Whether it's urinary tract infections (UTI), human papillomavirus (HPV), endometriosis or pelvic inflammatory disease (PID), it's important that all OB/GYNs are familiar with non-cancerous gynecological conditions — including how to talk to patients when a diagnosis is present.
Explore this collection of questions you might find yourself asking regarding these common gynecological conditions.
- Can ultrasound assist me with diagnosing a UTI? UTIs are one of the most common infectious diagnoses in older adults. More than 10 percent of women over the age of 65 report having experienced a UTI in the past year. Diagnosing a UTI typically involves a urine sample analysis, but when a patient has recurrent UTIs, ultrasound can play an important role in determining whether the UTI is part of a bigger diagnostic picture.
- How can I safely care for patients with HPV while eliminating transmission possibilities? HPV is the most commonly diagnosed STI in the U.S., but it can also be transmitted through nonsexual contact. This includes digital or oral contact, kissing, infected objects such as towels, and transvaginal ultrasound probes and colposcopes, if not properly disinfected. Therefore, caring for patients with HPV requires an additional level of vigilance when disinfecting equipment.
- How do I treat endometriosis? Endometriosis commonly goes undiagnosed for years and presents life-disrupting symptoms. Medication, endometrial ablation and lifestyle changes are three common recommendations. Surgery might enter the picture in some cases. For the prevention of recurrence after surgery, hormonal contraceptives are often recommended for symptom management.
- Why aren't women reporting loss of bladder control? A recent poll found almost half of women between the ages of 50 and 80 suffer from some degree of urinary incontinence. Further, 41 percent of that group said their symptoms were lowering their quality of life. However, shame and embarrassment keep them silent. Here's how to broach the subject with your patients.
- What do my patients need to know about PID prevention? PID is typically the result of exposure to an STI, and delaying treatment can cause long-term complications, such as infertility. Women who are of reproductive age need to know that abstinence and barrier contraceptives have a significant role in reducing exposure and preventing STIs and PID. Routine screening and early recognition/treatment of symptoms are key.
- How can 3D ultrasound help postmenopausal bleeding treatment? Vaginal spotting after menopause is an extremely common occurrence. In fact, one estimate is that 70 percent of gynecological visits are due to abnormal uterine bleeding. Despite its everyday nature, postmenopausal bleeding is a serious enough situation to warrant the fastest and most precise evaluation. A 3D transvaginal ultrasound can guide clinicians to the most effective treatment by identifying possible causes.
- How do I explain abnormal pap smear results to patients? Receiving abnormal pap smear results is an alarming and stressful experience for most patients. However, the most common abnormal pap smears typically indicate changes in cervical cells consistent with HPV infection and potentially precancerous changes. Clearly and calmly explaining the next steps (typically an HPV test and/or a second pap smear within six or 12 months) will help ease patients' fears.
- Can I diagnose urinary incontinence with 3D ultrasound? 3D ultrasound allows clinicians to clearly visualize the entire pelvic floor, including urinary structures such as the bladder neck, urethra angle and length, and bladder volume. The largest benefit of 3D over 2D ultrasound, for example, is the ability to view the image while rotating, tilting or slicing it to better understand the anatomy.
Diagnosing, treating and educating patients about these common gynecological conditions will be a daily occurrence in your practice as a gynecologist. Understanding the workups involved for each and the benefits of early screening and diagnosis will help you give your patients the best health outcome.
