Diagnostic Procedures in Gynaecology

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What are they?

There are various diagnostic procedures in gynaecology. The following information is intended to give you some basic information on the different procedures used in gynaecology. For details about any of the procedures, please discuss with your doctor.

Blood tests

Multiple blood tests can be performed to check for hormonal status. These include FSH, LH, Testosterone, full blood count, serum progesterone, CA 125, CEA and tumour HCG levels. Not all blood tests are done for everybody. Your doctor will be able to discuss the tests appropriate for you.

Pap Smear

 

What is Pap smear?

The Pap test is a screening test used to find changes in the cervix that can lead to cancer. The Pap smear is a very simple procedure where a few cells are collected from the cervix and placed on a slide. The slide is sent to the laboratory to check for any abnormal changes. The Pap smear is very good in finding some early changes which if untreated can lead to cancer over a period of time. It only takes a few minutes.

How often should I have a pap smear?

All women over the age of 18 who have ever had sex are advised to have a pap smear every two years. This should continue until you are 70 years of age or over. After 70 years if you have had two normal paps smears in the last 5 years you do not have to have pap smears. If you have had a hysterectomy talk to your doctor about whether you need routine pap smears. If you have any unusual symptoms like bleeding between periods or post-coital bleeding or bleeding after intercourse you should see your doctor even if you have had a normal Pap smear test in the past.

How effective is the Pap smear?

If performed as per the recommendation, regular pap smears help prevent up to 90% of cervical cancer. However, the test has some limitations. Sometimes the sample can be inadequate or difficult to interpret due to blood or mucus.

Pap Smear Results

Usually your pap smear result will be available within two weeks. You can contact the provider to find out the result. An abnormal result does not necessarily mean you have cancer. Sometimes the reports can be unsatisfactory due to blood, mucus or inadequate preparation of the smear. If this is the case you will be asked to have another pap smear.
If you need any further information regarding pap smear please check the national cervical screening program on the website www.health.gov.au

Vaginal swabs

Vaginal swabs are tests to check for infection in the vagina. These are done by your doctor using a speculum examination, very similar to your pap smear test. It only takes a few minutes to do it. Cotton swabs are used and hence they are not irritable. The swabs are then sent to the laboratory to check for various infections like Chlamydia and gonorrhoea.

Pelvic ultrasound

Pelvic ultrasound is ultrasound of the pelvis including uterus, tubes, ovaries, bladder, etc. This is performed by a qualified ultrasonologist or your doctor. It uses sound waves to create pictures of the internal organs of the pelvis. This is done abdominally or vaginally. The ultrasound helps to visualise fibroids (growths in uterus), polyps (benign or cancerous growth in the uterus and/or cervix), fluid in the peritoneal cavity, ovarian cysts (fluid filled bags in ovary) and intrauterine contraceptive device.

Hysteroscopy

Hysteroscopy is a technique used to visualise the inside of the uterus. This technique uses a thin, telescope with a camera at the end. It is inserted into the uterus through the vagina and cervix. This procedure can be done under local, regional or general anaesthesia. The hysteroscope can be used to see and treat a condition at the same time. The procedure is very safe with minimal complications. Very rarely, the hysteroscope can perforate a uterus or cause heavy bleeding and both are treatable.

Dilatation and curettage

This is a procedure used to diagnose or treat a condition that is causing the abnormal bleeding. Dilatation is a procedure to open the cervix to make it wider and curettage is to take a sample from the lining of the uterus. The procedure can be performed as an outpatient or as an inpatient. Sometimes, this is done as part of the hysteroscopy. Complications of this procedure are rare. They include bleeding, infection perforation of the uterus and adhesions formation.

Laparoscopy

This is a surgery performed to visualise the inside of the pelvis. The surgery uses very small incisions and a thin telescope so large cuts are avoided. The procedure is under general anaesthesia. Laparoscopy not only helps to identify the causes of pelvic problems but also to treat those conditions at the same time. Risks involved with this procedure are bleeding internally, infection, damage to the pelvic organs like bladder/bowel and a small need to make a larger cut anyway. However, laparoscopy offers multiple advantages like good views of pelvis, minimal stay in hospital, earlier return to activity, minimal pain requirement.