A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
- Inspection (viewing).
- Skin and mucous membranes
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, tapping pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing tapping pain?) [urogenital pelvic pain][due todifferential diagnosis:
- Inguinal hernia]
- Palpation of the renal region[due todifferential diagnosis:
- Pyelonephritis (inflammation of the renal pelvis): in the presence of fever and back or flank pain, pyelonephritis, ie, involvement of the upper urinary tract, such as ureters and / or kidneys including renal pelvis is very likely].
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency[due todifferential diagnoses:
- Benign prostatic hyperplasia (BPH; benign prostatic enlargement).
- Prostatitis (inflammation of the prostate)]
- Inspection (viewing).
- Cancer screening [due todifferential diagnoses:
- Cervical carcinoma (cervical cancer).
- Endometrial carcinoma (cancer of the uterus)
- Urinary bladder carcinoma (cancer of the urinary bladder)
- Prostate carcinoma (prostate cancer)
- Tumors of the adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tube (fallopian tube))]
- Gynecological examination
- Inspection[due todifferential diagnoses:
- Chlamydia
- Genital herpes – sexually transmitted disease caused by the herpes virus.
- HPV infection (human papillomavirus)
- Mycoplasma
- Vaginitis (vaginitis); also possible secondary disease]
- Palpation (bimanual; palpation with both hands) of the internal genital organs[due todifferential diagnosis:
- Endometriosis (presence of endometrium (endometrial lining) extrauterine (outside the uterine cavity), for example, in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder, or bowel)]
- Inspection[due todifferential diagnoses:
- Neurological examination, if necessary – including verification of reflexes, motor and/or sensory deficits/muscle weakness or paralysis of specific muscles and/or sensory deficits in the affected dermatome (skin area autonomously supplied by the sensory fibers of a spinal nerve root/spinal cord root)[due todifferential diagnosis:
- Disc prolapse (herniated disc)]
- Psychiatric examination[due todifferential diagnoses:
- Anxiety disorder
- Vulvodynia – discomfort and pain of the external primary sex organs lasting longer than three months without an identifiable cause; complaints are localized or generalized over the entire perineal area (tissue area between the anus and the external sex organs); may also present as a mixed form; prevalence (disease frequency) of essential vulvodynia: 1-3%]
[due topossible secondary diseases:
- Depression
- Exhaustion
- Daytime sleepiness]
- Urological/nephrological examination[due topossible cause:
- History of severe and recurrent (recurrent) bacterial cystitis]
[due todifferential diagnoses:
- Acute/chronic pyelonephritis (inflammation of the renal pelvis).
- Bladder diverticulum (sac-like protrusion of the bladder wall).
- Bladder neck rigidity
- Bladder stone
- Ureteral stone (ureteral stone)
- Urethral syndrome (irritable bladder; synonym: hyperactive / overactive bladder).
- Urethritis (inflammation of the urethra)
- Urogenital prolapse (prolapse of the anterior vaginal wall).
- Cystitis (inflammation of the bladder), bacterial)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
