transvaginale

Transvaginale, or transvaginal, is a medical term describing procedures, examinations, or interventions carried out through the vagina. The approach is commonly used in obstetrics and gynecology to access pelvic organs such as the uterus, ovaries, and surrounding structures. The term is used for diagnostic imaging methods, most notably transvaginal ultrasound, and for surgical techniques that access the peritoneal cavity via the vaginal route.

Transvaginal ultrasound (TVUS) involves inserting a lubricated ultrasound probe into the vagina to obtain high-resolution images of pelvic anatomy. It is particularly useful in early pregnancy assessment, evaluation of vaginal bleeding, uterine abnormalities, ovarian cysts, and endometriosis; it can supplement or replace transabdominal ultrasound when closer visualization is needed. The patient is typically placed in a lithotomy position; the probe is covered with a sterile sheath. The exam is usually brief and may cause mild discomfort but is generally well tolerated.

Transvaginal surgery refers to procedures performed through vaginal access, sometimes within the broader field of natural orifice translumenal endoscopic surgery (NOTES). Examples include transvaginal hysterectomy or tubal procedures. These approaches can reduce abdominal incisions, but they require specialized expertise and equipment and are not suitable for all patients. Decisions depend on anatomy, indication, and patient factors.

Safety and risks: TVUS carries minimal risk. Invasive transvaginal procedures carry risks of infection, vaginal bleeding, injury to pelvic organs, or uterine perforation. Proper asepsis, patient consent, and indication are essential. Preparation varies; TVUS usually requires an empty bladder, whereas transabdominal ultrasound often requires a full bladder.

Alternatives include transabdominal ultrasound, other imaging modalities such as MRI or CT, and different surgical routes (abdominal or laparoscopic) depending on the indication and patient factors.