EP24.15: Step‐by‐step technique to identify the proximal ureter with transvaginal ultrasound

Despite recommendations to use transvaginal ultrasound (TVS) to assess the ureter, there are no published descriptions of how to visualise and describe the proximal ureter above the crossing of the uterine artery. Parametrial endometriosis generally constricts the ureter at the level of the uterine artery-ureter crossing. We present a 5-step guide to assess the proximal ureter on TVS. Accompanying images and videos visually present the 5-step technique, with examples of normal and abnormal proximal ureters. A standardised approach is necessary to visualise the ureter proximal to the crossing of the uterine artery. This first-ever proposed step-by-step approach should allow clinicians to diagnose hydroureter and ureter endometriosis more accurately.