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Pelvic USS
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Pelvic USS
Last updated 17th May 2022
Referral for Pelvic USS:
The indications for pelvic USS are as follows:
- Heavy Menstrual bleeding: only if uterus palpable or pelvic mass
- Polycystic ovary syndrome
- Diagnosis depends on 2 of the following 3 criteria:
- Infrequent or no ovulation
- Clinical/biochemical signs of hyperandrogenism e.g. elevated testosterone
- Polycystic ovaries on USS
- Therefore no need for USS if first two criteria are met
- Diagnosis depends on 2 of the following 3 criteria:
- Post menopausal bleeding if in the West of region
- if in East refer to rapid access gynaecology clinic where USS can be done in clinic
BSUSS Guidance on requesting Pelvic USS
Pre-menopausal women | Post-menopausal women | |
---|---|---|
Accepted | o Suspicion of structural abnormality o Abnormal PV bleeding: where Tx has failed or abnormal pelvic exam o Pain that is cyclical/Dysmenorrhoea/Dyspareuni o IUD (copper or Mirena): to assess presence when threads not seen; to assesses suitability if concern of fibroids | o Post menopausal bleeding: where this occurs >12 months after last period o Pain, when accompanied by one of the following: Palpable mass Raised CRP or WCC Nausea/Vomiting Menstrual irregularities Dyspareunia >6 wks duration o Bloating, when associated with additional symptoms: palpable mass OR raised CA125 |
Rejected | o Vague symptoms o Known benign lesion without change in clinical picture o Menhorrhagia with normal pelvic exam and swabs o PCOS (Only useful in secondary care if investigating subfertility) o Pain: Pain is only symptom and under 50; Pain and vague clinical question e.g. rule out ovarian cyst o PID: unless abscess/hydosalpynx suspected | o Bloated – as an isolated symptoms not accepted. Must be specific clinical question. o Post-menopausal bleeding – with previous hysterectomy or where last bleed was within 12 months |
References
BMUS (British Medical Ultrasound Society), Justification of Ultrasound of Request, October 2021. https://www.bmus.org/policies-statements-guidelines/professional-guidance/guidance-pages/