Transvaginal Ultrasound

What is a transvaginal ultrasound?
An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions.

A transvaginal ultrasound, also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

Transvaginal means through the vagina. This is an internal examination.

Unlike a regular abdominal or pelvic ultrasound, where the ultrasound wand (transducer) rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about 2 or 3 inches into your vaginal canal.

When is a transvaginal ultrasound performed?
There are many reasons why a transvaginal ultrasound might be necessary, including:

an abnormal pelvic or abdominal exam
unexplained vaginal bleeding
pelvic pain
an ectopic pregnancy (which occurs when the fetus implants outside of the uterus, usually in the fallopian tubes)
infertility
a check for cysts or uterine fibroids
verification that an IUD is placed properly
Your doctor might also recommend a transvaginal ultrasound during pregnancy to:

monitor the heartbeat of the fetus
look at the cervix for any changes that could lead to complications such as miscarriage or premature delivery
examine the placenta for abnormalities
identify the source of any abnormal bleeding
diagnose a possible miscarriage
confirm an early pregnancy
How should I prepare for a transvaginal ultrasound?
In most cases, a transvaginal ultrasound requires little preparation on your part.

Once you've arrived at your doctor's office or the hospital and you're in the examination room, you have to remove your clothes from the waist down and put on a gown.

Depending on your doctor's instructions and the reasons for the ultrasound, your bladder might need to be empty or partially full. A full bladder helps lift the intestines and allows for a clearer picture of your pelvic organs.

If your bladder needs to be full, you have to drink about 32 ounces of water or any other liquid about one hour before the procedure begins.

If you're on your menstrual cycle or if you're spotting, you have to remove any tampon you're using before the ultrasound.

What happens during a transvaginal ultrasound?
When it's time to begin the procedure, you lie down on your back on the examination table and bend your knees. There may or may not be stirrups.

Your doctor covers the ultrasound wand with a condom and lubricating gel, and then inserts it into your vagina. Make sure your provider is aware of any latex allergies you have so that a latex-free probe cover is used if necessary.

You might feel some pressure as your doctor inserts the transducer. This feeling is similar to the pressure felt during a Pap smear when your doctor inserts a speculum into your vagina.

Once the transducer is inside of you, sound waves bounce off your internal organs and transmit pictures of the inside of your pelvis onto a monitor.

The technician or doctor then slowly turns the transducer while it's still inside of your body. This provides a comprehensive picture of your organs.

Your doctor may order a saline infusion sonography (SIS). This is a special kind of transvaginal ultrasound that involves inserting sterile salt water into the uterus before the ultrasound to help identify any possible abnormalities inside the uterus.

The saline solution stretches the uterus slightly, providing a more detailed picture of the inside of the uterus than a conventional ultrasound.

Although a transvaginal ultrasound can be done on a pregnant woman or a woman with an infection, SIS cannot.

What are the risk factors with this procedure?
There are no known risk factors associated with transvaginal ultrasound.

Performing transvaginal ultrasounds on pregnant women is also safe, for both mother and fetus. This is because no radiation is used in this imaging technique.

When the transducer is inserted into your vagina, you'll feel pressure and in some cases discomfort. The discomfort should be minimal and should go away once the procedure is complete.

If something is extremely uncomfortable during the exam, be sure to let the doctor or technician know.

What do the results show?
You might get your results immediately if your doctor performs the ultrasound. If a technician performs the procedure, the images are saved and then analyzed by a radiologist. The radiologist will send the results to your doctor.

A transvaginal ultrasound helps diagnose multiple conditions, including:

cancer of the reproductive organs
routine pregnancy
cysts
fibroids
pelvic infection
ectopic pregnancy
miscarriage
placenta previa (a low-lying placenta during pregnancy that may warrant medical intervention)
Talk with your doctor about your results and what type of treatment, if any, is necessary