Pelvic Ultrasound

When is a Pelvic Ultrasound Recommended? 

A Pelvic Ultrasound may be ordered by your physician to get a detailed look at the pelvic organs including the uterus, cervix, ovaries, and fallopian tubes. The bladder and rectum are also considered part of the pelvic space. Because ultrasound excels at evaluating organs that are fluid-filled, it is great for evaluating the bladder but not optimal for evaluating gas-filled organs such as the bowel. 

• Ultrasound helps to characterize findings as normal or abnormal. For ultrasound imaging that appears abnormal, the technology is used to diagnose and assist in any treatment planning. 

Ultrasound of the pelvis may help to evaluate findings your clinician has felt on your clinical examination such as ovarian cysts or uterine fibroids.  Your clinician may want to measure the thickness of the lining of the uterus called the endometrium, especially important for any uterine bleeding after menopause. A thickened endometrial lining can be a sign of endometrial hyperplasia. Too thin of an endometrial lining can also cause bleeding called atrophic or estrogen-deficient bleeding. 

Can Ultrasound Distinguish Normal Ovarian Cysts from Cancer?  

Ultrasound is the first line among medical diagnostic radiology imaging tools to diagnose ovarian cancer. It is excellent at this task as the ovaries naturally contain fluid called follicles or cysts. Follicle production is normal in all premenopausal women. Cysts (larger than follicles) can be more often seen in some women. The persistence of complex appearing ovarian cysts can suggest an abnormality that your gynecologist may want to follow up or evaluate further with laparoscopy. The ovaries cannot be biopsied externally like the cervix or endometrium because they are located within a larger peritoneal cavity. Therefore the pelvic ultrasound is important in assessing whether further intervention is required.  If necessary, the ultrasound can provide your GYN with a detailed map prior to any intervention.  

How is a Pelvic Ultrasound Useful For Uterine Bleeding? 

Pelvic ultrasound is also excellent at imaging premenopausal complaints you might have such as abnormal uterine bleeding. Some women experience changes in their menstrual cycle in length or quantity. Ultrasound can distinguish whether a uterine polyp is causing the bleeding you are experiencing in between your normal cycles. It can also distinguish if your complaint of heavy menstrual bleeding is because of fibroids or adenomyosis. 

Pelvic Ultrasound is useful to evaluate some components of pelvic floor prolapse or urinary incontinence. Since ultrasound excels at evaluating the fluid-filled bladder, it can be used to assess whether you retain urine after voiding. Some women who have frequent urinary tract infections (UTIs) may suffer from an inability to empty the bladder completely, an optimal environment for growing bacteria. 

How Does Ultrasound Work? 

Ultrasound is a radiology imaging technology that uses sound waves to distinguish normal from abnormal tissues within organs. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected back are presented as images for interpretation by a specialized radiologist to distinguish various findings. Because this radiology technology uses sound waves, it is also called a sonogram.

How Is the Pelvic Ultrasound Performed? 

• Pelvic ultrasound imaging has two components. 

The first part is to look at the pelvic organs from the outside of your abdomen called Transabdominal pelvic ultrasound. If you are premenopausal, try to schedule your imaging examination when you are not having your menses, optimally days 6-14 of your cycle. We use the filled bladder as a lens to see through. The bladder also displaces the bowel out of the way since ultrasound cannot see well through bowel gas. So it is important to ensure that you drink approximately 32 ounces of water 30 minutes prior to this part of the procedure. If you can’t drink this amount, please drink what you can comfortably prior to the transabdominal ultrasound. Ultrasound can see the uterus, the outside of the cervix, the ovaries well from this first component of the imaging. 

The second part is us asking you to void (urinate) as well as you can. We will use another type of transducer that resembles a tampon called a Transvaginal Ultrasound probe (wand). The probe is inserted into the vaginal canal like a tampon is inserted during your menstrual phase. You may insert the probe instead of the technologist if you desire. This component of the imaging scan allows the ultrasound crystals to be closest to pelvic organs. Using Transvaginal ultrasound we can obtain more detail on the ovaries and the endometrium. The cervix is also more closely evaluated but we can only see the gross detail, not on a cellular level like a PAP smear does. 

• The ovaries and the uterine lining can be measured most accurately in most women with an endovaginal ultrasound. However, if you are not sexually active OR if there is any reason you do not feel comfortable with this part of the pelvic ultrasound, please tell us that. We will make our impressions on the imaging we can obtain on both parts or just the transabdominal component. 

At The Women’s Imaging Center, our technologists and physicians specialize in the performance, detection, and diagnosis of pelvic ultrasound imaging and medical diagnostic conditions. We perform comprehensive imaging for women from head to toe and have decades of specialized training in all organ systems of the body and their interrelationship. Thyroid dysfunction may affect other conditions such as uterine bleeding. Polycystic Ovarian Syndrome (PCOS) may be associated with autoimmune conditions. 

• Only specialists who work within this comprehensive field of Women’s Imaging will appreciate the relationship of one organ system to another. 

We specialize in all these processes and work closely with other specialists such as endocrinologists or gynecologists or surgeons in a multi-disciplinary fashion.