Examination of female external genital organs
Last reviewed: 23.04.2024
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A special gynecological examination begins with an examination of the external genitalia. In this case, attention is drawn to the hair in the pubic region and large labia, possible pathological changes (swelling, tumors, atrophy, pigmentation, etc.), height and shape of the perineum (high, low, trough), its ruptures and their degree, slit (closed or gaping), omission of the walls of the vagina (independent and when straining). When sliding the genital gaps, it is necessary to pay attention to the color of the mucous membrane of the vulva, to examine the condition of the external opening of the urethra, the paraurethral cords, the excretory ducts of the large glands of the vestibule, to pay attention to the nature of the vaginal discharge. After examination of the external genitalia, the anal area (presence of cracks, hemorrhoids, etc.) should be examined.
The appearance and condition of the external genitalia, as a rule, correspond to the age. Women give birth to attention to the condition of the perineum and the sexual fissure. At normal anatomical ratios of the perineal tissues, the genital cleft is closed and slightly opened only with a sharp straining. In violation of the integrity of the muscles of the pelvic floor, the sexual gap gapes even with mild tension, the walls of the vagina drop.
The mucous membrane of the entrance to the vagina of a healthy woman has a pink color. In inflammatory diseases, it can be hyperemic, sometimes with the presence of purulent raids. During pregnancy, due to congestion, the mucous membrane acquires a cyanotic color, the intensity of which increases with the duration of pregnancy.
Hypoplasia of small and large labia, pallor and dryness of the mucous membrane, the vagina are signs of hypoestrogenia. Juiciness, cyanosis of the vulva, abundant secretion of the cervical mucus - signs of an elevated level of estrogens. Intrauterine hyperandrogenism is indicated by hypoplasia of the labia minora, an increase in the clitoral head, an increased distance between the base of the clitoris and the outer orifice of the urethra (more than 2 cm) in combination with hypertrichosis. Then they proceed to the study with the help of mirrors, which is especially important in gynecology to detect pathological changes in the vagina and cervix. Examination with the help of vaginal mirrors is an obligatory part of every gynecological examination, since many pathological conditions on the cervix and vagina are not accompanied by a certain symptomatology. It allows you to assess the condition of the vaginal mucosa (color, folding, tumor formations), its depth. On the cervix of the uterus is determined the shape of the external uterine throat, the presence of inflammatory changes, tumor formations (polyps, exophytic form of cancer, etc.), the nature of the discharge from the cervical canal.
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