Sonographic diagnosis of paravaginal defects: A standardization of technique

The qualitative and quantitative effects of bladder and vaginal balloon vol umes on the sonographic diagnosis of paravaginal defects were evaluated. Tr ansabdominal ultrasound measurements were performed on patients with stage 4 prolapse and coexisting paravaginal defects (study group) as well as on n ulliparous patients without prolapse or paravaginal defects (control group) . Paravaginal defects were measured, first without a water-filled condom in the vagina, and then sequentially with a 30, 60 and 90 mi water-filled bal loon in the vagina at bladder volumes of 150 and 300 mi. Paravaginal defect s were detected on transabdominal ultrasound in both groups. In both the st udy and the control groups the size of the paravaginal defect was directly related to the size of the balloon placed in the vagina (P<0.0001). There w ere no significant differences in the size of the paravaginal defects measu red at a bladder volume of 150 mi compared to those measured at 300 mi. We conclude that transabdominal ultrasound is not useful in detecting paravagi nal defects.