Transrectal ultrasonography in the assessment of congenital vaginal canalization defects

Our aim was to evaluate the reliability of transrectal ultrasonography in t he preoperative assessment of congenital vaginal canalization defects. We s tudied nine patients, six with suspected Rokitansky syndrome and three with suspected complete transverse septum. Before corrective surgery all the pa tients underwent pelvic examination, transabdominal and transrectal ultraso nography. The ultrasonographic findings were compared with the surgical one s. Transrectal ultrasonography provided an accurate map of the pelvic organ s showing the precise distances between the urethra and bladder anteriorly, rectum posteriorly, retrohymenal fovea caudally, and pelvic peritoneum cra nially. Transrectal ultrasonography produced a picture that corresponded pe rfectly with the real anatomical situation. Conversely, abdominal ultrasono graphy provided inadequate images in six of our nine patients, and magnetic resonance imaging was responsible for a mistaken diagnosis in one patient with suspected transverse vaginal septum. In conclusion, if our results are confirmed in larger series, transrectal ultrasonography could be considere d as a diagnostic procedure of choice in the assessment of vaginal canaliza tion defects.