IGeL ultrasound of the ovaries

In German medical practices, it is one of the most common self-pay services: the ultrasound of the ovaries. Does it make sense?

What is being done there?

Ultrasound examinations (sonography) are a proven method of determining changes in the lower abdomen. To examine the ovaries, a rod-shaped probe is inserted into the woman's vagina. "You can get closer than over the abdominal wall," explains Professor Barbara Schmalfeldt, Head of the Women's Clinic at the University Medical Center Hamburg-Eppendorf.

The sound waves emitted provide the doctor with an image of the surrounding tissue. If a patient complains about unclear complaints in the lower abdomen, the examination will be reimbursed by the health insurance company. Symptom-free patients who, however, have the ultrasound carried out as a so-called screening examination, have to pay for it themselves. In these cases, only the palpation examination is reimbursed.

Per

  • The examination is simple, radiation-free and comparatively inexpensive.As a rule, the patient does not feel any pain, just a feeling of pressure.
  • Vaginal ultrasound is the method of choice for detecting changes in the ovaries. In the case of complaints, it is therefore recommended in the guidelines.
  • Not only tumors and cysts on the ovaries can be detected with the probe. "Fibroids, benign tumors in the uterus, or a depression of the bladder are also visible," says Schmalfeldt.

Contra

  • In symptom-free women, sonography detects changes in the ovaries earlier and more often. "But that doesn't affect how many women die from ovarian cancer," says Dr. Andreas Waltering from the Institute for Quality and Efficiency in Health Care (IQWiG). In a large British study of 200,000 women, more suspicious changes were discovered. However, this did not reduce the risk of dying from it on average. "The tumor usually grows very quickly and forms settlements early," says gynecologist Schmalfeldt.
  • The examination carries the risk that ovaries are removed unnecessarily: If the suspicion of cancer cannot be dispelled by further examinations, the woman is usually operated on. "Suspicion of cancer is only confirmed in one out of ten patients," says Waltering. Possible consequences can be complications and infertility. There are also psychological stresses.
  • In the guidelines of the German Society for Gynecology and Obstetrics, the ultrasound examination for the early detection of ovarian cancer is expressly not recommended.

costs

According to the IGeL monitor, ultrasound of the ovaries costs between 25 and 53 euros. It can be more expensive if a tumor marker is determined in the blood at the same time, which some gynecological practices offer.

Conclusion

An ultrasound of the ovaries is considered the first important examination when a woman has unclear abdominal complaints. In this case, it will be reimbursed by the cash register. "According to current knowledge, ultrasound is not suitable for the early detection of ovarian cancer," emphasizes Waltering.

Many gynecologists see the examination as a useful preventive measure for other reasons. "With the aid of ultrasound, for example, the development of myomas and cysts can be assessed," says Schmalfeldt. This could be important for making the right therapy decision. Studies to prove this are lacking, however.