Transvaginal ultrasound evaluation of the ureter.

In this video, we present our technique for ureter assessment during pelvic ultrasound examination.

We used a general electric Voluson E10 (General electric, Wauwatosa, WI, USA) to perform transvaginal ultrasonog- raphy. These images were shared after thorough counselling, and obtaining informed consent from the patient. This video was edited using FinalCut ProX ® (Apple Inc, Cupertino, CA, USA).

We systematized this routine after assessing the cervix, uterus, and adnexa. The vaginal probe was slightly removed to focus on the urethra. Next, we approached the hand on the contralateral thigh to the ureter. At this point, the probe was directed to the lateral pelvic wall where the ureteric orifice was found. Then, we raised our hands and perform an internal rotation movement to ascend the ureteral segments until it is related to the iliac vessels.

The urinary tract may be involved in gynecological pathologies. Transvaginal ultrasound is an easy, reproducible, and well-tolerated examination that can be used to evaluate the ureters below the pelvic brim.

Medical sonography; Ureter; Ultrasound; Ureteral disease; Endometriosis Received: 2021.06.17. Revised: 2022.02.20. Accepted: 2022.03.31. Corresponding author: Juan Ramón Pérez Vidal, MD Department of Gynecology, University Hospital Virgen de la Arrixaca, 23, Calle Pintor Pedro Flores, 1b., Murcia 30011, Spain E-mail: [email protected] https://orcid.org/0000-0001-8564-3483 Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2022 Korean Society of Obstetrics and Gynecology Video Article Obstet Gynecol Sci 2022;65(4):382-383 https://doi.org/10.5468/ogs.21194 eISSN 2287-8580 www.ogscience.org 383 Juan Ramón Pérez Vidal, et al. Transvaginal ultrasound of the ureter the ultrasound of cervix, uterus, and adnexa. With the probe placed in the vaginal fornix, we must withdraw it and focus on the urethra. Next, we moved the hand towards the thigh contralateral to the ureter that we wanted to study. The cut we used was parasagittal, so the uterus should not be seen. In addition, the images of the two ureters have the same composition. At this point, the probe was directed towards the pelvic wall. The screen shows the ureteral orifice and in - travesical portion of the ureter. We can verify that the struc - ture we are focusing on is the ureter if peristalsis is observed and if we see the ureteral jet with color Doppler is observed. To scale the ureter’s path towards the pelvic brim, we slightly elevated the probe, making an internal rotation movement. We found the junction with the uterine artery, the relation - ship of the ureter with the posterior pole of the ovary, and the cranial relationship to the great vessels. The urinary tract is involved in gynecological pathologies. Transvaginal ultrasound is an easy, reproducible, and well-tol- erated examination that can be used to evaluate the ureters of most women below the pelvic rim. Conflict of interest No potential conflict of interest relevant to this article was reported. Ethical approval This study did not require approval from the institutional re - view board because no patient data were included. Patient consent Written informed consent was obtained from the patient for publication of the images. Funding information None. Video clip Video can be found with this article online at https://doi. org/10.5468/ogs.21194.

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