When Is a Pelvic Ultrasound Needed?
A pelvic ultrasound is useful for examining common concerns, such as:
- Ovarian cysts
- Uterine fibroids
- Uterine bleeding
- Urinary incontinence
- Uterine polyps
- Pelvic floor prolapse
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, which is 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 known as atrophic or estrogen-deficient bleeding.
Since ultrasound excels at evaluating the fluid-filled bladder, it can be used to assess whether you retain urine after voiding. Some women with frequent urinary tract infections (UTIs) may be unable to empty the bladder completely, which creates an optimal environment for growing bacteria.
What to Expect During a Pelvic Ultrasound
First, we use a transabdominal pelvic ultrasound to examine the pelvic organs from the outside of your abdomen. This imaging gives us a good view of the uterus, the outside of the cervix, and the ovaries.
We use the filled bladder as a lens to see through. In addition, a full bladder moves the bowel out of the way since ultrasound cannot see well through bowel gas. Therefore, we ask that you drink approximately 32 ounces of water 30 minutes before the procedure. If you can’t drink this amount, please drink what you can comfortably before the transabdominal ultrasound.
For the second part, we will ask you to empty the bladder as well as you can. We will use another type of transducer called a transvaginal ultrasound probe (wand). The technologist will insert the probe into the vaginal canal like a tampon, or you may insert the probe instead if you desire. This component of the imaging scan allows the ultrasound crystals to be closest to the pelvic organs. We can obtain more detail on the ovaries and the endometrium using transvaginal ultrasound. We can also more closely evaluate the cervix, gathering gross detail instead of the cellular-level information we get with a Pap smear.
Endovaginal ultrasound is the most accurate way to measure the ovaries and uterine lining. 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 let us know. We can use just the transabdominal component to gain impressions on the imaging if necessary.
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Frequently Asked Questions About Pelvic Ultrasound
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 is also considered part of the pelvic space. Because ultrasound excels at evaluating organs that are fluid-filled, it excels at evaluating solid or fluid-filled organs but is not optimal for evaluating gas-filled organs such as the bowel.
The technologist or radiologist will be able to share the pelvic ultrasound results with you at the time of the study. Your clinician will receive those results within 24 hours, unless comparisons are required which may take longer. You will then follow up with your referring clinician regarding their care plan. The technologist and radiologist will not be able to prescribe any treatment - that is solely the responsibility of the referring clinician as they are the ones who determine any next steps.
A Pelvic Ultrasound is optimal to evaluate any solid or fluid-filled organs such as for finding uterine fibroids, ovarian cysts or endometrial (pelvic lining) problems like hyperplasia or polyps. Since ultrasound excels at seeing fluid, it is also used to evaluate for excess fluids in patients who complain of “bloating”.
A Pelvic Ultrasound cannot visualize gas-filled structures so lower abdominal pain that could be caused by small or large bowel problems cannot be determined by this technique. Very small structures such as fallopian tubes are typically seen by Pelvic Ultrasound unless there is excess water in the tubes called hydrosalpinx.
The ovaries naturally contain fluid called follicles or cysts. Follicle production is normal in all premenopausal women. Cysts, which are larger than follicles, also occur 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, pelvic ultrasound is vital in assessing whether further intervention is required. The ultrasound can provide your GYN with a detailed map before any intervention.
If you are in need of an emergency pelvic ultrasound, please reach out to us at 303-321-2273. We have several locations in the Denver area where we can see you.
A pelvic ultrasound is a radiology imaging technology that uses sound waves to distinguish normal from abnormal tissues within organs. Sound waves emit from crystals in a hand-held wand called a transducer or probe, reflected back to produce images that a specialized radiologist uses to distinguish various findings. This radiology technology is also called a sonogram since it uses sound waves.