The gynaecological examination

Prof. Zeelha Abdool and Prof. Leon Snyman from the Department of Gynaecology and Obstetrics at the University of Pretoria point out that the discipline of obstetrics and gynaecology is distinctive in that care is extended to every stage in a woman’s life. This August we consider the importance of the gynaecological examination and discuss the type of care you should receive during a consultation.

In order for the correct diagnosis to be made, and to receive an effective treatment plan, the history taking and gynaecological examination that follows should take place in a calm, safe and private environment, and not be rushed. This is your opportunity to address any gynaecological concerns and to receive preventative screening and medical information from the attending medical practitioner.

Medical practitioners are trained to focus on core complaints and a skilled practitioner is one who listens attentively, uses appropriate eye contact, shares a reassuring smile, and allows you to explain the condition in your own words. Before the examination takes place, you should feel free to ask questions if there is any confusion about the physical examination, which may include procedures such as ultrasound, cervical cytology screening or biopsy.

The gynaecological examination is an intimate encounter and after you’ve shared sensitive and private information during the history taking, it is understandable to feel vulnerable. If you are not instructed, ask your doctor about the extent to which you have to undress, and if you feel hot or cold, ask if it is possible for the temperature to be adjusted.

The general examination, which forms part of the gynaecological examination, will include the normal aspects applicable to all cases such as pallor, oedema, central or peripheral cyanosis, clubbing of the fingers and palpable lymph nodes in the different regions. It may be necessary to perform either a full systemic examination or at least an examination of the potentially involved organ systems based on the information gathered from the history. At the end of the history taking and examination, the differential diagnosis and problem list should be completed and a management plan, consisting of further investigations and treatment options, should be documented, and discussed with you, the patient.

Wishing you well with your next visit!

Essential Gynaecology represents the ambitious work of two experienced and dedicated academics and practitioners, Prof. Abdool and Prof. Snyman, who have taken great care to provide core knowledge to empower health practitioners to develop an approach to, and evaluate, diagnose, and treat gynaecological conditions. This post is based on content from Chapter three in Essential Gynaecology which was published by Van Schaik Publishers in 2022 and is available from all academic bookshops.