The aim of the paper was to evaluate the diagnostic accuracy of transvaginal tenderness-guided ultrasonography in the identification of location of genital endometriosis, endometrial hyperplasia and uterine fibroids before and after treatment dienogest. It is a selective progestin for the treatment of endometriosis. Adenomyosis was diagnosed when a poorly defined area of abnormal echo-texture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) presented in myometrium. Typical ultrasonic changes of efficacy were: homogeneity of myometrium; clear and intense contours of uterine fibroid with increased echogenicity; reduction of the echogenic endometrial stripe with the average echogenicity and clear lines of myo- and endometrium with a reduction in local blood. These criteria can be used to select non-surgical management of patients. In cases where a poorly defined area of abnormal echotexture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) did not change the surgery or the embolization of artery uterine is required. The preferred imaging modality for the evaluation of uterine on therapeutic alternatives to hysterectomy and myomectomy is transvaginal ultrasonography.


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