Transvaginal ultrasound

Definition

Transvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix and pelvic area.

Transvaginal means across or through the vagina. The ultrasound probe will be placed inside the vagina.

Alternative Names

Endovaginal ultrasound; Ultrasound - transvaginal; Fibroids - transvaginal ultrasound; Vaginal bleeding - transvaginal ultrasound; Uterine bleeding - transvaginal ultrasound; Menstrual bleeding - transvaginal ultrasound; Infertility - transvaginal ultrasound; Ovarian - transvaginal ultrasound; Abscess - transvaginal ultrasound

How the Test is Performed

You will lie down on your back on a table with your knees bent. Your feet may be held in stirrups.

The ultrasound technician or doctor will introduce a probe into the vagina. It may be mildly uncomfortable, but will not hurt. The probe is covered with a condom and a gel.

• The probe transmits sound waves and records the reflections of those waves off body structures. The ultrasound machine creates an image of the body part.
• The image is displayed on the ultrasound machine. In many offices, the patient can see the image also.
• The provider will gently move the probe around the area to see the pelvic organs.

In some cases, a special transvaginal ultrasound method called saline infusion sonography (SIS) may be needed to more clearly view the uterus.

How to Prepare for the Test

You will be asked to undress, usually from the waist down. A transvaginal ultrasound is done with your bladder empty or partly filled.

How the Test will Feel

In most cases, there is no pain. Some women may have mild discomfort from the pressure of the probe. Only a small part of the probe is placed into the vagina.

Why the Test is Performed

Transvaginal ultrasound may be done for the following problems:

• Abnormal findings on a physical exam, such as cysts, fibroid tumors, or other growths
• Abnormal vaginal bleeding and menstrual problems
• Certain types of infertility
• Ectopic pregnancy
• Pelvic pain

This ultrasound is also used during pregnancy.

Normal Results

The pelvic structures or fetus is normal.

What Abnormal Results Mean

An abnormal result may be due to many conditions. Some problems that may be seen include:

• Birth defects
• Cancers of the uterus, ovaries, vagina, and other pelvic structures
• Infection, including pelvic inflammatory disease
• Benign growths in or around the uterus and ovaries (such as cysts or fibroids)
• Endometriosis
• Pregnancy outside of the uterus (ectopic pregnancy)
• Twisting of the ovaries

Risks

There are no known harmful effects of transvaginal ultrasound on humans.

Unlike traditional x-rays, there is no radiation exposure with this test.

References

Brown D, Levine D. The uterus. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 15.

Coleman RL, Ramirez PT, Gershenson DM. Neoplastic diseases of the ovary: screening, benign and malignant epithelial and germ cell neoplasms, sex-cord stromal tumors. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 33.

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.