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Vaginoscopy
Last reviewed: 17.10.2021
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Colposcopy is the method of endoscopic examination of the vagina during gynecological examination of sexually mature women, and such a diagnostic procedure as vaginoscopy can be performed on girls and girls with an intact hymen - the hymen surrounding the vaginal opening.
Indications for the procedure
Endoscopic examination of the vagina - vaginoscopy for children: pre-pubertal girls and adolescent girls after menarche - is rarely prescribed. [1] These cases concern:
- vaginal bleeding;
- vaginal discharge;
- chronic vulvovaginitis in girls (especially if the infection does not respond to treatment);
- recurrent genital infections, for example, vaginoscopy in children with gonorrhea is necessary to assess the state of the mucous epithelium, including that covering the vaginal part of the cervix;
- pain in the pelvic area of unknown etiology;
- diagnostics of malformations of the vagina and uterus with symptoms of congenital vaginal anomalies (for example, vaginal stenosis or transverse vaginal septum) - when a visual examination of the vaginal vestibule and transabdominal ultrasound are not informative enough;
- suspicion of the presence of a foreign body in the vagina or its traumatic injury with possible sexual abuse. [2], [3]
Read also - Features of gynecological examination of children and adolescents
Preparation
Parents (in particular, the girl's mother) should be informed about the purpose of this diagnostic procedure, as well as that during its implementation, the hymen will not be injured.
And the preparation of the patient consists in cleansing the intestines (using an enema, which is done in the morning before the examination) and emptying the bladder.
Before the procedure - for the prevention of infections - a broad-spectrum antibiotic is administered.
Technique of the vaginoscopy
Vaginoscopy for girls is performed on an outpatient basis or in a day hospital of a medical institution - under general anesthesia.
The technique eliminates the need to use conventional gynecological instruments (dilator mirrors). Equipped with a miniature video camera at the end, a flexible fiber optic vaginoscope (pediatric cystoscope or flexible irrigation endoscope) of small diameter is gently inserted into the vagina through the natural hymen opening (the intact hymen almost never covers the entire vagina) - without damaging it. [4]
When the camera captures the inside of the vagina, the doctor sees everything on the monitor.
Complications after the procedure
As a rule, there are no negative consequences of vaginoscopy, but discomfort is possible, as well as injury to the mucous membrane of the vaginal cavity. In this case, during the first few days, minor pains above the pubis may occur, and there may be a small amount of blood in the urine. Nausea and vomiting after anesthesia are also possible. [5]
Complications occur when the vagina and urinary tract are infected or due to damage to the hymen.
Reviews
According to the reviews of pediatric gynecologists, the use of diagnostic vaginoscopy - a painless and safe method for assessing the state of the lower genital tract - is advisable for the correct diagnosis and adequate treatment of gynecological diseases in childhood and adolescence.