Uterus

In: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie · 2017 · pp. 821–844 · doi:10.1007/978-3-662-53662-9_32 · W4244983036
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Transvaginal sonography is a common gynecological examination that detects benign changes like polyps and fibroids, assesses the endometrium and myometrium, and aids in diagnosing malignancies such as endometrial cancer.

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This chapter reviews the role of uterine ultrasound in routine gynecology, describing how ultrasonographic assessment of the endometrium and myometrium can support detection and classification of benign uterine changes and malignant uterine conditions. It summarizes typical benign findings identifiable with transvaginal sonography—such as polyps, fibroids, adenomyosis, and endometrial hyperplasia—and notes that malignancies like endometrial carcinoma and the rare sarcoma are mainly addressed around peri- and postmenopause, where effective screening by ultrasound has not been demonstrated. It states that, even without proven screening effectiveness, ultrasound remains a required component of oncologic diagnostic work-up. Relevance to endometriosis: the chapter is centrally focused on uterine ultrasound and explicitly includes adenomyosis as a benign condition identifiable by transvaginal sonography, which is closely related to endometriosis within the spectrum of uterine causes of pelvic pain, though the chapter does not discuss endometriosis itself.

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Zusammenfassung Die sonographische Untersuchung des Uterus gehört zu den am häufigsten durchgeführten Untersuchungen des gynäkologischen Alltags. Im Kinder- und Jugendlichenalter kann die Erkennung und korrekte Einordnung von genitalen Fehlbildungen von Bedeutung sein. In der Prämenopause steht die funktionelle Beurteilung des Endometriums und Myometriums im Vordergrund. Typische benigne Veränderungen, die mittels transvaginaler Sonographie erkannt werden können, sind Polypen, Myome, Adenomyosis oder Endometriumhyperplasien. Maligne Veränderungen, welche überwiegend in der Peri- wie Postmenopause im Fokus stehen, stellen das Endometriumkarzinom und das sehr seltene Sarkom dar. Auch wenn die Sonographie hier keinen Nachweis eines effektiven Screenings erbringen konnte, so gehört sie in die onkologische Diagnostik obligat dazu. 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Obstet Gynecol Clin North Am 33: 85–95 Wamsteker K, Emanuel MH, de Kruif JH (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 82: 736–740 Werbrouck E, Veldman J, Luts J, et al (2011) Detection of endometrial pathology using saline infusion sonography versus gel instillation sonography: a prospective cohort study. Fertil Steril 95: 285–288 Wetzstein R, Renn KH (1970) Arrangement of smooth muscle in the human uterus. Verh Anat Ges 64: 461–468 Wolfman W, Leyland N, Heywood M, et al (2010) Asymptomatic endometrial thickening. J Obstet Gynaecol Can 32: 990–999 Author information Authors and Affiliations Corresponding authors Editor information Editors and Affiliations Rights and permissions Copyright information © 2018 Springer-Verlag GmbH Deutschland About this chapter Cite this chapter Hoopmann, M., Dürr, W., Van den Bosch, T., Timmerman, D., Brezinka, C. (2018). Uterus. In: Gembruch, U., Hecher, K., Steiner, H. (eds) Ultraschalldiagnostik in Geburtshilfe und Gynäkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53662-9_32 Download citation DOI: https://doi.org/10.1007/978-3-662-53662-9_32 Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-662-53661-2 Online ISBN: 978-3-662-53662-9 eBook Packages: Medicine (German Language)

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