Perineogram (eg, vaginogram, for sex determination or extent of anomalies)
CPT4 code
Name of the Procedure:
Perineogram (also known as vaginogram)
Summary
A Perineogram is a radiographic imaging test used to visualize the structures of the pelvic area, specifically the vagina, perineum, and adjacent organs. This procedure helps in identifying congenital anomalies, structural abnormalities, or for determining sex in certain cases.
Purpose
The primary purpose of a Perineogram is to diagnose and assess congenital anomalies or other structural issues within the pelvic region. It is also used in sex determination when needed, and to plan surgery or other treatments.
Indications
- Congenital anomalies of the reproductive organs
- Ambiguous genitalia for sex determination
- Structural abnormalities such as fistulas or tumors
- Assessment before surgical reconstruction
Preparation
- Fasting may not be required.
- Patients might need to discontinue certain medications as advised by a physician.
- A preliminary physical examination and possibly an ultrasound may be required.
Procedure Description
- The patient lies down on the X-ray table.
- A contrast dye is introduced into the vagina via a catheter.
- X-ray images are taken from different angles to visualize the pelvic structures.
The imaging might be paired with fluoroscopy for real-time visualization.
Tools: X-ray machine, fluoroscope, catheter, and contrast dye.
Anesthesia/Sedation: Generally not required, but local anesthesia may be used if the insertion of the catheter causes discomfort.
Duration
The procedure typically takes about 30 minutes to an hour.
Setting
The procedure is usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist
- Radiologic Technologist (X-ray technician)
- Nurse (if necessary)
Risks and Complications
- Allergic reaction to contrast dye
- Discomfort or pain during catheter insertion
- Infection
- Radiation exposure
Benefits
- Accurate diagnosis and assessment of pelvic anomalies.
- Valuable information for planning surgical or other medical interventions.
- Immediate imaging results in certain cases.
Recovery
- Post-procedure, patients can usually resume normal activities immediately.
- Drink plenty of fluids to help flush out the contrast dye.
- Possible mild discomfort or spotting.
- Follow-up appointment may be needed to discuss results.
Alternatives
- Ultrasound: Less invasive and does not use radiation, but might be less detailed.
- MRI: Detailed imaging without radiation but more expensive and time-consuming.
Patient Experience
During the procedure, patients might feel slight discomfort when the catheter is inserted and a sensation of fullness when the contrast dye is injected. Post-procedure, there might be minor discomfort or spotting, but pain management typically isn't necessary.