Gynäkologische Untersuchung in Der PRAXIS Unter Besonderer Berücksichtigung Der Krebsvorsorgeuntersuchung
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Die vorliegende Gynakologische Untersuch.ung in der Praxis ist als Gegenstuck zu dem im gleichen Verlag erschienenen Taschenbuch Schwan- gerschaftsvorsorge in der Praxis gedacht. Wahrend es sich dort um die Untersuchung, Betreuung und arztliche Fuhrung in der Schwangerschaft handelt, solI hier der gynakologische Untersuchungsgang als solcher im Sinne der erweiterten gynakologischen Diagnostik behandelt werden. Das technische V orgehen bei der Untersuchung laBt sich Schritt fur Scbritt darlegen. Die einzelnen MaBnahmen folgen einander in einer bestimmten Reihenfolge, wobei der Aufwand apparativer Hilfsmittel im Gegensatz zu anderen Disziplinen gering bleibt. Man kommt zur Anhiebs-Diagnose durch die Erhebung einer genauen Anamnese, durch das inspizierende Auge und durch die tastende Hand. Die Untersuchung wird erweitert mit Hilfe der Kolposkopie und durch die Beurteilung von Sekretproben im Mikroskop. Die Anwendung beider Verfahren gehort heute zur Routine in der gynakologischen SprechstIJnde. Die mikroskopische Untersuchung kann durch die Ubersendung der Sekretprobe an ein Laboratorium aus der Sprechstunde ganz oder teilweise herausgenommen werden, was vor aHem fur die Krebsvorsorgeuntersuchung nach Papanicolaou ublich ist. Die pedantische Anwendung der einzelnen Untersuchungsschritte ist un- umganglich, um ein organisches Leiden festzustellen oder auszuschlieBen und - ganz besonders - um ein lebensbedrohendes Neoplasma fruhzeitig zu erkennen. Kein Arzt kann daher auf die einzelnen diagnostischen Schritte verzichten, denn das Ubersehen eines beginnenden Neoplasmas hat die Verschleppung des Leidens und damit oftmals den Tod der Patientin zur Folge.
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