A pelvic ultrasound is a noninvasive procedure used to assess organs and structures within your pelvis. A pelvic ultrasound allows your doctor to get a quick visualization of your pelvic organs and structures including the uterus, cervix, vagina, fallopian tubes and ovaries. Doppler ultrasound may also show blood flow in certain pelvic organs.
Ultrasound uses a transducer that emits ultrasonic sound waves that bounce off the organs like an echo and return to the transducer, converting the echo into an electronic image of the organs. A clear conducting gel is placed between the transducer and the skin to allow for smooth movement over the skin and to eliminate air for the best sound conduction.
By using Doppler ultrasound during an ultrasound procedure, blood flow can be assessed. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel by making the sound waves audible. The degree of loudness of the audible sound waves indicates the rate of blood flow within a blood vessel. Absence or faintness of these sounds may indicate an obstruction of blood flow.
The type of ultrasound procedure performed depends on the reason for the ultrasound. Your doctor may use only one method, or both methods may be needed to provide the information needed for diagnosis or treatment.
Methods of Pelvic Ultrasound
The two methods of pelvic ultrasound are:
- Transabdominal (through the abdomen): A transducer is placed on the abdomen using the conductive gel.
- Transvaginal (through the vagina): A long, thin transducer is covered with the conducting gel and a plastic/latex sheath and is inserted into the vagina.
Other related procedures that may be used to evaluate problems of the pelvis include hysteroscopy, colposcopy and laparoscopy.
Reasons for a Pelvic Ultrasound
Pelvic ultrasound may be used for measuring and evaluating your pelvic organs. Ultrasound assessment of the pelvis may include, but is not limited to:
- size, shape, and position of the uterus and ovaries
- thickness, echogenicity (darkness or lightness of the image related to the density of the tissue) and presence of fluids or masses in the endometrium, myometrium (uterine muscle tissue), fallopian tubes or in or near the bladder
- length and thickness of the cervix
- changes in bladder shape
- blood flow through pelvic organs
Pelvic ultrasound can provide information about the size, location and structure of pelvic masses, but cannot provide a definite diagnosis of cancer or specific disease. A pelvic ultrasound may be used to diagnose and assist in the treatment of the following conditions:
- abnormalities in the anatomic structure of the uterus, including endometrial conditions
- fibroid tumors (benign growths), masses, cysts and other types of tumors within the pelvis
- presence and position of an intrauterine contraceptive device (IUD)
- pelvic inflammatory disease (PID) and other types of inflammation or infection
- postmenopausal bleeding
- monitoring of ovarian follicle size for infertility evaluation
- aspiration of follicle fluid and eggs from ovaries for in vitro fertilization
- ectopic pregnancy
Risks of Pelvic Ultrasound
There's no radiation used in a pelvic ultrasound and generally no discomfort from the application of the ultrasound transducer to the skin. You may experience slight discomfort with the insertion of the transvaginal transducer into the vagina and since transvaginal ultrasound requires covering the transducer in a plastic or latex sheath, this may cause a reaction in patients with a latex allergy.
There may be additional risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Certain factors or conditions may interfere with the results of the test. These include, but are not limited to, the following:
- severe obesity
- barium in the intestines from a recent barium procedure
- intestinal gas
- inadequate filling of bladder with transabdominal ultrasound (a full bladder helps move the uterus up and the bowels away for better imaging)
What to Expect from a Pelvic Ultrasound
Pelvic ultrasounds are common medical examinations that are generally pain and risk free. Here's what to expect when you're scheduled for a pelvic ultrasound:
Before the procedure
- Your doctor will explain the procedure offer you the opportunity to ask any questions that you might have about the procedure.
- Notify your doctor if you are sensitive to or allergic to latex.
- Generally, no fasting or sedation is required for a pelvic ultrasound, unless the ultrasound is part of another procedure that requires anesthesia.
- Although the gel applied to the skin during the procedure does not stain clothing, you may wish to wear older clothing, as the gel may not be completely removed from your skin afterwards.
- For a transabdominal ultrasound, you'll be asked to drink several glasses of water one to two hours before the procedure. Do not empty your bladder until the procedure is over.
- For a transvaginal ultrasound, you should empty your bladder right before the procedure.
- Based on your medical condition, your doctor may request other specific preparation.
During the procedure
A pelvic ultrasound may be performed in your doctor's office, on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your hospital's practices.
Generally, a pelvic ultrasound follows this process:
Transabdominal ultrasound
- You'll be asked to remove clothing, jewelry or other objects that may interfere with the scan.
- If asked to remove clothing, you will be given a gown to wear.
- You'll lie on your back on an examination table.
- A gel-like substance will be applied to your abdomen.
- The transducer will be pressed against the skin and moved around over the area being studied.
- If blood flow is being assessed, you may hear a "whoosh, whoosh" sound when the Doppler probe is used.
- Images of your pelvic structures will be displayed on the computer screen. Images will be recorded for your health care records.
- Once the procedure has been completed, the gel will be removed.
- You may empty your bladder when the procedure is completed.
Transvaginal ultrasound
- You'll be asked to remove any clothing, jewelry or other objects that may interfere with the scan.
- If asked to remove clothing, you will be given a gown to wear.
- You'll lie on an examination table, with your feet and legs supported as for a pelvic examination.
- A long, thin transvaginal transducer will be covered with a plastic or latex sheath and lubricated. The tip of the transducer will be inserted into your vagina. This may be slightly uncomfortable.
- The transducer will be gently turned and angled to bring the areas for study into focus. You may feel mild pressure as the transducer is moved.
- If blood flow is being assessed, you may hear a "whoosh, whoosh" sound when the Doppler probe is used.
- Images of your pelvic structures will be displayed on the computer screen. Images will be recorded for your health care records.
- Once the procedure has been completed, the transducer will be removed.
After the procedure
There is no special type of care required after a pelvic ultrasound. You may resume your normal diet and activity unless your doctor advises you differently.
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.