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Safer and More Effective Gynaecological Examinations

Greta Edelstam started working as a gynaecologist in 1985 and is a senior physician at Danderyd's Hospital. After many years in the profession she got her eyes on a recurring problem a few years ago: Why should patients need to lie uncomfortably when examining something as intimate as their genitals? Now she has developed a new chair for gynaecological examinations which increases the patient's safety, and comfort as well as streamlining the examination.

It all started with Greta Edelstam – now Associate Professor at Uppsala University – becoming aware that patients she met at the Endometriosis Centre brought their own heating pads to be able to lie comfortably on the cold bench. The difficulty of adjusting the leg support of the standard gynaecological chairs made her apologise to patients for the chair’s shortcomings.

“Eventually I was so tired of hearing myself apologising to the patients. I felt that I cannot retire without doing something about it.”

Strengthens patient integrity

In 2014 she applied for money from Vinnova’s program for norm-critical innovations to develop a genderneutral examination chair. Oscar Medtec in Kungälv helped to develop two prototypes that were then tested at the Academic Hospital in Uppsala and at Danderyd’s Hospital in Stockholm.

The new model has built-in heat with simple controls that the patient has control over, as well as leg arches instead of traditional leg support. All in all, this also better protects the dignity of the patients, by minimising the time they need to lie with their legs apart, and it increases comfort at the time of examination.

An unexpected effect of the innovation was the time gain: every examination became on average a minute and a half shorter.

“For a physician who meets 20 patients a day, this saves half an hour”, according to Greta Edelstam.

Innovation in a female dominated area

Medical staff who have used the chair also experience great advantages in their own work environment. In addition to saving time compared to traditional examination chairs, it is ergonomically better even for them.

“For example, traditional chairs are poorly adapted for patients with hip replacement surgery, who can rarely put both legs in the leg rests,” says Greta Edelstam. As a rule, you have to ask a nurse to come in and help to keep one leg up, which is both inconvenient and impractical for both the staff and the patient.

Innovation is often associated with male dominated professions and areas such as technology and data, but the development of the new chair is a clear example of innovation in a female dominated area of sexual and reproductive health.

Although it may be mainly women who will benefit from the new chair’s advantages, Greta Edelstam emphasises that the chair is actually gender neutral and also designed for male patients, although the results have not been as significant in that group.

“While women are usually accustomed to gynaecological examinations and routinely called, most men are unfamiliar with these examinations and only seek care when they have serious problems or illnesses. This makes it more difficult to compare their experiences of being examined in this or a more traditional chair – the whole situation is probably perceived as unpleasant regardless of the chair.

More satisfied patients

At present, the chair is available at a limited number of health care facilities. The high cost compared to traditional chairs seems to be an obstacle.

“It is clear that such a chair costs more than ordinary chairs, not least because it is more technically advanced with built-in heat and controls, but I argue that there may be savings in the long run, with reduced examination time and increase in patient satisfaction”, says Greta Edelstam.

In the long run, the dignity of the patient along with increased comfort that the new chair leads to can hopefully result in fewer people associating gynaecological examinations with discomfort – men, women and non-binary transgender people. For men who undergo an andrological examination for the first time, or for transgender people, for which gynaecological examinations may be associated with extraordinary discomfort, a more positively charged care experience can at best increase the propensity to seek care when needed.

Edited: 27 Feb 2019
Published: 27 Feb 2019
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