Pelvic or Transvaginal Ultrasound – Gynecological Tests

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Pelvic or Transvaginal Ultrasound

In pelvic or transvaginal ultrasound, a device called a transducer is used to direct high-frequency sound waves (ultrasound) at the organs and structures within the pelvic region—typically the uterus and ovaries in women. The transducer may either be passed over the surface of the abdomen (pelvic ultrasound) or inserted into the vagina (transvaginal ultrasound). The sound waves are reflected back to the transducer and electronically converted into images displayed on a viewing monitor. These images can be saved on film or video and then reviewed for abnormalities.

Purpose of the Pelvic or Transvaginal Ultrasound

  • To determine the size, shape, and position of organs in the pelvic region
  • To evaluate pain, abnormal bleeding, or other menstrual problems in women
  • To detect abnormalities affecting the ovaries and uterus, such as fibroid tumors (these are non-cancerous), masses, abscesses, cysts and inflammation.
  • To evaluate infertility problems
  • To monitor follicle development in the ovaries of an infertility patient receiving ovulation-inducing drugs (fertility drugs) or undergoing in vitro fertilization
  • To monitor the health and development of the fetus and placenta in pregnant women, and to detect problems such as ectopic (tubal) pregnancy. (Transvaginal ultrasound is more often used early in pregnancy and pelvic ultrasound later in pregnancy.)
  • To guide the removal of an ovarian follicle for in vitro fertilization

Who Performs Pelvic or Transvaginal Ultrasound

  • A doctor or a radiology technician

Special Concerns about Pelvic or Transvaginal Ultrasound

  • Because transvaginal ultrasound places the transducer closer to the internal pelvic structures, it can produce more detailed images than external pelvic ultrasound. It may also be more comfortable because it doesn’t require a full bladder. However, an external exam is better for viewing structures in the upper pelvis (especially in pregnant women); giving an overall picture of pelvic organs in relation to one another; and examining obese patients, since fat may interfere with transmission of sound waves.
  • Because residual barium and gas in the colon can distort sound waves and affect the test results, this exam should be done before any barium contrast x-rays are performed.

Before the Pelvic or Transvaginal Ultrasound

  • External pelvic ultrasound requires a full bladder to displace the bowel from the pelvic cavity and push the uterus and ovaries outward, making them easier to see on the scan. Your doctor will instruct you to drink 3 to 4 glasses of water or other liquid about 1 hour before the test; do not urinate until the procedure is complete. (This step is not necessary, however, late in pregnancy.)
  • Empty your bladder before a transvaginal ultrasound exam.
  • Your clothes will be arranged so as to expose your lower abdomen before a pelvic ultrasound exam. You must disrobe from the waist down and put on a drape before transvaginal ultrasound.
  • Tell your doctor if you are allergic or sensitive to latex.

What You Experience

Pelvic ultrasound:

  • You will lie on your back on an examination table.
  • A water-soluble gel is applied to the skin on your lower abdomen to enhance sound wave transmission.
  • The examiner then moves the transducer back and forth over the surface of your pelvic region to obtain different views of the targeted organs on a viewing monitor.
  • Once clear images are obtained, they are recorded on film or video for later analysis.
  • The test takes about 20 minutes.

Transvaginal ultrasound:

  • You will assume a position similar to the one used for a pelvic exam—lying on your back with your knees bent and feet placed in stirrups.
  • A sterile latex condom is placed over a special oblong transducer (which is slightly smaller than a tampon), and a small amount of water-soluble gel is applied to the device.
  • The transducer is gently inserted (either by the examiner or yourself) into the vagina and rested against the cervix.
  • The examiner rotates the transducer to one side, then the other, to obtain different views of the targeted organs on a viewing monitor.
  • Once clear images are obtained, they are recorded on film or video for later analysis.
  • The transducer is gently withdrawn.
  • The test takes less than 10 minutes.

Risks and Complications of Pelvic or Transvaginal Ultrasound

  • Ultrasound is painless, noninvasive, and involves no exposure to radiation. There are no associated risks.

After the Pelvic or Transvaginal Ultrasound

  • After pelvic ultrasound, the examiner removes the conductive gel from your skin.
  • You may urinate and resume your normal diet and activities.

Pelvic or Transvaginal Ultrasound Results

  • A radiologist reviews the recorded images and video for evidence of any abnormality.
  • If a definitive diagnosis can be made, appropriate treatment will be initiated.
  • If ultrasound fails to yield a definitive diagnosis, other diagnostic tests, such as a sonohysterogram, may be needed to provide more specific information or to further evaluate abnormal findings.

The Johns Hopkins Consumer Guide to Medical Tests

Simeon Margolis, M.D., Ph.D., Medical Editor

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at

Published: 10 Jan 2012

Last Modified: 08 Jan 2015

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