Table 2.

Summary of steps to be taken for performing transvaginal echo-guided puncture.

Selection of the patient: evaluate the accessibility of the pelvic tumor transvaginally and the clinical conditions Prepare the transvaginal probe with the ultrasound gel, the cover, and the biopsy guide, making sure it is well aligned with the transvaginal tube Place the speculum, clean with aqueous chlorhexidine or povidone iodine Instill local anesthesia into the 4 quadrants of the vaginal sac bottom by rotating the speculum Remove the speculum and insert the transvaginal probe with the needle or biopsy hidden inside the biopsy guide attached to the transvaginal probe Ultrasound location of the optimal puncture/drainage site using the transvaginal probe-coupled reference guide Perform the puncture, biopsy or drainage. Make sure you take at least two biopsy cylinders if possible. Place the speculum again and check for hemostasis (use of ferrous sulphate if necessary) After observation of 15–30 min with the patient seated, she can go home Recommendations: If fever, intense abdominal pain, malodorous discharge or severe bleeding you should go to the Emergency Department of the Reference Hospital