Ultrasound of the female genital area. Ultrasound of the genital organs

23.06.2020 -

Ultrasound has a wide range of applications in medicine, as it is a highly accurate and very informative source of diagnosis; it is used in obstetrics and gynecology. After all, this method provides an opportunity to observe the development intrauterine fetus, determine the sex of the unborn child and allows you to track the occurrence possible violations and abnormalities in fetal development. So we can say that ultrasound of the internal female organs contributes to improving the demographic situation in our country.

Each appointment with a gynecologist in mandatory must be accompanied by an ultrasound examination. This especially applies to the diagnosis of teenage girls, which at this age makes it possible to quickly identify and, if necessary, influence malformations of the organs of the female reproductive system.

Ultrasound can be divided into two main types:

Transabdominal (through the anterior abdominal wall) - this type requires the patient to fill bladder, for which she needs to take at least one liter of water one hour before the procedure;
Transvaginal (the sensor is inserted into the vagina) - this type is characterized by its accuracy and is more informative for the doctor.

An ultrasound of the female organs is necessary to examine the condition of the bladder, ovaries, cervix, and vagina. Ultrasound allows you to determine their size, identify the presence of pathologies, and determine the degree of functionality.

Gynecological ultrasound Ministry of Health Russian Federation recommends that all women undergo this on a regular basis annually. This will allow, if necessary, to identify in time various types pelvic diseases, which may not have clearly defined symptoms.

If they are detected, the doctor prescribes appropriate treatment, which helps avoid complications in the future. After all, we know very well that any disease of the genitourinary system that is not treated in a timely manner can lead to various kinds of complications and even infertility. And this despite the fact that modern medicine She practically knows no incurable diseases and has long made huge strides in the treatment of infertility. But, even despite this, you and I understand that prevention is always easier and cheaper than treatment.

The diagnosis of yersiniosis is made on the basis of clinical, laboratory and instrumental studies. Clinical studies include the collection of anamnestic information and an external examination of the patient. Anamnestic data is information about the disease (

) and about the circumstances that could contribute to its development (

). There are no external specific signs for yersiniosis, however, upon external examination, a skin rash can be detected in the patient (

), pale skin, red tongue (

) on days 5–6 of illness (

), lacrimation, hyperemia (

) conjunctiva of the eyes.

In some cases, yellowing may be detected in patients skin (

), which may be a consequence of damage to liver tissue. On palpation (

) abdomen, pain in the epigastric region is often detected (

), navel and right iliac region. Sometimes hepatomegaly can be detected (

), hepatosplenomegaly (

), lymphadenopathy (

) cervical nodes.

In the abdominal form, enlarged lymph nodes can be palpated (

) to the right of the navel. Clinical studies are necessary in order for the doctor to fully understand what exactly is happening with the patient, to find out the full clinical picture disease and determine further tactics for patient management. After clinical trials the patient, as a rule, should be prescribed laboratory tests (

), which are simply necessary to confirm or refute the diagnosis of yersiniosis. It is this group of studies that is basic in the diagnosis of this disease.

For yersiniosis, the attending physician may also prescribe the patient to undergo certain instrumental examinations (

). These tests cannot detect the causative agent of the disease in the patient's body. The doctor needs them in order to exclude other pathologies during the diagnosis process that may have symptoms similar to yersiniosis, as well as to detect various complications.

Basic laboratory methods diagnosis of yersiniosis

Diagnostic method	Methodology	What signs of disease does this method reveal?
General blood test	For these two types of studies ( general and biochemical blood tests) blood is taken from the patient from the ulnar vein into a special plastic tube - a vacutainer. Then the blood samples will be placed into special hematological and biochemical analyzers, which determine the main indicators for these types of studies. IN general analysis blood, the number of different blood cells is usually calculated ( erythrocytes, leukocytes, platelets, monocytes, lymphocytes, etc.) and some other indicators, such as total hemoglobin content, hematocrit ( percentage of red blood cells to whole blood ), ESR ( erythrocyte sedimentation rate). At biochemical analysis the analyzer determines the concentration in the blood of various enzymes, proteins, minerals and products of exchange.	A general blood test for yersiniosis can reveal anemia ( decrease in the number of red blood cells and hemoglobin), leukocytosis ( increased levels of leukocytes in the blood), lymphopenia ( decreased level of lymphocytes in the blood), eosinophilia ( increase in the number of eosinophils in the blood), increase in ESR ( erythrocyte sedimentation rate), rod shift ( an increase in the content of segmented neutrophils and a decrease in the content of band neutrophils).
Biochemical blood test		A biochemical blood test can detect an increase in the activity of alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), alkaline phosphatase, an increase in the concentration of C-reactive protein, total bilirubin, and a decrease in the concentration of albumin.
Immunological blood test	In an immunological analysis, a blood sample is taken in the same way as in a general or biochemical research. The essence this study– find antigens using certain methods ( Yersinia particles) in the patient's blood. It can also be used to detect antibodies ( protein protective molecules that are produced by cells immune system for infection) to harmful microbes in the blood. The main immunological methods that are used to detect such antigens and/or antibodies are ELISA ( enzyme immunoassay ) , RIF ( immunofluorescence reaction), RAL ( latex agglutination reaction), etc.	Antigens of the causative agent of yersiniosis can be detected in the blood of patients, usually from the 10th day of the disease. Antibodies ( protein defense molecules that are produced by cells of the immune system during infection) you need to look for from the 14th day of illness. In this case, 10 days after the first immunological blood test for antibodies, it is necessary to schedule a repeat test to assess the level of antibodies and the dynamics of their growth/decrease.
Genetic analysis	Genetic analysis makes it possible to detect in any pathological material ( blood, vomit, feces, etc.), taken from the patient, DNA of the causative agent of yersiniosis. This study is highly accurate and based on the method PCR ( polymerase chain reaction) .	DNA ( deoxyribonucleic acid) is a molecule that carries an encoded genetic information, which contains information about individual growth specific biological organism. All contain a DNA molecule dead or alive) Yersinia, so if using genetic analysis If it is established that it is present in the material, then it can be concluded that the patient has yersiniosis.
Microbiological analysis	By using microbiological research can be isolated from clinical material ( blood, vomit, feces, washings back wall pharynx, etc.) in its pure form as the causative agent of yersiniosis. The essence of this study is as follows. The pathological material taken from the patient will be placed (sown) on special plant media in which the pathogen can freely grow and multiply. After a certain period of time, bacterial colonies are assessed and identified.	Microbiological analysis is the main method for diagnosing yersiniosis, since the detection of harmful microbes in clinical material will be direct evidence of yersiniosis in the patient. It is recommended to send samples for microbiological testing to bacteriological laboratory no later than 7 days from the onset of the disease. This analysis can also be used to study objects environment (e.g. water, food), which could cause infection.

Differential diagnosis of the most common form (

) yersiniosis is mainly carried out with

Foodborne toxic infections (

With these pathologies, the patient, as a rule, does not have catarrhal (

), skin (

), dysuric (

), articular (

) disorders, hepatosplenomegaly (

), lymphadenopathy (

), jaundice (

). Fever with yersiniosis is quite long-lasting (

), while with dysentery, IPT and salmonellosis its duration does not exceed several days. Abdominal pain in the first case (

) are cramp-like in nature and are projected in the peri-umbilical and right iliac regions of the abdomen, while in the second case (

) they may have different character and be localized either in the lower (

), or in the upper and middle abdomen (

Stool with dysentery is very scanty with blood and mucus; with PTI and salmonellosis, it has a greenish color and a fetid odor. Yersiniosis is characterized by the appearance of liquid fecal masses, which, in some cases, may contain small streaks of blood and mucus.

), an increase in mesenteric lymph nodes, promotion in blood ESR (

), exanthema (

). Acute appendicitis in the vast majority of cases begins with pain in the right iliac region, to which symptoms of general intoxication are added over time (

). With the abdominal form, the opposite is true - first symptoms of intoxication appear, and then they are accompanied by painful sensations in the abdomen.

Abdominal pain with yersiniosis is cramping, with acute appendicitis– are permanent. The first pathology is characterized by epidemiological outbreaks and seasonality of incidence (

), and for the second, the absence of such. Leather (

) and mucous membranes (

) with the abdominal form of yersiniosis are often hyperemic (

). In acute appendicitis, they are either unchanged or pale in color. Differential diagnosis of generalized and secondary focal forms of yersiniosis presents enormous difficulties, especially if it is done with the same clinical forms pseudotuberculosis. This is explained by the pronounced polymorphic (

) symptoms. The results of laboratory tests are decisive here.

Treatment of uncomplicated forms of yersiniosis is medicinal. This is being treated infectious disease by using various means (

What foods can cause yersiniosis?

Yersiniosis is a fairly common acute infectious disease gastrointestinal tract. The causative agent of yersiniosis is a harmful bacterium - Yersinia enterocolitica (

). From a morphological point of view, this

looks like an oval rod, which turns red when stained with Gram stain (

). Yersinia is a facultative anaerobic microorganism that can exist without the presence of oxygen in the external environment. Y. eenterocolitica is a fairly resistant organism to temperature changes.

The causative agent of yersiniosis for a long time can live and reproduce on various food products - on confectionery and bread (

), milk (

), butter (

). Yersinias divide and grow especially well in vegetable salads. The ideal temperature for the growth of these microbes is 25 - 29°C. At temperatures above 100°C they die instantly, so boiling is one of the methods to combat this

Another equally reliable means of combating Yersinia are various disinfectants, to which these microbes are very sensitive. Y. enterocolitica thrives in conditions external environment.

), in the water of natural reservoirs it is detected for one month, in the soil it persists for more than 125 days.

The natural habitat of Yersinia is soil, but humans are predominantly infected from various animals, which play the role of a secondary reservoir of infection (

). The main carriers of yersiniosis for humans are rodents, dogs, cats, pigs, cattle, birds, rabbits, etc. Humans become infected from animals not only through contact and household contact, but also through fecal-oral (

), which is, in most cases, the most common.

Animals themselves usually become infected with yersiniosis by eating food contaminated with the causative agent of yersiniosis, or by drinking water from naturally contaminated bodies of water, or by contact, which is most often caused by keeping farm animals in poor sanitary conditions. Transmission factors (

) yersiniosis is served by food products (

) and water contaminated with harmful microbes. People can also be sources of yersiniosis (

Diagnostic testing plays an important role in examining the genital organs. ultrasound examination. And although the technique for performing an ultrasound procedure is the same for any organ, there are certain differences between male and female examinations. Let's look at ultrasound of the genitals in detail: from indications to preparation and features.

In what cases is ultrasound diagnostics prescribed for representatives of both sexes?

Women

This diagnostic method is often called gynecological, because its main goal is a complete examination of the organs of the female reproductive system, the parametrium (section of the pelvic tissue) and the uterine ligaments.

Sometimes this study is called “ultrasound of the internal female genital organs,” because reproductive system women consists of two groups of genital organs of the pelvis:

External: labia minora and labia majora, clitoris and vaginal opening.
Internal: vagina, uterus, tubes, ovaries.

Purpose of appointment gynecological ultrasound usually is:

early detection of diseases of the female genital area;
assessment of the characteristics of the uterus and its cervix;
control of the treatment measures carried out;
clarification of the diagnosis.

For men

Ultrasound of the genitals provides a unique opportunity to detect some specific diseases the stronger sex due to high-quality visualization prostate gland and scrotums. However, ultrasound of the genitals should be differentiated from examination of the prostate, for which transrectal and transabdominal examination methods are more often used. Moreover, transrectal examination, performed through the rectum, is considered more meaningful and accurate.

For men, ultrasound of the genitals is prescribed for:

inflammations and their appendages;
varicose veins of the spermatic cord;
suspected oncological lesions of the testicles;
genital injuries;
the need to find out the causes of infertility;
non-inflammatory diseases of the genitals;
necrotic lesions of the scrotum;
torsion of the testicle or spermatic cord;

An examination of the genitals for both sexes can be prescribed with color Doppler mapping.

Video 1. Testicles on ultrasound.

In boys, the reason for an ultrasound of the genitals is:

obesity;
developmental delay or lack of body weight;
dwarfism or gigantism;
heart defects.

What does it show?

Ultrasound of the female genitalia makes it possible to learn about:

pregnancy and location of the fetus (uterine or ectopic);
anomalies in the location of the uterus and its structure (so the patient can find out that she has an infantile, saddle or bicornuate uterus);
the presence of inflammation of the uterus or (if necessary, the doctor may prescribe an assessment of tubal patency);
accumulation of fluid contents in the uterine cavity ( it could be blood, pus, mucus or other liquid);
postpartum complications of any etiology;
complications after artificial termination of pregnancy or abortion;
neoplasms in the uterus or genitals (including about fibroids or polyps);
cysts located in the ovaries or uterus;
accumulation in biological fluid.

Norm and decoding

The research protocol will certainly include all information about the genitals that was established during the study. It can be given to the patient either immediately after the ultrasound or a few hours after the examination. The conclusion is intended for transmission to the attending physician.

Reference! During the examination or in the process of forming a conclusion, the doctor conducts comparative analysis obtained indicators with established standards.

If the conclusion is accompanied by an image, it can be recorded on a disk or flash drive, or transmitted via the Internet.

Photo 1. Ultrasound protocol form for a woman’s pelvic organs (internal genital organs).

Photo 2. Ultrasonography of a woman’s breast organs. Decoding.

In women

The genital ultrasound protocol should include:

parameters of the uterus (that is, shape and size);
thickness of the walls of the organ mucosa (depending on the day of the cycle);
ovarian size;
the presence or absence of neoplasms in the organ cavity;
assessment of the quality of neoplasms (if any), which is determined by the doctor based on indirect signs;
presence of cysts and determination of their type.

Video 2. Measuring the uterus and ovaries using ultrasound.

In men

Normal testicles should be visualized as round, smooth objects. In boys, they have low echogenicity, but with the onset of puberty, echogenicity increases to adult levels.

During an ultrasound, you can also see a club-shaped appendage.

Reference! Not everyone healthy men it is possible to determine the boundaries of the epididymis and testicles.

In boys, the appendage is not visible at all; only a thin formation of a hyperechoic structure can be seen, which is a protein membrane.

Photo 3. Transcription form for ultrasound of the male genitals.

Pathologies

Sonography in men helps to detect a number of pathologies and problems that require special attention:

Cryptorchidism is the failure of the testicle to descend into the scrotal cavity, or its incorrect or incomplete descent.
Inconsistency of testicular size with age norms.
Stones in the testicles (usually calcifications).
Neoplasms (both cysts and tumors).
Orchitis is inflammation of the testicle.
An abscess is a purulent inflammatory process.
Dropsy is an excessive accumulation of fluid in the testicular cavity.
Varicose veins of the spermatic cord or varicocele (more common on the left).
Bruises and injuries.

Contraindications

Contraindications to ultrasound depend on the method of diagnosis.

If ultrasound is performed transabdominal, then contraindications to it will be:

excess weight (if obese, the subcutaneous layer makes scanning difficult, reducing access to the organ being examined);
any skin lesions - open wounds, manifestations of herpes, infections or burns.

At transrectal In the study, the procedure is not recommended if the patient:

there is no rectum (during the operation it can be replaced with an anostomy);
the intestines are inflamed, or there are other diseases in the acute stage that can interfere with ultrasound - for example, hemorrhoids and dysentery;
obstruction or narrowing of the rectum;
allergy to latex.

If the doctor chose transvaginal method of examination, there are some nuances here too.

This type of ultrasound is contraindicated for:

latex intolerance;
virginity;
pregnancy (if more than 12 weeks);
genital infection.

At transurethral In this way, the patient should not have inflammation of the urethra and intolerance to painkillers.

Pros and cons

The safety and painlessness of the study makes it the most prescribed method for diagnosing pathologies of the genital organs. This type of diagnosis has no restrictions on gender and age; it is recommended even for pregnant women and young children.

Where is the best place to do it and how much does it cost?

Diagnosis of the condition of the genital organs can be carried out free of charge or for a fee, depending on the patient’s choice.

For free

If the attending physician has referred for an ultrasound of the genitals, and the patient has compulsory medical insurance policy, then the procedure is performed free of charge in a clinic at your place of residence (if the hospital has the appropriate equipment).

Paid

If you couldn’t get a referral or you simply don’t have time to sit in queues at the clinic, then you can undergo an ultrasound of the genital organs at any private medical center or diagnostic point.

Prices for ultrasound diagnostics:

Moscow – 250-2000 rubles;
St. Petersburg – 400-1900 rubles;
regions – 450-1500 rub.

Provide medical service genital examination can be done in any clinic in the country, but it is best to entrust your health to specialized urological or gynecological clinics with extensive work experience.

Conclusion

The purpose of ultrasound examination of the genitals is to detect or exclude gynecological and urological pathologies. Special significance Ultrasound is acquired when the doctor has insufficient information to make a diagnosis. Important role The process of examining the genitals is also involved in searching for the causes of a couple’s infertility. The examination is absolutely painless, but very informative.

More than 50 years of history of ultrasound diagnostics have experienced different stages its development: a period of complete denial, distrust, and reluctance of specialists to use the method, which gave way to total enthusiasm and its revaluation. This stage is characterized by an adequate assessment of the capabilities and reliability of the results of ultrasound examination (US).

Ultrasound has become especially popular among patients and doctors in gynecology and obstetrics. It allows you to diagnose inflammatory diseases and developmental anomalies with high reliability, identify pelvic tumors, including during screening examinations, etc.

Advantages of the method and reasons for its popularity

The method became possible thanks to such basic properties of ultrasound as focusing, the ability to propagate in biological tissues and various reflections from dense environments of the body, including from the boundaries between them. Ultrasound examination is based on the principle of echolocation, which is the perception of reflected waves.

A special sensor device is connected to the device that generates ultrasonic waves. As one of the main elements, it includes a converter of the received information. Using the sensor, directional radiation occurs, reflected signals are perceived and converted. As a result, a certain “picture” is displayed on the device’s display screen.

When passing through dissimilar tissues and cavities, varying degrees attenuation and absorption of a wave, its partial reflection and refraction. When encountering homogeneous structures that have the same temperature and tissue density in all areas, ultrasound will be uniformly partially absorbed and equally uniformly reflected, creating an image of an organ with its more or less clear boundaries. If in this environment there is tissue with different characteristics, for example, a myomatous node in muscle layer uterus (myometrium), different intensity reflected signals forms the corresponding pathological formation with its boundaries on the display screen.

The ultrasound method has taken a strong position among other types of radiation diagnostics. Its popularity is explained by:

the reliability and information content of the results obtained, which in most diseases coincide with the results of pathological studies (85-100%);
accessibility of the procedure, its relative simplicity and non-invasiveness;
the ability to obtain information in real time;
the ability to carry out diagnostic and some therapeutic manipulations under visual control;
absence of negative effects on tissues and the body as a whole during short-term research;
low cost compared to others by radiation methods diagnostics

Principles of Ultrasound

Ultrasound diagnostics comes down to determining indications and goals, choosing the type and mode of examination, and preparing the patient.

Indications for use

In gynecology, ultrasound examination is recommended:

In case of violations menstrual cycle and changes in their nature (abundant or, conversely, scanty, premature or delayed, etc.), which may be a sign of ovarian dysfunction, fibroids or other neoplasms, endometrial or cervical polyps, etc.
If menstrual pain is a symptom of endometriosis or inflammatory processes, the assumption of the presence inflammatory diseases uterus, fallopian tubes, ovaries or pelvic cavity.
When discharge and/or pain appears in the lower abdomen; they can occur with the development of tubal pregnancy, torsion of the fallopian tube, adhesions and inflammatory processes in the pelvis, tumors, and ovarian cysts.
For the purpose of diagnosing congenital anomalies of the uterus and appendages, pregnancy and dynamic monitoring of fetal development.
At complex diagnostics causes of infertility.
Upon admission oral contraceptives or if there are doubts about the correct installation of the intrauterine device in order to timely identify complications.
For urinary disorders, including urinary incontinence.
Before and after diagnostic curettage, medical or instrumental termination of pregnancy.
As a routine preventive examination for the purpose of early detection benign and malignant tumors that are asymptomatic.

Types and modes

Various types of ultrasound in gynecology are performed using sensors different shapes. Depending on the purposes and conditions of acoustic access, three types of studies are distinguished:

Vaginal ultrasound (through the vagina), which uses a standard probe. Visualization of the pelvic organs with this method is the clearest. It is performed with an empty bladder by inserting a sensor into the vagina. Transvaginal examination is used in most cases.
Transabdominal or transabdominal ultrasound - the sensor is manipulated along the surface of the lower parts of the anterior abdominal wall with a full bladder. The technique is used mainly when there are formations of significant size in the pelvis.
Transrectal ultrasound - through the rectum. This type of diagnosis in gynecology is used only when examining virgins.

The choice of method and, accordingly, the type of sensor depends on the functional, anatomical and topographical features of the area under study or the targeted study of a specific organ or pelvic area.

Vaginal ultrasound

Transabdominal ultrasound

To conduct an ultrasound of the pelvic organs, equipment with various modes is used, which have different capabilities and have the corresponding purpose:

2D mode, or two-dimensional

It is characterized by the formation of a planar image of a gray-white color with many shades, that is, the organs are depicted in the same plane (tomogram). practical work the method is used most often and is basic for any ultrasound examination.

This mode allows you to determine the shape and size of the uterus and its cavity, cervical canal, their condition inner shell, position in relation to other pelvic organs, structure, shape and size of the uterus and ovaries, the presence of myomatous nodes, the condition of the ovaries, the size of the follicles and corpus luteum, the presence of neoplasms in the pelvis and their size, the presence of fluid, as well as some pathological changes bladder when it is sufficiently full.

3D, or three-dimensional, but static mode

It is a synthesized volumetric image in several planes (two or more). This mode provides conditions for layer-by-layer study of the pelvic organs on different depths, as well as by “cuts” in different planes and different thicknesses - from several centimeters to less than 1 millimeter.

If you do a gynecological ultrasound in 3D, this will make it possible to determine the gender of the child, congenital anomalies development of the uterus (one-horned, two-horned, saddle-shaped), more accurate shapes and sizes of benign or malignant tumor, endometrioid ovarian cysts, degree of spread of endometriosis, size of cervical neoplasms. You can also diagnose the presence of polyps and determine their size, the presence of intrauterine septa and synechiae (adhesions), the position of the intrauterine device, the ingrowth of its elements into the mucous membrane of the walls or prolapse from the uterine cavity.

4D mode

This is a three-dimensional image, but in dynamics. It allows you to see the movements of the fetus and the dynamics of its development, detail the vascular network of the pelvic organs along the bloodstream for carrying out differential diagnosis inflammatory processes with tumors, determining their volume, exact size and even the nature and condition of the tumor, insufficiency of blood flow during necrosis of the myomatous node. You can also see the state of blood supply and varicose veins veins of the cavity and pelvic organs, diagnose venous thrombosis.

In most devices, 3D and 4D modes are combined with the CID mode, which allows you to obtain a color image. In some cases, it becomes necessary to combine examination modes and ultrasound sensors, for example, transabdominal and transvaginal.

Patient preparation and optimal diagnostic timing

The doctor recommends to each patient individually when it is best to do a gynecological ultrasound. In standard cases, it is recommended in the first phase of the menstrual cycle, that is, 5-7 days after the start of menstruation. Optimally, this is the 3-5th day after its end, but not later than 7-10 days of the cycle. To assess ovarian function (formation of the corpus luteum, development of follicles), ultrasound is performed on days 8-10, 14-16 and 22-24 of the menstrual cycle.

The first diagnosis of pregnancy is possible from 3-4 weeks. When using a transvaginal sensor, it is possible for more early stages. To all women, in order to identify asymptomatic pathological processes, especially tumors, it is recommended preventive maintenance Ultrasound of the pelvic organs annually or once every 2 years, and after 40 years - annually.

The study is carried out on an empty stomach after defecation and urination. The last meal should be no later than 8-12 hours before the procedure. If there are certain indications, the study is carried out regardless of the timing of the menstrual cycle:

severe pain;
intense bleeding;
suspicion of ectopic pregnancy - tubal, ovarian, cervical;
removal of the intrauterine device;
availability foreign body etc.

Recommended preparation for ultrasound in gynecology is aimed at maximally freeing the intestines from feces and gases. This is necessary to ensure optimal conditions for ultra sound waves and their visualization on the screen. Therefore, appropriate preparation should begin 3-4 days before the upcoming study.

During these days, it is recommended to exclude from the diet indigestible and fatty foods and foods that contribute to gas formation in the intestines. The latter include legumes, fresh vegetables and fruits rich in fiber, brown bread, whole milk, carbonated drinks, coffee, high-calorie confectionery products (cakes, pastries)

To improve food digestion, you can take enzyme preparations- Festal, Creon, Panzinorm, Enzistal, and for better removal of gases - Espumisan, Carbolen, infusions of fennel or chamomile flowers. If you are prone to constipation, it is recommended to take laxatives. You should not use cleansing enemas, as this contributes to the retention of gases and air trapped with water in the lower intestines.

To fill the bladder, if an examination is to be performed through the anterior abdominal wall, it is recommended to drink 1-1.5 liters of liquid 1 hour before the procedure (depending on age and the presence of heart, vascular or kidney diseases).

Results of ultrasound examination in gynecology

When performing an ultrasound of the pelvic organs, a holistic picture of the organs being studied is created based on the comparison and interpretation of such characteristics as the localization and mobility of the organ or its parts, shape and size, structure, external and internal contours, location and anatomical relationship with neighboring structures or organs, indicators of functionality, the degree of conductivity of sound waves and the degree of their reflection (echogenicity), the absence or, conversely, the presence of effects characteristic or not characteristic of acoustic systems.

The examination protocol only describes the above indicators, but does not make a final diagnosis. Often, the conclusions of medical specialists on radiology diagnostics the results of ultrasound examination of the same patient, which were carried out in different diagnostic institutions, are different. This is due to the equipment used, the adequacy of the patient’s preparation for the procedure, the tasks set by the treating gynecologist, and the qualifications of the specialist.

As a rule, a diagnostician, describing the resulting “picture” of the pelvic cavity and its organs, can in his conclusion only make an assumption about certain deviations from the norm, but does not make a final diagnosis. Diagnostics is the prerogative of a gynecologist who formulates a diagnosis based on comprehensive survey patient, including general clinical examination, laboratory data, results histological examination, additional consultations necessary specialists.

However modern technology Ultrasound examination, which makes it possible to obtain three-dimensional images of the pelvic organs at any depth and in various planes, especially in real time, provides the opportunity to solve complex problems in diagnosing the majority of gynecological diseases, and in most cases is a decisive factor in making a diagnosis.

Gynecological ultrasound is a diagnostic performed to assess the condition of the genital organs, periuterine space, and ligaments supporting the uterus.

This study can be performed in three ways. Each of them, although it gives an idea only of the state pelvic organs, has features of preparation and conduct.

An ultrasound of the female genital organs is performed on certain days of the cycle, depending on the purpose of the study. Data interpretation is carried out jointly by a sonologist and a gynecologist.

Why is ultrasound diagnostics performed in gynecology?

This type of survey has the following goals:

identify diseases of the internal genital organs of a woman at any stage of their development
evaluate anatomical features development of the uterus, its tubes, cervix, ligamentous apparatus,
evaluate the effectiveness of the treatment
diagnose a disease of the genital area, especially if the symptoms are so scarce that this does not allow this to be done.

What does ultrasound examination show in gynecology?

pregnancy – uterine, tubal, celiac
developmental anomalies of the uterus and appendages (bicornuate, saddle-shaped, “infantile” uterus, duplication of fallopian tubes, etc.)
inflammation of the uterus and appendages (but ultrasound of the patency of the fallopian tubes is a separate type of study)
endometriosis
hydro-, hemo- and pyosalpinx (that is, accumulation of inflammatory fluid, blood or pus in the fallopian tube) without precise differentiation of the type of pathological fluid
complications after childbirth and abortion (for example, if not all parts of the fetus or its membranes come out)
diagnosis of pelvic organ tumors. Ultrasound of the uterus and appendages can only indirectly judge the degree of their malignancy, while the final diagnosis and histological characteristics are made on the basis of a biopsy
endometrial polyps
uterine fibroids, its stage, condition of myomatous nodes, their effect on the patency of the uterus
ovarian cysts (in this case, pelvic ultrasound in women helps to indirectly determine what type of cyst - luteal, follicular, endometrioid - is present in this case)
torsion of the pedicle of an ovarian cyst
pathological fluid in the pelvis.

During IVF, gynecological ultrasound allows for dynamic monitoring of the condition of the ovaries and uterus, and during pregnancy - to monitor the development of the fetus and the condition of the maternal and temporary organs.

Types of female ultrasound diagnostics

Ultrasound in gynecology can be divided depending on the condition of the woman and the organs examined.

1. Diagnostic testing outside of pregnancy

Such a study in the absence of pregnancy may be called:

gynecological ultrasound diagnostics
Ultrasound examination of the uterus and appendages
Ultrasound in gynecology
ultrasound examination of female organs.

All these terms are equivalent, therefore, when asking a clinic whether they conduct ultrasound diagnostics of diseases gynecological sphere, you can use any of them - the doctor will understand you.

How is research conducted?

This type of research can be carried out in three ways:

transvaginal examination is performed for more accurate diagnosis diseases of the genital area. It is performed by inserting a special sensor into the woman’s vagina.
transabdominal examination is performed in virgins or to detect gross pathology of organs located in the pelvis. Passed through the abdominal wall
transrectal diagnosis of women: performed through the rectum; In terms of information content, it is not inferior to transvaginal examination. It is carried out in rare cases, only in virgins.

2.Folliculometry

This too ultrasound diagnostics female organs. But in this case, folliculometry examines only the ovaries for the maturation of follicles in them. This diagnosis is almost always carried out transvaginally.

3. Diagnosis during pregnancy

This is also, to some extent, an ultrasound of the female organs, since During pregnancy, not only the fetus itself is examined, but also the uterus, its cervix, and fallopian tubes, and appendages.

This type of diagnosis can be carried out both transvaginally (in the first trimester of pregnancy) and transabdominally (in the next two trimesters).

Preparation for the procedure

Preparation for a gynecological ultrasound depends on how this study will be carried out.

For example, a transabdominal examination is performed after:

three days before it, you excluded from food everything that causes fermentation in the intestines: fatty foods, carbonated drinks, fresh sweet berries and fruits, cabbage, black bread
ate the last time at 18-19:00 the day before the study, and only drank in the morning (if the study is scheduled for the morning). If it’s in the evening, then you can eat until 11-12 noon (so that there are 4-5 hours before the ultrasound), but only diet food
An hour before the study, we drank about a liter of still water.

How to prepare for a gynecological ultrasound performed transvaginally:

you need to follow the above diet for 1-2 days
then do not eat for 4 hours before the test
Before the procedure itself, you need to go to the toilet in a small way.

Preparation for ultrasound diagnostics of the gynecological sphere, which will be performed transrectally, is as follows:

you also follow a diet (for 1-2 days)
then in the evening you give a small cleansing enema (you can give a microenema, a glycerin suppository, or drink Picolax). The main thing is that the rectum into which the sensor will be inserted is empty.

When and why research is carried out

Timing, when to do it this type Ultrasound must be prescribed by the attending physician.

If this procedure- planned, then it should be carried out in the first half of the cycle. This is due to the fact that at this time the mucous membrane of the uterus is still thin, it is easier to see some formations in it - polyps, condylomas, tumors small sizes. On what day of the cycle is the ultrasound performed in this case - 3-5 (no later than the seventh) day after the end of menstruation.

In addition, in the second phase of the cycle, a small cyst develops in the ovary - a follicle, which then bursts. What a cyst may look like and corpus luteum- a structure formed at the site of a ruptured follicle from which an egg was released.

Both such structures disappear by the beginning of menstruation, leaving only pathological cysts.

On what day is this type of examination performed in case of such complaints:

pain in the lower abdomen
copious discharge, especially if it is purulent in nature
bleeding outside of menstruation
heavier periods than before
pain during sexual intercourse.

In this case, the study can be carried out on any day.

In case of delayed menstruation, you can undergo an ultrasound examination on days 5-10.

How is ultrasound performed in obstetrics and gynecology?

It depends on which diagnostic method you decide to use.

A transvaginal ultrasound is done this way - you undress completely from the waist down, lie down on the couch, bend your knees. A thin sensor inside a disposable condom is inserted into the vagina. During the examination, the doctor moves it slightly, pressing on the walls of the vagina, but painful sensations it shouldn't cause any harm.
Transrectal examination is done in a similar way, only it uses a thinner probe, which (also in a condom) is inserted into the rectum.
Ultrasound in gynecology abdominally (through the abdomen): it is not necessary to undress, you need to free the entire abdomen from the pubis to the sternum from clothes. A small amount of gel will be applied to your stomach and a sensor will be moved across it in different directions.

How are the research data interpreted?

The interpretation of a gynecological ultrasound is that the doctor measures and compares with the norm:

shape of the uterus
uterus size
thickness of the uterine mucosa (depending on the day of the cycle)
ovary sizes
the presence or absence of tumors of the uterus and appendages (this is an important aspect of decoding pelvic ultrasound), their localization, benignity
presence/absence of ovarian cysts, determination of their nature (luteal, follicular, endometrioid).

Attitude of patients to gynecological examination

Reviews of the study are positive.

Women write that such a diagnosis helped the attending physician prescribe correct treatment, and for them to get rid of the unpleasant symptoms of various serious illnesses(fibroids, adnexitis, endometriosis).

Ultrasound diagnostics performed within a week after an abortion or childbirth in some cases helped to avoid unexpected bleeding, since the woman had the remnants of the fertilized egg removed from the uterus as planned.

Prices for ultrasound in gynecology differ depending on how the examination should be carried out and for what diseases:

examination of the patency of the uterine tubes (hysterosalpingoscopy) costs 1,500-25,000 rubles
price for transabdominal examination of female organs – from 300 to 3800 rubles
transvaginal diagnostics – 500-4000 rubles
folliculometry – 200-7100 rubles

Successful diagnosis and treatment, health and well-being!

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