Transvaginal.

What is Transvaginal Ultrasound Imaging?
What are some common uses of the procedure?
How should I prepare?
How does the procedure work?
How is the procedure performed?
What will I experience during and after the procedure?
Who interprets the results and how do I get them?
What are the benefits vs. risks?
What are the limitations of Transvaginal Ultrasound Imaging?

What is Transvaginal Ultrasound Imaging?

Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound examinations do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
Transvaginal ultrasound provides pictures of the uterus and the ovaries.
What are some common uses of the procedure?
A transvaginal ultrasound is usually performed to view the endometrium or the lining of the uterus, including its thickness, and the ovaries. Transvaginal ultrasound also affords a good way to evaluate the muscular walls of the uterus, called the myometrium.
In women, a transvaginal ultrasound is most often performed to evaluate the:

  •     uterine anomalies.
  •     uterine scars.
  •     endometrial polyps.
  •     fibroids.
  •     cancer, especially in patients with abnormal uterine bleeding.

Ultrasound examinations can help diagnose symptoms experienced by women such as:

  •     pelvic pain
  •     abnormal bleeding
  •     other menstrual problems

and help identify:

  •     palpable masses such as ovarian cysts and uterine fibroids
  •     ovarian or uterine cancers

How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.
You may be asked to wear a gown during the procedure.

How does the procedure work?

In medicine, ultrasound is used to detect changes in appearance of organs, tissues, and vessels or detect abnormal masses, such as tumors.
In an ultrasound examination, a transducer both sends the sound waves and receives/records the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off of internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Small loops of the moving “real time” images may also be saved.
The same principles apply to ultrasound procedures such as transvaginal which require insertion of a special transducer into the body.

How is the procedure performed?

Transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer into the vagina after the patient empties her bladder. The tip of the transducer is smaller than the standard speculum used when performing a Pap test. A protective cover is placed over the transducer, lubricated with a small amount of gel, and then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina. The images are obtained from different orientations to get the best views of the uterus and ovaries. Transvaginal ultrasound is usually performed with the patient lying on her back, possibly with her feet in stirrups similar to a gynecologic exam.
When the examination is complete, the patient may be asked to dress and wait while the ultrasound images are reviewed.

What will I experience during and after the procedure?

Most ultrasound examinations are painless, fast and easy.
With transvaginal ultrasound, although the examination is often performed to look for a cause of pelvic pain, the sonogram itself should not be painful or significantly increase your discomfort. A vaginal sonogram is usually more comfortable than a manual gynecologic examination.
After an ultrasound examination, you should be able to resume your normal activities immediately.

Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care physician or the physician who referred you for the exam, who will share the results with you. In some cases the radiologist may discuss results with you at the conclusion of your examination.
Follow-up examinations are often necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may be necessary so that any change in a known abnormality can be detected over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable over time.

What are the benefits vs. risks?

Benefits

  •     Most ultrasound scanning is noninvasive (no needles or injections) and is usually painless.
  •     Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
  •     Ultrasound imaging does not use any ionizing radiation.
  •     Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
  •     Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn babies.
  •     Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and needle aspiration.
  •     Transvaginal ultrasound can help to identify and evaluate a variety of urinary and reproductive system disorders without even the minimal risks associated with x-ray exposure.

Risks

  •     For standard diagnostic ultrasound there are no known harmful effects on humans.

What are the limitations of Transvaginal Ultrasound Imaging?

Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique for air-filled bowel or organs obscured by the bowel. In most cases, barium exams, CT scanning, and MRI are the methods of choice in this setting.
Large patients are more difficult to image by ultrasound because greater amounts of tissue attenuates (weakens) the sound waves as they pass deeper into the body.