A nonincisional, Doppler-guided transvaginal approach to uterine artery identification and control of uterine perfusion.
OBJECTIVE
To determine the location and depth of uterine arteries from the vaginal fornix using a Doppler-guided nonincisional transvaginal approach.


METHODS
Observational study (Canadian Task Force classification II-3).


METHODS
Two women's health and fertility centers.


METHODS
One hundred nine healthy premenopausal women (age >18 yrs).


METHODS
Transvaginal uterine artery identification.


RESULTS
After uterine size and position were determined, with a standard bivalve speculum in place, uterine arteries were located bilaterally using the DWL Multi-Dop B+ system with 8-MHz probe (Sipplingen, Germany) in toggle mode. Continuous Doppler mode was used to locate uterine arteries, and pulsed Doppler to estimate depth of the arteries from the vaginal fornix. The average uterine size was less than 8 weeks, with the largest measuring 18 weeks' gestational size. The right uterine artery could be identified between 8 and 11 o'clock positions, and was most commonly found at the 9 o'clock position (average depth 9.30 mm, range 4-17 mm). The left uterine artery could be identified between 1 and 4 o'clock positions and was most commonly found at the 3 o'clock position (average depth 8.88 mm, range 4-15 mm).


CONCLUSIONS
Due to ease of identification of uterine arteries transvaginally, despite differences in parity, uterine size, and position, access to and occlusion of uterine arteries with a Doppler-guided device might offer an alternative to invasive procedures intended to occlude uterine artery blood flow in women with symptomatic uterine leiomyomas.
Dickner
Susan K
SK
Women's Health Research, Phoenix, Arizona 85015, USA.
Cooper
Jay M
JM
Diaz
David
D
D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000628:therapy; D018608:Ultrasonography, Doppler; D014594:Uterine Neoplasms / Q000098:blood supply / Q000628:therapy; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging