Transvaginal ultrasound is normal. Which ultrasound method to choose: transvaginal, transabdominal, rectal. Indications for use

Transvaginal ultrasound is one of the main diagnostic methods used in obstetrics and gynecology. With its help, you can identify diseases of various types, as well as assess the condition of the fetus during pregnancy.

Transvaginal ultrasound is performed to identify pathologies of the female reproductive system

Description of the examination

A feature of transvaginal pelvic ultrasound in women is that during diagnosis a special sensor is used, which is inserted into the vagina. This is necessary in order to ensure optimal projection on the pelvic organs, when they are separated from the sensor only by a thin vaginal wall.

Thanks to this, transvaginal ultrasound provides more accurate information than a similar method performed through the anterior abdominal wall. But due to the fact that the diagnostic procedure requires the insertion of a sensor into the vagina, this method is not allowed for all female representatives and has a number of contraindications. In addition, preparation for transvaginal ultrasound has a number of features that must be observed.

The main areas in which this diagnostic method is used are gynecology, urology and obstetrics. During the examination, the doctor can identify various pathologies of inflammatory and non-inflammatory nature, determine the duration of pregnancy, and also assess the shape and size of the woman’s internal genital organs. Thanks to modern technologies, some sensors are equipped with a special device that allows for targeted biopsy.

Using transvaginal ultrasound, you can diagnose the condition of the fetus during pregnancy

It is worth noting that irregular shape or location of the uterus can often be the cause of impaired fertility. The way ultrasound works is that the waves sent and captured by the sensor propagate differently in the tissues. This is due to the density and structure of the fabric.

Indications for examination

The main indications for prescribing ultrasound with a vaginal sensor are:

Endometritis.
Salpingitis.
Oophoritis.
Tumor diseases of the pelvic organs of various types.

During transvaginal ultrasound, salpingitis and oophoritis can be detected

Endometriosis.
Anomalies in the structure of the genital organs.
Tumors of the sigmoid and rectum, for which transrectal ultrasound is prohibited.

Diseases of the female reproductive system are accompanied by the following symptoms:

In addition, this type of ultrasound diagnostics is used in the early stages of pregnancy. Using ultrasound in the early stages, you can confirm pregnancy when other diagnostic methods do not provide accurate results.

Ultrasound is the most reliable method for diagnosing pregnancy

Transvaginal ultrasound during pregnancy is performed exclusively in the first trimester. Late pregnancy is a contraindication, since insertion of the sensor may cause premature birth or miscarriage.

Also, ultrasound of the pelvic organs is performed transvaginally during artificial insemination. It is performed to monitor whether the fertilized egg has attached to the functional layer of the endometrium.

Women over 40 years of age are recommended to undergo an ultrasound of the uterus and appendages at least once a year. This is due to the fact that tumors often develop in premenopause. Their early diagnosis makes it possible to begin treatment without waiting for symptoms to appear, which is the key to a favorable outcome.

To monitor the development of pregnancy during artificial insemination, ultrasound is performed

Contraindications

Some girls do not know whether such an ultrasound can be done if she has already begun to be sexually active. Of course not. The main reason why a transvaginal ultrasound cannot be done is the presence of a hymen. An exception may be the presence of life-threatening conditions that cannot be diagnosed using the transabdominal method. In such a situation, the girl is indicated for artificial defloration.

Such measures are taken only with the written consent of the parents, since actions of this nature, made by medical personnel on their own initiative, are fraught with criminal liability.

Relative contraindications include ruptures of the vagina and perineum, an abnormally narrow vagina, when insertion of the sensor will be accompanied by pain, as well as pregnancy in the second and third trimester.

In the third trimester, ultrasound is not performed with a transvaginal probe.

Preparing for the examination

Transvaginal ultrasound requires special preparation from the woman. There are several main points in it.

A woman should prepare herself mentally, since this ultrasound method sometimes causes discomfort. In addition, you need to coordinate a visit with your doctor and find out what day of your menstrual cycle to come on. This is due to the fact that the diagnosis of various diseases is more accurate at different stages of the cycle.

The date of the ultrasound should be agreed with the doctor

Most routine examinations are carried out between 5 and 8 days after the end of menstruation. During this period, you can assess the condition of the ovaries, in which the egg is preparing for the onset of ovulation. An exception is the diagnosis of endometriosis. With this pathology, it is better to be examined on the eve of the onset of menstruation, when the functional layer of the endometrium is hyperplastic and is preparing for detachment.

How is the examination carried out?

Almost every woman knows how to do a transvaginal ultrasound, as she has encountered it at least once in her life. It is more convenient to perform a transvaginal ultrasound on a gynecological chair. The woman should take the same position in which she undergoes a routine gynecological examination. This ensures the most convenient insertion of the sensor and reduces the discomfort associated with it.

Before using the vaginal sensor, the doctor places a condom on it and then applies the gel. This gel provides better conductivity of ultrasonic waves. In addition, it acts as a kind of lubricant and simplifies the insertion of the TVUS sensor. This is of greatest importance for patients over 40 years of age who have a lack of lubricating fluid caused by dysfunction of the Bartholin glands.

A vaginal sensor is used to conduct the study.

The sensor is inserted slowly and over a short distance, which completely eliminates the risk of injury to patients. With vulvovaginitis and other inflammatory pathologies of the external genitalia, painful sensations may occur. They are caused exclusively by the inflammatory process.

The duration of the procedure is on average 20 minutes. For pelvic tumors with extensive adhesions, diagnosis may be slightly delayed. If the patient does not have indications for hospitalization in a hospital, then she can go home after waiting for a written conclusion from the doctor.

Decoding the results

In order for a woman to independently evaluate the conclusion of a diagnostician, she needs to know the normal size, location and shape of internal organs.

Transvaginal ultrasound interpretation should be entrusted to a doctor

It is worth noting that the size of the body and cervix in women who gave birth is slightly larger. Another feature is that the uterus decreases in size over time after menopause, which is not a sign of pathology.

The main thing a woman should pay attention to in the examination results is the presence of foci of inflammation, neoplasms and structural changes in organs. Such phenomena are always considered a deviation from the norm and require therapeutic measures.

Ultrasound in early pregnancy allows you to diagnose congenital anomalies of the fetus. In addition, early ultrasound is performed to identify factors that may cause miscarriage or spontaneous abortion.

Ultrasound image shows fetal development abnormalities

Transvaginal ultrasound is a diagnostic method that has virtually no analogues. Examinations that are equally informative are often associated with the negative effects of various radiation on the body or are invasive, which makes the range of their contraindications quite wide.

What information can an ultrasound scan provide during pregnancy? You will learn the answer to this question from the video:

Modern gynecology has several very accurate and safe research methods. One of them is transvaginal ultrasound. Unfortunately, women are not sufficiently informed about its features, do not know how to prepare for a vaginal ultrasound, and some are prejudiced against the procedure. Let's look at what transvaginal ultrasound is and how it is done, and what results can be obtained with this method.

Features of the procedure

Transvaginal ultrasound (TV) is essentially no different from traditional sonography. The tissue is exposed to ultrasonic waves. They are “reflected” from objects with different densities and are recorded by a special receiver that transforms them into an image. The fewer layers the waves overcome to reach the object under study, the less distortion the “picture” on the monitor will have.

Methods of gynecological ultrasound examination

Ultrasound with a vaginal sensor, which is placed directly in the vagina, allows you to minimize the distance to the organs being examined. The main advantage of the method over traditional transabdominal (through the abdominal wall) examination is the obtaining of a higher quality and clearer image. A transvaginal examination of the pelvic organs makes it possible to diagnose the most minor deviations from the normal tissue structure.

Indications

Ultrasound of the pelvis with a transvaginal sensor allows you to identify diseases that have not yet manifested themselves in a detailed clinical picture. This expands the possibilities of early diagnosis in gynecology and urology. The indications are:

Pain in the lower abdomen of any intensity, which in combination with other symptoms allows one to suspect diseases of the pelvic organs.
Pathology associated with the menstrual cycle: heavy bleeding, irregular, excessively painful and prolonged menstruation.
The appearance of bleeding in the middle of the cycle.
Discomfort and pain in the lower abdomen during sexual intercourse.
Diagnosis of the causes of infertility in women (one of the few methods that visually assesses the patency of the fallopian tubes).

Lower abdominal pain -
indication for a complete gynecological examination

To control artificial insemination.
Indications for combination with transabdominal ultrasound are suspicions of tumor changes. This is especially important for the early diagnosis of tumors in the ovaries, when surgical treatment not only saves the patient’s life, but also gives her a chance to become a mother.
If an ectopic pregnancy is suspected, a vaginal ultrasound can reliably determine the location of the attachment of the fertilized egg.
Control over various methods of contraception: IUD, vaginal ring. With long-term use of hormonal contraceptives, a study of their effect on.
Diseases of other pelvic organs: cystitis, urethritis. Determining the organic causes of enuresis.

The advantage of the procedure is that it is safe for the woman’s health (as with conventional sonography). Ultrasound examination can be done as many times as necessary in each specific case.

What diseases are determined using TV ultrasound?

What does the study show? This question, of course, interests more professional gynecologists and urologists.

We will give a list of the main pathologies to show how important and informative a vaginal ultrasound examination is:

The tumor process is both malignant and benign (uterine fibroids, ovarian cancer, chorionepithelioma).
Pathology of pregnancy (hydatidiform mole, ectopic pregnancy).
Diseases of the ovaries and fallopian tubes (polycystic disease, ruptured ovarian cyst, fluid in the tubes).
Deviations in the structure of the inner layer of the uterus (endometrial polyposis) or its spread to neighboring organs (endometriosis).
The presence of fluid in the pelvis or lower abdomen.

The study is carried out (the quantity and quality of maturing follicles are assessed) and, as it makes it possible to detect a fertilized egg of minimal size.

Transvaginal ultrasound during pregnancy

Many women ask the question: is it possible to do a transvaginal ultrasound during pregnancy? They feel that a procedure performed through the vagina can harm the development of the child. In fact, the method is absolutely safe.

Gynecological ultrasound room

6 arguments to do a transvaginal ultrasound during pregnancy:

Diagnosis of pregnancy using ultrasound in the early stages. Sometimes, when examining through the abdominal wall, the doctor doubts the location of the fertilized egg in the uterus. Then an additional ultrasound is done through the vagina, which is a more sensitive method.
Definition of multiple pregnancy. In the early stages, only with the help of transvaginal ultrasound can you see two or more embryos in the uterus.
This is an indispensable way to detect an ectopic pregnancy, and, most importantly, the site of atypical attachment of the fertilized egg. If such a diagnosis is carried out on time, then surgical intervention to remove the embryo will minimally injure the tissue and preserve the woman’s ability to conceive in the future.
In combination with Doppler ultrasound, it allows you to detect the very first signs of pathology of the nervous and vascular system of the fetus. This is important for early (in the 1st trimester) diagnosis of developmental defects and genetic diseases of the child.
Obtaining more reliable information about the state of the endometrium and the thickness of the chorion (the place from which the placenta is subsequently formed), early detection of symptoms of miscarriage. This allows you to take timely measures and maintain the pregnancy.
The examination is safe and does not cause discomfort.

It should be noted that transvaginal ultrasound is performed only in the 1st trimester of pregnancy. Subsequently, the fetus is examined using the usual transabdominal method.

How is the procedure performed?

In order to dispel all doubts about the safety and comfort of this research method, we will describe in detail how a vaginal ultrasound is performed.

The woman will have to undress to the waist and sit on the couch in a position traditional for any gynecological examination.
The transvaginal sensor, which is inserted into the vagina, is a tube with a diameter of 3 cm (length 12 cm). There is often a channel inside for the placement of a biopsy needle.
For hygiene purposes, a disposable condom is placed on the sensor before the test.
The vaginal sensor is inserted to a shallow depth, so it usually does not cause discomfort. During the procedure, the doctor may move it a little, but this should not affect the sensations. Most women who underwent the procedure noted the complete absence of any unpleasant moments.

Transvaginal sensor

No special preparation is required before performing a transvaginal ultrasound of the pelvic organs. If an examination through the abdominal wall requires filling the bladder, which often causes discomfort in patients, then in this case the bladder should be empty.

Preparation for a transvaginal ultrasound involves emptying the large intestine (sometimes you need to do an enema for this) and combating excess gas formation. Before the procedure, you should limit some foods: dairy, vegetables and fruits, sweets, soda, mushrooms, fried foods. You can additionally take medications to combat flatulence (Espumizan).

Some patients ask whether it is possible to have sex before the procedure. They are accustomed to the fact that such restrictions are appropriate when collecting vaginal smears. In this case, sex does not affect the ultrasound results.

Optimal timing of the procedure

When is the best time to do a transvaginal ultrasound? It is better to find out the answer to this question from your attending physician, depending on the specific goals of the study. We will outline several common features.

Timing for performing TVUS if certain diseases are suspected:

Endometriosis can be confirmed using ultrasound in the second half of the cycle.
When preparing for conception or determining the causes of infertility, follicles are examined over time. On what day of the cycle? It’s better three times - 8-10 days, 15-16 and after 22 days of the cycle.
If a woman complains of bleeding outside of menstruation, then do not delay diagnosis, as this may be a sign of diseases that require immediate treatment.

If the procedure is planned, then it, like an abdominal ultrasound, is performed immediately after the end of monthly bleeding.

Interpretation of results

All women are interested in what can be seen with a transvaginal ultrasound. For convenience, we give some characteristics in the table ( click on table to enlarge).

How the ultrasound picture changes in various diseases can always be clarified by the treating gynecologist. The main thing is not to try to interpret the results yourself, since they differ greatly depending on the cyclical processes occurring in the woman’s body.

Transvaginal ultrasound is one of the most effective methods of early diagnosis in gynecology. Its safety has been confirmed even in pregnant women.

Transvaginal ultrasound is an ultrasound diagnostic method in which the examination of the pelvic organs is carried out with a special vaginal sensor. This study is carried out for gynecological and urological diseases, as well as in the early stages of pregnancy. Transvaginal ultrasound allows you to diagnose gynecological and urological diseases, and diagnose pregnancy in the early stages. This type of examination is more informative than examination through the abdominal wall, since in this case the sensor of the device is separated from the pelvic organs themselves only by a thin vaginal wall. Transvaginal ultrasound of the pelvic organs is widespread, safe, informative and can be performed repeatedly.

Indications for transvaginal ultrasound

Indications for this examination method are suspicion of diseases of the pelvic organs, emergency conditions (for example, ectopic pregnancy), monitoring of treatment. Transvaginal ultrasound is performed for the following conditions:

Diagnosis of pregnancy in the early stages;
Pain in the lower abdomen;
Diagnosis of the causes of infertility and monitoring of the follicular apparatus of the ovaries;
Menstrual irregularities (delayed menstruation, bleeding in the middle of the cycle), pathological discharge from the genital tract;
Detection of inflammatory gynecological diseases;
Diagnosis of pelvic tumors, including uterine fibroids, endometriosis, ovarian cysts, etc.;
Taking hormonal medications, having intrauterine contraceptives (IUDs) to monitor the condition of the endometrium and prevent complications;
Early pregnancy, when traditional transabdominal access (through the abdominal wall) is of little information;
Support of the IVF (in vitro fertilization) procedure;
Determining the causes of urological diseases, urinary disorders, urinary incontinence and pathology of the urethra (urethra).

Transvaginal ultrasound of the pelvic organs is an ideal option for obese women, since conventional examination through the abdominal wall is not very informative.

Contraindications

There are no absolute contraindications to transvaginal ultrasound. In virgins, examination through the rectum (transrectal) is possible. Transvaginal ultrasound during pregnancy is justified only in the early stages (up to 11-12 weeks).

Preparing for a transvaginal ultrasound

For transvaginal ultrasound of the uterus and appendages, special preparation (filling the bladder) is not required. When visiting the ultrasound room, you will need a towel or diaper to lie on during the examination.

If a transvaginal ultrasound is performed during pregnancy, the patient's bladder should be moderately full (drink approximately 500 ml of fluid an hour before the examination).

A prerequisite for transvaginal pelvic ultrasound is the absence of gas in the intestines. To do this, 2-3 days before the study, you need to limit foods that cause increased gas formation (vegetables, fruits, bread, dairy products, confectionery), and it is also recommended to take certain medications that reduce gas formation in the intestines - enzistal, activated carbon. It is not recommended to perform cleansing enemas before the study. Transvaginal ultrasound of the uterus and appendages does not have to be performed on an empty stomach.

In emergency cases, transvaginal ultrasound can be performed without preparation, but its information content may be reduced.

Ultrasound examination of the gynecological organs is recommended to be carried out in the first half of the menstrual cycle (usually on days 5-7), since in the second half the uterine endometrium is in the secretory phase, which can lead to incorrect interpretation of the results. However, for endometriosis, it is recommended to perform a transvaginal ultrasound of the uterus in the second phase of the cycle. To assess folliculogenesis (formation and development of ovarian follicles), the study must be carried out on days 5, 9, 11-14 and 15 of the menstrual cycle.

Methodology

The patient lies down on the couch with her head towards the ultrasound machine. The doctor places a condom on the vaginal sensor, lubricates it with gel and inserts it into the vagina. The examination is absolutely painless, with the exception of acute conditions during inflammatory processes. During the examination, the doctor may press on the abdominal area to better locate the organs. The time for a transvaginal ultrasound of the pelvic organs is usually 15-20 minutes.

Complications of transvaginal ultrasound

When the transvaginal ultrasound procedure is performed correctly, there are no complications.

To obtain a complete picture of the condition and functioning of a woman’s reproductive organs, doctors often use transvaginal and intrauterine ultrasound. During these procedures, a probe is inserted deep into the vagina and uterus to examine organs and tissues.

Purpose of vaginal ultrasound (indications)

To maintain their health and preserve reproductive function, women need to regularly undergo ultrasound examination (US) of the pelvic organs (PMP).

Indications for vaginal ultrasound to diagnose diseases:

irregular menstrual cycle;
bleeding in the middle of the cycle;
suspicion of infertility;
postpartum examination;
pain and discharge of unknown nature;
inflammatory process in the pelvic organs and urinary system;
developmental anomalies of OMT, etc.

During pregnancy, vaginal ultrasound is performed:

to confirm the fact of pregnancy;
to exclude or confirm ectopic pregnancy;
in order to identify pathology (uterine tone, observation of a scar on the uterus, pathology of the placenta, etc.);
for diagnosing fetal development.

In the first trimester, the transvaginal method is predominantly used, and in later stages - the transabdominal method.

Vaginal ultrasound of the female reproductive organs is also performed to prevent relapses of diseases and complications after surgery.

Preparing for the study

Preparation for an ultrasound depends on the method of access to the pelvic organs chosen by the specialist:

Type of ultrasound	How is it carried out?	Preparing for the study
Transvaginal	A recto-vaginal sensor (transducer) is inserted into the vagina, with the help of which OMT is examined	Before an ultrasound, care should be taken to clean the external genitalia to prevent pathogenic microorganisms from entering the vagina. The procedure is performed with an empty bladder. If you have bloating, you need to take a drug that reduces gas formation. It is not advisable to have sex before an ultrasound
Intrauterine	The probe is inserted into the uterine cavity	The examination is carried out with an empty bladder
Transabdomial (abdominal)	Performed using an external sensor through the anterior wall of the peritoneum	The day before the ultrasound, you should remove foods that increase gas formation from your diet. Otherwise, the survey data may be distorted. To obtain more accurate information, you must attend the procedure with a full bladder, so 40-60 minutes before the procedure you need to drink a liter of clean still water
Transrectal	OMTs are examined through the walls of the rectum using a recto-vaginal probe	It is carried out after cleansing the intestines. It is recommended to do an enema (250-300 ml) 2 hours before the procedure. This method is mainly used to clarify transabdominal ultrasound data when examining virgins

The choice of phase and day of the menstrual cycle for vaginal ultrasound depends on the purpose of the examination:

Routine examination and prevention of pathology. Ultrasound is prescribed in the first phase from days 5 to 7 of the cycle, regardless of the presence of bleeding (if menstruation lasts more than 7 days). It is not recommended to carry out the procedure after ovulation (days 12-14 of the cycle), since at this time the woman’s body is preparing to bear a fetus, and it is not always possible to objectively assess the health of the reproductive organs.
If pathological processes are suspected in OMT Ultrasound is recommended to be performed several times during one menstrual cycle to determine the dynamics of follicle growth, endometrial development, the onset of ovulation, etc.
Emergency situation. If sharp pain occurs in the uterine area or bleeding appears, an ultrasound of the reproductive organs is performed on any day of the cycle.

How is the transvaginal ultrasound procedure performed?

Transvaginal ultrasound significantly expands the boundaries of diagnosing OMT diseases.

To ensure the closest contact of the ultrasound machine sensor with the surface of the OMT, the woman needs to lie with her back on the couch, bend her knees and slightly spread her legs. Relaxing the pelvic floor muscles will help avoid pain and discomfort when inserting the transducer into the vagina.

Before inserting the vaginal-rectal sensor into the vagina, the specialist puts a medical condom on it and applies gel, which ensures the sterility of the procedure and easy penetration of the transducer inside.

The sensor is inserted slowly deep into the vagina. A dynamic image of the organs being examined is displayed on the monitor of the ultrasound machine. If necessary, a specialist can record the resulting image and zoom in for a thorough study of the tissue structure.

Thanks to the ability of ultrasound to pass through tissues and organ membranes, maximum examination accuracy is achieved.

The ultrasound procedure lasts from 5 to 20 minutes; based on the results of the examination, a form is filled out, possible pathologies are determined, and photographs are printed.

Decoding the results

The ultrasound result is deciphered by a specialist, comparing the average statistical indicators with the data obtained:

Ultrasound parameter	Normal echo pattern	Signs of pathology
Size and position of the uterus	Length: 16-62 mm. Width: 15-60 mm. Thickness: 12-48 mm. In virgins and menopausal women, the organ is smaller. The more a woman gives birth, the larger the size of the uterine body. The contours of the organ are smooth and clear. The uterus is bent anteriorly or slightly posteriorly	An enlarged uterus and blurred contours can appear with inflammatory diseases, endometriosis. Fuzzy contours, lumpiness, compactions are a sign of oncological processes. Incorrect position of the uterus in the pelvic cavity can cause infertility and spontaneous abortion
Surface of the cervix	The contours are clearly visible, the surface is smooth	An uneven surface and blurred contours may indicate inflammation or congenital anomalies
The fallopian tubes	Not rendered	Thickening of the walls, increase in diameter, accumulation of fluid indicates the development of an inflammatory process, ectopic pregnancy
Free liquid	It is visible behind the uterus during the period of ovulation in a small amount	A large volume of fluid is a symptom of the inflammatory process in OMT
Ovarian size	Length: 20-25 mm. Width: 12-15 mm. Thickness: up to 12 mm. Volume up to 4 cubic meters cm. Contours are smooth and clear	An increase in the size of the ovaries, uneven contours may be a sign of polycystic disease, oncological processes, cysts, congenital pathologies of the organ structure

Separately, it is necessary to consider the indicator of double endometrial thickness - M-echo, median echo.

The endometrium is the functional layer of the uterus, most susceptible to the influence of hormones, as a result of which the structure of the epithelium changes throughout the menstrual cycle.

Standard indicators of endometrial thickness with normal cycle duration (28 days):

Vaginal ultrasound is only one of the methods for diagnosing pathological processes in the reproductive organs.

Advantages of the method

Transvaginal ultrasound is superior to other examination methods:

The accuracy of the data obtained is explained by the close proximity of the sensor to the surface of the organs.
Modern technologies make it possible to obtain information in 3D format, to study the blood flow and structure of OMT tissues.
No special preparation is required for the procedure.
The woman does not feel discomfort during the examination.
The ultrasonic waves emitted by the device pass through the tissues of organs without disturbing the natural processes occurring in them.

Contraindications and complications

The vaginal ultrasound procedure cannot be used when examining virgins, since the integrity of the hymen will be compromised. In this case, transrectal and transabdominal methods are used.

Transvaginal ultrasound during advanced pregnancy

Transvaginal ultrasound of a pregnant woman is used only in the first trimester of pregnancy. During this period, the sensor indicates the presence of a fertilized egg, the condition of the placenta, pathologies of fetal development, etc.

During the second and third trimesters, the transabdominal ultrasound method is used predominantly, since inserting a sensor into the vagina can provoke an increase in uterine tone and premature birth. Transvaginal ultrasound is performed according to indications: for example, to determine the length of the cervix and exclude ICI.

Questions and answers

Question: Can discharge appear after a vaginal ultrasound?

Answer: After the transvaginal ultrasound procedure, bloody discharge may appear, which is explained by the sensitivity of the inner surface of the vagina, dilation of blood vessels in the tissues during pregnancy, and inaccurate insertion of the sensor. The duration of such discharge should not exceed 3 days.

Question: How often can an OMT ultrasound be done?

Answer: There are no restrictions on the number of ultrasound scans, since the emitted waves, passing through the tissues, do not disrupt the normal functioning of the body.

Question: Which ultrasound is better: internal or external?

Answer: The most informative is internal ultrasound, since the sensor is located near the organs being examined.

Transvaginal ultrasound is a more reliable diagnostic method compared to others. This is explained by the close location of the device to the female genital organs. This medical examination is based on the delivery of ultrasound waves through a special sensor that is placed in the vagina.

This ultrasound examination is performed vaginally and is an instrumental method with which the doctor can make an accurate diagnosis and subsequently prescribe effective treatment for the disease.

In modern gynecology, this diagnostic method is called differently:

intravaginal examination;
intravaginal examination;
vaginal examination of female reproductive organs.

The general name is transvaginal ultrasound.

Often, when performing ultrasound examinations, doctors use a special technology for visualizing blood flow - color Doppler mapping. Using color circulation, you can evaluate the resistance of blood vessels, their diameter and patency, as well as other pathological processes.

Intravaginal ultrasound examination of the genitals can be used as a separate diagnostic method or in combination with a transabdominal examination (through the walls of the abdominal cavity) or palpation.

Indications for use

The doctor may refer the patient to undergo a transvaginal ultrasound in the following cases:

for pain in the lower abdomen;
inflammatory diseases of the female genital organs;
pathologies of the urinary system;
implementation of artificial insemination;
using hormonal contraception, installing an IUD or vaginal ring;
irregular menstruation;
suspicion of infertility;
pain during sexual intercourse or immediately after it.

Intravaginal examination is also used to determine pregnancy. This method is more informative than a standard transabdominal examination and allows you to see a clearer picture of the uterus.

Advantages of the method

The intravaginal diagnostic method has its positive aspects:

availability;
harmlessness and safety of ultrasound for the patient;
does not require extensive preparation;
high level of image detail;
carried out without filling the bladder;
can be used for obese women (when other examination methods cannot be implemented).

In addition, thanks to a vaginal ultrasound, the doctor will be able to examine in detail the cervix (which is difficult to visualize during an abdominal examination).

Preparing for a transvaginal ultrasound

To carry out this type of procedure, no special preparation is required.

take a hygienic shower before the examination;
take with you a disposable diaper, dry wipes and a special condom for intravaginal ultrasound (sold in every pharmacy);
an hour before the procedure, you need to empty your bladder;
It is not advisable to have sexual intercourse the day before the test.

Women who are concerned about increased gas formation should prepare in advance. It is better to do an ultrasound after taking medications, they will help reduce flatulence (Espumizan, Smecta).

On what day of the cycle is it done?

The most appropriate time for examination is the first days of the cycle after the end of menstruation. It is recommended to do an examination on days 5–8 of the menstrual cycle. The reliability of the sensor readings will depend on when the patient last ovulated. As a rule, it occurs 12–14 days after the critical days; subsequently, the condition of the reproductive organs changes noticeably.

If uterine endometriosis (proliferation of endometrial tissue) is suspected, the procedure is postponed to the second part of the cycle.

Transvaginal ultrasound is not recommended during menstruation. However, certain pathologies of the pelvic organs (polyps, fibroids, small cysts) can be seen only in the first days of menstruation.

How is the procedure done?

Before the examination, the woman must remove all clothing below the waist. In order for the small pelvis to bring less discomfort, you need to take care of your clothing (come for examination in a skirt or dress).

The procedure is carried out as follows:

The woman lies on the couch lying on her back. In this case, you need to bend your legs and spread them slightly at the knees.
Next, the doctor puts a condom on the sensor and lubricates it with a special gel. It will help eliminate air between the internal organs and the device, and also promote better penetration.
The reproductive organs are displayed on the screen, and the doctor reads out the data.

A nurse takes part in the implementation of the procedure; she records the results of the study in the protocol.

In the absence of sudden movements, it is not painful and is not accompanied by other unpleasant sensations.

Photo gallery

Device Introduction Ultrasound sensor (photo) Direct procedure

What does a vaginal ultrasound show?

An intravaginal examination may reveal the following conditions and diseases:

malignant and benign tumors of the reproductive organs;
uterine fibroids (a neoplasm in the muscle layer of the female genital organ);
fluid in the pelvic area;
endometriosis;
complete or partial hydatidiform mole;
blood, purulent formations in the uterine tubes;
inflammatory processes.

Decoding the results

This procedure is carried out by a specialist who, upon completion of the manipulation, will provide the patient with the results and conduct a consultation to compare them with normal values.

Table of norms for ultrasound of internal organs

Parameter	Normal echo pattern	Symptom of pathology
Ovarian size	Length: 20–25 mm. Width: 12–15 mm. Thickness: up to 12 mm. Volume: up to 4 cubic meters cm. Smooth and clear contours	Increased size of the ovaries, as well as their uneven contours, may indicate polycystic disease, congenital malformation, or oncological processes.
Position of the uterus and its size	Length: 16–62 mm. Width: 15–60 mm. Thickness: 12–48 mm. In girls who are not sexually active, as well as in women during menopause, the uterus is smaller. Women who have given birth will have larger organs. The contours of the organ should be even and smooth. The uterus is bent in front or slightly behind.	Increased size of the uterus and blurred contours can be observed in various inflammatory diseases. Lumpiness and compaction of the organ indicate pathologies of an oncological nature. Incorrect location of the organ can cause infertility or termination of pregnancy (unauthorized).
Surface of the cervix	Clear contours and smooth surface	Blurred contours indicate congenital anomalies or inflammation.
The fallopian tubes	Not rendered	Thickening of the walls, an increase in the diameter of the fallopian tubes, and fluid accumulation are observed during ectopic pregnancy or inflammation.
Free liquid	Present in small quantities behind the uterus during ovulation	A large volume of fluid is a sign of an inflammatory process.

Ultrasound of the uterus and appendages

This study is a scan of:

vaginal cavities;
uterus;
ovaries;
fallopian tubes.

This diagnostic method allows you to identify the following pathologies:

adnexitis (inflammation of the appendages and uterus);
fibroids;
leiomyoma (benign tumors);
neoplasms on the cervix;
ovarian cancer.

Ultrasound of the bladder

This study is used as an alternative to palpation or catheterization (insertion of a special medical instrument through the urinary system, which is carried out for various purposes).

Indications for ultrasound examination of the bladder may be as follows:

frequent urination or retention;
blood in the urine or detection of red blood cells;
cystitis;
various organ injuries.

Ultrasound of the pelvic organs

It is a comprehensive examination, during which the doctor, at his discretion, determines the need to examine a particular organ. Intravaginal ultrasound of the anatomical space can be performed with. This method allows you to identify vascular (pelvic) disorders and show images of other pathological processes in more detail.

Transvaginal ultrasound during pregnancy

This examination method is widely used in obstetrics and allows you to display an image of the uterus and fetus on a screen monitor and take a picture. Transvaginal ultrasound examination reflects the developmental characteristics of the child. As a rule, the doctor prescribes a scanning procedure for the pregnant woman in the first trimester.

General indications for prescribing an intravaginal ultrasound in the early stages of pregnancy are the following:

the need to establish the fact of fertilization;
control over fetal development;
study of the periuterine space;
identifying possible threats to pregnancy.

Transvaginal or transabdominal?

Your attending physician will help you decide on the examination method. Thanks to its unique technology, intravaginal diagnostics are significantly superior to examinations carried out through the walls of the abdominal cavity. In addition, the specialist may refer the patient for a vaginal ultrasound if she has postoperative adhesions on her abdomen.

How often can I do it?

For preventive purposes, you should prepare for a vaginal ultrasound at least once a year.

As for the pregnancy period, this method of ultrasound examination can be carried out until the twelfth week. The doctor may prescribe a repeat procedure to determine the woman’s health or to exclude signs of a frozen fetus. Transvaginal examination is completely safe for the mother and child.

Contraindications and complications

Doctors should not be allowed to perform intravaginal ultrasound on girls who are not sexually active. In this case, it is recommended to conduct an examination of the pelvic organs in only two ways: transabdominal or transrectal (through the rectum). In addition, this type of examination is prohibited during the second or third trimester of pregnancy.

The implementation of the procedure is not accompanied by any complications. In case of discharge of various types, it is recommended to visit a specialist.

Post-procedure care

Many patients rush to douche after an intravaginal ultrasound. However, no additional hygiene procedures should be carried out without a doctor’s prescription.

How much does the procedure cost?

Video

A qualified specialist will tell you about the main indications for the pelvic organs. Published by Kaluga Pain Clinic.