A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin and mucous membranes
- Abdominal wall and inguinal region (groin area).
- Inspection (viewing).
- Gynecological examination
- Inspection
- Vulva (external, primary female sexual organs).
- Vagina (vaginal) [presence of cystocele/protrusion of anterior vaginal wall involving bladder, if any; presence of vaginal enterocele/protrusion of posterior vaginal wall involving rectum/pelvic rectum, if any; ulceration/ulceration of uterus/vagina, if any].
- Cervix uteri (cervix), or portio (cervix; transition from cervix uteri to vagina (vagina)) [Utereovaginal prolapse / prolapse of the uterus and vagina], taking a Pap smear (for early detection of cervical cancer).
- Palpation (bimanual; palpation with both hands) of the internal genital organs.
- Cervix uteri (cervix) [prolapse to vulva if necessary].
- Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness; prolapse/prolapse deep into vagina to vulva if applicable]
- Adnexa (appendages of the uterus, i.e., the ovary and uterine tube). [Normal: free]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
- Pelvic walls [Normal: free]
- Douglas space (pocket-shaped bulge of the peritoneum (peritoneum) between the rectum (rectum) behind and uterus (uterus) in front) [Normal: free; possibly also prolapse].
- Inspection
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.