Transvaginal ultrasound approach for diagnosing pelvic venous disorders

This article presents a detailed, step-by-step protocol for performing transvaginal ultrasound (TVUS) examination to assess the pelvic veins, emphasizing its importance in the diagnosis of pelvic venous disorders (PeVDs).

The protocol outlines the anatomical landmarks, scanning techniques, and key ultrasound findings associated with PeVDs. It also provides practical recommendations for optimizing image acquisition and interpretation. TVUS examination provides enhanced visualization of pelvic venous structures, with a particular emphasis on the pelvic venous plexuses, tributaries of the internal iliac vein, and gonadal veins.

This protocol is designed to assist practitioners in the accurate assessment of PeVDs by guiding the evaluation of the periuterine, perivaginal, gonadal, and iliac veins. It also includes techniques for identifying venous reflux and post-thrombotic changes. The advantages, limitations, and specific considerations for obtaining and interpreting TVUS images are also discussed.

The proposed standardized TVUS protocol offers a practical and reproducible approach to evaluating pelvic venous anatomy and function. It enhances diagnostic accuracy in PeVDs, particularly in detecting venous reflux and post-thrombotic changes, and supports more effective clinical decision-making.