Perineal ultrasound evaluation of urethral mobility after the TVT-O procedure.

AIMS: The aim of study was to assess, by means of perineal ultrasound (US), women treated with the trans-obturator suburethral sling procedure for urinary stress incontinence (USI). METHODS: Twelve women with USI and urethral hypermobility were enrolled. Static and dynamic perineal US of urethral mobility was performed before and after tension-free vaginal tape opturator (TVT-O) procedure: US parameters evaluated were pubis-urethra distance and inclination angle of the urethral axis. RESULTS: The Valsalva stress US evaluation showed a return to normal range of the pubic urethral distance in all cases (p = 0.0001); also a correction of the angle of inclination of the urethral axis occurred in all patients (p < 0.0001). CONCLUSIONS: Our results propose the use of perineal US for patients with USI as an additional diagnostic tool and a means for postsurgical follow-up.

Ultrasound diagnosis and Doppler monitoring of a pelvic spleen in pregnancy.

We describe a patient with a pelvic spleen diagnosed during pregnancy and monitored through gestation which we believe to be the first reported case. A 40-year-old woman was referred at 8 weeks of gestation because of a chronic intense pain in the left iliac cavity which had spread to her lower back. Clinical examination revealed a poorly defined pelvic mass. Pelvic ultrasound demonstrated a gestational sac containing a viable embryo whose size was consistent with the period of amenorrhea. While the splenic area in the left hypocondrium was found to be empty, a homogeneous and elongate mass measuring 152 x 123 mm with a maximum thickness of 53.4 mm was observed in the left iliac cavity above the uterus. This mass, the ectopic spleen, was monitored by Doppler velocimetry at monthly intervals until delivery and no variation throughout gestation was observed; therefore, despite the occasional occurrence of heavy pain, it was possible to exclude circulatory complications such as thrombosis or torsion. Doppler ultrasound proved to be a useful tool for the differential diagnosis of this rare anatomical variation.

Echopatterns of the ovarian dermoid tumor.

The authors report the ovarian dermoid echopatterns observed in 189 cases. The ultrasonic key of the diagnosis is a particular "pearly-gray" colour. The early diagnosis by USG gives the Gynecologist some advantages in: a) avoiding the operation in those cases of small mass; b) making a pfammenstiel incision in the surgical operation; c) trying a conservative surgery.

Integrated techniques in the identification of ovarian tumors.

This work is intended to be an effort to standardise the diagnostic iter of ovarian pathology. This protocol is carried out with a clinical examination and later by USG and celioscopy. It tests the management of functional and endometriosic cysts and the other ovarian pathologies.