Introduction/Background The use of transvaginal ultrasound guided biopsy and puncture of pelvic lesions has many advantages compared to other techniques. The main aim of the work is to describe a standardized ambulatory technique and to determine its usefulness.

Methodology Prospective study of ultrasound transvaginal punctures (tru-cut biopsies and cytologies) and drainages of pelvic lesions performed on an outpatient basis during the last two years. The punctures were made with local anesthesia, under transvaginal ultrasound guidance with an automatic 18G biopsy needle with a length of 20–25 cm and a penetration depth of 12 or 22 mm. The material obtained was sent to anatomopathological, cytological and/or microbiological study if necessary.

Results In a total of 55 women, we performed 44 biopsies, 10 punctures and drain of pelvic mases and one diagnostic puncture of ascites. In 7 cases the punction and drain provided clinical. Seventeen biopsies were vaginal (previously hysterectomized) finding 10 carcinomas; 12 were ovarian tumours in advanced stages or peritoneal carcinomatosis obtaining the appropriate histology in each case; 12 were suspicious cervical biopsies finding carcinomas in 7 of them and one shwannoma; 3 were myometrial biopsies including one breast carcinoma metastasis in the miometrium and a benign placental nodule; a periurethral biopsy was performed on a woman with previous endometrial cancer confirming recurrence. The pathological diagnosis was satisfactory in all cases. The tolerance was excellent and no complications were detected.

Conclusion The ambulatory ultrasound transvaginal puncture and drainage technique is useful for obtaining a sample for pathological and microbiological diagnosis with excellent tolerance used to rule out recurrence of malignant lesions, diagnose masses not accessible to gynecological exploration (vaginal vault, myometrium or cervix) and for early histologic diagnosis in peritoneal carcinomatosis or ovarian carcinoma as well as drainage and cytological study of cystic pelvic masses.

Disclosures The ambulatory ultrasound transvaginal puncture and drainage technique is useful for:

- obtaining a sample for pathological (cytology and biopsy) and microbiological (culture material) diagnosis

- treatment of pelvic lesions (drainage) with excellent tolerance