Which physical findings are characteristic of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Patients with endometriosis do not frequently have any physical findings beyond tenderness related to the site of involvement. [3, 4, 5] The most common finding is nonspecific pelvic tenderness. In one study, 22% of adolescents had abnormal physical findings consistent with anatomic lesions found during surgery.

On pelvic evaluation, tenderness upon examination is best detected at the time of menses. The hallmark finding on examination is the presence of tender nodular masses along thickened uterosacral ligaments, the posterior uterus, or the posterior cul-de-sac. Obliteration of the cul-de-sac in conjunction with fixed uterine retroversion implies extensive disease. Occasionally, a bluish nodule may be seen in the vagina due to infiltration from the posterior vaginal wall.

Rupture of an ovarian endometrioma may present as an acute abdomen.

Extensive involvement of the rectum and other areas of the gastrointestinal (GI) tract may cause adhesions and obstruction.

Examination should also include evaluation for cervicitis, abnormal discharge, and sexually transmitted diseases (STDs).


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