Pelvic ultrasound

An ultrasound scan is a safe procedure with no contraindications. 

Trans vaginal pelvic ultrasound is avoided in females who are not sexually active, instead, a transrectal ultrasound may be done for them.

A pelvic ultrasound is done in women to evaluate the cervix, uterus, fallopian tubes, ovaries and the bladder for any changes in their shape, size or structure. A transvaginal ultrasound specifically helps to view the inner lining and muscular walls of the uterus and the ovaries.

Doctors order a pelvic ultrasound in women in the following instances: 

• To diagnose the cause of symptoms such as:
  • Pelvic pain 
  • Menstrual conditions like abnormal vaginal bleeding
• To monitor the development of the baby early in the pregnancy 
• To detect tumours, cysts or cancer 
• To check for pregnancy occurring outside the uterus Read more: Symptoms of ectopic pregnancy
• To evaluate and treat infertility problems
• To detect inflammation or infections in the pelvis 
• To guide a needle for sampling a tissue (biopsy) from the uterus for testing

In men, a pelvic ultrasound is done through a transrectal approach to check areas including the prostate gland, seminal vesicles (a pair of glands that add fluid to the semen) and the urinary bladder 

The following are some symptoms that may prompt a doctor to order pelvic ulrasound in men:

• A lump that is felt on physical examination 
• Difficulty urinating 
• Elevated blood test results in a PSA test

You may be allowed to wear loose-fitting clothes or might be given a hospital gown for the test. You will be asked to remove all the jewellery from the area to be scanned.

Also, your doctor may ask you to drink a minimum of three glasses of water an hour before the test. A full bladder is needed to get clear images in the test. Do not empty your bladder unless advised by your doctor.

For a transrectal ultrasound, you may be told to avoid blood thinners for seven to 10 days before the test, especially if a biopsy is planned. An enema may be given to cleanse your bowel two to four hours before the test.

Inform your doctor if you have latex allergy, as the transducer may be covered with a latex sheath for transvaginal and transrectal ultrasound..

Pelvic ultrasound can be done in one of the following ways:

Abdominal ultrasound:

• You will be asked to lie face-up on the exam table. 
• Your doctor or a sonographer will apply a water-based gel on your abdomen. He/she will then move the transducer back and forth over the area to be examined until sufficient images are captured. 
• After the scan, the gel can be wiped off.

Transvaginal ultrasound:

• Your doctor will ask you to empty your bladder before the scan. 
• You will be asked to lie on the exam table, with your feet supported in stirrups. 
• Your doctor will insert a thin transducer in your vagina. The transducer will be protected with a latex or plastic sheath and lubricated to facilitate easy passage. 
• Once the required images are obtained, the doctor will remove the transducer.

Transrectal ultrasound:

• You will have to lie on your side, with your hips and knees slightly bent. 
• Your doctor will insert a transducer (covered with plastic sheath and lubricated) into your rectum through your anus. 
• He/she will then take the images of the area to be scanned.
• After the scan, the doctor will remove the transducer.

A pelvic ultrasound is usually completed within 30 minutes.

Pelvic ultrasound is painless. However, you may feel mild pressure when the transducer is moved over a painful area. In case of a transvaginal or transrectal ultrasound, you may feel mild discomfort when the transducer is inserted.

The following conditions can be diagnosed with a pelvic ultrasound scan:

• Growths in the uterus or ovaries, such as fibroids, polyps or cysts
• Abnormalities in the uterus or vagina
• Cancer of the uterus, ovary, cervix, vagina and other pelvic organs
• Scars in the uterus
• Bladder stones, tumour or cancer
• Twisting of ovaries
• Visualisation of very early pregnancy 
• Pregnancy occurring outside the uterus
• Infection in the uterus, ovaries or fallopian tubes
• Enlarged prostate
• Abnormal growths or other disorders in the prostate

Pelvic ultrasound has no risks.

The following are the benefits of this ultrasound:

• Non-invasive 
• Gives clear images of soft tissues that are not seen well on x-ray images 
• Safe, with no radiation exposure

Specific care is not needed after a pelvic ultrasound. You can continue your normal diet and activities after the test unless instructed otherwise.

The following tests can be performed with the pelvic ultrasound:

• Doppler ultrasound
• Biopsy

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.