Background:
Clients presenting to integrated sexual health services may have gynaecological and contraceptive problems requiring ultrasound assessment.  This would usually need referral to radiology causing delays in diagnosis and engendering patient worry and anxiety.  To address this we have developed an in-house ultrasound service.

Aim:
To analyse if the use of pelvic ultrasound improves the patient journey, avoids referrals to radiology and saves time and potentially money.

Methods:
Over a 6-month period, 180 transvaginal pelvic ultrasounds were performed.  So far we have reviewed 50 case notes.  Information collated includes the indication for the scan, the findings and diagnosis.  Further analysis of the rest is on going.

Results:
Preliminary results show that 96% of patients had their ultrasound on the day of initial presentation.  Some of the indications for scanning included pelvic pain (36%), confirmation of position of IUC (30%) and abnormal bleeding (10%).  88% of patients were managed within the sexual health service and did not require onward referral.  The majority of these had normal scans.  Abnormal findings on scanning included fibroids, partial uterine perforation, adenomysosis and polycystic ovaries.  6 patients required referrals; one for a urological problem and 5 for appropriate gynaecological problems such as endometriosis and pelvic congestion syndrome.  No radiology departmental ultrasound scans were required.

Conclusion:
Use of ultrasound in an integrated sexual health service provides patients with a streamlined experience, effectively providing a ‘one stop shop’ for most sexual health presentations.  In the long run it could provide a value-based local service.

The use of Pelvic Ultrasound in an Integrated Sexual Health Service