EP30.07: Extrauterine pathology detected with transvaginal gynecological ultrasound examination

To illustrate the detection of extrauterine pathology not related to ovarian disease nor deep infiltrating endometriosis in women undergoing transvaginal gynecological ultrasonography. We present a series of 20 illustrative cases detected at a gynecological outpatient clinic of a regional hospital. During transvaginal gynecological ultrasound examination, the anterior, lower central and posterior compartment of the pelvis was routinely evaluated, starting from the perineum. In the anterior compartment urological pathology e.g. lithiasis in the distal ureter, urethral dilatation or bladder cancer may been seen. The reasons for referral in our series were abdominal pain, urgency and (allegedly) vaginal bleeding. In the posterior compartment anal conditions such as a sphincter tear or a perianal abscess, or bowel pathology such as an abscess, a plastron or diverticulitis can be seen as well as non-intestinal conditions such as a posttraumatic retrorectal cyst, a pelvic kidney, presacral perineural cysts or leiomyomatosis peritonealis disseminata. Perineal or abdominal pain was the presenting symptom in some cases but in others it was an incidental finding. In the lower central compartment malignant masses such as a lymphoma, a melanoma or a spinocellular carcinoma, or benign conditions such as a Gartner's cyst and a Schwannoma can be detected. The women with malignant masses in our series presented with abnormal vaginal bleeding. Although the main focus of a gynecological ultrasound examination is to diagnose uterine and ovarian pathology or pelvic endometriosis, the transvaginal approach may result in the diagnosis of other pathological conditions in the pelvis. Transvaginal ultrasound examination should not be limited to the evaluation of the uterus and the ovaries.