Which examination are you interested in?
Gynaecological ultrasound
Fast, non-invasive, without ionising radiation.
A gynaecological ultrasound uses high-frequency sound waves to image the uterus, endometrium, ovaries, fallopian tubes and other pelvic structures.
It can be performed abdominally (through the abdominal wall) or transvaginally (by inserting a probe into the vagina). During the examination, the person is not exposed to ionising radiation.
During an abdominal ultrasound, gel is applied to the lower abdomen, and the doctor examines the organs through the abdominal wall using a probe. A full bladder is often required for a better view.
During a transvaginal ultrasound, a protective cover and gel are placed on the narrow ultrasound probe, which is gently inserted into the vagina. The urinary bladder is generally empty during this procedure.
In gynaecology, a transvaginal ultrasound is usually more informative due to the proximity of the structures, but a combination of both methods often provides the most information.
Ultrasound is a non-invasive, outpatient examination that requires no recovery time. In addition, it provides immediate information in emergency situations, while also helping in the diagnosis of pain, intermenstrual bleeding, fibroids, cysts, polyps, and abnormalities of the uter
No special preparation is required for the examination, and it is recommended that you bring your previous medical reports with you.
Ask your gynaecologist whether you should arrive with a full or empty bladder.
Menstruation is generally not an obstacle, but the day of the cycle can be important when assessing ovulation, the endometrium or certain changes.
smear test
Cell screening that can detect cancer even before symptoms appear.
As the name suggests, it is cervical cell debris.
Cell samples are examined in a laboratory under a microscope with the aim of early detection of potential changes that, without monitoring or treatment, could eventually develop into cervical cancer.
A pathological report does not necessarily mean that a woman has cancer, The final diagnosis of the lesion is determined by biopsy.
It often shows mild changes for which a follow-up examination or additional testing is sufficient.
During the gynaecological examination, a speculum (colloquially known as a ‘duck bill’) is gently inserted into the vagina,
that the cervix is well visible. Using a small brush or spatula, cells are collected from the surface of the cervix and from its canal.
The whole procedure takes only a few minutes, and most women do not experience significant discomfort during it.
The main advantage is, of course, that it can prevent the development of cancer even before dangerous symptoms appear; and all this in a quick way that requires no recovery.
According to the latest results, Regular PAP tests have prevented up to 90 % cases of cervical cancer.
If possible, sexual intercourse, vaginal douching, and the use of vaginal medications, creams, and spermicides are not recommended for two days prior to the swab collection, as they may affect the quality of the sample. In addition, it is recommended that the swab be taken after menstruation, as heavier bleeding can obscure the cells.
In the event of unusual bleeding outside of the cycle, examination must not be delayed.
HPV test
A step ahead of changes: the HPV test can detect high-risk types of the virus even before cellular changes occur.
HPV stands for human papillomavirus, which is considered one of the most common sexually transmitted infections.
There are more than 200 types of virus, most of which are not dangerous. Unfortunately, however, there are also high-risk HPV types that can cause cervical, anal and genital cancers.
The HPV test is a molecular examination used to detect high-risk types of human papillomavirus in a cervical sample.
The procedure is similar to taking a PAP smear. After inserting a speculum, a sample is taken from the cervix using a soft brush. The laboratory then determines the presence of clinically significant high-risk HPV types, and in some tests, individual genotypes as well.
The HPV test effectively identifies women who are at increased risk of developing significant precancerous changes even before these occur.
This enables precise monitoring and individual management of each female patient separately, as well as the rapid removal of dangerous changes should they occur.
A positive HPV test does not constitute a cancer diagnosis, as the majority of infections clear up spontaneously within one to two years.
Special preparation is usually not required. Here too, it is recommended to avoid sexual intercourse, vaginal medications and spermicides for 48 hours prior to the test.
HPV testing is recommended also for those who have been vaccinated, as the vaccine does not provide protection against all high-risk types.
Testing for sexually transmitted infections
The right sample, taken from the right place, is the basis for accurate and targeted treatment.
At present, there is still no single swab that reliably detects all sexually transmitted and other vaginal infections.
Based on the medical history and clinical examination, the gynaecologist will decide which test is most appropriate for you.
A specimen can be obtained from the vagina, cervix, urethra, pharynx or rectum. HIV, syphilis, and hepatitis B and C are confirmed by a blood test.
First, a consultation regarding symptoms and potential exposures takes place. This is followed by a clinical examination and the collection of appropriate swabs, urine, or blood samples.
Taking a vaginal swab takes a few seconds and is usually only mildly uncomfortable. In the case of visible sores or blisters, the sample can be taken directly from the lesion.
Many microorganisms can cause genital infections, and some unrecognised or untreated infections can lead to serious complications, including fertility problems. This is why it is so important to be able to accurately identify the causative agent, as this is the only way we will be able to treat it in a targeted manner.
Upon a confirmed sexually transmitted infection, testing or treatment of partners is often necessary.
It is important that testing is carried out before antimicrobial treatment has started. Vaginal douches, antiseptics and intravaginal medicines are not recommended before taking a swab, while for a urine test, the laboratory's instructions regarding the first-catch stream must be followed. A routine microbiological swab does not automatically include all sexually transmitted infections, so it is important to discuss the desired tests when booking.
Colposcopy
A magnified and illuminated view enables us to assess a suspicious lesion more accurately.
Colposcopy allows the cervix, vagina and, if necessary, the external genitalia to be magnified up to 40 times using an optical instrument.
It is most commonly performed following a pathological PAP test result, a positive high-risk HPV test, unexplained bleeding, or when a visible lesion is present.
Colposcopy is not an operation and in itself does not mean that cancer is present. The purpose of the examination is to evaluate whether a biopsy, monitoring or treatment is necessary.
The examination begins similarly to a standard gynaecological examination. A speculum is inserted into the vagina, which opens the walls and allows a better view.
Next, the gynaecologist positions a colposcope in front of the vagina to examine the altered tissue in detail, and can also photograph the changes under magnification or take a biopsy for further histopathological examination.
Colposcopy without biopsy is generally painless.
Colposcopy allows directed biopsy of the most suspicious site and reduces the risk of missing a significant lesion.
At the same time, it helps to prevent unnecessary treatment of benign lesions that are safer to monitor.
It is recommended to bring previous cytological, HPV and histological results to the examination. For 48 hours prior to the procedure, avoid sexual intercourse, tampons and vaginal medications.
A heavier period can reduce clarity, so an examination is recommended after the period has ended, or during lighter bleeding.
If a biopsy is planned, it is also sensible to discuss pain relief options in advance.
Cervical biopsy
A small tissue sample holds the most crucial answers: it reveals the grade of the change and guides further treatment.«
A cervical biopsy means that a small piece of cervical tissue is sent to a laboratory for further histopathological examination.
Unlike the Pap smear, in which cellular changes can be assessed, a biopsy assesses tissue structure, which allows for a more reliable determination of the type and grade of the change.
A biopsy is most commonly performed during colposcopy.
After inserting the speculum and performing the colposcopic examination, one or more samples are taken using small forceps. The samples are properly labelled and sent for further examination to the histopathology laboratory.
Based on the test result, decide whether monitoring, further excision or other treatment is necessary.
During the procedure, short-lived discomfort or period-like cramping may be felt, so pain relief, including a local anaesthetic, can be arranged beforehand.
A biopsy can be used to distinguishes between precancerous and cancerous changes. In addition, the examination can determine whether these are merely mild changes or invasive cancer.
Such treatment can be planned according to the actual diagnosis, thereby preventing under- or over-treatment.
Before the procedure, discuss taking anticoagulant medications, blood clotting disorders, and allergies with your gynaecologist. Do not stop taking medications on your own, but only after discussing it with a doctor.
Following the biopsy, minor discharge and bleeding are possible for a few days, so please bring a sanitary towel with you to the procedure.
Following a minor biopsy, sexual intercourse, the use of tampons, and bathing in a tub or pool are not recommended until the bleeding stops (approximately 5 to 7 days).
Frequently asked questions
What is the difference between a PAP smear and an HPV test?
The Pap test assesses the appearance of cervical cells and looks for already developed cellular changes, whereas the HPV test detects the presence of high-risk HPV types that can cause such changes.
Does an abnormal Pap smear result mean cancer?
No. The pathological report means that abnormal cells were found in the smear, which are defined more precisely by a biopsy. Precancerous cell changes can be mild, moderate or severe, and a cancerous change only occurs when the altered cells grow through the basement membrane and invade deeper tissue.
Do I still need to have an HPV test if I have been vaccinated against HPV?
Yes. The vaccine significantly reduces the risk, but it does not protect against all high-risk types of HPV and does not treat an infection that was already present before vaccination.
Can one swab test show all sexually transmitted infections?
No. The type of sample and test is chosen according to symptoms, sexual contacts and site of exposure. For chlamydia and gonorrhoea, a vaginal or cervical swab or urine can be collected, and in the case of oral or anal contact, a throat or rectal swab as well; HIV, syphilis and hepatitis B and C are detected by a blood test.
What is a colposcopy and does it hurt?
Colposcopy is a precise examination of the cervix under magnification. The procedure is generally painless, as the colposcope remains outside the body. A feeling of discomfort may be caused by a biopsy, if it is indicated at the same time as the colposcopy.
Can I use a tampon after a cervical biopsy?
Until the bleeding or coloured discharge stops, the use of tampons, menstrual cups and vaginal medications is generally not recommended. It is also advised to abstain from sexual intercourse.
Does a normal ultrasound scan rule out all gynae conditions?
Ultrasound is a very important diagnostic method in gynaecology, but it does not rule out all forms of endometriosis, tiny mucosal lesions, infections, functional disorders of the pelvic floor or early cellular changes. The findings are therefore always interpreted in conjunction with the clinical picture and the results of other examinations.
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