Diagnostic and therapeutic value of ultrasound screening pelvic masses

ABSTRACT

To ascertain the superiority of Ultrasound screening over traditional bimanual pelvic examination in diagnosis and treatment of pelvic masses. Design: Retrospective study of 1000 consecutive patients attending the outpatient clinic for various complaints. Settings Ultrasound clinic, a tertiary care gynae-obstetric unit in private sector, Islamabad. Subjects: One thousand consecutive patient who attended the outpatients for gynaecological checkup or first antenatal visit. Main outcome measures: Adnexal masses assessed bimanually, and with ultrasound scan and Doppler study of their blood vessels, the diagnosis then confirmed by observation, aspiration, laparoscopy or laparatomy, then follow up evaluated with ultrasound. eighty six% of adnexal pathology was missed on bimanual vaginal examination if the masses were cystic, less than 7 cms, and the patient obese and tender. Pathological changes were suspected in 230 patients at first ultrasound scan and confirmed in 100 after repeat scan in 2 weeks. 24 patients with clear cysts were aspirated under ultrasound control and aspirated fluid sent for cytology. 16 patient underwent laparoscopic evaluation and 32 were put an pituitary suppression for multiple small functional cysts. Only 28 underwent laparotomy. Ultrasound scan combined with abdominal and vaginal probes along with pulse wave Doppler is a very useful and non-ivasive tool in the diagnosis and treatment of adnexal masses and each gynecologist should aspire to have the machine besides the examination couch like the BP apparatus and the speculum, and learn to use it as recommended in the XIV FOGO World Gongress of Montreal, Canada 1994