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.Transvaginal sonography is a later addition to the diagnostic techniques available for the evaluation of the female pelvis. To date, it’s most frequent use has been in the evaluation of ovulation2
and in oocyte recovery in infertile patients3
. Transvaginal sonography is performed with a high frequency transducer placed in the vagina where it is in close anatomic proximity to pelvic structures. The procedure overcomes difficulties in imaging obese patients, those with a large amount of bowel gas, and those with inadequate bladder filling.Transabdominal sonography conventionally has been one of the best methods for evaluating the female pelvis. However, the necessity of traversing the abdominal wall and subcutaneous tissues causes degradation of image quality. Transvaginal sonography is a relatively new technique in pelvic imaging and can overcome many of the limitations of traditional transabdominal scanning2
. The transvaginal transducer accurately assesses early embryos, ectopic pregnancies, and incomplete abortions4
. It is especially useful in the work-up of the infertile patient and the monitoring of follicle development in these patients2, 5
. Transvaginal sonography recently was used for transvaginal cyst aspirations6
and in fetal cephalocentesis for severe hydrocephalus7
.Transvaginal sonography provided more information than transabdominal sonography in most cases. However, the transvaginal technique is limited in some circumstances because of the smaller field of view of transvaginal probe. Transvaginal sonograms may be limited in patients with large myomatous uteri or large pedunculated fibroids, because it is difficult to image the entire uterus, and in the evaluation of cephalad or laterally displaced ovaries, because the pelvic structures are out of the focal zone of the transducer. In addition, because of the limited view, a global view of the pelvis cannot be obtained as it can be with transabdominal imaging.
It is unusual for the patients to experience discomfort, but this does occur and may be a limitation for this procedure in some cases. Patients with pelvic inflammatory disease or laterally located ovaries (requiring more manipulation of the transducer) are uncomfortable. Because elderly patients are uncomfortable with this technique, the transvaginal examination is seldom performed in these patients.
Over the last decade, there has been increasing use of transvaginal ultrasound in a wide range of gynaecological and obstetric contexts. Transvaginal ultrasound is an invasive investigation and there are a number of reasons for hypothesizing that it may be a difficult procedure for some women. For example, research has shown that a significant minority of women find vaginal examinations distressing8
and that, for some women, vaginal examinations may trigger post-traumatic stress symptoms9
. There have been anecdotal reports that some women have found transvaginal scans very distressing10
, and there have been some medico legal cases involving transvaginal scans11
. This suggests that there is a need for research on women’s experiences of the procedure, examining both its acceptability to women and the relative effects of their perceptions.1.2 Statement of Problem
Transvaginal sonography involves the placement of the probe within the vagina. This is uncomfortable for most women especially in this part of the world where ethical issues are now a challenge12
. This could reduce the practicability of transvaginal sonography.There is reluctance in adopting this technique as a routine ultrasound investigation in our locality. The reasons for this are yet to be determined.
1.3 Purpose of Study
The purpose of this study is to assess women’s perception of transvaginal sonography in Image Diagnostics Port Harcourt.
1.4 Significance of Study
1.5 Scope of Study
This study will be carried out on patients who have undergone transvaginal scans in Image Diagnostics Port Harcourt. The research is intended to be for a period of 3 months in year 2012.
1.6 Operational Definition of Terms
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