The gynecology (étymologiquement science, study of the woman ) is a speciality médico - surgical which deals with the Physiologie and of the affections of the genital system of the Femme. The doctor specialized practitioner gynecology is called a Gynécologue.
The genital apparatusIt is the whole of the sexual organs which include the functions of insemination, of the Fertilization, the Gestation and of parturition (natural childbirth).
Means of exploration
ExaminationIt is typically an art of specialist. In the majority of the countries, the women must consult a general practitioner. If the circumstances require knowledge or equipment this last does not have, they are directed towards a gynecologist. However, the United States, the law and much of companies of health insurance make it possible to the gynecologists to examine in general medicine and some women choose this option.
As everywhere in medicine, the principal instruments of diagnosis are the clinical history and the examination. The gynaecological examination has this of special that being completely intimate it implies a special instrument: the speculum. This last consists of two blades with metal hinge polished, which is employed to open the vagina and to allow the examination of the cervix uteri . The gynecologists can also proceed an examination to two hands (a hand on the abdomen, two fingers in the vagina), to palpate the uterus and the ovaries. They can from time to time make a rectal examination. Gynecologists men often have a female assistant (a nurse or a coed in medicine) for this kind of examination. Abdominal ultrasounds get busy normally to confirm the examination with two hands.
The Department of Cosmetic surgery at the Medical school of the University of Virginia recommends not to use during surgical acts of the gloves powdered with talc, because of the acute problems and chronicles which can occur if this product is introduced into the abdominal cavity via the vagina. One says the same thing of the condoms on which one employs the same talc powders.
- Echography: always possible, painless and nonirradiant, can be by way endovaginale (especially for the study of the uterine collar) or pelvic, it is particularly useful during the pregnancy, to supervise the growth, morphology, the presentation of the baby.
- IRM : less available than echography, the IRM gives indications of large quality, especially in research of fibromes and for certain cancers.
- Hysterography: examination not very irradiant, painless, presenting an infectious risk, allowing to study the uterine cavity (less and less used, especially indicated within the framework of an assessment of infertility)
- Scanner: irradiating, painless and fast, he studies general pathologies, or in the event of diagnostic uncertainty.
- Hystéroscopie : examination carried out with the cabinet or under general anesthesia, allowing to see the uterine and to carry out directed biopsies, useful cavity for the diagnosis of cancer of the endometer
Vagina and cervixThe gynaecological examination of the Vagina and the collar includes/understands two stages:
- vaginal examination in the search of a pain, a polyp, a cervical lesion;
- installation of the Speculum appreciating the collar and the vagina, seeking a Leucorrhée, bleedings, lesions, and allowing the cervical smear.
Disorders of the rules
- Hypo or hyper-ménorrhée: disorders of the duration (AND frequency, according to acceptances)
- Oligo or polyménorrhée: disorders of the quantity
- Disorder of the frequency:
- Pollakiménorrhée, lower than 24 days
- Spanioménorrhée, higher than 35 days
- Ménorragie: rules long and abundant (AND frequent, according to acceptances)
- Métrorragie: Hemorrhage apart from the rules
- Subway-menorrhagia: perpetual bleeding.
- Dysmenorrhoea: this term indicates the difficulty of the flow of the rules. But one especially indicates by this word the painful rules (the term algoménorrhée would be more exact).
- Amenorrhoea: absence of rules for at least 3 months apart from the Pregnancy.
- Primary: at a woman of more than 18ans not having never had its rules
- Secondary: at a woman having already had her rules
Disorders of the MenopauseVoir article Ménopause
- turbid of the rules (irregular, abundant)
- taken circulatory trouble weights
- puffed out heat
- psychiatric disorders
- dryness of the mucous membranes
- atrophies glandular Sein
- coronary and cardiac risk
Pathologies of the Uterus
- Fibrome : benign tumor of the uterine muscle
- Polyp: outgrowth, benign formation sometimes associated with a cancer
- Aplasia: absence of bicornuate uterus
- Uterus, uterus partitioned
Pathologies of the collar
- Cervicite : ignition and parasitic, microbial or viral infection declaring itself by leucorrhées (nonblood flows)
Pathologies of the ovary S
Syndrome of the ovaries polykystic
- Standard I: primary education (Syndrome of Stein-leventhal)
- Standard II: secondary with a genital infection generally (salpingite)
- small stuck lips (coalescence)
- vagina partitioned
- obstetric traumatisms
ProlapsusThe prolapsus is a failure of the pelvic structures of support and périnéales. This pathology is supported by a long or difficult childbirth, a muscular atrophy, a slimming, a hypoactivity, a congenital malformation etc
it does not present specific clinical signs but can result in a varied symptomatology which can change a patient to another:
- rare pains but rather gravity or a local discomfort
- dyspareunie occasional
- turbid urinary varied (incontinence to see on the contrary dysurie, pollakiurie, urinary infections with repetition)
- digestive disorders (final constipation)
- turbid related to the exteriosation (tumefaction or " boule" with lentrée of the vagina, bleeding induced by the mechanical ulcerations created by friction…)
EndométrioseThe Endométriose is a localization out of the uterine cavity of cells of the Endomètre having the same morphological and functional characteristics. Many theories were proposed, but none was still proven.
Cancer S gynaecological
- Summarized recent medical literature on the vaginal and uterine prolapsus. In English.
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