Abstract
Purpose
To determine patient preferences for use of a chaperone during transvaginal sonography.
Materials and methods
Informed consent was waived for this IRB-exempt, HIPAA-compliant, retrospective review of prospectively acquired quality improvement survey data. Willing unique consecutive adult patients (n = 155) scheduled to undergo a transvaginal pelvic ultrasound between March 1, 2015 and August 15, 2015 completed a survey before and after the ultrasound examination assessing their opinions regarding the need for a chaperone. Surveys were collected from three outpatient centers (n = 35/center) and an inpatient center (n = 50) in the same health system. Respondent opinions were compared with Chi-Square test or Fisher’s Exact test.
Results
Most respondents (78% [121/155]) had previously undergone a transvaginal pelvic ultrasound. Respondents were significantly more likely to prefer a chaperone if their sonographer was male than if their sonographer was female (pre-ultrasound: 46% [69/155] vs. 12% [19/155], p < 0.0001; post-ultrasound: 43% [66/155] vs. 6% [10/155], p < 0.0001). The fraction of respondents who said they would be somewhat or substantially reassured by a chaperone if their sonographer was female was similar to the fraction of respondents who said they would be somewhat or substantially embarrassed by presence of a female chaperone (pre-ultrasound: 12% [19/155] vs. 6% [9/155], p = 0.07; post-ultrasound: 6% [10/155] vs. 7% [11/155], p = 0.82; respectively).
Conclusion
Approximately half of adult women scheduled to undergo transvaginal pelvic sonography prefer that a chaperone be present if their sonographer is male, but in general do not feel it is necessary if their sonographer is female. These opinions do not change after performance of a transvaginal pelvic ultrasound.
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Disclosures
Matthew S. Davenport, M.D. has book contracts with LW&W and Elsevier. The remaining authors have no relevant disclosures.
Ethical approval
No external funding was solicited or used for this work. All procedures performed were HIPAA-compliant, and were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
The requirement for informed consent was waived by the institutional IRB for this quality improvement effort.
IRB
This HIPAA-compliant review of anonymous de-identified survey data was determined to be “not regulated” by the IRB.
Appendices
Appendix 1: Handout and questionnaire administered immediately prior to the pelvic ultrasound.
Pelvic ultrasound
Overview
Ultrasound uses sound waves to make pictures of the organs and structures in the body. Ultrasound of the pelvis is used to look at the bladder, ovaries, uterus, cervix, and fallopian tubes (some of these are known as the female organs).
Most pelvic ultrasound studies use two ways to create the pictures. An ultrasound probe or wand that is moved over your abdominal wall is known as a transabdominal pelvic ultrasound. An ultrasound probe or wand that is placed inside the vagina is known as a transvaginal pelvic ultrasound. Transvaginal ultrasound takes a clearer picture than transabdominal ultrasound because the probe is closer to the organs being viewed.
How it is done
You will lie on your back on a padded table. Gel will be used to improve the quality of the sound waves. A small, handheld instrument or wand called a transducer will be used to obtain the pictures. A picture of the organs and blood vessels will be seen on a video screen.
For transabdominal imaging, the transducer will be gently moved over your abdomen. For transvaginal imaging, the tip of the transducer will be gently inserted into the vagina by you.
During transabdominal ultrasound, you will likely feel pressure in your bladder and an urge to urinate because your bladder may be full. During transvaginal ultrasound, you will feel pressure from the transducer probe as you place it into your vagina. The gel may feel cold when it is put on your belly or into your vagina. You will feel light pressure from the transducer. If you have an injury or pelvic pain, the light pressure of the transducer may be painful. You will not hear or feel the sound waves.
Benefits and risks
Transabdominal and transvaginal pelvic ultrasound is used to make pictures of the organs and structures of the lower belly (pelvis), and is used to make medical decisions about your current condition. There are no common risks from this procedure. Rarely, a transvaginal ultrasound can increase your risk of infection.
Appendix 2: Questionnaire administered immediately following the pelvic ultrasound.
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Davenport, M.S., Brimm, D., Rubin, J.M. et al. Patient preferences for chaperone use during transvaginal sonography. Abdom Radiol 41, 324–333 (2016). https://doi.org/10.1007/s00261-015-0556-z
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DOI: https://doi.org/10.1007/s00261-015-0556-z