It is carried out in two phases: bimanual examination to evaluate possible disorders of the external (vulva and vagina) and internal (uterus, ovaries) genitalia, followed by the examination using a speculum for the visual evaluation of the neck of the uterus. If required, it is also possible to perform PAP tests and cervico-vaginal swab. These tests allow screening for the prevention of neoplastic lesions of the cervix and the research of infections in the lower genital tract (Candida, common germs, mycoplasma, ureaplasma, Chlamydia Tracomatis, HPV, Trichomonas, Gardnerella).
This method uses ultrasounds emitted by a probe placed on the abdomen (transabdominal ultrasound) or inserted into the vagina (transvaginal ultrasound) allowing the display of the internal genital organs, uterus, ovaries and tubes on a monitor; the latter can only be viewed if pathologically dilated (hydrosalpinx/pyosalpinx ).
ULTRASOUND MONITORING OF OVULATION
The ovarian cycle, whether natural or pharmacologically stimulated, is monitored using ultrasounds in series of follicular and endometrial growth, untill ovulation is reached. Ultrasound monitoring is often associated with hormonal monitoring of the production of estradiol and possibly other hormones involved in ovulation. At the Valle Giulia Clinic we have an analysis laboratory that can quickly and efficiently perform (1-2 hours) all the hormonal assays required.
It is a non-invasive ultrasound examination which consists in the introduction of 10 to 20 cc of saline solution into the uterine cavity across a small catheter inserted through the vagina. The distension of the uterine cavity produced by the fluid allows the identification of any anomalies in the uterine cavity and determining tubal patency.
Diagnostic hysteroscopy is a minimally invasive technique that allows viewing the uterine cavity by means of a fibre optic instrument introduced through the canal of the cervix. In over 95-97% of cases the exam can be performed in the outpatient clinic.
The main indications are:
- Abnormal uterine bleeding
- Study of infertile patients
- Identification of abnormal endometrial thickening (detected by ultrasound)
- Suspicion of endometrial polyps or submucous fibroids in ultrasound
- Repeated miscarriages
- Suspicion of uterine malformations
It is a surgical technique that allows viewing of abdominal and pelvic organs. It is carried out by inserting a fibre optic cable through a small incision in the navel. It is therefore possible to confirm the presence of ovarian cysts, uterine fibroids, endometriosis, states of pelvic inflammation and adhesion phenomena for which there were suspects following clinical assessments and ultrasound examination. These pathological situations can be managed surgically by surgical laparoscopy which is performed under general anaesthesia and requires a day of hospitalization. It is also indicated for diagnostic purposes in cases of unexplained infertility. It is done under general anaesthesia and requires 2-3 days of hospitalization.