Pelvis Ultrasound - Procedure, Indications, Uses, and Benefits

What Is a Pelvis Ultrasound?

A pelvis ultrasound is a simple, non-invasive test that is useful for providing scanned images of the organs inside a woman’s pelvis. This method helps healthcare professionals quickly examine the structures (uterus, ovaries, fallopian tubes) present inside the pelvis of a female body. The pelvis ultrasound test involves using a device called a transducer. This device helps send out ultra-high-frequency sound waves. The sound waves travel through the body and bounce back from the organs like an echo. A transducer receives these echoes, and a computer attached to the device turns them into scanned pictures of the organs.

Sound waves travel at different speeds based on the type of tissue they pass through. The sound waves are fastest through bone and the slowest through air. This difference in speed helps the transducer device identify the different tissues. A special gel is then applied to the transducer and skin to ensure the smooth passage of sound waves, which also helps get the best images. There is also a type of ultrasound called Doppler ultrasound. This technique shows the speed and direction of vascular (blood) flow in certain pelvic organs. Unlike regular ultrasound, some of the sound waves in Doppler can be heard during the test.

Ultrasound can also be used to examine the pelvic area in men, including the rectum (the lowest part of the intestines), prostate (a gland present in men), and urinary bladder (an organ that stores urine). However, its use is limited in men.

The female pelvic organs that can be examined using a pelvis ultrasound include -

• Endometrium - The endometrium, also referred to as the lining of the uterus, is a hollow, pear-shaped organ between the urinary bladder and rectum. This uterine lining is shed every month until pregnancy.

• Ovaries - The ovaries are two small organs in the pelvis where eggs are stored, and female hormones like estrogen and progesterone are secreted.

• Cervix - The cervix is the lower part of the uterus. It forms a canal opening into the vagina.

• Vagina - The vagina is the passageway that connects the uterus to the outside of the body. It allows menstrual fluid to exit and also serves as the birth canal during childbirth.

• Vulva - The vulva is the external part of the female genital organ.

These are the key structures in a female’s pelvis that can be examined using pelvis ultrasound.

What Are the Types of Pelvic Ultrasounds?

• Transabdominal Ultrasound: It helps look at organs from outside the belly to get a clear image of what is happening inside the pelvis region.

• Pregnancy Ultrasound: It helps monitor a fetus's growth and development inside the uterus during pregnancy.

• Rectal Ultrasound: It examines the inside of the rectum. A transrectal ultrasound is a special type of rectal ultrasound that helps check the prostate gland in men.

• Transvaginal Ultrasound: This type of pelvis ultrasound scan provides a zoomed view of the reproductive organs from inside the vagina for detailed examination.

What Are the Indications and Uses of Pelvis Ultrasound?

• Pelvic Examination: Pelvis ultrasound can be used for routine examination in women.Pelvis ultrasound can check normal pelvic organs, including the uterus, ovaries, and adnexal structures (the area adjacent to the uterus that includes the ovary, fallopian tubes, and the surrounding blood vessels, ligaments, and connective tissue).

• Mass or Lump Evaluation: A pelvis ultrasound can provide further insights for a better diagnosis if a lump or a mass is felt during a physical examination. Common examples include large ovarian tumors, ovarian cysts, congenital uterine abnormalities (usually detected during pregnancy), and uterine fibroids (noncancerous growths).

• Pelvic Pain Diagnosis in Appendicitis and Diverticulitis: Ultrasound helps diagnose the cause of pelvic pain in conditions like appendicitis, inflammatory bowel disease, or diverticulitis.

• Ectopic Pregnancy Detection: Pelvis ultrasound helps diagnose pelvic inflammatory disease, ovarian torsion (an ovary twists around its supporting structures), ectopic (egg is fertilized outside the uterus) pregnancy, and normal pregnancy.

• Abnormal Vaginal Bleeding: It helps assess abnormal vaginal bleeding related to possible pregnancy, menstruation, early puberty, or postmenopausal bleeding.

• Intrauterine Device (IUD) Positioning: Pelvis ultrasound is used to examine the correct placement of an intrauterine device (IUD).

• Polycystic Ovarian Syndrome (PCOD) and Infertility: It can help evaluate polycystic ovarian syndrome (PCOS) and infertility issues. PCOS is a condition where a woman’s ovaries produce a large number of eggs that are either immature or only partially mature.

• Detection of Abnormal Abdominal Fluid: Ultrasound can confirm the presence of ascites (fluid in the abdomen) or other free fluid.

• Male Pelvic Examination: In males, pelvic ultrasound can examine the prostate and seminal vesicles. Pelvis ultrasound is beneficial when checking for prostate cancer using a transrectal probe. It can also help identify testicular infection or penile injury in men.

• Certain Guided Procedures: Pelvisultrasound assists in needle biopsies and fluid aspiration procedures.

• Pain During Sex or Urination: The healthcare professional may suggest a pelvis ultrasound if there is pain during sex or pain during urination.

What Are the Contraindications of Pelvis Ultrasound?

Pelvis ultrasound is usually contraindicated in late pregnancy or high-risk patients. Several factors can affect the accuracy of the test results, including:

• Severe obesity.

• The presence of barium in the intestines is from a recent procedure.

• Intestinal gas.

• An insufficiently full bladder during a transabdominal ultrasound.

What Are the Advantages of Pelvis Ultrasound?

• Provide detailed and scanned high-resolution images of the structures and organs.

• It is a quick procedure that takes 15 minutes to almost an hour.

• It is a safe procedure as it does not utilize radiation.

Conclusion

Pelvis ultrasound provides important details about various structures and organs. It reveals the shape, size, and characteristics of the uterus and its endometrial lining. It also helps assess the size and structure of the ovaries, identifying any abnormalities and detecting masses like fibroids. Ovarian tumors, including cysts, solid components, and even bone or calcium, can be examined. In neonates and young children, ultrasonography can examine the rectum for issues like thickened bowel walls from inflammation or tumors. It can also help detect urethral cysts in adult females.