Diagnosis

The diagnosis of an inflammation of the ovaries is divided into several steps. As a rule, a detailed doctor-patient consultation (anamnesis) is conducted first. During this conversation, the symptoms and the causal relationship between the pain occurring should be explained.

The quality and exact localization of the symptoms felt by the woman affected can also provide an initial indication of the underlying clinical picture. This is usually followed by a physical examination. During this orienting examination, the abdominal cavity is examined for possible pressure pain.

If there are any abnormalities and a well-founded suspicion of an inflammation of the fallopian tubes, a specific gynecological examination should be followed. During this step in the diagnosis of inflammation of the ovaries, an external as well as an internal examination of the female genitals can be performed. By inserting the finger into the vagina and simultaneously exerting pressure against the abdominal wall, the pressure pain of the ovaries can be specifically examined.

In addition, a digital-rectal examination should be performed to exclude a ruptured fallopian tube as a result of ectopic pregnancy. Due to the fact that the lowest part of the uterus lies directly in front of the rectum, it can be palpated through the rectum. In the presence of a ruptured fallopian tube, clear hardening can be felt.

In case of an inflammation of the ovaries, the digital-rectal examination can trigger a so-called “shifting pain” in the lower abdomen. In addition, vaginal smears can be taken during the gynecological examination. For this purpose, the treating gynecologist strokes the cervix with special cotton swabs.

The samples obtained can then be examined for various bacterial pathogens typical of the triggering of inflammation of the ovaries. In addition, a blood sample should be taken during the diagnostic procedure, followed by a laboratory chemical examination. An obvious result for the presence of inflammation of the fallopian tubes would be an increase in the inflammation parameters (leukocytes and C-reactive protein).

These parameters can also be used to estimate the extent of the existing inflammation.However, it should be noted that an increase in inflammatory parameters does not prove the presence of ovarian inflammation. The increase in white blood cells and C-reactive protein (CRP for short) may also have another cause. If the findings are unclear, further diagnostics should be considered.

In particular, the performance of an ultrasound examination to visualize the ovaries has proven itself in the diagnosis of adnexitis. In the presence of inflammatory processes, ultrasound would typically reveal accumulations of fluid and pus. In addition, a laparoscopic examination of the ovaries may be necessary in cases of doubt. In this examination method, a small camera is guided through a surgical incision through the abdominal wall to the ovaries.