Despite the existence of many laboratory and instrumental diagnostic methods, in practice obstetricians and gynecologists still use bimanual examination. This method is quite simple and informative. With its help, the doctor is able to make a preliminary diagnosis.
Opportunities
Bimanual examination (its other name is two-handed) allows you to assess the condition of the uterus and ovaries, pelvic tissues. During the procedure, the doctor carefully examines the cervix, the organ itself, determines its shape and size, consistency, mobility and the nature of the surface. All this allows timely detection of the presence of a pathological process, diagnosing pregnancy.
Normally, the procedure is not associated with any pain, the patient may feel only slight discomfort.
In order to prevent various diseases, every woman should visit a gynecologist twice a year. Bimanual examination is a mandatory item at every examination of the patient.
Indications
Diagnosis of the condition of the internal genital organs is carried out not only for preventive purposes. Bimanual examination in gynecology is indicated for:
- menstrual irregularities;
- frequent pain in the pubic area and lower abdomen;
- chronic diseases of the reproductive system;
- presence of benign or malignant neoplasms;
- suspected ectopic pregnancy;
- bleeding of unclear etiology;
- appearance of secretions that differ from normal in quantity, color and consistency;
- adhesions and obstruction of the fallopian tubes;
- pregnancy;
- postpartum.
The list of these symptoms and conditions can be greatly expanded due to the huge variety of gynecological diseases.
Method benefits
The main advantage of bimanual research is a high degree of informativeness. In this case, the doctor does not need any equipment.
With the help of palpation, the gynecologist assesses the condition of the internal genital organs (uterus, ovaries, fallopian tubes, etc.) and promptly detects the presence of pathologies.
In addition, during the bimanual examination, pregnancy is guaranteed to be confirmed or excluded.
Flaws
The disadvantage of this method is its dependence on the physique of a woman. As a rule, palpation is difficult in patients with severesubcutaneous fat. In this case, additional diagnostic methods are required.
In addition, each doctor can interpret the symptoms that bother a woman differently, which affects the reliability of the result. Nevertheless, for experienced specialists, this examination is enough to make a verdict and draw up a treatment regimen.
Preparation
Before visiting a gynecologist, it is recommended to follow the following rules:
- To avoid the appearance of excess discharge, it is necessary to exclude sexual intercourse the day before the examination.
- During the same time, it is advisable to refrain from eating foods that cause increased gas formation. Failure to follow this recommendation will not distort the result, but may provoke an awkward situation.
- On the day of the examination, before the procedure, it is necessary to carefully conduct hygiene of the external genitalia.
- Immediately before the examination, it is recommended to empty the bladder.
Thus, preparation for a bimanual examination does not require any special steps. The main thing is hygiene, everything else depends on the level of professionalism of the doctor.
Methodology
Before the start of the examination, the specialist wipes the gynecological chair with a special solution and lays a new disposable diaper on it. While the patient is located, the doctor puts sterile gloves on both hands. After the completion of the preparatory phase, the inspection begins.
Techniquebimanual research consists in sequentially performing the following actions:
- The doctor gently inserts the fingers of the right hand into the vagina. The left hand should palpate the internal organs from the outside - in the lower abdomen of the patient.
- Bimanual examination of the uterus is paramount. The doctor determines its position, shape, size, mobility, consistency, nature of the surface. Normally, the process is painless. If this is not the case, you must immediately notify the gynecologist. Patience in this case is inappropriate - any pain signals the presence of an inflammatory process.
- Next, the doctor probes the fallopian tubes, appendages, ligaments. In the absence of pathologies, they are, as a rule, practically inaccessible for palpation.
- Special attention is paid to the ovaries: they must be well palpable, mobile and sensitive. If the ovaries are enlarged, this may indicate pregnancy or early ovulation.
- The fiber and lining of the uterus should not be palpable. Otherwise, it is a sign of adhesions, infiltration, or inflammation.
After the examination is over, the doctor takes off his gloves and throws them away. Then he washes his hands with soap and takes notes in the patient's medical record. If there is any doubt about the existing symptoms, other diagnostic methods are additionally prescribed.
In closing
Bimanual study is a simple but informative way to assesscondition of the internal genital organs of a woman. With its help, various diseases are detected in a timely manner. The disadvantages of the method are its subjectivity and dependence on the patient's physique. If necessary, other diagnostic methods are assigned.
