Pelvic Ultrasound
Test OverviewA pelvic
ultrasound uses sound waves to make a picture of the
organs and structures in the lower belly (pelvis). A pelvic
ultrasound looks at the bladder and: Organs and structures that are solid and uniform (such as
the uterus, ovaries, or prostate gland) or that are fluid-filled (such as the
bladder) show up clearly on a pelvic ultrasound. Bones may block other organs from being seen. Air-filled organs, such as the intestines, can make the image less clear. Pelvic ultrasound can be done three ways: transabdominal, transrectal,
and transvaginal. - Transabdominal ultrasound. A small handheld device
called a transducer is passed back and forth over the lower belly. A
transabdominal ultrasound is commonly done in women to look for large
uterine fibroids or other problems.
- Transrectal ultrasound. The transducer is shaped to
fit into the
rectum. A transrectal ultrasound may be done to check for problems in men or women. It is the most common
test to look at the male pelvic organs, such as the prostate and seminal
vesicles. The test may also be done to look for rectal sphincter problems, such as incontinence. Sometimes, a small sample of tissue (biopsy) may be
taken with small tools inserted through the rectum during a transrectal
ultrasound.
- Transvaginal ultrasound. The transducer is shaped
to fit into a woman's
vagina. A woman may have both transabdominal and
transvaginal ultrasounds to look at the whole pelvic area. A transvaginal
ultrasound is done to look for problems with
fertility or pregnancy. In rare cases, a hysterosonogram is done to
look at the inside of the uterus by filling the uterus with fluid during a
transvaginal ultrasound. Sometimes, a small sample of tissue (biopsy) may be
taken with small tools inserted through the vagina during a transvaginal
ultrasound.
In all three types of pelvic ultrasound, the
transducer sends the reflected sound waves to a computer, which makes them into
a picture that is shown on a video screen. Ultrasound pictures or videos may be
saved as a permanent record. Why It Is DoneFor men and women, pelvic ultrasound may
be done to: - Find the cause of blood in the urine
(hematuria). An ultrasound of the kidneys may also be done.
- Find
the cause of urinary problems.
- Look at the size of the bladder
before and after urination. This can determine whether the bladder is emptying
completely during urination.
- Check for growths in the
pelvis.
- Guide the placement of a needle during a biopsy or when
draining the fluid from a cyst or
abscess.
- Check for
colorectal cancer and how it is responding to
treatment.
For women, pelvic ultrasound may be
done to: - Find out what is causing pelvic
pain.
- Look for the cause of vaginal bleeding.
- Look for
pelvic inflammatory disease (PID).
- Find
an
intrauterine device (IUD) .
- Look at the
size and shape of the uterus and the thickness of the uterine lining (endometrium).
- Look at the size and shape
of the ovaries.
- Check the condition and size of the ovaries during
treatment for
infertility.
- Confirm a pregnancy and
whether it is in the uterus. Pelvic ultrasound may be used early in pregnancy
to check the age of the pregnancy or to find a tubal pregnancy (ectopic pregnancy) or multiple pregnancy.
- Check the cervical length in a pregnant woman at risk for
preterm labor.
- Check a lump found during
a
pelvic examination.
- Check uterine fibroids
found during a pelvic examination. Pelvic ultrasound may also be done to check
the growth of uterine fibroids.
- Guide a procedure to remove an
ovarian follicle for
in vitro fertilization.
For men, pelvic ultrasound may be
done to: How To PrepareTell your doctor if you
have had an X-ray with
contrast material (such as barium) within the past 2
days. Barium that remains in the intestines can interfere with the ultrasound
test. Wear loose clothes for the pelvic ultrasound. You may need
to remove all your clothes below the waist and put on a gown before the
test. If you are having a biopsy or a special procedure during the
ultrasound, you may need to sign a consent form that says you understand the risks of the test and agree to have it done. Talk to your
doctor about any concerns you have regarding the need for this test, its risks,
how it will be done, or what the results will mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?). Transabdominal ultrasoundIf you are having a
transabdominal ultrasound, your doctor will ask you to drink 4 to
6 glasses of juice or water about an hour before the test to fill your bladder.
A full bladder pushes the intestines (which contain air) out of the way of the
pelvic organs. This makes the ultrasound picture clearer. If the ultrasound is
being done in an emergency situation, your bladder may be filled with water
through a thin flexible tube (catheter) inserted into your bladder. Transrectal ultrasoundIf you are having a
transrectal ultrasound, you may need an
enema about an hour before the test. Tell your doctor if you are allergic to latex so that a latex-free cover can be put
on the transducer before it is used. If a man is also having a
biopsy of the prostate gland, he may be given
antibiotics for a day before the test. Transvaginal ultrasoundIf you are having a
transvaginal ultrasound, tell your doctor
if you are allergic to latex so that a latex-free cover can be put on the
transducer before it is used. If both a transabdominal and transvaginal ultrasound
will be done, the transabdominal ultrasound will usually be done first. How It Is Done This test is done by a doctor or by an
ultrasound technologist (sonographer). It is done in an ultrasound room in a
hospital, clinic, or doctor's office. You will need to remove any
jewelry that might be in the way of the ultrasound. You will need to take off
most of your clothes below the waist. You will be given a gown to use during
the test. You will lie on your back (or on your side) on a padded
table. Gel will be put on your belly to improve the quality of the sound waves.
A small, handheld instrument called a transducer is gently moved over your
belly. A picture of the organs and blood vessels can be seen on a video
screen. You need to lie very still while the ultrasound is being
done. You may be asked to take a breath and hold it for several seconds during
the test. Pelvic ultrasound takes about 30 minutes. You may be
asked to wait until the doctor has looked at the pictures. The doctor may want
to do more pictures. Transabdominal ultrasoundFor transabdominal ultrasound, you will need to drink 4
to 6 glasses of juice or water about an hour before the test. Do not empty your
bladder until the test is over. If you cannot drink enough fluid, your bladder
may be filled with water through a thin flexible tube (catheter) inserted into
your bladder. When the test is done, the gel is cleaned off your
skin. You can urinate as soon as the test is done. Transrectal ultrasoundFor transrectal ultrasound, you will be asked to lie on
your left side with your knees bent. A digital rectal examination will be done
before the ultrasound test. Then a lubricated transducer probe will be gently
inserted into your rectum. It will slowly be moved to take pictures from
different angles. You may feel some pressure. Water may be put into your rectum
to clean the end of the transducer so that clear pictures can be seen. Transvaginal ultrasoundFor transvaginal ultrasound, you will empty your bladder. You will be asked to lie on your back
with your hips slightly raised. A thin, lubricated transducer
probe will be gently inserted into your vagina. Only the tip of the transducer
is put in the vagina. You need to lie very still while the ultrasound scan is
being done. Transvaginal ultrasound may give more information than
transabdominal ultrasound for women who: - Are very overweight.
- Are being
checked or treated for infertility.
- Have a hard time with a full
bladder.
- Have a lot of gas in the intestines. This makes it harder
for your doctor to see all the organs in the pelvis.
Transvaginal ultrasound often makes a clearer picture
than transabdominal ultrasound because the transducer probe gets closer to the
organs being viewed. It is often used in early pregnancy. But transvaginal ultrasound looks at a smaller area than
transabdominal ultrasound. In rare cases, sterile saline is put in
the uterus through a thin tube (catheter), to allow the doctor to look at the
inside of the uterus (hysterosonogram). How It FeelsIf you have transabdominal ultrasound, you
will likely feel pressure in your bladder and a strong urge to urinate because
your bladder is full. The gel may feel cold when it is put on your
belly. You will feel light pressure from the transducer as it passes over your
belly. If you have an injury or pelvic pain, the light pressure of the
transducer may be painful. You will not hear or feel the sound waves. You most likely will have a little pain during a transvaginal or
transrectal ultrasound. You will feel pressure from the transducer probe as it
is put into your vagina or rectum. If a biopsy is done during the
ultrasound, you may have some pain when the sample is taken. RisksThere is a slight risk of infection from a
transvaginal or transrectal ultrasound. If a biopsy is done, the chance of
infection is higher. Call your doctor if you have an abnormal discharge or
fever after the test. ResultsA pelvic
ultrasound uses sound waves to make a picture of the
organs and structures in the lower belly (pelvis). Pelvic ultrasound in women| Normal: | Your
ovaries,
cervix, and
uterus have a normal shape and size and are in the
normal place. No growths, tumors, fluid, or other problems, such as
cysts, are present. Small cysts (follicles) in the
ovaries of women who are able to have children are normal. |
|---|
If you are using an
intrauterine device (IUD), it is in the uterus.
| If you are in the first
trimester of pregnancy, your baby (fetus) is developing inside the uterus. | Your
bladder is normal in size and shape. No stones or
abnormal growths are present. If the bladder is checked before and after
urination, it empties completely. Urine flows normally from the
ureters into the bladder. | | Abnormal: | Your uterus is big or abnormally shaped
because of
uterine fibroids. Cysts or tumors are present, such as
cancerous or noncancerous tumors of the ovaries, uterus, or cervix.
|
|---|
The thickness of the lining of the uterus
(endometrium), called the endometrial stripe, is
greater than normal. In some age groups, a thicker endometrial stripe (also
called
endometrial hyperplasia) may mean a higher chance of
endometrial cancer. | Pelvic inflammatory disease (PID),
abscesses,
kidney stones, or other problems are
present. | An
ectopic pregnancy is present. | An abnormal amount of fluid is present in
the pelvis. | The bladder has an abnormal shape or a
thick wall. A growth or stone is seen in the bladder. If the bladder is checked
before and after urination, it may not empty completely during
urination. | Pelvic ultrasound in men| Normal: | Your
prostate gland and
seminal vesicles are normal in size and shape. No
growths, tumors, or other problems, such as cysts, are present. |
|---|
Your bladder is normal in size and shape.
No stones or abnormal growths are present. If the bladder is checked before and
after urination, it empties completely during urination. Urine flows normally
from the
ureters into the bladder. | | Abnormal: | Your prostate gland is enlarged (benign prostatic hypertrophy, or BPH). This is one of
the most common abnormal findings. An abscess, kidney stone in the urinary
tract, or a tumor in or near the prostate gland or bladder may be
present. |
|---|
The bladder has an abnormal shape or a
thick wall. A growth or stone is seen in the bladder. If the bladder is checked
before and after urination, it may not empty completely during
urination. | An abnormal amount of fluid is present in
the pelvis. | What Affects the TestReasons you may not be able to
have the test or why the results may not be helpful include: - Stool (feces), air or other gas, or X-ray
contrast material (such as barium) in the intestines
or
rectum.
- Inability to remain still during
the test.
- Obesity.
- Having an open wound on the
belly.
A full bladder is needed for a transabdominal ultrasound,
so that the pelvic organs can be seen clearly. What To Think About- Ultrasound costs less than other tests that
make pictures of organs and structures in the body, such as a
computed tomography (CT) scan or
magnetic resonance imaging (MRI). But in some cases, a
CT scan or an MRI may also be needed to confirm a problem, such as
cancer.
- Ultrasound does not use X-rays or other types of radiation.
- With pelvic ultrasound, your doctor can
usually tell the difference between a fluid-filled cyst, a solid tumor, or
another type of lump. This is one of the main advantages of an ultrasound. An
abnormal lump needs more testing. A follow-up ultrasound is often done in 6 to
8 weeks because many problems go away on their own within that time. Pelvic
ultrasound cannot determine whether a lump is cancerous (malignant) or
noncancerous (benign). A
biopsy may have to be done for
this.
- Transvaginal ultrasound is used during fertility checks
to help guide the removal of
ovarian follicles for
in vitro fertilization.
- Fetal ultrasound
can be done to see your baby (fetus). For more information, see the topic
Fetal Ultrasound.
- If male problems, such
as a big prostate, are found on ultrasound, more testing may be done.
ReferencesOther Works Consulted- Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
CreditsByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Elizabeth T. Russo, MD - Internal Medicine
Specialist Medical ReviewerKevin C. Kiley, MD - Obstetrics and Gynecology Current as of:
May 4, 2017 Last modified on: 8 September 2017
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