Genital Prolapse: Examination

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).
  • 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].
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.