The vaginal intervenes only to the operations of the pelvic area
After the publication of these figures which show that these practices are far from marginal, the CNGOF wished to recall the good practices of preoperative vaginal examination.
You should know that the clinical examination is performed before an intervention concerning the pelvic area only (pelvic tumors such as fibroids or cysts, prolapse, urinary incontinence, an induced abortion or a hysteroscopy).
"There can not be any physical examination whatsoever without the consent of the patient. The vaginal no exception to the rule," recalls the CNGOF in a press release dated December 7, 2015. If the College explains that the patient should be informed and give consent, its president, Prof. Bernard Hédon, acknowledges that "the preoperative examination and place are not reported in the information sheets given to patients before gynecological surgery." These sheets rather detailing the technical aspects and the operation of complication risks. "From the moment the patient accepts the procedure, it implicitly accepts the pre-clinical examination," says Dr. Hédon.
Given this vagueness in the texts, the CNGOF will recommend that clinical examination including a vaginal or rectal or future reported in preoperative documents given to the patient (s).
Vaginal: develop learning through simulation
On learning of the clinical examination by medical students, the CNGOF advocates the practice of vaginal on dummy as far as possible. But in fact, this learning can be achieved in real situations.
First scenario: vaginal examination is performed in the normal clinical setting (a single examination before the operation). It must be in the presence of a teacher practitioner or not, if it has explicitly permitted the student to practice outside his presence.
Second scenario: the teacher practitioner advantage of this preoperative examination to learn the gesture with one or more medical students after himself practiced once. The patient must be warned before being anesthetized and vaginal examination should not be repeated multiplied way (the number of students accompanying the teacher should be limited). Add it to accept or refuse. The CNGOF still states that "this should be exceptional."
Measures to stop "illegal and unacceptable practices"
Following the report cited above, Marisol Touraine announced in October 2015, the establishment of three measures to end these "illegal and unacceptable practices":
The launch of an inspection mission in health institutions assigned to the General Inspectorate of Social Affairs (IGAS) and the General Inspectorate of Directors of Education and Research (IGAENR) to deepen the results of the investigation.
Sending instructions to the heads of health institutions that receive training health professionals reminding them of their legal obligations, particularly in terms of patients' rights, and ask them to ensure their full implementation.
The development of learning through simulation, already favored by many institutions, with the aim of equipping all university hospitals (CHU) a health simulation center by 2017.
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