Ultrasound Diagnosis in Searching for Causes of Chronic Pelvic Pain in Women

Ultrasound examination in 3D scanning mode provides a non-invasive detailed evaluation of the structure of internal genital organs, their blood supply, and also the vessels of the small pelvis. The method of ultrasound examination of pelvic organs in women is an integral part of the diagnostic algorithm in modern gynecological practice. The purpose of the study was to examine the place of the three-dimensional sonography in the diagnostic searching for the causes of chronic pelvic pain in women. Materials and Methods. We examined 213 patients with chronic pelvic pain syndrome, including: 106 women (46.5%) with hysteromyoma, 49 (21.5%) – with pelvic organs inflammatory diseases, 35 (15, 4%) – with external and internal endometriosis, and 23 women (10.1%) – with the adhesive process of the small pelvis. The sonography was performed on a SonoScape 6 by transabdominal and transvaginal approach. Results and discussion. At present, there is no single algorithm for diagnosis and treatment of chronic pelvic pain syndrome. Diagnostic search always begins with a careful collection of complaints and anamnesis. The survey algorithm is traditional: Anamnesis (the cause of pain appearance, its duration, intensity, localization, irradiation, connection with menstrual cycle days, provoking factors, concomitant factors, the effectiveness of previous therapy); general clinical and gynecological examination; laboratory examination of blood, urine, separated from the cervical canal and vagina; ultrasound examination of the pelvic organs. Ultrasonic examination of the pelvic organs is an integral part of the diagnostic search for the causes of chronic pelvic pain in women. Based on the study, we proposed a diagnostic algorithm that includes indications for carrying out three-dimensional echography with a different gynecological pathology, accompanied by a syndrome of chronic pelvic pain. Conclusions. Based on the results of the work, we propose an algorithm for echographic examination of patients with pelvic pain, an echographic test for pelvic pain in women with uterine myoma, an echographic test for pelvic pain in women with inflammatory diseases, an echographic test for pelvic pain in women with genital endometriosis, an algorithm echographic examination of pelvic pain in women with adhesive process of the pelvic organs.