Page 18 - ESHRE2019

Single digit pelvic exam
• Single well-lubricated digit
• Insert slowly
• Voluntary contraction, relaxation
• Palpation of pelvic floor muscles, assess for tenderness and tone
• Single digit palpation of anterior vaginal wall (bladder), cervix, posterior lower
uterine segment, cervix, vaginal fornix
Don’t miss rare forms of endometriosis
Abdominal wall endometriosis:
• Cyclic abdominal pain
• Tender nodule
• Most common after cesarean section
Vaginal or rectovaginal endometriosis
• Daily or cyclic pelvic pain
• Deep dyspareunia
• Place speculum posterior to cervix,
rectovaginal exam
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