Due to the dynamics of the female genital organs, system examination should be done every year without negligence even though everything is normal.
Gynaecological examination include the pelvic system as the examination of external bodies and internal organs.
General acception is performing the first examination at the ages of 13-15 despite no complaints. Unobserved genetic disorders, anatomic abnormalities, problems that may ocur are attempted to be identified. This examination includes many issues such as whether menstruation has started or not, he development of secondary sex characteristics, height - weight, skeletal disorders, intelligence etc. Structural disorders of sexual organs, organ absence, cancer ... are examined.
Physician should be also consulted in cases such as discharge, interval bleedings, irregular menstruation, painful menstruation, excessive hair growth.
Since most of the genital organsa re internal organs , ultrasound is used in vaginal examination. Vaginal ultrasound is usually used in appropriate cases. In cases of virginitiy, vaginismus, organ abnormalities, concomitant renal anomalies, etc. abdominal (intraperitoneal) ultrasound is performed.
Since gastric-intestinal cancers are very common among female deaths, especially occult blood in stool should be examined in every women once a year after 40s although there is no complaint.
Purposes of the annual examination include detection of development and structures of age-inappropriate organs, identifying their pathology, cancer screening, evaluation and arrangement of prevention methods, breast control, vaccination in order to be protected from cervical cancer starting from the age of 9 if it has not been done yet, assessment of cognitive function, especially evaluating the psychological status during puberty and menopause and screening of patients having familial risk.
Ovarian cancer is a fatal disease which peaks up especially at the age of 63 and progresses quitely until reaching advanced stages. Ther e is generally no complaint in 85% of the patients. Diagnosis is established in gynecologic examination by using ultrasound and radiological devices.
Being more common especially in undeveloped – developing countries, cervical cancer is a type of cancer which again cause simple complaints such as bleeding disorders, smelling discharge, bleeding during sexual intercourse and it can be detected with “SMEAR” test which is performed once a year.
Nearly all cervical cancer is caused by the Human Papilloma Virus (HPV). Thanks to the vaccine which has been improved within the last 10 years, it is possible to be prevented from cervical cancer. Starting from the age of 9, every males and females can have the vaccination through the arm in 3 doses which is made by using genetic technology.
Most common intra-uterine problem is “Fibroid”. Uterus is formed of a thick muscular layer which surrounds the thin and hormone-sensitive membrane and a thic membrane surrounding it. Fibroids originates from the muscle tissue. It’s seen in 20-25% of the women, they are benign and the risk of cancer is %0,4. (It is considered that this is not a transformation but these carry the characteristics of cancer from the beginning.) Fibroids present different findings according to their location. A very large fibroid may be quiet or also cause excessive bleeding and require surgical intervention. It is easily diagnosed with examination adn ultrasound. Follow up and treatment are determined afterwards.
Polyps of the inner membrane of the uterus or cervix are detected in the examination and treated.
The most common problems that can occur in tubes; may be tube closure and unable to give birth. This condition is most commonly related to neglected vaginal infections and endometriosis. The tube that become visible on ultrasound don’t cause complaint and it can be detected during routine examination.
Ovaries are the internal organs and play the main role in menstrual regularity. This organ is dynamic and constantly operates for the development and continuity of ovum . In annual examination, its liberalization and size are evaluated, its dimensions, capacity, function and pathologies are detected with the help of ultrasound. Most common problem is follicular cysts. Generally these are simple structures less than 3 cm in size with fluid content. Mostly they disappear in 1 to 2 months spontaneously without reqquiring treatment. Whereas pathologies such as chocolate cyst (endometrioma) are very important have an effect on ovulation and pregnancy. It is the settlement of endometrium (intra-uterine membrane) to the ovary. These have tendency to form adhesion and growth and sometimes surgical intervention may be required.
The treatment of benign cysts with complex content such as terratoma can be planned earlier if diagnosed before they cause complaint.
Mammography and breast ultrasound should be performed in annual examination especially after 40 years old if there is no special risk factor such as family history. Early stage cancer can be detected if these methods are added to examination by hands after these ages.
Examination is done once every 6 months after 50s and menopause. The initial scope is to detect the pathologies such as cancer.
In routine examination while questioning the past medical history, psychosocial status and sexual life and its complaints should be listened and if necessary, neurological and psychiatric consultation should be carried out.
Bone mineral density should be evaluated in annual examination after the age of 40 (earlier if there is a family risk). Supplements of the calcium, vitamin D should be made if necessary.
Occult blood in stool should be examined once ayear, blood tests should be done.