Transvaginal ultrasonography in the diagnosis of extrauterine pelvic diseases

Extrauterine pelvic diseases include several kinds of adnexal masses. In addition, pelvic adhesions and deep endometriosis can be considered extrauterine pelvic diseases. In this article we will review a practical approach to adnexal pathologies using simple transvaginal ultrasonographic findings of several benign masses. Moreover, we will investigate the additional role of color Doppler and explain a simplified presurgical triage of adnexal masses that uses color Doppler as a secondary test for the detection of ovarian cancer, already confirmed by several studies. We will also evaluate the new insight of transvaginal ultrasonography in the detection of pelvic adhesions and deep endometriosis. A possible improvement in the field of the preoperative diagnosis of ovarian cancer in the next years comes from the constitution of the International Ovarian Tumor Analysis Group and from the introduction into clinical practice of 3D color Doppler sonography.