Transvaginal ultrasound in the diagnosis and treatment of tubo-ovarian abscess

Article Abstract:

An infection in the female reproductive structures, pelvic inflammatory disease, can develop into a serious abscess in the ovaries or the fallopian tubes (tubo-ovarian abscess). The treatment of unruptured abscesses varies from clinician to clinician, with some performing surgery and others electing to administer intravenous antibiotics. Physical examination cannot always detect pelvic abscess. The tubes and ovaries can be visualized by inserting a small tube affixed with a magnifying end into the abdomen (laparoscope) for both diagnosis and treatment of abscesses. Some studies have shown that ultrasound, a diagnostic tool that uses high frequency sound to visualize internal structures, is more accurate in diagnosing pelvic abscesses. Transvaginal ultrasound transmits sound waves through a probe inserted into the vagina and produces high-resolution images of reproductive structures. Transvaginal ultrasound can be used to diagnose and guide needles used to drain infected fluid from abscesses in the tubes and ovaries. The experience with transvaginal ultrasound in the diagnosis and treatment of women with severe pelvic inflammatory disease is reported. A pelvic mass was detected in 6 of the 10 patients studied. The procedure did not require general anesthesia and was performed under light sedation. The procedure was well-tolerated and the recovery was quick and uneventful. Transvaginal ultrasound-guided needle aspiration of infected, unruptured abscesses appears less complicated than surgical laparoscopy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Ultrasound imaging, Pelvic inflammatory disease

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Menstrual symptoms in women with pelvic endometriosis

Article Abstract:

The endometrium is a mucous membrane that forms the inner lining of the uterus. When this membrane grows in the pelvic region outside of the uterus, it causes a condition called endometriosis. This condition is a common gynecological problem. Some of the frequent symptoms of endometriosis include pain in the pelvic region, dysmenorrhea (difficult and painful menstruation), pain during sexual intercourse, abnormal vaginal bleeding, and infertility. A survey of 1,200 women about to undergo exploratory surgery (laparoscopy) for pelvic pain or menstrual symptoms was performed. Of these women, 598 were undergoing sterilization, 312 were having surgery to determine the cause of infertility, 156 were having surgery to determine the cause of chronic pelvic pain, and 134 were having hysterectomies for abnormal uterine bleeding. Symptoms of menorrhagia (excessive menstrual bleeding), irregular menstrual cycles, and spotting (light bleeding) prior to menstruation occurred in all four groups of women. Pain during sexual intercourse, chronic pain in the pelvic region, and dysmenorrhea were more common among women diagnosed with endometriosis than those who were not. It is concluded that dysmenorrhea is the most common symptom in women who have endometriosis. Laparoscopy should be performed to make an accurate diagnosis before treating women with pelvic pain or menstrual symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Surveys, Endometriosis, Menstruation disorders, Women patients

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Transvaginal ultrasonic assessment of endometrial growth in spontaneous and hyperstimulated menstrual cycles

Article Abstract:

The lining of the uterus, the endometrium, changes during the phases of a normal menstrual cycle. The development of this tissue can be assessed by ultrasound, the use of high frequency sound to visualize internal structures. When the endometrium is artificially stimulated to produce a menstrual cycle so that it will be more receptive to fertilization, transvaginal ultrasound probes (inserted into the vagina) can be used to assess the endometrial lining. The following three groups of women were studied: women with ovulatory cycles but unexplained infertility, women using donated sperm for fertilization, and women requiring hormonal stimulation (hyperstimulated cycles) to produce many eggs for retrieval for in vitro fertilization (fertilization of egg and sperm outside the body and later reintroduced into the uterus). Ultrasonographic evaluation of the endometrial lining found basic changes to be similar in all three groups indicating that lining receptability for in vitro fertilization can not be assessed using this method. It was useful in examining ovulation.

Methods, Evaluation, Physiological aspects, Menstrual cycle, Endometrium, Ovulation, Prenatal ultrasonography, Ultrasonics in obstetrics

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