What is a pelvic ultrasound? 

Pelvic ultrasound is a diagnostic test that uses high-frequency sound waves to produce images of the organs in your lower abdomen and pelvis. The pelvis is the region between the lower abdomen and thighs.

This test is used to evaluate the urinary and reproductive organs. It is of three types:

  • Transabdominal
  • Transrectal (usually done for men or women who are not sexually active)
  • Transvaginal (for women)

In an ultrasound scan, a small handheld probe called a transducer is passed on the area to be scanned. It passes sound waves through the body and collects the waves that bounce off the organs. These waves are then converted to images that can be viewed immediately on a screen.

  1. Who cannot have a pelvic ultrasound?
  2. Why is a pelvic ultrasound done?
  3. How should I prepare for a pelvic ultrasound?
  4. What is the procedure for a pelvic ultrasound?
  5. How will a pelvic ultrasound feel?
  6. What do the results of a pelvic ultrasound mean?
  7. What are the risks and benefits of a pelvic ultrasound?
  8. What happens after a pelvic ultrasound?
  9. What are the other tests that can be done with a 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.

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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: 

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.

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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
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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.

References

  1. Radiological Society of North America (RSNA) [internet]. Oak Brook. Illinois. USA; Ultrasound - Pelvis
  2. Centers for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Pelvic Inflammatory Disease (PID) - CDC Fact Sheet
  3. Office on women's health [internet]: US Department of Health and Human Services; Pelvic organ prolapse
  4. National Health Service [Internet]. UK; What are pelvic floor exercises?
  5. Cleveland Clinic [Internet]. Ohio. US; 9 Tips to Keep Your Vagina Happy + Healthy
  6. Cincinnati Children's [Internet]. Cincinnati Children's Hospital Medical Center. Ohio; Female Reproductive Anatomy
  7. mycourses: Harvard Medical School [Internet]. Harvard University, Cambridge. Massachusetts. USA; Ultrasound (US).
  8. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Pelvic Ultrasound
  9. Stolz L, Adhikari S. Point-of-care pelvic ultrasound. In: Lumb P, Karakitsos D, eds. Critical Care Ultrasound. Philadelphia, PA: Elsevier Saunders; 2015:chap 43.
  10. Benacerraf BR, Goldstein SR, Groszmann YS, eds. Gynecologic Ultrasound: A Problem-Based Approach. Philadelphia. PA: Elsevier Saunders; 2014: 221-233.
  11. Dolan MS, Hill C, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18.

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