Gynaecology Instruments and Patient Preparation

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Questions and Answers

What is the purpose of washing the vagina with soap and water after the procedure?

To maintain cleanliness and prevent infection.

What is the primary goal of cystography and urethrography?

To detect anatomic and/or functional abnormalities of the lower urinary tract.

What is an indication for cystography?

Evaluation of recurrent urinary tract infections.

Why is aseptic technique important when catheterizing the urethra or bladder?

To prevent infection. Signup and view all the answers

What is the primary indication for an IVU examination?

Repeated infections, Renal colic, Flank pain, Trauma, Retention and decreased urinary output, Kidney Stones, Renal cell carcinoma, Polycystic Kidneys Signup and view all the answers

What is an indication for urethrography?

Evaluation of urethral diverticula. Signup and view all the answers

What is a contraindication to the use of contrast agents in an IVU examination?

General contraindications to contrast agent, Hepato renal syndrome, Pregnancy, Blood urea raised above a certain defined or normal level, Anuria, Diabetes, especially diabetes mellitus, Severe hepatic or renal disease Signup and view all the answers

What is the benefit of using fluoroscopy during voiding studies?

It optimizes diagnostic yield. Signup and view all the answers

What is the purpose of the control film in an IVU examination?

To serve as a baseline for subsequent films Signup and view all the answers

What should guide decisions about contrast quantity and infusion or injection technique?

Clinical judgement. Signup and view all the answers

Why is it essential to tailor the examination to the individual patient's needs?

To ensure an accurate diagnosis and effective treatment. Signup and view all the answers

What is HSG, and what does it refer to?

HSG refers to the radiographic examination of portions of the female reproductive system, particularly the uterus and the uterine tubes (fallopian tubes). Signup and view all the answers

What is the purpose of injecting contrast material into the uterus during an HSG examination?

To visualize the uterus and fallopian tubes under fluoroscopic guidance Signup and view all the answers

What is the primary purpose of patient preparation for an HSG examination?

To ensure the patient is properly prepared for the examination, reducing the risk of complications and improving image quality Signup and view all the answers

What is the role of fluoroscopic guidance during an HSG examination?

To guide the injection of contrast material into the uterus and visualize the uterus and fallopian tubes in real-time Signup and view all the answers

What is one of the potential applications of HSG in uterine pathology investigation?

Evaluating the patency and morphology of the fallopian tubes Signup and view all the answers

What is the purpose of using a tenaculum during an HSG procedure?

To pick up small pieces of tissue, specifically the anterior lip of the cervix. Signup and view all the answers

Why is it essential to perform an HSG during the proliferative phase of the menstrual cycle?

To avoid any potential interference with the results due to hormonal changes during other phases of the cycle. Signup and view all the answers

What is the role of ß-HCG test in patient preparation for HSG?

To rule out pregnancy or confirm irregular menstrual cycles. Signup and view all the answers

What is the purpose of giving 40mg Buscopan to the patient an hour prior to the HSG procedure?

To reduce pain from cramps and relax the uterine muscles. Signup and view all the answers

What is the significance of cannulation of the cervix during an HSG procedure?

To allow for the injection of contrast media into the uterine cavity. Signup and view all the answers

Why is it essential to clean the perineum with antiseptic solution during the HSG procedure?

To prevent potential infections and maintain a sterile environment. Signup and view all the answers

What is the purpose of using a uterine sound during an HSG procedure?

To probe the uterus and potentially dilate the cervix. Signup and view all the answers

Why is the lithotomy position used during an HSG procedure?

To allow for easy access to the perineum and uterine cavity. Signup and view all the answers

Study Notes

Equipment and Accessories Required

Tenaculum: used to pick up small pieces of tissue, such as the anterior lip of the cervix
Uterine Sound: used to probe the uterus and possibly dilate the cervix

Patient Preparation

Procedure is done during the proliferative phase of the menstrual cycle (7th-10th day or 8th-12th day)
Patient must avoid sexual intercourse from the onset of their period to the day of the exam
ß-HCG test (Beta human chorionic gonadotropin test) should be carried out to rule out pregnancy or for patients with irregular menstrual cycles
The patient is given 40mg Buscopan an hour prior to the exam
Mild analgesics and prophylactic antibiotics may be given to reduce pain from cramps and potential infections
The patient may be asked to empty their bladder to prevent displacement of the uterus and uterine tubes

Procedure

Informed consent is obtained before the procedure starts
Patient is placed in lithotomy position with legs bent at the knee or supported with stirrups
Patient is draped with sterile towels and the perineum is cleaned with antiseptic solution
Vaginal speculum is inserted and the cervix is localized and cleaned with antiseptic solution
Cervix is cannulated and dilated with a balloon catheter to occlude the cervix and prevent contrast media from flowing out during the injection phase

Specific Indications

Repeated infections
Renal colic
Flank pain
Trauma
Retention and decreased urinary output
Kidney Stones
Renal cell carcinoma
Polycystic Kidneys

Contraindications

General contraindications to contrast agent
Hepato-renal syndrome
Pregnancy
Blood urea above a certain defined or normal level
Anuria or absence of urine excretion
Diabetes, especially diabetes mellitus
Severe hepatic or renal disease
Patients taking certain medications (e.g. metformin, Glucophage, Fortamet, Glumetza, Glucovance, Diabex, Riomet, Actoplus Met, Avandamet)

Projections

Control projection
Immediate projection
5-minute projection
10-minute/15-minute projection
20-minute projection
Post-void projection

Hysterosalpingography (HSG)

Refers to the radiographic examination of the female reproductive system, particularly the uterus and uterine tubes (Fallopian tubes)
Involves injecting contrast material into the uterus under fluoroscopic guidance
Patients should carefully wash their vagina with soap and water and change vaginal pads as needed after the procedure

Cystography and Urethrography

Cystography: imaging the bladder before, during, and after administration of contrast via urethral or cystostomy catheter
Urethrography: imaging the urethra before, during, and after administration of contrast via urethral or cystostomy catheter
Goals: detect anatomic and/or functional abnormalities of the lower urinary tract

Indications for Cystography and Urethrography

Recurrent urinary tract infections
Vesicoureteral reflux
Bladder contour
Bladder diverticula
Suspected rupture
Fistulae
Integrity of postoperative anastomoses or suture lines
Bladder outlet obstruction
Incontinence
Hematuria
Neoplasia
Urethral diverticula
Urethral strictures
Bladder outlet or urethral obstruction
Trauma
Recurrent urinary tract infection

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Description

This quiz covers the equipment and accessories required for a gynaecological procedure, including tenaculum and uterine sound, as well as patient preparation beforehand.