DOI: https://doi.org/10.18370/2309-4117.2017.38.53-57

Translabial ultrasound: “three tracks” technique

В. В. Дощечкин

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.


Keywords


transperineal ultrasound; translabial ultrasound; TPUS; TVUS; TLUS; “three tracks” technique

References


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Benacerraf, B.R., Shipp, T.D., Bromley, B. “Is a full bladder still necessary for pelvic sonography?” J Ultrasound Med 19 (2000): 237.

Martensson, O., Duchek, M. “Translabial ultrasonography with pulsed colour-Doppler in the diagnosis of female urethral diverticula.” Scand J Urol Nephrol 28.1 (1994): 101–4.

American Institute of Ultrasound in Medicine. AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis (2014). Available from: [http://www.aium.org/].

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GOST Style Citations


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Park, B.K. “Ultrasound-guided genitourinary interventions: principles and techniques.” Ultrasonography 36.4 (2017): 336–48. DOI: 10.14366/usg.17026

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comparison.” Am J Obstet Gynecol 181.4 (1999): 780–3.

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Antonio Sainz, J., Borrero, C., Aquise, A., et al. “Intrapartum translabial ultrasound with pushing used to predict the difficulty in vacuum-assisted delivery of fetuses in non-occiput posterior position.” J Matern Fetal Neonatal Med 29.20 (2016): 3400–5. DOI: 10.3109/14767058.2015.1130816

Kokinidis, I., Dimitrov, A., Karagozov, I. “Translabial sonography of the lower uterine segment.” Akush Ginekol (Sofiia) 38.3 (1999):18–20.

Ki Hoon Ahn, Min-Jeong Oh. “Intrapartum ultrasound: A useful method for evaluating labor progress and predicting operative vaginal delivery.” Obstet Gynecol Sci 57.6 (2014): 427–35. DOI: 10.5468/ogs.2014.57.6.427

Blasi, I., Fuchs, I., D’Amico, R., et al. “Intrapartum translabial three-dimensional ultrasound visualization of levator trauma.” Ultrasound Obstet Gynecol 37.1 (2011):88–92. DOI: 10.1002/uog.8818

Fleischer, A.C., Burnett, L.S., Jones, H.W. 3rd, Cullinan, J.A. “Transrectal and transperineal sonography during guided intrauterine procedures.” J Ultrasound Med 14.2 (1995): 135–8.

Castineiras, J., Varo, C., Castro, C., et al. “Complications of ultrasound-guided transperineal puncture biopsy of the prostate.” Actas Urol Esp 19.7 (1995): 544–8.

Wang, Z., Hu, L., Jin, X., et al. “Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations.” J Pediatr Surg 51.3 (2016): 416–20. DOI: 10.1016/j.jpedsurg.2015.09.024

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Mate, A., Bargiela, A., Mosteiro, S., et al. “Contrast ultrasound of the urethra in children.” Eur Radiol 13.7 (2003): 1534–7.

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Notten, K.J.B., Vergeldt, T.F.M., van Kuijk, S.M.J., et al. “Diagnostic Accuracy and Clinical Implications of Translabial Ultrasound for the Assessment of Levator Ani Defects and Levator Ani Biometry in Women With Pelvic Organ Prolapse: A Systematic Review.” Female Pelvic Med Reconstr Surg 23.6 (2017): 420–8. DOI: 10.1097/SPV.0000000000000402

Deepti Jain. “Perineal scar endometriosis: a comparison of two cases.” BMJ Case Rep (2013). DOI: 10.1136/bcr-2013-010051

Troiano, R.N., McCarthy, S.M. “Mullerian duct anomalies: imaging and clinical issues.” Radiology 233 (2004): 19–34. DOI: 10.1148/radiol.2331020777

Hoogendam, J.P., Smink, M. “Gartner’s Duct Cyst.” N Engl J Med 376.14 (2017): e27. DOI: 10.1056/NEJMicm1609983

Najjari, L., Hennemann, J., Larscheid, P., et al. “Perineal Ultrasound as a Complement to POP-Q in the Assessment of Cystoceles.” Biomed Res Int 2014 (2014): 740925. DOI: 10.1155/2014/740925

Sperling, D.C., Needleman, L., Eschelman, D.J. “Deep pelvic abscesses: transperineal US-guided drainage.” Radiology 208.1 (1998): 111–5.

Reuter, K.L., Young, S.B., Colby, J. “Transperineal sonography in the assessment of a urethral diverticulum.” J Clin Ultrasound 20.3 (1992): 221–3.

Trombetta, C., Lissiani, A., Moro, U., Belgrano, E. “Infrequent application of intraoperative ultrasonography in urology.” Arch Ital Urol Androl 68 Suppl 5 (1996): 31–6.

Bogusiewicz, M. “Ultrasound imaging in urogynecology – state of the art 2016.” Prz Menopauzalny 15.3 (2016): 123–32. DOI: 10.5114/pm.2016.63060

Pietrus, M., Pityński, K., Bałajewicz-Nowak, M., et al. “Translabial ultrasonography in pelvic floor prolapse and urinary incontinence diagnostics.” Ginekol Pol 83.9 (2012): 694–9.

Hennemann, J., Kennes, L.N., Maass, N., Najjari, L. “Evaluation of established and new reference lines for the standardization of transperineal ultrasound.” Ultrasound Obstet Gynecol 44.5 (2014): 610–6. DOI: 10.1002/uog.13318

Benacerraf, B.R., Shipp, T.D., Bromley, B. “Is a full bladder still necessary for pelvic sonography?” J Ultrasound Med 19 (2000): 237.

Martensson, O., Duchek, M. “Translabial ultrasonography with pulsed colour-Doppler in the diagnosis of female urethral diverticula.” Scand J Urol Nephrol 28.1 (1994): 101–4.

American Institute of Ultrasound in Medicine. AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis (2014). Available from: [http://www.aium.org/].

American Institute of Ultrasound in Medicine. AIUM Practice Parameter for Ultrasound Examinations in Reproductive Medicine and Infertility (2017). Available from: [http://www.aium.org/].

Society and College of Radiographers and British Medical Ultrasound Society. Guidelines for professional ultrasound practice (2015). Available from: [https://www.sor.org/sites/default/files/documentversions/ultrasound_guidance.pdf].





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