Gynecologic Surgery: Preoperative Assessment With Ultrasound

Abstract

Ultrasonography, especially 3D, is essential in the diagnosis and preoperative evaluation of gynecologic surgeries and is important in surgical planning and counseling of patients. In addition, it is useful during hysteroscopic procedures, particularly difficult Asherman syndrome cases, resection of transverse vaginal septum, and treatment of hematometria. 3D ultrasound is especially helpful for fibroid mapping as the simultaneous visualization of the endometrium and myometrium with the coronal view is possible, it can be done by the gynecologist and at a lower cost than an magnetic resonance imaging. The ability to visualize with ultrasound during surgery may reduce complications and eliminate the use of laparoscopy.

Clinical Value of Transvaginal Ultrasonography in Comparison to Hysteroscopy with Histopathologic Examination in Diagnosing Endometrial Abnormalities

“…Ultrasound is a widespread method that has evolved through sophisticated programs and devices. However, 2D ultrasound is still the most used method 5 . Ultrasound examination is simple, fast, noninvasive and easy to learn, with no side effects, while providing additional information to physical examination.…”

Reporting of uterine fibroids on ultrasound examinations: an illustrated report template focused on surgical planning

“…Finally, 3D ultrasound can facilitate the spatial assessment, allowing more accurate characterization and localization of fibroids than what is achieved with two-dimensional ultrasound. Multiplanar views, especially the coronal view, have improved the description of fibroids on ultrasound ( 40 ) .…”

“…Although the FIGO classification system has provided gynecologists with a well-standardized framework for characterizing uterine fibroids, there is still significant variability across transvaginal ultrasound reports in terms of the quality of the descriptions of fibroids. Incomplete descriptions of fibroids or associated lesions such as adenomyosis and endometriosis can raise questions or lead to inappropriate surgical planning ( 40 ) . Consequently, a structured, illustrated model of an ultrasound report, standardizing the description of uterine fibroids—based on the critical criteria for surgical management, the FIGO classification of uterine fibroid location, and the MUSA group descriptors—could be useful for sonographers and physician examiners.…”

Management of Transverse Vaginal Septum by Vaginoscopic Resection: Hymen Conservative Technique

“…1 Clinical examination, ultrasound, and magnetic resonance imaging (MRI) are all used in the diagnosis, and the MRI is useful before the surgery to determine the thickness and depth of the septum. 9,10 A review of the literature suggests that ultrasound is still the primary diagnostic tool used, while the MRI is particularly useful to delineate more complex gynecologic anatomies. 11,12 In the literature, several approaches are described, but none seems to be better than the others.…”

“… 1 Clinical examination, ultrasound, and magnetic resonance imaging (MRI) are all used in the diagnosis, and the MRI is useful before the surgery to determine the thickness and depth of the septum. 9 10 …”