Pelvic ultrasound

What is a pelvic ultrasound?

A pelvic ultrasound is a medical imaging test used to examine organs in the pelvic area. In women, this includes the uterus, fallopian tubes, cervix, and bladder. In men, this encompasses the bladder, prostate, and seminal vesicles.

The ultrasound uses high-frequency sound waves, which are sent through the body, bouncing off tissues and transforming into visual images by a computer to create pictures of the organs.

There are 3 different types of pelvic ultrasounds. The choice of method will depend on the purpose of the examination, your specific symptoms, and your doctor’s recommendation:

• Transabdominal ultrasound
• Transvaginal ultrasound
• Transrectal ultrasound

Why is it done?

A pelvic ultrasound is a versatile tool that can be used to diagnose, monitor, and guide treatment for various conditions.

In women, it may be performed to:

• Investigate symptoms, such as pelvic pain, abnormal bleeding, irregular menstrual bleeding, unexplained infertility.
• Detect conditions, such as ovarian cysts, fibroids, endometriosis, ectopic pregnancy.

During pregnancy, pelvic ultrasounds are essential for assessing the health and development of the fetus. They can help confirm the due date, detect multiple pregnancies, and monitor the placenta and amniotic fluid levels.

In men, it may be performed to:

• Examine the prostate for any enlargement or abnormalities.
• Investigate symptoms, such as unexplained infertility, abdominal pain.
• Detect conditions, such as pelvic masses or urinary infections.

In addition, a pelvic ultrasound can be used to assist with biopsies, monitor bladder health, evaluate post-surgical outcomes, and identify tumours in both sexes.

How can I prepare for the ultrasound?

The preparation required will depend on the type of pelvic ultrasound being performed.

Transabdominal ultrasound: You will need to drink several glasses of water about 1 hour before the test and avoid urinating until after the procedure. A full bladder will help move the intestines out of the way and provide a clearer image of the pelvic organs.

Transvaginal ultrasound: You will need to empty your bladder prior to the test. This procedure doesn’t require a full bladder, as the ultrasound probe will provide close-ranging imaging.

Transrectal ultrasound: Your specialist will provide specific instructions, such as using an enema to clear the rectum before the test.

In all cases, wearing comfortable, loose clothing is recommended, as you may be asked to change into a hospital gown for the procedure.

How is a pelvic ultrasound performed?

The procedure is conducted in a medical imaging room, often by a sonographer.

Transabdominal ultrasound: You will be instructed to lie on your back on the examination table, and a clear gel will be applied to the lower abdomen. The technician will then move the ultrasound probe across the skin over the area, capturing real-life images of the pelvic organs.

Transvaginal ultrasound: You will be instructed to lie on the examination table with your knees bent. The technician will insert a thin ultrasound probe, covered with a protective sheath and lubricated with gel, into the vagina. This type of ultrasound provides a closer and more detailed view of the uterus, ovaries, and other pelvic organs.

Transrectal ultrasound: The technician will gently insert a thin ultrasound probe, covered with a protective sheath and lubricated with gel, into the rectum. This type of ultrasound provides more detailed images of the prostate gland and surrounding tissues.

The procedure lasts 20 to 30 minutes, depending on the complexity of the examination. You can usually resume your normal activities immediately after the scan.

Is it painful?

A pelvic ultrasound isn’t generally painful. However, it may cause mild discomfort in some cases, especially during a transvaginal or transrectal ultrasound due to the insertion of the probe. Your sonographer will carefully guide you through the process and make any necessary adjustments to ensure your comfort throughout the procedure.

Can I have a pelvic ultrasound if I’m pregnant?

Yes, a pelvic ultrasound is one of the safest imaging tests during pregnancy, routinely used to monitor fetal health, assess growth, and detect potential complications.

In early pregnancy, a transvaginal ultrasound is typically the first choice for evaluating the pregnancy. As the pregnancy progresses, a transabdominal ultrasound may be performed to get clearer images, particularly during the first trimester.

Since the procedure doesn’t involve radiation, it poses no risk to the mother or the fetus. If you are pregnant, inform your sonographer so they can tailor the approach to guarantee your safety and ensure optimal results.

When will I receive the results?

In most cases, your sonographer will provide preliminary observations during or immediately after the scan. However, the detailed analysis and official results will need to be reviewed by a radiologist, which can take a few days.

Your doctor will discuss the results with you during the follow-up appointment. If the ultrasound reveals an abnormality, such as a cyst, fibroid or unusual growth, your doctor will recommend further testing. This might include additional imaging tests, blood tests, or a biopsy to confirm the diagnosis and determine the best course of treatment.

For urgent cases, such as suspected ectopic pregnancy or other emergency conditions, the results will be expedited, and immediate medical attention will be provided as needed.