Endometriosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

Examination findings on digital vaginal examination and speculum examination include: fixed retroverted uterus, with palpable nodularity of the uterosacral ligaments and cul-de-sac with narrowing of the posterior fornix.

Physical Examination

Physical Examination findings in a patient with endometriosis include:

HEENT

Pallor may be present due to anemia

Cardiovascular

Normal heart sounds are heard

Respiratory

Normal breath sounds are heard

Abdominal examination

• Lower abdominal tenderness will be present
• Bimanual examination will demonstrate a fixed retroverted uterus with tenderness.

Digital examination of the vagina

Common physical examination findings on digital examination include:

• Fixed retroverted uterus
• Nodualrity of the uterosacral ligaments
• Narrowing of the posterior vaginal fornix in patients with stage 3 and stage 4 disease
• Enlarged and fixed ovaries can be palpated
• Lateral displacement of the cervix

Speculum examination of the vagina

• Lesions of endometriosis may present on the cervix or vagina
• Cervical displacement can be visualized