Endovaginal ultrasonographically guided transvaginal drainage for treatment of pelvic abscesses.

OBJECTIVE: This study assessed the ability of endovaginal ultrasonographically directed transvaginal drainage of pelvic abscesses to treat patients who failed intravenous antibiotic therapies and whose abscesses were not amenable to percutaneous or colpotomy drainage. STUDY DESIGN: Thirty-one women who would otherwise have required surgery to treat their pelvic abscesses underwent the procedure. Immediate clinical response and longer-term follow-up results were collected retrospectively. RESULTS: Thirty-four procedures were performed on 31 women. Purulent material (10 to 350 ml) was aspirated in every case. Twenty-six of the 31 women (84%) were successfully treated by drainage. In the 6- to 21-month follow-up period, 10 women remained without problems, eight had sequelae related to pelvic infection, and eight were lost to follow-up. CONCLUSION: Endovaginal ultrasonographically guided transvaginal drainage is a safe, effective procedure for treatment of pelvic abscesses and should be considered the route of choice for draining collections not amenable to percutaneous or colpotomy drainage.

The role of fine-needle aspiration in the diagnosis of breast lesions.

OBJECTIVE: To show that using a combination of clinical impression, mammogram, and fine-needle aspiration (FNA), an accurate diagnosis of breast lesions can be made in a gynecologic office setting. STUDY DESIGN: All patients requiring FNA between January 1987, to February 1990, had a clinical and mammographic impression recorded as to whether the lesion was benign or malignant. All lesions in which a FNA diagnosis was given were evaluated. RESULTS: One hundred one patients met the criteria for inclusion into the study. There were two false-positives and one false-negative aspiration for carcinoma in the study. However, in all three of these patients, the clinical impression, or the mammogram, did not agree with the aspiration results. There were no false-negative or positive results when all three criteria were used. CONCLUSIONS: Although a larger study is needed to confirm this study, FNA in combination with clinical impression and mammogram can be used reliably to diagnose a breast lesion.

Regional lymph node recurrence following local excision for microinvasive vulvar carcinoma.

A case of microinvasive squamous cell carcinoma of the vulva is reported in which regional lymph node recurrence was noted after excisional therapy. Review of the initial pathology revealed only 0.72 mm of invasion. The results of a literature survey regarding microinvasive vulvar carcinoma are discussed.