Preparation of the patient for research

Gynecological examination does not require the careful preparation of the vulva, as is necessary in obstetrics, and only in case of pollution of their blood, purulent or feces should wash the sex part. In some diseases, accompanied purulent, malodorous secretions (for example, with cancer of the cervix), it is advisable to proprietati vagina any weak disinfectant solution (potassium permanganate, lactic acid, etc.,). With all the manipulations on the uterus (extension of the neck, the sounding of the uterus, trial excision and puncture back arch) requires thorough disinfection of external genital parts and vagina.
Before you begin to study the genitals, you must first offer the patient to empty the bladder. If by the nature of the disease the patient is unable to urinate, you should resort to the emptying of the bladder through the catheter. Catheterization should be performed with strict observance of all rules of aseptics (see below), because otherwise it is, though small, the intervention can lead to severe infections of the urinary tract. Females usually easy to make a catheterization and thus receive the urine without any pollution for immediate investigation.
In diseases of the urinary tract, collecting urine individual portions, we can get important information on the localization of the infection. For example, when collecting urine (without catheter) into two glasses we can make a conclusion about an isolated lesion of the urethra. If in the first glass will be cloudy urine (due to the leaching of pus from the urethra), and the second - net - then there is the disease of the mucous membrane in the urethra, and the mucosa of the bladder is free from destruction; otherwise the two portions of urine would be muddy.
For releasing urine use catheters (Fig. 11). They can be metal, rubber, and glass. Pre-catheter should be sterilized by boiling.
Technique catheterization is this: after careful preparation of the first hand with the thumb and middle fingers of the left hand pushing labia to the opening of the urinary canal was completely available for inspection. The other hand take a piece of cotton wool soaked 0,2% solution of bleach or other does not cause pain disinfectant, and wipe them the entrance into the urethra from the clitoris to the entrance of the vagina. Continuing with his left hand to push the lips, take the right hand catheter for its wide end, or so-called the pavilion, and, closing his finger outer end of the catheter, gently, without violence, dvigayut it to the urethra. As the women's urethra is short (3-4 cm) and has a wide gap, the introduction of the catheter does not encounter any obstacles (Fig. 12).
In some cases, may encounter difficulties with the introduction of the catheter, so as the women's urethra is not straight and curved channel, the bulge facing backwards, And the outer hole sometimes covered with urethral roller.
After urine from the opening of the urethra in mild raise catheter no longer shown, the catheter is removed, and the thumb, in which keep the tool is clamped hole "pavilion"; the latter method prevents contact with the external sexual part remaining in the urine catheter.
Before each two-handed study it is necessary to think about the possible overflow of the bladder, as it makes the study and causes a shift in the sexual organs. Crowded bladder with little experience sometimes mistaken for a tumor (cyst).
In the lower part of the rectum accumulate sometimes hard faeces, which are narrowing the lumen of the vagina, make it difficult vaginal examination, and at a higher position can simulate the tumor. To avoid these difficulties and errors, you must empty rectum that a patient must do at home, and in the second study to appear already after a thorough emptying of the bowels.