Dr Steven R. Goldstein MD: Dynamic Ultrasonography for Pelvic Pain

 

 

 

Doctor Steven R. Goldstein MD, an obgyn in NYC is a pioneer in gynecologic ultrasound and is one of the most highly recognized and regarded individuals in the field of vaginal probe ultrasounds.

Many women come to the office with pelvic pain or abnormal bleeding or both and physicians will rely on an ultrasound “examination” to help diagnose the cause of the pain and bleeding, and rely on still images. Gynecologists are trained as to what images to obtain, where to look and how to measure.

But how can you evaluate a patient’s pelvic pain with just an anatomical image? It cannot be done. Evaluating pain requires dynamic assessment. During the transvaginal ultrasound, the operator must place one hand on the abdomen and liberally move it over the abdomen. The tip of the vaginal probe can elicit where the patient’s pain exists and whether the pain can be recreated. 

 

 Pelvic adhesions can be a significant source of pelvic pain, and, also sometimes infertility. Here again, the transducer tip is pointed at the uterus, ovaries or any pelvic finding and a gentle push/pull movement of a few centimeters started. If no adhesions are present, the organs will move freely in the pelvis.

Dr Goldstein, a NYC Gynecologist and ultrasound expert, put forward this thesis of dynamic ultrasonography in one of his articles and coined the phrase “the ultrasound enhanced bimanual exam”. In it, the gynecologist doesn’t just rely on still images, but actually performs the ultrasonography instead of relying on a report or just viewing still images.

Dr Goldstein is a one of the world’s most skilled operators on ultrasounds, sonohysterograms. He personally performs each transvaginal ultrasound so he can not only look at the images, but actually feel and sense the patient’s pain points. It is the reason why he is consulted on very difficult cases of pelvic pain, bleeding, suspected uterine cancer and more. It is why he has findings that other physicians miss.

The “ultrasound enhanced bimanual exam” can also be used in cases of endometriosis, pelvic organ prolapse and incontinence, or abnormal bleeding.

Dynamic ultrasonography is an important and emerging topic in gynecologic imaging. Static imaging and cine clips will give information only on anatomy. Increasingly, whoever holds the transducer  - whether it be the gynecologist, radiololgist, or sonographer, needs to examine the patient with the probe and include liberal use of the hand on the abdomen.

If you are suffering from pelvic pain, abnormal bleeding, and your physician has had no success finding the source of the problem, then consider an appointment with Dr Steven R. Goldstein, a top NYC Gynecologist, by calling his office at 212-717-5554