Posterior vaginal vault tenderness is commonly caused by chronic pelvic inflammatory disease, miscarriage or rupture of tubal pregnancy. The pathogenesis is that when fluid accumulates in the posterior vault after chronic inflammation or tubal pregnancy miscarriage or rupture, it can cause an inflammatory reaction around it, and when a gynecologic triage is performed, posterior vaginal vault tenderness can occur. Related tests: 1. laparoscopy A method of examination and treatment of the abdominal cavity through laparoscopy. Laparoscopy can clearly observe the structure of pelvic tissues and the appearance of ovarian tumors, which is significant for the diagnosis and treatment of ovarian diseases. It is especially important in determining the nature of the tumor when deciding what kind of surgery to perform on the ovary, such as tumor removal, oophorectomy or preservation of the ovary. Clinical significance: Abnormal findings: (1) Diagnostic laparoscopy for the etiology of unexplained lower abdominal pain, localization, characterization, staging and review of pelvic masses after treatment, probing the etiology of infertility, clarifying the classification of genital malformations, exploring endocrine or endocrine disorders, etc. (2) Surgical laparoscopic family planning surgery, tissue biopsy, adhesiolysis, conservative endometriosis surgery, ectopic pregnancy surgery, adnexal surgery, uterine surgery, ovum taking, pelvic abscess drainage. Who should be examined: Women with diseases of the reproductive system, women with endocrine disorders. Procedure: Clean enema in the morning, cleaning of the umbilicus before the procedure, cleaning of the vagina, manipulation of the uterine cavity and vagina and placement of the wand. A catheter is placed and the bladder is emptied. Then the procedure is performed, the laparoscope is inserted and the results of the various parts of the abdominal cavity are observed on the monitor to check for any abnormalities. 2.Scraping examination Scraping (D and C) is performed by dilating the cervix with a metal dilator so that a scraper can enter the uterus to scrape the endometrium. This scraping examination procedure is used to take biopsies, diagnose endometrial abnormalities, or treat incomplete abortions. Clinical significance: Abnormal findings: positive tissue examination. In women with postmenopausal uterine bleeding, diagnostic curettage can diagnose the presence of cancer in the uterine cavity and in the cervical canal. And for patients with menstrual irregularities, pathological examination of the endometrium by diagnostic scraping. The abnormal changes in reproductive endocrine secretion in the body can be understood. In addition, endometrial tuberculosis is also diagnosed by diagnostic curettage. Diagnostic scraping can also be used in patients with infertility to find out the endocrine status of the body, whether there is ovulation or not, and the pathology of the endometrium itself. Diagnostic scraping involves gently scratching the four walls of the uterine cavity with a spatula and sending the scraped tissue for pathological examination to clarify the condition. Who should be examined: postmenopausal women, married women. The procedure: general or local anesthesia, exposure of the cervix with a vaginal speculum, sterilization of the cervix, numbing of the cervical canal (unconventional), dilatation of the cervix with a rod-shaped cervical dilator, and reaching into the uterine cavity with a thin metal rod with a spatula at the end to scrape out the endometrium and send it for pathological examination. 3.Transvaginal ultrasound Transvaginal ultrasound is a breakthrough technological advancement in the application of obstetrical and gynecological ultrasound in recent years. It can clearly display the internal organ and tissue structure of the female pelvis without filling the bladder compared with traditional transabdominal ultrasound, and has the characteristics of early and accurate diagnosis of normal and abnormal pregnancy and gynecological diseases. Clinical significance: Abnormal findings: Gynecology (1) Endometrial sonography of the normal menstrual cycle and the mature and immature follicles in the normal ovary (so-called “ovulation testing”). (2) Benign tumors of the uterus. (3) Malignant tumors of the uterus. (4) Non-redundant cysts of the ovary. (5) Ovarian tumor. Obstetrics (1) Early and definitive diagnosis of early pregnancy. (2) Abnormal early pregnancy, especially ectopic pregnancy (i.e. “ectopic pregnancy”) is particularly important because ectopic pregnancy is a clinical emergency and can lead to death if not rescued in time. Who should be examined: Pregnant women during maternity checkups or gynecologists who need to assist in the diagnosis of uterine ovarian disease. Examination procedure: Examination method: The vaginal probe is covered with a disposable condom and coated with a disinfectant coupling agent both inside and outside the condom. The operator wears gloves, holds the probe handle in the right hand, and sends the probe slowly into the vaginal fornix; the probe handle is tilted, pushed and pulled, and rotated to observe all pelvic structures. Advantages: compared with traditional transabdominal ultrasound, the probe almost directly touches the scanned organ, shortening the distance between the probe and the examined organ; due to the relaxed vaginal structure, the operator can improve the image resolution; for women with more intestinal gas and more obese, they can avoid intestinal gas interference and attenuation of the fatty layer of the abdominal wall; traditional transabdominal ultrasound requires the patient not to urinate and start drinking water 3-4 hours before, and the amount of water drunk The amount of water consumed is equivalent to about 2-3 bottles of mineral water, which makes the patient work hard and is not conducive to emergency care, whereas transvaginal ultrasound does not require a full bladder. Because transvaginal ultrasound provides a more reliable basis for early diagnosis and differential diagnosis of normal and multiple obstetrical and gynecological disorders, it has been widely used in recent years and is continuing to improve further.