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Diagnostic investigations in gynecology

Diagnostic investigations in gynecology involve a range of general or more specialized laboratory tests. These may be part of a routine gynecology check-up, cancer screening, or requested as part of fertility investigations. Patients with a family history or a previous medical condition / complications may be required to have additional laboratory tests in combination with blood testing.

Your gynecologist will discuss with you everything you need to know for the health of your reproductive system and treatments that may be required.

Some of the most common procedures that we perform here at AAFC include:

The Pap, or Papanicolaou test (also known as a smear test)

The Pap, or Papanicolaou test (also known as a smear test) is a procedure checking for signs of cervical cancer. It is performed by a doctor with the use of a speculum and it involves the scraping of a layer of cells from the neck of the cervix (opening towards the womb). The collected samples are sent off in the laboratory where they are stained and observed under the microscope. Detecting potentially pre-cancerous and cancerous cells early with a Pap test can offer you a good chance for a therapy.

Liquid cytology is a wet-based method of preparing samples for the detection of disease-related signs on the cellular level (cytopathology). The sample is collected by your doctor with the use of a small brush, in the same way as for a conventional smear test. The difference is that a liquid cytology smear is transferred directly onto a microscope slide and stored vertically in a small bottle containing a preservative liquid. When at the laboratory, the liquid is processed for the removal of elements, such as mucus, and the isolated cells are deposited on a slide as a very thin layer for microscopic observation. This technique is considered more reliable than the Pap test, but depending on the case, either of the two may be employed.

The HPV detection test screens for the presence of the Human Papilloma-Virus (HPV), which is a virus responsible for the development of genital warts, abnormal cervical cellular appearance and eventually, cervical cancer. Your doctor will perform a visual inspection and then collect a sample, the same way as for a Pap test. HPV testing will be required by your doctor, when you had an abnormal Pap smear test. If you result is returned as positive, you still have a good chance of a therapy.

A colposcopy is performed when the cervix has an unusual morphology (appearance) at a routine examination or when a Pap test or an HPV screening have been returned with an abnormal result. Because the presence of abnormal cells is linked to the risk of developing cervical cancer, a colposcopy is required in order to determine the appropriate treatment. It is performed in our day AAFC clinic by a doctor with the use of colposcope (a specialized microscope with a strong light for looking inside your cervix). If any of the abnormal areas are detected by the colposcope, a small biopsy (a sample of tissue) is removed for a closer examination.

Diagnostic hysteroscopy: (Click for more information).

Surgical hysteroscopy: Surgical hysteroscopy, like diagnostic hysteroscopy, is employed for examining the inner of the womb and for minimal intervention aiming to remove and correct an underlying uterine condition. The hysteroscope (a small fiber-optic tube connected to a video camera) involved in the surgical hysteroscopy allows some space for specialized instruments to also enter the womb at the same time for the intervention to take place. Procedures performed with surgical hysteroscopy involve removal of submucosal fibroids, polyps, scar tissue and endometrial bleeding among others. This procedure is performed by a doctor here in our day AAFC clinic, usually with general anesthesia (sedation), depending on your individual circumstances and the reason for needing a surgical hysteroscopy.