Transvaginal ultrasound-guided procedures: case selection and review of technique.

Female pelvic pathologies-including infectious or inflammatory conditions as well as benign or malignant tumors-are frequently encountered in clinical practice and may require tissue sampling, aspiration or drainage to guide management and therapeutic decisions. Due to anatomical constraints, transabdominal or transgluteal percutaneous access to target lesions in the pelvis may be technically challenging or unsafe. In such cases, transvaginal ultrasound (TVUS)-guided procedures offer a valuable alternative, providing direct, safe, and effective access, making it a highly useful technique in both diagnostic and therapeutic contexts. Despite its advantages, broader implementation of TVUS-guided interventions is often limited by variability in procedural familiarity and operator confidence. This review aims to outline the procedural technique, indications, and practical considerations associated with TVUS-guided procedures, with the goal of promoting wider adoption and proficiency among practitioners.