Transvaginal ultrasound: your questions answered

A transvaginal ultrasound is a diagnostic procedure where a probe is inserted into the vagina to obtain detailed images of the uterus, ovaries, and pelvic organs using sound waves. Renowned consultant gynaecologist and obstetrician Mrs Pradnya Pisal explains what happens during the procedure, alternatives and any questions you may have.

What happens at a transvaginal ultrasound? What's the process from start to finish?

For an internal (vaginal) ultrasound scan, you will be asked to empty your bladder and undress from the waist down. A hospital gown or sheet will be provided for coverage. You will lie on your back on the ultrasound couch with a chaperone present. Your knees will be bent and placed on movable footrests, and then raised to facilitate the scan. A thin, elongated ultrasound probe, covered with a protective sheath and lubricating gel, will be gently inserted into the vagina.

The probe will be moved to different positions to get clear images of the uterus and ovaries. While ultrasound scans are generally painless, you may feel some discomfort when the probe is inserted.

The procedure takes about 15-20 minutes and will be performed in the ultrasound department or the clinic's consulting rooms.

What is the ultrasound looking for?

An ultrasound scan can be performed for various reasons, and it's natural to feel anxious about it. However, it is a valuable tool for detecting cysts, endometriosis tissue, cancers, irregularities, and awkwardly positioned contraceptives, among other issues.

An ultrasound scan uses sound waves to create an image of the organ or body part being examined. It aids in diagnosis, enabling appropriate treatment to be provided. Medical doctors and specially trained healthcare professionals (sonographers) conduct these scans using an ultrasound probe that emits high-frequency sound waves, which are inaudible.

For an internal (vaginal) ultrasound scan, the probe is placed inside the vagina, bringing it closer to the pelvic organs. This proximity allows for clearer images of the uterus, ovaries, and any abnormalities deep in the pelvis.

What happens next? Do patients receive immediate results or is there a waiting period? If there is a wait, are there measures to help reduce anxiety during this time?

The person conducting the scan will typically inform you of the findings or arrange for you to discuss them with your doctor. If a sonographer performs the scan, they will inform you of any detected abnormalities if appropriate.

You will receive a report immediately or it will be emailed to you. For pregnancy scans, you will be given images of your baby. Your consultant will explain the scan results, provide a diagnosis, and discuss further investigations and treatment options with you.

What if someone is allergic to latex?

If you are undergoing an internal (vaginal) scan and have a latex allergy, please inform the sonographer or doctor performing the scan so they can use a latex-free probe cover.

How is the care managed for someone who has experienced sexual trauma?

Please inform the clinic or the person performing the scan about this. You can also bring a friend with you and request a female sonographer. Additionally, you can ask for a local anaesthetic gel to make the scan more comfortable. If you feel that a transvaginal scan might be too difficult for you, you can request a transabdominal scan (which requires a full bladder) or an MRI scan instead.

Why aren't virgins allowed to have a transvaginal ultrasound?

A transvaginal scan involves inserting a probe, which can be uncomfortable and sometimes inappropriate. Therefore, a transabdominal scan is often preferred.

Are there alternatives if someone doesn't want to have a transvaginal ultrasound?

In obstetrics and gynaecology, the three most frequently used types of ultrasound scans are:

1. External abdominal ultrasound scan – the probe is moved over the skin.
2. Internal (vaginal) ultrasound scan – the probe is inserted into the vagina.
3. HyCoSy or Aqua scan – this scan assesses the uterine cavity and fallopian tube patency.

An external ultrasound scan is typically used to examine an unborn baby (after 10 weeks of pregnancy) or when an internal scan is not possible for examining pelvic organs. A small handheld probe is moved over the skin, with lubricating gel applied to ensure smooth movement and continuous contact. You may feel the cold gel and the probe on your skin. For scans of the womb or pelvic area, a full bladder may be required, causing minor discomfort. In some cases, there are no alternatives to ultrasound, but MRI or CT scans can be used instead or in addition to ultrasound.

Is there any other advice you can give before undergoing a transvaginal ultrasound?

Before certain ultrasound scans, you may need to follow instructions to improve image quality, such as drinking water and avoiding the toilet. Eating is allowed. For pelvic or prenatal scans, you may need a full bladder. Tampons must be removed for vaginal scans. Bringing a friend or relative is welcome.

If you would like to book a consultation with Mrs Pisal, do not hesitate to do so by visiting her Top Doctors profile today.