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) [in rare cases, metastases/daughter tumors are possible in the vagina]
- Cervix uteri (cervix), or portio (cervix; transition from cervix uteri to vagina (vagina)) [Bleeding ex utero/from the uterus; uterine fluorine – vaginal discharge originating in the uterus, may occur with advanced endometrial cancer], taking a Pap smear (for early detection of cervical cancer), and performing a dash curettage (to detect endometrial cancer).
- Palpation (bimanual; palpation with both hands) of the internal genital organs.
- Cervix uteri [may be distended; in approximately 10% of cases, there may be continuous growth into the cervix uteri; this may also lead to obstruction of the cervical canal, resulting in hematometra/accumulation of blood in the uterus]
- Uterus (uterus) [Normal: anteflexed/angled forward, normal size, no tenderness; hematometra (see above), when infected may result in infected pyometra/accumulation of pus in the uterus; in approximately 10% of cases, growth may cause the uterine boundaries to be exceeded]
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian 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; infiltration of the parametria is possible]
- Pelvic walls [Normal: free; infiltration into the lesser pelvis is possible]
- Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) posteriorly and the uterus (uterus) anteriorly) [Normal: clear]
- Inspection of the mammae (breasts), right and left; nipple (breast), right and left; and skin [Normal: unremarkable].
- Palpation of the mammae, both supraclavicular pits (upper clavicular pits), and axillae (axillae) [Normal: unremarkable].
- Inspection
- Health check (as an additional follow-up measure).
Square brackets [ ] indicate possible pathological (pathological) physical findings.