What is a pelvic ultrasound?
A pelvic ultrasound is an imaging exam. Ultrasound exams create pictures of organs and body structures using sound waves. A hand-held transducer produces the sound waves. This kind of imaging is different from standard X-rays that use ionizing radiation to make the images. As a result, ultrasound technology does not expose you to radiation. Ultrasound can also show doctors things X-rays can’t, such as the internal structure of organs and pockets of fluid. Sonography and sonogram are other terms for an ultrasound.
Pelvic ultrasounds help your doctor see the organs and structures in the area between your hip bones. This includes the bladder, reproductive organs, rectum, and the bottom of the spine and tailbone. There are three main types of pelvic ultrasound. The type you will have depends on which organ your doctor needs to see and the reason.
The types of pelvic ultrasound include:
Abdominal, or transabdominal ultrasounds can produce images of the bladder, uterus, cervix, ovaries and fallopian tubes.
Rectal, or transrectal, ultrasounds can make images of a man’s prostate gland and seminal vesicles.
Vaginal, or transvaginal ultrasounds can create different views of a woman’s uterus, cervix, ovaries and fallopian tubes. It can show the lining of the uterus, along with the muscular structure of it.
Sometimes, doctors order more than one type of pelvic ultrasound to get the most complete information about an organ or structure.
Why is a pelvic ultrasound performed?
The purpose of a pelvic ultrasound can depend on whether you are male or female. General uses in both men and women include evaluating bladder problems, bladder tumors, kidney stones, and pelvic pain and masses. In children, pelvic ultrasounds can give doctors more information in cases of ambiguous genitalia. Doctors can also use pelvic ultrasound during biopsy procedures to precisely locate suspicious areas, such as a mass.
Uses of pelvic ultrasound in women
If you are female, the most common use of a pelvic ultrasound is to monitor a pregnancy. Your doctor may also recommend a pelvic ultrasound to evaluate the following:
Abnormal vaginal bleeding and other menstrual problems
Cancer anywhere in the female reproductive system
Early or delayed puberty in girls
Uterine fibroids and endometrial polyps
Uses of pelvic ultrasound in men
If you are male, the most common reason for a pelvic ultrasound is a prostate problem, such as prostate cancer. Your doctor may also recommend a pelvic ultrasound to evaluate possible causes of male infertility. This may include looking at the seminal vesicles, which help produce semen. Ultrasound can find blockages and other problems with the production and ejaculation of sperm.
Who performs pelvic ultrasound?
Sonographers perform pelvic ultrasounds. Ultrasound technician and ultrasound technologist are other names for this healthcare provider. A radiologist will read and interpret the ultrasound results. Radiologists also perform certain imaging exams, including ultrasound-guided biopsies. The radiologist will send a report to your doctor, who will share the findings with you.
For pregnancy, your obstetrician may be the provider performing the ultrasound, although some practices have a dedicated sonographer. Another name for this type of pelvic ultrasound is an obstetric ultrasound or prenatal ultrasound. You may need to go to a specialized imaging center for diagnostic ultrasound or if there are potential problems with the pregnancy.
Other providers who may perform prenatal and transvaginal ultrasound include specially trained nurse practitioners, physician assistants, and nurse-midwives.
How is a pelvic ultrasound performed?
Ultrasounds take place in darkened procedure rooms. There will be some light in the room, but it will be dim to allow optimal viewing of the ultrasound images. The specific procedure details for a pelvic ultrasound depend on the type of exam you need.
In general, this is what happens during a pelvic ultrasound:
Abdominal ultrasound: You will need to wear loose-fitting clothing or change into a patient gown and drape. You will lie on your back on a procedure table. The sonographer will squirt a water-based gel on your lower abdomen. The gel helps the transducer maintain contact with your skin to produce good-quality images. The sonographer will move the transducer across your skin. It may be necessary to apply pressure to the transducer to get the best images.
Rectal ultrasound: You will likely wear a patient gown for this procedure. You will lie on your side on a procedure table and bend your knees into a fetal position. For this exam, the thin transducer is shaped like a probe or wand to fit inside the rectum. The sonographer will place a protective cover on the wand and lubricate it before inserting it into the rectum.
Vaginal ultrasound: You will undress from the waist down or wear a patient gown for this procedure. Either way, you will have a drape to cover your lower half and will put your feet in the stirrups similar to a pelvic exam. The transducer has a thin wand-like shape to fit inside the vagina. The sonographer will place a protective cover and lubrication on the wand, and hand it to you between your legs. You will insert it into your vagina. Then, the sonographer will hold it and may turn or angle it to get the necessary images.
Pelvic ultrasound exams take about 30 minutes. It may take longer if you are having more than one type of pelvic ultrasound. At the end of the exam, the sonographer will give you towels so you can wipe off the gel. The gel is water based, so it cleans away easily.
What are the risks and potential complications of a pelvic ultrasound?
There are no known risks of a standard pelvic ultrasound. It does not expose you to ionizing radiation. For rectal and vaginal ultrasounds, sonographers sometimes use a latex condom to cover the transducer wand. If this is the case, it is possible to have an allergic reaction to the latex. If you know you have a latex allergy, be sure to tell the sonographer before the exam. The sonographer can use a different kind of protective cover.
With any imaging exam, it is possible to have a false-positive or false-negative result. For pelvic ultrasounds, certain factors can interfere with the quality of the images. Your doctor may recommend repeating the exam if these factors affect your results. These factors include:
Excessive movement during the exam
Inadequate bladder fullness, which fails to lift the uterus into view
Intestinal gas or other contents in the intestines or rectum
How do I prepare for a pelvic ultrasound?
The necessary preparation depends on the specific type of pelvic ultrasound. Your doctor will give you detailed information if you need to prepare. In general, pelvic ultrasound preparation involves the following:
Abdominal ultrasound: You will need a full bladder for this exam. It helps move aside the intestines and lift the uterus for optimal imaging. To adequately fill your bladder, you will need to drink 24 ounces of water or more an hour before the exam. You should not empty your bladder until after the exam.
Rectal ultrasound: You may need to use an enema an hour before the exam. This will help you empty your colon and rectum for optimal imaging.
Vaginal ultrasound: You will need to empty your bladder for this exam. If you are also having an abdominal ultrasound, you will have that exam first with a full bladder. Then, you will empty your bladder before having a vaginal ultrasound.
Ask your doctor if you have any questions about preparing for the exam.
What can I expect after a pelvic ultrasound?
Knowing what to expect after a pelvic ultrasound makes it easier to plan and prepare for it.
How long will it take to recover?
You should be able to resume your normal diet and activities right after a pelvic ultrasound. If you have an ultrasound-guided biopsy, your doctor may have instructions for activity restrictions afterwards.
Will I feel pain?
Abdominal, rectal and vaginal ultrasounds can be somewhat uncomfortable. You may feel pressure, but you should not feel pain. Let the sonographer know if something is painful.
If you have an ultrasound-guided biopsy, you may briefly feel pain when the doctor takes the tissue sample.
Your doctor will share the results of your pelvic ultrasound with you once they are available. The results will guide the next steps you need to take. This may involve more testing, exams or treatments.