Vaginoscopy is a diagnostic exam that uses a tiny camera on a long, thin, flexible piece of plastic to examine the inside of the vagina. The tiny camera can capture photos and video. On the other end of the vaginoscope is a small display screen that lets the clinician see what the camera sees.
What is a vaginoscopy?
Your child may be experiencing unexplained pain, bleeding, and/or vaginal odor. A vaginoscopy is performed to help explain what may be causing your child’s symptoms. The vaginoscope will help the gynecologist see inside your child’s vagina via the small display screen that is attached to the scope.
Some people will have had surgeries involving their vagina or have variations in their vaginal anatomy. Vaginoscopies are useful for evaluating vaginas after a surgery, including to evaluate for areas where the vagina may have become smaller (stricture) or may not have healed entirely (e.g., granulation tissue). For those who have variations in vaginal anatomy, vaginoscopies can help patients better understand their own anatomy.
Where is a vaginosopy performed?
The vaginoscopy will be done in our office, while your child is awake. Before starting, the provider will talk with you and your child about the procedure and review the consent form. Signing the consent form is required before we can begin the procedure. This is a good time for you to ask questions. Often times, before the procedure begins, the nurse or provider will apply a temporary numbing cream (lidocaine) to the entrance of the vagina. Once the cream is applied, a clear plastic band aide (tegaderm) will be applied over the cream. The tegaderm will help keep the cream in place for about 15 to 30 minutes. Before the vaginoscopy procedure starts, the provider will remove the tegaderm and wipe away the cream with a soft piece of gauze.
How can I help my child during the vaginoscopy?
Preparing for the vaginoscopy takes about 30 min, while the procedure itself takes about 10 minutes. Helping your child be calm and still will help decrease the time of the overall exam. Bringing a book, lovie, or special toy can provide a helpful distraction. Before the exam begins, someone on the provider team will help your child sit in a frog-like position with their legs open (seen in the photo above). We also call this “butterfly legs”.
No one will force your child to complete the vaginoscopy procedure. If it is unsuccessful, your child’s provider will discuss other options with you.
How is a vaginoscopy performed?
The provider team will first review some questions (name, date of birth, allergies) with you and your child, this is called a “time out.” Once the numbing cream has started to work, and your child is in position, the vaginoscopy can begin. The provider will talk your child through each step of procedure. Once the vaginoscope is placed gently inside the vagina, sterile water will be introduced through the vaginoscope, helping your provider see clearly inside. We expect your child will experience little to no discomfort with the insertion of the vaginoscope. The provider has the option to capture photos and/or video, so that they can show you what they find, and these can be saved to your child’s medical chart. The provider will only save photos/video to your child’s medical chart if it will be helpful.
What is vaginoscopy with irrigation?
Vaginoscopy with irrigation simply means that after the vaginoscopy is performed the doctor may use a syringe and tubing filled with sterile water to flush out the vaginal canal. No needles are used with the syringe.
There are two reasons why the doctor may choose to do this. The first is if the doctor needs a more clear view inside the vagina. The second reason is if the doctor notices a small foreign object (toilet paper, coins, etc.), which is not an uncommon finding in young children. The sterile water can help “flush” the object out of the vagina. This process may require several flushes. If your child requires a vaginal swab to check for infection, the doctor will obtain the swab at this time.
What to expect after the vaginoscopy?
Your child may experience mild discomfort. If there is any pain, you may give them Tylenol (Acetaminophen). It is unlikely, but your child may experience some vaginal bleeding and/or “spotting.” This should resolve shortly after the procedure. Your child may return to normal activity following the procedure. Your child’s provider will let you know if a follow up visit is required.