ultrasound uses sound waves to make a picture of the
organs and structures in the lower belly (pelvis).
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
or air-filled organs, such as the intestines, do not show up well on an
ultrasound and may keep other organs from being seen clearly.
Pelvic ultrasound can be done three ways: transabdominal, transrectal,
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.
For men and women, pelvic ultrasound may
be done to:
For women, pelvic ultrasound may be
For men, pelvic ultrasound may be
Tell 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
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
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?).
If 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.
If 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.
If 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 you are having only a
transvaginal ultrasound, do not drink any fluids for 4 hours before the test.
You will not need to drink fluids to fill your bladder for the test as you do
in a transabdominal ultrasound.
If both a transabdominal and transvaginal ultrasound
will be done, the transabdominal ultrasound will usually be done first.
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
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
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
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.
For 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
When the test is done, the gel is cleaned off your
skin. You can urinate as soon as the test is done.
For 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.
For 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
Transvaginal ultrasound may give more information than
transabdominal ultrasound for women who:
Transvaginal ultrasound often makes a clearer picture
than transabdominal ultrasound because the transducer probe gets closer to the
organs being viewed. But transvaginal ultrasound looks at a smaller area than
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).
If 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.
There 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.
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.
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.
Your uterus is big or abnormally shaped
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
endometrial hyperplasia) may mean a higher chance of
Pelvic inflammatory disease (PID)
kidney stones, or other problems are
ectopic pregnancy is present.
An abnormal amount of fluid is present in
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
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
ureters into the bladder.
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
Reasons you may not be able to
have the test or why the results may not be helpful include:
A full bladder is needed for a transabdominal ultrasound,
so that the pelvic organs can be seen clearly.
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis:
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.
June 8, 2011
Adam Husney, MD - Family Medicine
& Howard Schaff, MD - Diagnostic Radiology
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