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Pelvic Ultrasound - Indications, Technique, and Outcome

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Pelvic ultrasound is a diagnostic procedure done to produce images for evaluating structures present in the female pelvis. Read this article for details.

Medically reviewed by

Dr. Jain Padmesh Satishchand

Published At December 30, 2022
Reviewed AtFebruary 23, 2024

What Is a Pelvic Ultrasound Procedure?

A pelvic ultrasound is a noninvasive diagnostic examination used frequently by gynecologists, urologists, general physicians, general surgeons, or oncologists, and performed by radiologists or sonologists. Its aim is to produce images by the use of sound waves inside the female pelvis. A pelvic ultrasound helps in the visualization of the female pelvic organs. It can also be used to check the health of babies in pregnant women. The following female organs or structures can be examined by pelvic ultrasound-

  • Vagina.

  • Uterus.

  • Cervix.

  • Fallopian tubes.

  • Bladder.

  • Ovaries.

  • Sometimes, it can be used in men to examine the bladder, prostate gland, and seminal vesicles.

The type of ultrasound procedure depends on the reason for which the ultrasound is being done.

Pelvic ultrasound can be performed using any one of the following methods-

  1. Transabdominal ultrasound (through the abdomen).

  2. Transvaginal ultrasound (through the vagina).

  3. Transrectal ultrasound (in females with vaginal stenosis or scarring due to radiotherapy or infiltrative cervical cancer).

  4. Translabial or Transvulval ultrasound to look for vaginal cysts or other pathologies.

What Is Sonosalpingography (SSG)?

A diagnostic procedure called sonosalpingography (SSG), commonly referred to as the Sion test, is primarily used to assess the patency of fallopian tubes. It was developed as a screening method for infertility studies. SSG test is an ultrasonography procedure in which a saline solution is injected inside the uterus.

What Are the Indications of a Pelvic Ultrasound Procedure?

Pelvic Ultrasound in Women- In women, a pelvic ultrasound can be done for the following purposes-

  • To find anomalies of the uterus and ovaries.

  • To diagnose cancer in the ovaries, bladder, or uterus.

  • To diagnose non-cancerous growths like cysts, tumors, or fibroids.

  • To locate an intrauterine device (IUD).

  • To discover the reasons for abnormal bleeding or pain.

  • Monitoring pregnancy and baby's growth.

  • To check the thickness, echogenicity, and presence of fluids in the endometrium.

  • Treatment and evaluation of fertility-related issues.

  • To check for pelvic inflammatory disease (PID).

  • Endometrial biopsy (tissues taken from the uterus for pathologic evaluation).

  • To diagnose an ectopic pregnancy.

  • To detect lower ureteric stones.

Pelvic Ultrasound in Men-

  • To check for problems related to the bladder, seminal vesicles, and the prostate gland.

  • To diagnose tumors or stones in the bladder.

What Are the Contraindications for a Pelvic Ultrasound?

There are no absolute contraindications for a pelvic ultrasound. However, a transvaginal ultrasound may be relatively contraindicated in high-risk patients and late pregnancy. Pelvic ultrasound is also not done in virgin females or patients with severe vaginismus.

How to Get Prepared for a Pelvic Ultrasound?

  • A transvaginal ultrasound must always be done with an empty bladder. Thus, the patient is advised to use the bathroom before the test and wear loose and comfortable clothes for the procedure.

  • A transabdominal ultrasound must always be done with a full bladder. Thus, the patient is advised to drink about 32 ounces (four to five glasses of water) of any clear fluid at least one hour prior to the test. A full bladder gives better organ visibility.

  • Fasting or sedation is not required for a pelvic ultrasound.

What Is the Procedure of a Pelvic Ultrasound?

A device called a transducer is used for ultrasound; it transmits sound waves. The sound waves reflect from the organs and tissues and echo back to the transducer. The computer converts these received sound waves into an image that appears on a doctor's video screen.

The following ways can be used to perform ultrasound-

  • Transabdominal Ultrasound- It is done through the abdomen. The patient is made to lie on the back of an exam table. A little bit of gel is applied to the transducer, and the doctor will move it back and forth over the belly skin. The gel helps the transducer move smoothly and prevents air from getting trapped between the device and the skin.

  • Transvaginal Ultrasound- It is done through the vagina. The patient is made to lie on the back of an exam table with legs folded up in stirrups. The transducer is covered in gel and plastic covering before inserting it into the vagina.

  • Transrectal Ultrasound- It is done in men through the rectum. The patient is made to lie down on one side, facing away from the doctor. After covering the transducer, it is inserted inside the rectum.

  • Doppler Ultrasound- This type of ultrasound measures the speed and direction of blood flow through abdominal blood vessels. This test can be used to diagnose narrowing or blockages in blood vessels. A "whooshing" sound may be heard during a doppler ultrasound. Doppler ultrasound also helps in the characterization of tumors and the detection of cancers. It also helps in the detection of ovarian torsion and ectopic pregnancy vs. corpus luteal cysts.

  • Translabial or Transvulval Ultrasound - It is done using a linear or convex probe.

What Are the Risks Due to a Pelvic Ultrasound?

  • Pelvic ultrasound is a noninvasive method, and it does not use any sort of radiation for imaging, so it is a very safe diagnostic method.

  • It offers no risk and no pain. However, the person undergoing pelvic ultrasound might feel a little discomfort when the transducer is inserted into the vagina or the rectum.

  • There is no special care required after a pelvic ultrasound, and the person can resume their normal diet and activities.

  • There are no adverse biological effects on patients due to exposure to ultrasound.

  • Transvaginal ultrasound requires a plastic or latex covering on the ultrasound transducer, which may cause an allergic reaction in people with a latex allergy.

  • Pulsed wave doppler has thermal or heat effects and, therefore, should not be used in fetuses less than eight weeks of age.

  • Some conditions may interfere with the results of the test like-

    • Severe obesity.

    • Barium is present in the intestines due to a recent procedure.

    • Inadequately filled bladder in a transabdominal ultrasound.

    • Presence of intestinal gas.

What to Expect After a Pelvic Ultrasound?

  • After a pelvic ultrasound, the ultrasound images are saved on the computer or printed on a report. This report is sent to the doctor for analysis.

  • The report will show any problems related to pelvic organs, blood vessels, or unborn babies.

  • Further treatment is planned by doctors based on these reports. The doctor might prescribe other tests to check the health of pelvic organs like-

    • Hysteroscopy- A thin, lighted device is inserted through the vagina and into the uterus to view the uterus.

    • Laparoscopy- A thin, lighted tube is inserted through the abdominal wall to view organs in the pelvis.

Conclusion:

A pelvic ultrasound is a safe, reliable, and quick diagnostic method. It helps to detect and diagnose a range of health conditions, especially those of female reproductive organs. With the help of pelvic ultrasound, it becomes very easy to monitor the growth and health of unborn babies in the mother's womb. An accurate, timely scan helps to get an early diagnosis and treatment sooner. An ultrasound can help to rule out severe life-threatening health conditions and confirm a person's good health.

Dr. Jain Padmesh Satishchand
Dr. Jain Padmesh Satishchand

Radiology

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