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Transvaginal ultrasound: MedlinePlus Medical Encyclopedia

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Transvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix and pelvic area.

Transvaginal means across or through the vagina. The ultrasound probe will be placed inside the vagina during the test.

You will lie down on your back on a table with your knees bent. Your feet may be held in stirrups.

The ultrasound technician or doctor will introduce a probe into the vagina. It may be mildly uncomfortable, but will not hurt. The probe is covered with a condom and a gel.

  • The probe transmits sound waves and records the reflections of those waves off body structures. The ultrasound machine creates an image of the body part.
  • The image is displayed on the ultrasound machine. In many offices, the patient can see the image also.
  • The provider will gently move the probe around the area to see the pelvic organs.

In some cases, a special transvaginal ultrasound method called saline infusion sonography (SIS) may be needed to more clearly view the uterus.

You will be asked to undress, usually from the waist down. A transvaginal ultrasound is done with your bladder empty or partly filled.

In most cases, there is no pain. Some women may have mild discomfort from the pressure of the probe. Only a small part of the probe is placed into the vagina.

Transvaginal ultrasound may be done for the following problems:

  • Abnormal findings on a physical exam, such as cysts, fibroid tumors, or other growths
  • Abnormal vaginal bleeding and menstrual problems
  • Certain types of infertility
  • Ectopic pregnancy
  • Pelvic pain

This ultrasound is also used during pregnancy.

The pelvic structures or fetus is normal.

An abnormal result may be due to many conditions. Some problems that may be seen include:

  • Birth defects
  • Cancers of the uterus, ovaries, vagina, and other pelvic structures
  • Infection, including pelvic inflammatory disease
  • Benign growths in or around the uterus and ovaries (such as cysts or fibroids)
  • Endometriosis
  • Pregnancy outside of the uterus (ectopic pregnancy)
  • Twisting of the ovaries

There are no known harmful effects of transvaginal ultrasound on humans.

Unlike traditional x-rays, there is no radiation exposure with this test.

Endovaginal ultrasound; Ultrasound - transvaginal; Fibroids - transvaginal ultrasound; Vaginal bleeding - transvaginal ultrasound; Uterine bleeding - transvaginal ultrasound; Menstrual bleeding - transvaginal ultrasound; Infertility - transvaginal ultrasound; Ovarian - transvaginal ultrasound; Abscess - transvaginal ultrasound

  • Ultrasound in pregnancy
  • Female reproductive anatomy
  • Uterus
  • Transvaginal ultrasound

Brown D, Levine D. The uterus. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 15.

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Hur HC, Lobo RA. Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.

Kelly CM. Ectopic pregnancy. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2022. Philadelphia, PA: Elsevier; 2022:1240-1243.

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

Ovarian Cysts | Polycystic Ovary Syndrome

The ovaries are part of the female reproductive system. They produce a woman's eggs and make female hormones. Ovarian cysts are fluid-filled sacs in or on an ovary. They usually form during ovulation, when the ovary releases an egg. They are usually harmless and go away by themselves. Most women have them sometime during their lives.

Most ovarian cysts are small and don't cause symptoms. Women may not find out that they have them until they have a pelvic exam. If there are symptoms, they may include:

  • Pressure
  • Bloating
  • Swelling
  • Pain in the lower abdomen, on the side where the cyst is

If your health care provider finds a cyst, you may be able to wait to see if it gets bigger. You may need surgery if you have pain, are past menopause, or if the cyst does not go away. If a cyst bursts or causes bleeding, you should get medical help right away. Birth control pills can help prevent new cysts.

Rarely, ovarian cysts can become cancerous. This risk increases as you get older.

A health problem that involves ovarian cysts is polycystic ovary syndrome (PCOS). Women with PCOS can have high levels of male hormones, irregular or no periods, and small ovarian cysts.

Dept. of Health and Human Services Office on Women's Health

  • ClinicalTrials.gov: Ovarian Cysts (National Institutes of Health)
  • Article: Spatial heterogeneity of infiltrating T cells in high-grade serous ovarian cancer revealed. ..
  • Article: Distinct clinicopathological features of ovarian endometriosis after long-term exposure to mifepristone.
  • Article: Comparison of immunohistochemical characteristics of endometriomas with non-endometriotic benign ovarian cysts.
  • Ovarian Cysts -- see more articles

vaginal and transvaginal - MEDSI

What is vaginal ultrasound?

Vaginal (transvaginal) pelvic ultrasound is performed by inserting a special device equipped with a transducer into the vagina.

The device is a rod with a handle, which is made of plastic, about 10-12 centimeters long and up to three centimeters in diameter. A special groove can be built into it to insert a needle for taking biopsy material. nine0005

Examination allows to determine the presence of pathologies, neoplasms or diseases in the following female genital organs:

  • Uterus
  • Fallopian tubes
  • Ovaries
  • Cervix

It is considered the most effective for the study of these parts of the reproductive system, as it allows you to identify various health problems in the patient at an early stage. Ultrasound of the small pelvis with a sensor is able to show the presence of deviations already at a time when other studies do not show any problem areas. nine0005

How is the procedure?

The examination is organized as follows:

  • The patient must remove clothing from the lower part of the body (from the waist down)
  • She settles down on a special couch in the same way as during a regular gynecological examination
  • The doctor prepares the transducer: puts an individual condom on it, lubricates it with a special gel for the procedure
  • The physician then inserts the device shallowly into the patient's vagina
  • To get a complete picture of the state of the organs, he can move the sensor from side to side
  • All data is recorded and processed by the doctor

The gel is needed to facilitate the penetration of the transducer (and thereby reduce the likelihood of negative sensations) and enhance the ultrasonic effect by increasing the conductivity.

This type of examination lasts no more than 10 minutes. It is painless and gives the most complete picture even when an abdominal ultrasound shows nothing or cannot be done. nine0005

When is a pelvic ultrasound probe needed?

There are symptoms in which the doctor must refer the patient to a transvaginal examination:

  • Pain in the lower abdomen (not related to the menstrual cycle)
  • Neoplasm suspected
  • Too short or too long period of menstrual bleeding or lack thereof
  • Impossibility of pregnancy
  • Bleeding other than menstruation
  • The presence of violations of the patency of the fallopian tubes
  • Nausea, vomiting and weakness with bleeding from the vagina

Doctors recommend using this type of examination for preventive purposes, since not every ailment can have symptoms at an early stage, just as pregnancy in the first trimester may not manifest itself with classic symptoms (nausea, etc. ). nine0005

In this case, vaginal ultrasound is used for:

  • Infertility diagnostics
  • The need to determine the presence of changes in the size of the ovaries and uterus
  • Pregnancy diagnostics
  • Pregnancy control (first trimester only)
  • General supervision of the uterus, fallopian tubes and ovaries

A pelvic ultrasound with two probes can be performed at the same time. In this case, an abdominal ultrasound examination is performed first, and then a transvaginal one. The use of two types of analysis at once is necessary to detect violations in the highly located organs of the small pelvis. nine0005

What does a vaginal ultrasound show?

This examination allows to evaluate the following parameters of the organs of the reproductive system:

  • The size of the uterus. In normal condition, it should be about seven centimeters long, six wide and 4.2 in diameter. If it is significantly less or more, then this indicates the presence of pathology
  • Echogenicity. The structure of the organs should be homogeneous, uniform, have clearly defined, well-visible edges
  • General picture of the internal organs. The uterus should be slightly tilted forward. And the fallopian tubes may be slightly visible, but should not be clearly visible without the use of contrast agent

Diagnosable diseases

Transvaginal ultrasound can detect a number of diseases and problems in the reproductive system at an early stage. It allows you to detect:

  • Fluid and pus in the uterus and fallopian tubes. The cause of their appearance may be infections, viruses, mechanical damage
  • Endomentriosis - excessive growth of cells of the inner layer of uterine tissues into other layers and organs. It can occur due to inflammatory processes, damage (surgery, abortion), the appearance of neoplasms, disruption of the endocrine system, too frequent use of certain drugs and substances
  • Myoma is a benign neoplasm in the tissues of the uterus or its cervix. May occur due to chronic diseases, frequent abortions, hormonal disorders, constant stress, pathologies, overweight, with hereditary predisposition
  • Cysts and polycystic ovaries are tumors filled with fluid. Occur in endocrine disorders, chronic diseases of the genitourinary system
  • A variety of polyps on the walls of the uterus - benign formations in the endometrium of the organ. They can reach several centimeters in diameter. Their appearance may be associated with polycystic disease, chronic diseases, mastopathy, fibroma
  • Inflammation and enlargement of organs can occur due to both infection and trauma
  • Cystic skid - appears instead of a full-fledged embryo in the process of conception, filled with fluid. It occurs due to duplication of male chromosomes with the loss of female chromosomes, sometimes due to the fertilization of an egg that does not contain a nucleus. This disease is rare
  • Fetal development disorders during pregnancy
  • Malformations and pathologies in the development of the fallopian tubes: obstruction, spiral or too long tubes, blind passages, duplication of organs
  • An ectopic pregnancy occurs when an egg, after fertilization, attaches itself outside the tissues of the uterus. Occurs due to blockage of the fallopian tubes, congenital anomalies in them, as well as after the inflammatory process, abortion
  • Cancer - a malignant tumor in various organs:
    • Uterus
    • Ovaries
    • Cervix
  • Chorionepithelioma is a malignant neoplasm that occurs during or after pregnancy from chorion cells (the membrane of the embryo attached to the wall of the uterus)

Steps to prepare for the exam

No special preparation is required for a pelvic ultrasound with a transducer, but there are several mandatory requirements:

  • If she emptied her bladder earlier than an hour before the analysis, then she needs to do it her time immediately before the procedure
  • With increased flatulence, the patient needs a drug that will help normalize the processes of gas formation in the gastrointestinal tract. She can consult a doctor about the choice of medicine

    • Doctors also recommend using such a study on certain days of the cycle, depending on which organ and for what purpose you need to diagnose:0012

  • If there is a suspicion of an increase in the endometrial layer in the uterus, then in the second half of the cycle
  • When it is necessary to follow the development of the disease or the progress of treatment, the study can be carried out several times in one cycle, at different stages
  • Ultrasound is performed urgently if there is bleeding that is not menstrual, regardless of the day of the cycle

    • It is important to remember about personal hygiene before the examination, use wet and other wipes. nine0005

    If you plan to perform a pelvic ultrasound with two sensors, then you should pay attention to the preparation for the abdominal examination.

    This includes:

    • Diet at least three days prior to the examination to reduce the likelihood of symptoms of flatulence and bloating
    • The last meal must be finished by six o'clock in the evening on the eve of the analysis
    • It is recommended to take an enema after a meal
    • If there is still a risk of flatulence, special drugs should be used to reduce gas formation
    • Drink at least 400 ml of water one hour before the examination

    The diet involves the exclusion of a number of products from the diet:

    • Sweets
    • Flour (bread, biscuits and other)
    • Legumes
    • Cabbage
    • Milk and dairy products
    • Uncooked vegetables and fruits
    • Coffee and strong tea
    • Carbonated drinks
    • Fast food
    • Fatty foods (meat, fish, oils)

    You can eat cereals cooked with water, low-fat boiled beef, poultry and fish, hard cheeses. It is recommended to drink loosely brewed lightly sweetened tea.

    It must be remembered that since fluids are required before the abdominal examination, the bladder must be emptied before the transvaginal examination. nine0005

    Contraindications

    Vaginal ultrasound has a small number of contraindications:

    • It is never performed if the patient is a virgin, so as not to violate the integrity of the hymen. In this case, it is possible to perform a transrectal examination for such a patient, in which the probe is inserted into the rectum
    • Examination should not be performed during the second or third trimester of pregnancy because it may cause preterm labor or uterine contractions before the expected date of delivery
    • This test is not used if the patient is allergic to latex
    • If the patient has epilepsy because the examination requires her to lie still

    Do not delay treatment, see a doctor right now:

    • Ultrasound
    • Ultrasound of the pelvic organs for a child
      • nine0011 Hospitalization and transportation

    About ultrasound | Memorial Sloan Kettering Cancer Center

    This information will help you prepare for your ultrasound at Memorial Sloan Kettering (MSK). Ultrasound is also called sonography.

    Ultrasound is an imaging technique that uses sound waves to create images of internal organs. It can be used to check blood flow or determine if the mass is solid or filled with fluid. An ultrasound does not involve the use of radiation, has no known side effects, and you usually do not need any injections (shots) to perform an ultrasound. nine0005 back to top of page

    What to expect

    You will lie on a bed or gurney during your ultrasound. The ultrasound technician will apply the gel to the area of ​​the body that will be examined. It will then guide a small device called a probe over the surface of your skin.

    The technologist will not be able to tell you the results during the test. At the end of the procedure, the results of the ultrasound will be analyzed by the radiologist, who will send a written report to your healthcare provider within 24 hours. Ask your healthcare provider how and where you can get your ultrasound results. nine0005 back to top of page

    Types of ultrasound

    There are different types of ultrasound. They are named after the part of the body that is being examined.

    Preparation for your procedure depends on the type of ultrasound you are having. Follow the instructions below for your type of ultrasound. If you have questions or are not sure what type of study you are having, please contact your healthcare provider. nine0005

    Abdominal Ultrasound

    This type of ultrasound is used to examine the organs located in the abdomen (belly). These organs are the liver, gallbladder, pancreas, spleen and kidneys.

    • Do not eat or drink for 6 hours before the ultrasound. An empty stomach allows a clearer view of the gallbladder and other internal organs.
    • Take your medicines with a small sip of water. nine0012
    • If you are taking diabetes medication (such as insulin), check with the healthcare provider who prescribes it for you.

    Pelvic Ultrasound

    This type of ultrasound is used to look at organs in the pelvis. These organs are the ovaries, uterus, cervix, vagina, and bladder.

    • Drink 4-6 cups (8 ounces) of water 1 hour before your exam. nine0012
    • Do not urinate (do not go to the toilet in a small way) before the procedure. With a full bladder, the uterus and ovaries will be more clearly visible.
    • If you need a close-up view of the lining of your uterus and ovaries, you may have a transvaginal ultrasound after your pelvic exam. See the Transvaginal Ultrasound section below for more information.

    Combined abdominal and pelvic ultrasound

    This type of ultrasound is used to examine organs located in the abdomen and pelvis.

    • Do not eat solid food for 6 hours before the test.
    • Drink 4-6 glasses (8 ounces (240 ml)) of water 1 hour before your test.
    • Do not urinate (do not go to the toilet in a small way) before the procedure.

    Transvaginal ultrasound

    This type of ultrasound is used to examine the lining of the uterus and ovaries. nine0005

    • You don't need to do any special preparation.
    • You will lie down with your legs elevated, as you would for a cervical smear or pelvic exam. The ultrasound technician will insert a rod-shaped probe into your vagina.

    Renal Ultrasound

    This type of ultrasound is used to look at one or both kidneys.

    • You don't need to do any special preparation. nine0012

    Bladder ultrasound

    This type of ultrasound is used to examine the bladder.

    • Drink 4-6 glasses (8 ounces (240 ml)) of water 45 minutes before your exam.
    • Do not urinate (do not go to the toilet in a small way) before the procedure.

    Ultrasound of blood vessels (Doppler ultrasound)

    This type of ultrasound is used to diagnose blood clots in the vessels of the legs or arms. nine0005

    • You don't need to do any special preparation.

    Breast Ultrasound

    This type of ultrasound is used to examine the internal structure of one or both breasts.

    • You don't need to do any special preparation.

    Scrotum Ultrasound

    This type of ultrasound is used to look at one or both testicles, their epididymis, and the scrotum. nine0005

    • You don't need to do any special preparation.

    Carotid Ultrasound

    This type of ultrasound is used to look at the blood vessels in the neck. These vessels provide blood flow to the head.

    • You don't need to do any special preparation.

    Thyroid ultrasound

    This type of ultrasound is used to examine the thyroid gland. This gland is located in the front of the neck. nine0005

    • You don't need to do any special preparation.

    Ultrasound-guided thyroid or lymph node biopsy

    This type of ultrasound is used to correctly insert a fine needle into the thyroid or lymph node. The cells are removed and sent to a laboratory, where it is determined whether any of them are cancerous or other abnormal cells.

    • You don't need to do any special preparation.
    • This test may be done even if you are taking aspirin or other anticoagulants (blood thinners). However, if a large needle is to be used for the biopsy, the radiologist performing the procedure will contact you with instructions. nine0012

    Hysterosonography

    This type of ultrasound is used to examine the inside of the uterus and look for polyps (tissue growths).