DIAGNOSTIC METHODS IN GYNECOLOGY General overview

METHODS - gynecology History Clinical examination Microbiology Serology Oncology- prebiopsy Morphology Endoscopy

History Family / genetic factors Personal - blood pressure, BMI, etc… gynecological - obstetric Menstrual cycle Delivery – spontaneus / S.C. Gynecologicla disease Contraception / hormonal therapy Status present Sexual life

Gynecological examination palpation cervix, uterus, adnexis, cavum Douglasi, abdominal wall, small pelvis, urinary bladder - pain, resistence, peritoneal irritation In speculis Pathology of : introitus, vulva, cervix (speculae: Simpsons, Scherbacks, Cuzks) Examination per rectum- palpation pediatric gynecology cervix, uterus, adnexis, cavum Douglasi Examination in anestesia / analgesia

Pre-bioptic examination methods Kolposcopy Screening examination 6 - 40x (magnification) native kolposcopy Cervical and vulvar patholgy Change of the epithelium, Inflammation angiogenesis Pre-cancerosis, tumor process

Colposcopy

Pre-bioptic examination methods Expanded colposcopy Acetic acid – diferentiation of squamous and cylindric epithelium – change of the colour and transparence Schiller´s examination – Lugol´s dilution – squamous epithelium is brown, cylindric epithelium or erosion are non-colured

Pre-bioptic examination methods Functional cytology changes of the epithelium during the menstruation cycle diagnotic of the mestrual cycle disorders Oncological cytology The most important screening methods for ca cervicis Cytological crieiria of the smear from the cervix – exocervix / endocervix

Pre-bioptic examination methods Classification of the oncological cytology – Bethesda system SIL – squamous intraepithelial leasion LSIL HSIL ASCUS HPV infection

Breast examination shape, density, skin and nipple of the breast palpation: 4 quadrants, nipple discharge recommendation: self examination once a months Mamograph screening programme: from 45 years – every 24 months – event. ultrasound

Ultrasound The most important diagnostic method Abdominal ultrasound Pediatric gynecology Abdominal tumors, ascites Vaginal ultrasound Small pelvis pathology Ectopic pregnancy Tumors ot the ovaries and uterus Doppler

Endoscopic methods Vaginoscopy Hysteroscopy Laparoscopy Cystoscopy

Hysteroscopy

laparoscopy

ENDOSKOPIE a KALIBRACE

METHODS III.- urogynecology History Clinics Laboratory testing Morphology Endoscopy Urodynamics

Vyznačen inklinační úhel uretry – tzv. úhel 

UPP - equipment

Invasive diagnostic and treatment methods Dilatation of the cervix curretage Punction of the Douglas space Biopsy of the cervix Biopsy of the vulva

We want something better ! More interesting! Videos,please!!

OK:After the short break you are invited for: Some clips from laparoscopies