TRANSRECTAL AND TRANSPERINEAL SONOGRAPHY DURING GUIDED INTRAUTERINE PROCEDURES

Transrectal sonography was used to provide intraoperative guidance for dilatation and curettage and placement of intrauterine tandem apparat us in 20 patients in whom the external cervical os could not be visual ized adequately. Transrectal sonography was found to be useful in prov iding guidance for these procedures and at the same time helped avoid uterine perforation. This method also was used during cerclage placeme nt in two patients who had undergone several conizations. Transperinea l sonography was used in three patients whose area of abnormality was best approached transperineally. These cases included transvaginal bio psy of a metastatic trophoblastic tumor and one guided aspiration of a perirectal abscess after pelvic exenteration. The potential advantage s and pitfalls in the intraoperative use of transrectal and transperin eal sonography for guided intrauterine procedures are discussed and il lustrated.