Obstet Gynecol Clin NorthAm 1992;19:39, 10. A vaginal self-examination is a way to look at your vulva and vagina to better understand your body and to spot problems that may need medical attention. For example, if a girl complains of . In the period surrounding the time of puberty, children often develop a physiologic discharge secondary to the increase in circulating estrogen levels. Children usually are asymptomatic,but they may present with secondary infection. Includes menu so you can select the portion of the video most applicable to you. What Stands in the Way of Bedside Teaching? Thepediatrician may have the additional advantage of already having built arelationship with the child who requires a gynecologic examination. Your patient gets this rash, whats the diagnosis? Sarah's Physical Exam with Pelvic Exam - YouTube A minor vulvar irritation may result in a scratch-itch cycle, with the possibility of secondary seeding because children wash their hands infrequently. Examination of the Female Genitourinary System. In the office setting, the examination should be limited to external inspection only; speculum exams should not be performed in pediatric patients. Prep for OSCEs! Palpate the abdomen for masses and the inguinal areasfor a hernia or gonad. 25:50. The history shouldassess the child's growth and development; signs of puberty such as breastdevelopment, axillary hair, pubic hair, growth spurt, and leukorrhea; genitaltrauma; vaginal discharge; and a history of foreign body insertion. Nonspecific vulvovaginitis often is associatedwith an alteration in vaginal flora, which may be due to a change in theaerobic flora or overpopulation with fecal aerobes and anaerobes. Or your doctor might recommend a pelvic exam if you have symptoms such as unusual vaginal discharge or pelvic pain. In rare circumstances, it may be necessary to use continuous intravenous conscious sedation or general anesthesia to complete an essential examination. . The pathophysiology of the majority of instances of vulvovaginitis in children involves a primary irritation of the vulva, which may be accompanied by secondary involvement of the lower one-third of the vagina.
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