Differentials
Cervical elongation
SIGNS / SYMPTOMS
Physical examination is essential for differentiation.
Women with pelvic organ prolapse (POP) demonstrate greater descent of the cervix and the vaginal wall when straining.
Women with isolated cervical elongation may experience protrusion of the cervix without descent of the vaginal walls.
INVESTIGATIONS
Vaginal speculum and bimanual examination are the most reliable tests for differentiating between POP and cervical elongation.
Vaginal cyst
SIGNS / SYMPTOMS
Often asymptomatic, vaginal cysts can be superficial or deep. The patient may report a soft lump in the vaginal wall or protrusion of a lump from the vagina. Superficial dyspareunia or difficulty inserting tampons may be experienced.
INVESTIGATIONS
Diagnosis is usually clinical. However, vaginal ultrasound and MRI are useful to identify the content of the cyst and its topographical relation with adjacent anatomical structures.
Gynaecological cancer
SIGNS / SYMPTOMS
Symptoms of pelvic pain and mass are common. Pelvic examination may reveal cervical, uterine, or pelvic mass. Digital rectal examination may detect rectal carcinoma.
INVESTIGATIONS
CT scan and, if needed, cystoscopy with cytology and biopsy can differentiate between POP and these cancers.
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