of the examination, either by calling the doctor directly or by collecting information from people who have been examined. Remember: Ultrasonography is an imaging method and can never replace a manual examination.

Whether the area examined in manual examination is sensitive to pain, the consistency, and some other qualities of the mass in the presence of mass cannot be determined by ultrasonography examination. In the examination of a virgin woman, the stages until the speculum examination are the same. The speculum examination phase is skipped. For rectal (rectal) double-handed examination, the right forefinger is lubricated with vaseline and placed in the rectum, and the left hand is placed in the lower part of the abdomen. All the information in the vaginal examination is obtained in this examination. Although this examination is slightly inconvenient, it is useful to perform it because it gives very important information.

Ultrasonographic examination; Internal organs are monitored in detail by using sound waves with ultrasonographic examination. It is a reliable examination method since it is not exposed to radiation. Abdominal (abdominal) or vaginal ultrasonography can be performed. The woman's bladder should be full in the examinations to be made from the abdomen. The full bladder pushes the intestines, making it easier to see the reproductive organs. The bladder does not need to be filled for vaginal ultrasonographic examinations. Reproductive organs can be examined better by vaginal ultrasonography.


Conditions requiring gynaecological control, regardless of age.

Pain in the lower abdomen and groin
Menstrual irregularities, menstrual bleeding or disruption
Severe pain during or before menstrual bleeding
Abnormal bleeding
Pain, swelling, itching, mass and sores in external genital organs
Vaginal discharge, itching and pain
Fifteen, sixteen years of age, no menstrual bleeding
Exposure to diseases passing through sexual contact
Situations where more than one gynaecological control is required per year:
When pregnancy is planned,
In the presence of the disease passing through sexual contact,
In the presence of sexual health problems,
When the Pap smear result is not normal.

Op. Sibel Malkoç, MD

Gynecology and Obstetrics Specialist

Dr. Sibel Malkoç attended many domestic and international training seminars and congresses during 25 years of specialised physician service.

Pregnancy follow-up, urinary incontinence surgery and laser treatments, genital aesthetic surgery and laser applications and vaginismus treatment are of special interest.

It serves its patients especially in surgical and laser-assisted Vagina aesthetics.

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