Culdoscopy (transvaginal endoscopy via the cul-de-sac) is a useful technique for evaluating the pelvic and abdominal cavities in women. It should not be attempted if there are contraindications to the procedure, which could result in significant complications for the patient.


Culdoscopy should not be done on a woman who has not had a clinical examination and vaginal ultrasonography done prior to the procedure.


General contraindications:

(1) frozen or obliterated rectouterine space

(2) presence of a large pelvic mass

(3) vaginal or pelvic infection

(4) significant coagulopathy

(5) narrow vagina

(6) history of multiple abdominal or pelvic operations

(7) history or evidence of significant adhesions

(8) significant endometriosis


Conditions that may be indicative of significant endometriosis:

(1) laterally deviated uterus or cervix

(2) fixed, retroverted uterus


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