Today was exciting because I've been given the chance by Dr Tit to perform the Vaginal Touche a.k.a VE (Vaginal Examination). It'a a routine gynaecologic procedure in Poli KB. Doctors have to ensure that if the patient is using IUD (Intra Uterine Device), the device is inserted in the right place and the filament can be observed in the portio.
Ps : An IUD is a device inserted in the uterus (womb aka rahim) to inhibit fertilization of the egg by the sperm. It has a small string that hangs down from the IUD into the upper part of the vagina. This string is not visible during intercourse! So ladies jangan takot k, as this is one effective, simple and cheap method for family planning. A single IUD costs only Rp 28,000 and can stay in your womb up to 10 years!
First, I visually inspect the vulva, vagina and cervix (Ok, this is how a multipara woman's vagina would look like)
Then I carefully insert my middle and index finger (with so much doubt, i dunno if i'm doing it correctly or not!! and i looked at the patient's face expression as she was feeling uncomfortable and in slight pain. Gosshhh!) but then i continued and my dancing fingers started to explore any lump or fluctuative tumors within the pelvic cavity. (nak jadi doc xboleh takut-takut..buat je ok!)
Then i place my left hand on the woman's abdomen and feel for the uterus. I did not feel any 'hardness' or 'mass' so i concluded that the woman's uterus position is retroflex. Then, Dr Tit feel again for the ptn's uterus and she said, yes it is retroflex. Yeay!! at least i'm right about the retroflex position of her uterus! (pandai jugak aku merasa dgn jari2 ni. hehe)
Ok, for a normal examination, these are the steps that u should carefully examine:
•External genitalia are of normal appearance. There is no enlargement of the Bartholin or Skene glands.
•Urethra and bladder are non-tender.
•Vagina is clean, without lesions or discharge
•Cervix is smooth, without lesions. Motion of the cervix causes no pain.
•Uterus is normal size, shape, and contour. It is non-tender
•The adnexa (tubes and ovaries) are neither tender nor enlarged
Here are some conversation i had with my patients, some of them are VERY funny that i laughed my heart out. hehe.
Dr Kim : Ibu, ada keluhan apa-apa ngak buk sepanjang memakai spiral (IUD) ini?
Ibu A : Gak ada apa-apa buK dokter..baik2 saja. Cuman..waktu awal2 make (memakai) spiral ini agak2 sakit gitu.
Dr Kim : Sakit? ibu merasa sakit dimana?
Ibu A : Owh bukan saya yang sakit dokter, suami saya yang mengeluh sakit!!
Dr Kim : Tersenyum simpul ^^
(OK this is verrrry funny! Now i get the picture. During penetration, the hubby felt a little painful because of the filament (part of the IUD device that looks like benang yang panjang) left outside the portio of vagina. So, what doctors will do is to cut them shorter during the next follow up and the couples will be happy again *especially the hubby* ;p)
I did the procedure, i leart few things and interesting facts. So today Dr Kim is *happy* (senyum)