Abstract
Introduction: there are various options for the application of an ultrasound transducer in transperineal sonography procedure (TPUS), starting from percutaneous scanning of the perineum area by sector transducers and ending with the use of transalabial (TLUS), transvaginal (TVUS) and transrectal access by the intracavitary transducers. In all these cases, it is necessary to identify the relationships of pelvic organs. The ultrasonic technique of the “three tracks” (TTT) allows real-time evaluation of the spatial ratio of the urethra, vagina and rectum, as well as adjacent subjects of the pelvis, visualizing them simultaneously in the same scanning plane.Objective: to present the “three track» technique used in the conduct of translabial ultrasonography, and to study the results of revealing the pathology in lower pelvis in comparison with routine transvaginal ultrasonography (TVUS).Participants, settings, methods: the study was conducted between January 18, 2016 and November 27, 2017 in the clinic for reproductive medicine “Remedi” (Odesa). Informed consent to the investigation was obtained from all females. 70 patients of the main group underwent translabial ultrasonography in the “three track” technique (TLUS + TTT). 71 women of comparative group underwent a routine transvaginal ultrasonography.Results and discussion: visualization of three tracks: urethra, vagina and rectum in one scan plane was achieved in 65 patients of the main group (93%). In addition, in the main group, approximately twice as often as in the comparison group, a rare pathology of the lower pelvis, such as Gartner duct cysts, the Bartolin cysts, the deep endometriosis of the rectovaginal septum and unclassified cysts of the vagina, were found. However, the insufficient number of obtained results does not allow confirming their reliability.Conclusion: the using of TTT during TLUS, extends the diagnostic opportunities of the examiner in the evaluation of the relationship of adjacent organs and tissues in the pelvic floor and lower pelvis. The method requires further research and can be used as an additional bonus to improve for accuracy and safety of diagnostic and surgical gynecological practice.There is no conflict of interest to declare.
Highlights
С помощью ТПУС/ТЛУС без повышения риска инфицирования можно получить информацию о степени предлежания плаценты, рисках кровотечения и асфиксии плода [16,17,18]
Castiñeiras и соавторы изучали риск вероятных осложнений, связанных с пункционными биопсиями, выполняемыми под контролем ТПУС [24]
Применение УЗ техники «трех треков» расширяет диагностические возможности врача при оценке взаимоотношений смежных субъектов, локализованных в области тазового дна и нижних отделах полости малого таза
Summary
С помощью ТПУС/ТЛУС без повышения риска инфицирования можно получить информацию о степени предлежания плаценты, рисках кровотечения и асфиксии плода [16,17,18]. ТПУС успешно применяется для получения системной оценки состояния мышц тазового дна и степени опущения органов малого таза [30,31,32]. Ряд авторов доказали высокую информативность ТПУС/ ТЛУС в оценке поражения эндометриозом ректовагинального пространства [34], кист протока Гартнера [35, 36], серозоцеле [37] и абсцессов мягких тканей тазового дна [38].
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