Pelvic ultrasound: Why do you need one and what to expect?

A pelvic ultrasound is a safe and painless imaging test technique that utilises high-frequency sound waves to produce detailed images of the organs and structures in the pelvic region. This procedure is commonly used to evaluate the health and condition of the female reproductive organs, including the uterus, ovaries, and fallopian tubes, as well as the bladder and other structures in the pelvic area. However, minimal preparation is needed which will help you make things smoother and more effective. Here is everything you need to know about pelvic ultrasound and how to prepare for it.

What is pelvic ultrasound?

A pelvic ultrasound is a simple diagnosis procedure that generates pictures used for assessing various tissues and organs in the female pelvis. A pelvic ultrasound may quickly see the female pelvic organs and structures such as the uterus, cervix, vagina, fallopian tubes, and ovaries, as found in a study published in the Frontiers in Pharmacology Journal.

Ultrasound utilises a transducer to generate ultrasonic waves at a frequency that is too high to be heard. The ultrasound transducer is inserted into the skin, and the ultrasonic waves travel through the body to the organs and structures inside. The sound waves bounce off the organs like an echo before returning to the transducer. The transducer processes the reflected waves, which are subsequently transformed by a computer into an image of the organs or tissues under examination. It can also be used to examine the prostate and seminal vesicles in men.

Types of pelvic ultrasound

There are two types of pelvic ultrasound:-

1. Transabdominal ultrasound

Transabdominal ultrasound was initially used to check for pregnancy but now it can be used to look at many organs inside your abdomen, like your liver, kidneys, and bladder, found a study published by StatPearls. The ultrasound transducer (a small handheld device) is moved over the lower abdomen. For this ultrasound, a full bladder is often required to enhance the visibility of pelvic organs.

2. Transvaginal ultrasound

“This type of ultrasound is tested only for women. In this, the transducer is inserted into the vagina, providing a closer and more detailed view of the female pelvic organs. It usually does not require a full bladder, says gynaecologist and obstetrician Dr Madhu Juneja.

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What is the need for pelvic ultrasound?

A pelvic ultrasound is needed for various medical reasons to diagnose, monitor, and manage conditions related to the pelvic region. Here are some of the primary reasons for undergoing a pelvic ultrasound, as explained by the expert.

• Determines the source of unexplained pelvic pain.
• Identifies issues such as ovarian cysts, endometriosis, or pelvic inflammatory disease (PID).
• Investigates the causes of heavy, irregular, or painful menstrual periods.
• Assesses bleeding after menopause.
• Evaluates the size, shape, and position of the uterus and ovaries.
• Checks for abnormalities, such as blockages or ectopic pregnancies.
• Monitors the growth and development of the foetus.
• Detects benign tumours in the uterus.
• Assesses the presence of endometrial tissue outside the uterus.
• Checks the development of ovarian follicles.
• Evaluates the structure and function of the reproductive organs in the context of
• fertility treatments.
• Measures the thickness of the uterine lining.
• Detects the abnormalities that may develop in the uterine and ovarian after menopause.
• Checks any abnormalities in the urinary bladder.
• Investigates problems related to the urinary tract.
• Assists in the placement of needles for biopsies.
• Ensures the proper placement of IUDs (Intrauterine Device).
• Evaluates the prostate and seminal vesicles in men.

How to prepare for a pelvic ultrasound?

Preparing for a pelvic ultrasound involves a few specific steps to ensure the procedure goes smoothly and provides the most accurate images. Here is a complete guide to preparing for pelvic ultrasound, as suggested by the expert.

Transabdominal pelvic ultrasound

1. Drink water

You will likely need a full bladder for this type of ultrasound to enhance the visibility of pelvic organs. Typically, you will be asked to drink about 32 ounces (1 litre) of water an hour before your appointment and avoid urinating until after the test.

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2. Wear comfortable clothing

Wear loose-fitting clothing that can be easily adjusted or removed if needed. It is recommended to not wear tight-fitting clothing.

3. Arrive early

Arrive a little early to complete any necessary paperwork and to ensure you are ready for the procedure. This will help you to not wait for a long time and the test will happen smoothly and effectively.

Transvaginal pelvic ultrasound

1. Empty bladder

You may be asked to empty your bladder before the procedure to increase comfort and improve the clarity of the images.

2. Personal cleanliness

Practise good personal hygiene before the procedure for your comfort and that of the technician.

3. Wear comfortable clothing

Similar to the transabdominal ultrasound, wear loose-fitting clothing for ease of access and comfort.

Are there any side effects of pelvic ultrasound?

A pelvic ultrasound is generally a safe and non-invasive procedure with minimal risk. However, there are some considerations and potential minor side effects to be aware of:

1. Discomfort

You might feel mild discomfort from having a full bladder during the transabdominal ultrasound procedure. The pressure applied by the transducer on a full bladder during a transabdominal ultrasound might be the reason. The insertion of the transducer during a transvaginal ultrasound can be uncomfortable, especially for those with conditions like vaginismus or pelvic pain.

2. Allergic reactions

Although rare, some individuals may have a mild allergic reaction to the ultrasound gel used on the skin or the transducer.

3. Spotting or discharge

Some women may experience light spotting or vaginal discharge after a transvaginal ultrasound. This is usually minor and temporary.

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4. Infection

Although extremely rare, there may be a slight risk of infection with any procedure that involves inserting an instrument into the body, such as a transvaginal ultrasound. Proper sterilisation practices significantly reduce this risk.

Who should take extra precautions?

1. Pregnant women

Pelvic ultrasounds, including transvaginal ultrasounds, are generally safe during pregnancy and are commonly used to monitor foetal development. But always inform your healthcare provider if you are pregnant so that any specific precautions can be taken.

2. Individuals with certain medical conditions:

Those with existing pelvic pain or conditions like endometriosis may experience increased discomfort during the procedure. Individuals with known allergies to substances similar to the ultrasound gel should inform their healthcare provider.

Aftercare measures to consider after pelvic ultrasound

• Resume normal activities: Most people can resume their normal activities immediately after the procedure.
• Follow-up: If you experience any unusual symptoms or prolonged discomfort after the procedure, contact your healthcare provider.

Overall, a pelvic ultrasound is a safe procedure with minimal risk of side effects. It is an invaluable diagnostic tool that provides critical information for managing and monitoring various health conditions.