Invasive Procedures in the Female Pelvis: Value of Transabdominal, Endovaginal, and Endorectal US Guidance

摘要

Transabdominal, endovaginal, and endorectal ultrasonographic (US) guidance is indispensable for a multitude of invasive procedures in the female pelvis. Transabdominal uterine US performed with a fluid-filled bladder is appropriate and convenient for guidance of difficult dilation and curettage procedures. Transabdominal intraoperative US can be employed to guide several procedures for which the more expensive intraoperative hysteroscopic procedure is now used. Aspiration of symptomatic ovarian cysts that appear benign at US with an endovaginally guided small-gauge needle is simple and effective. Simple noninfected pelvic fluid collections may be aspirated transvaginally for both diagnosis and therapy by using endovaginal guidance. Endovaginal US demonstrates the anatomic relationships of a pelvic abscess to adjacent structures, allowing safe access for transvaginal drainage. By using an endovaginal transducer with a needle guide, cervical and vaginal cuff masses may be easily sampled. An obstructed uteru...