Diagnosis and Management of Endometriosis

Diagnosis and Management of Endometriosis

Physical Examination

 

  1. Inspection by examiner sitting at eye level of cervix
    1. Cervix displaced 1 cm or more lateral to midline
    2. Outflow obstruction favoring retrograde menstruation
  • Cervical stenosis
  • Imperforate hymen
  • Transverse vaginal septum
  • Uterine anomaly with blind uterine horn
    1. Tender, fixed angulation of rectum at sigmoidoscopy
  1. Palpation: bimanual pelvic, rectovaginal, rectal examination
    1. Tenderness on stretching shortened cardinal ligament
    2. Tender rectovaginal pouch of Douglas
    3. Tender uterosacral ligaments
    4. Tender nodules in uterosacral ligaments
    5. Fixed retroverted uterus

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