Each gynecologist must have knowledge of the anatomy of the female reproductive system in order to be able to determine its individual characteristics in a particular case. This is a condition for the correct conduct of various diagnostic and therapeutic procedures.
The concept of "probing the uterus"
Information about the state of the internal genital organs of a woman the doctor receives during a bimanual examination, ultrasound, manipulations in the uterine cavity.
To determine the main parameters of the uterine cavity - depth, position in the pelvic cavity, sounding is used. It is carried out using a special gynecological instrument - a probe.
Indications and contraindications for cavity probing
Probing the uterus is necessary when:
- early termination of pregnancy;
- diagnostic curettage of the walls of the uterus with uterine bleeding;
- removal of the cervix for tumors, malignant process;
- fusion of the walls of the cervical canal.
Manipulation is carried out in order to determine the length and shape of the uterine cavity, the presence of neoplasms of the organ body, partitions (Asherman's disease).
Contraindications for probing the uterus - desired pregnancy, inflammatory diseases of the external, internal genital organs, purulent discharge from the vagina, cervical cancer in the decay phase.
Instruments for probing the uterus. Manipulation technique
To make a probing of the uterus, use special tools:
- Mirrors of Sims or Cusco;
- bullet tongs - 2 pieces;
- forceps, tweezers, uterine probe;
- solution of alcohol, iodine;
- sterile medical gloves;
- cotton gauze balls;
- sterile diapers;
- Hegar expanders;
It is also required to obtain the consent of the patient for this manipulation.
Uterus probing algorithm:
- Issuing informed consent to the procedure.
- Preparing to use the basic toolkit.
- Sanitation of the patient's external genitalia.
- Treatment of the skin of a woman's thighs with iodine solution.
- Bimanual genital examination.
- Introducing a speculum into a woman's vagina.
- Exposure, alcohol treatment of the cervix.
- Fixation of the anterior lip of the cervix with bullet forceps.
- Removing the speculum from the patient's vagina.
- Introduction of the uterine probe into the uterine cavity withouteffort.
- Determination of the state of the cervical canal.
- Fixing the length of the uterine cavity (the probe moves into the cavity until the wall stops).
- Finding out the position of the uterus, the presence of various obstacles in the path of the probe in the uterus.
- Removal of the probe from the uterine cavity.
- Go to the next step of the ongoing diagnostic or therapeutic manipulation.
Interpretation of uterine probing results. Complications after the procedure
When the probe passes through the cervical canal, it is possible to diagnose neoplasms, wall fusion, scarring.
The length of the uterine cavity during probing is determined using the mark on the uterine probe when the instrument reaches the bottom of the organ. This value is recorded in the intervention protocol. In the case of different lengths of the uterus, its asymmetry is determined at two points, and it is imperative to identify the cause of this process.
After the doctor has determined the length of the uterine cavity, with extreme caution, he begins to slide the device along all the walls of the organ. This is done to diagnose the presence of neoplasms of the uterine cavity, namely, adenomyosis, polyps, adenomatous nodes.
Also, with the help of probing the uterus, it is possible to determine the consistency of its walls. With a significant density of neoplasms, one can draw conclusions about the presence of fibromyoma, with a mild one, a malignant disease of the uterine body can be suspected.
After probing the uterus maythere is scanty bleeding from the vagina, which normally stops after 2 days. If the bleeding continues, increases, changes in the patient's condition (general weakness, fever), you should immediately contact a specialist.
Complications may develop after probing the uterine cavity:
- wall perforation requiring emergency surgery;
- formation of a false move followed by incorrect measurement of the length of the uterus;
- infection with the development of endometritis.
