Background: In many cultures, Hymen preservation during the investigation of virginal gynecological problems is of utmost importance
Aim: to assess the diagnostic performance and acceptability of sonographic modalities (3D transabdominal and Transrectal ultrasound) compared to vaginoscopic hysteroscopy during the diagnostic workup of virginal gynecological lesions
Patients and methods: Virgin patients with different presentations (Bleeding, Amenorrhea, pelvic pain and chronic discharge) were recruited from outpatient clinic and ER. After detailed history and clinical examination, they were assigned to have a 3D transabdominal and transrectal ultrasound followed by a confirmatory vaginoscopy under anesthesia. Patients were then assessed for discomfort and satisfaction by visual analog scale
Results: 41 consented to participate and have a vaginoscopy however five patients (13%) refused to have a transrectal ultrasound. Transrectal ultrasound showed higher concordance with vaginoscopic hystoscopy in detection of different lesions where 94% of patients were correctly diagnosed by transrectal ultrasound on the other hand 3D Transabdominal ultrasound correctly diagnosed 65% of the patients. Still significantly more patients expressed their dissatisfaction with transrectal ultrasound in comparison to 3d transabdominal ultrasound and vaginoscopy
Conclusion: Although transrectal ultrasound had high accuracy in detecting different genital tract lesions in concordance with vaginoscopy more patients expressed their dissatisfaction towards it.