Ultrasound of the pelvic organs in women. What is included in an ultrasound of the pelvic organs in women. What happens after the procedure

Ultrasound (ultrasound) is a medical procedure using high-frequency sound waves.

The device, which doctors call a “sensor,” sends and receives these sound waves, which produce images on a computer screen in real time and in real time.

These images include various body parts, organs, and blood flow.

Usually an ultrasound is performed 1-2 days after the end of menstruation, but you can visit a doctor 8-12 days after the end of menstruation.

In case of bleeding that is not related to menstruation, an ultrasound is performed regardless of the day of the cycle. For endometriosis, it is advisable to perform an ultrasound of the pelvic organs in the second half of the cycle.

A pelvic ultrasound is performed using one or both of the following methods:

Transabdominal (through the abdominal cavity).
Transvaginally (through the vagina).

In rare cases, transrectal ultrasound, also known as TRUS, is also used. It is performed by inserting a small ultrasound probe into the anus. Indications for this type of ultrasound include: deep pelvic endometriosis with (or without) infiltration of the intestinal wall, uterine fibroids, adenomyosis, obstruction of the fallopian tubes, cysts and polycystic ovaries, cervical cancer, endometrial cancer, tumors on the fallopian tubes and inflammation of the fallopian tubes. The type of ultrasound procedure depends on the reason for the patient's visit.

Only one method or both methods may be used if they may be necessary to provide information required for diagnosis or treatment. Other diagnostic procedures that may be used to evaluate pelvic problems include hysteroscopy, colposcopy and laparoscopy. However, they are more invasive than pelvic ultrasound in women, and preparation for them also takes longer.

Ultrasound of the female pelvic organs is useful in that it allows assessment of:

The size, shape and position of the uterus and ovaries.
Thickness, echogenicity (darkness or brightness of the image related to tissue density), and the presence of fluid or mass in the endometrium, myometrium (uterine muscle tissue), fallopian tubes, or in or near the bladder.
Length and thickness of the cervix.
Changes in the shape of the bladder.
Blood flow in the pelvic organs.

Ultrasound examination is often performed after childbirth or surgery in order to avoid possible complications. In the early stages of pregnancy, an experienced specialist can identify some problems associated with pregnancy.

note

Pelvic ultrasound can provide more information about the size, location and structure of the pelvic organs, but cannot provide a 100% reliable diagnosis.

The big advantage is that with an ultrasound of the pelvic organs in women, preparation for the procedure is minimal, and its implementation does not carry any risks. The only unpleasant moment may be slight discomfort when inserting a transvaginal sensor into the vagina. The transvaginal method requires covering the ultrasound transducer with a plastic or latex sheath, which may cause a reaction in patients with latex allergies. During a transabdominal ultrasound, the patient may experience discomfort from having to keep the bladder full.

Pelvic ultrasound can be used to diagnose and help treat the following problems:

Abnormalities in the anatomical structure of the uterus, including endometrium, fibroid tumor (benign formation), cyst and other types of tumors within the pelvis.
The presence and position of an intrauterine contraceptive device (IUD).
Pelvic inflammatory disease and other types of inflammation or infection.
Uterine bleeding during menopause.
Monitoring ovarian size to assess infertility.
Aspiration of follicular fluid and eggs from the ovaries for in vitro fertilization.
Ectopic pregnancy (pregnancy occurs outside the uterus, usually in the fallopian tube).
Monitoring fetal development during pregnancy.
Transvaginal ultrasound may be used for sonohysterography, a procedure in which the uterus is filled with fluid to stretch it for better imaging.

After an ultrasound of the pelvic organs in women, a gynecologist or phlebologist prepares the results for the patient if the examination was carried out after complaints of varicose veins. Further diagnosis for various diseases may include a general blood and urine test, a gynecological examination in a chair and a smear test for flora.

Certain conditions may affect test results. These include: obesity, gases in the intestines, insufficient filling of the bladder (with transabdominal ultrasound). A full bladder helps move the uterus up and the bowel out to the side, giving a better image.

Preparation for pelvic ultrasound for women using different techniques

Preparing for a pelvic ultrasound for women is very simple: you need to drink 2-3 glasses of clear liquid at least one hour before the appointed time. And do not empty your bladder until the ultrasound is performed. Two days before the examination, it is better to avoid eating foods that can lead to flatulence, as this condition can distort the results of the ultrasound. The diet two to three days before the examination should consist of lean fish, cheeses, cereals, beef and poultry. It is advisable to take activated carbon.

Preparation for pelvic ultrasound for women before transabdominal ultrasound and its features

This type of ultrasound is done with a full bladder. You will be asked to remove any clothing, jewelry, or items that may interfere with the inspection. You will lie on your back, on a couch or on an examination table. The doctor will apply a gel-like substance to your stomach. It doesn't hurt, but it can be slightly uncomfortable because the substance is cold.

The sensor will be pressed against the skin and the specialist will move it around the area being examined. Images of body structures will be displayed on the computer screen. After the ultrasound is completed, the gel can be wiped off with a tissue. You will be able to empty your bladder when the procedure is finished.

Preparation for pelvic ultrasound for women before transvaginal ultrasound and its features

There is no need to fill the bladder before this type of ultrasound. You will be asked to remove any clothing, jewelry, or items that obstruct the inspection. You will lie on your back, on an examination table or on a couch. This type of ultrasound uses a long, thin transvaginal transducer that is covered with a plastic or latex sheath and lubricated to prevent discomfort.

The tip of the sensor will be inserted into the vagina. It may be a little uncomfortable, but it doesn't hurt. The doctor will gently rotate the probe at an angle so that the areas to be examined are in focus. You may feel a slight pressure as the sensor moves. Images of organs and structures will be displayed on the computer screen. Once the ultrasound is complete, the probe will be removed.

Preparation for pelvic ultrasound for women before transrectal ultrasound and its features

7-10 days before the start of TRUS, you must stop taking blood thinning medications. TRUS is done on an empty stomach, 1-4 hours before the procedure you need to do an enema (or take a laxative) to cleanse the intestines. And immediately before the procedure you need to urinate to empty your bladder. During the examination, you will likely be asked to lie on your side and pull your knees toward your chest.

The doctor puts on a protective cover (usually a condom) and applies lubricant to the ultrasound probe. Then a probe, no wider than the width of a finger, is passed into the rectum. You may feel pressure in your rectum when the probe is in place. TRUS takes 10 to 15 minutes. What happens after a pelvic ultrasound? There is no special type of care that is required after a pelvic ultrasound. You can resume normal activities and eat normal foods.

note

There is no confirmed evidence of adverse biological effects of ultrasound at the intensity levels used in diagnostic ultrasound.

How to prepare for a pelvic ultrasound in a woman, and which doctor to go to with the results

How a woman can prepare for a pelvic ultrasound depends on the type of procedure being planned. It is best to avoid foods that cause bloating for several days before the test, as gas in the intestines may reduce image quality.

A full bladder is essential for successful transabdominal examination of the lower abdomen. On the day of the test, you can take your regular daily pills if needed.

How to prepare for a pelvic ultrasound in a woman during pregnancy

In pregnant women, ultrasound is no different from the same procedure in non-pregnant women. The results of the ultrasound are sent either to the doctor who referred you for a routine examination, or are evaluated by the doctor who performed the ultrasound diagnostics.

He will give a written report of the examination results to either you or the doctor who referred you for the ultrasound. Procedures such as computed tomography and magnetic resonance imaging may be used to further examine ultrasound findings that are not conclusive. These methods allow you to identify and evaluate even the most minor changes in the body.

One of the most highly accurate and safe diagnostic methods used in gynecological practice is ultrasound examination of the pelvic organs (USP).

The essence of this method is the reflection of the sound wave sent by the sensors by the internal organs. The reflected radiation is converted using technical instruments into a graphic image, which is interpreted by a diagnostician.

Using ultrasound, you can track the pelvic organs over time, which allows you to make accurate conclusions.

The ultrasound method of examining female organs is completely safe, as it does not involve invasive intervention in the body.

The result of the condition of tissues and organs is obtained due to the influence of ultrasound waves. Using a sensor and an acoustic transducer, the health status of the pelvic organs and other organs and systems is diagnosed. This device is very often used in gynecology.

Ultrasound signals pass through tissue, undergo different periods of vibration, and are also characterized by different lengths and frequencies. These parameters are directly dependent on the density and elasticity of the tissues through which they pass.

Therefore, when passing through certain organs, the parametric value of the waves changes. The reflected echo signals are received using the sensor.

In order to create the best conditions for full contact of the body with the ultrasound machine and guarantee accuracy, it is necessary to use a gel that is intended for this study.

First, part of the body is exposed to access the organs located in the pelvis. Then it is lubricated with gel and a sensor is applied.

An image appears on the screen, and the specialist assesses the condition of the organs. When using a vaginal probe, it is inserted directly into the vagina.

In some cases, this method is more informative.

This examination method is absolutely painless and does not cause discomfort or discomfort. It does not carry radiation exposure, unlike X-rays and computed tomography, in which the radiation is especially powerful.

And at the same time, it is ultrasound that allows us to give a correct assessment of the condition of the organs. Therefore, this method of examination is given preference in the first place.

The principle of ultrasound research is echolocation. Body tissues have different acoustic properties.

The ultrasound sensor first sends and then receives signals reflected from various tissues of the body. Based on these data, a visual series is built on the monitor, from which a specialist can thoroughly examine the internal organs and draw appropriate conclusions.

1 Types of ultrasound of pelvic organs

There are three main classifications of ultrasound of the female genital organs.

The first is based on the specifics of the conduct. From this point of view, ultrasound is divided into:

Transabdominal is most often practiced. Provides for the passage of waves through the peritoneal wall. The sensor is placed in the lower abdomen. It does not apply if there is damage to this area of the skin (abrasions, scratches, purulent lesions, burns), as well as obesity, which is an obstacle to the passage of waves and can significantly distort the picture.
Transvaginal involves inserting a sensor with a condom on it into the woman’s vagina. It is considered more informative than transabdominal. It is not carried out for girls who have not yet had sexual experience. It is often used in obstetrics in the early stages of pregnancy, when it is impossible to see the fetus through the abdominal wall. The method requires maximum caution, as it can provoke a miscarriage.
Transrectal involves inserting a thin sensor into the anus. It is not performed on women who do not have a rectum, or in the presence of inflammatory processes in this area. This type is indicated for virgins when transabdominal ultrasound is for some reason impossible or impractical.

Ultrasound in gynecology can be performed in three ways. There are the following types of gynecological ultrasound:

transrectal ultrasound (performed through the rectum in girls who are not sexually active);
transvaginal ultrasound (carried out by inserting a sensor into the vagina for an accurate examination of diseases of the pelvic organs);
transabdominal (or simply abdominal) ultrasound, or simply abdominal ultrasound (performed through the abdominal wall when signs are detected pelvic inflammation or girls who are not sexually active).

For what indications is an ultrasound of the pelvic organs performed in women?

Regardless of the purpose of a gynecological ultrasound (routine examination or pregnancy management), diagnosis is made using 3 methods. These are transabdominal, transvaginal and transrectal examinations.

During pregnancy, only the first two methods are used. During a medical examination, all types of ultrasound are used, depending on the age and physiological condition of the patient.

Transabdominal (external) scanning.

This method is best suited for a general examination by a gynecologist. It is done through the lower abdomen, that is, the abdominal wall.

This ultrasound is the most comfortable for a woman; it is suitable for all patients, but requires special training. During pregnancy, external scanning is used starting from the 12th week.

Transvaginal (cavital scanning).

Such ultrasound diagnostics are carried out today in three main ways.

Transvaginal (internal) ultrasound.

This method is used most often and is recognized as the most accurate and informative for examining the female pelvic organs. Internal echography is done using a special vaginal sensor, onto which a condom is placed.

The biggest advantage of such an ultrasound is that you practically do not need to specially prepare for it.

But this method is not suitable for girls who are not sexually active and patients with large tumors in the area under study.

Transabdominal (external) ultrasound.

Making an absolutely accurate diagnosis to a patient during an initial examination is a very difficult task even for a highly qualified specialist. However, thanks to modern diagnostic methods, it has become possible to see all the nuances of the body’s condition. Ultrasound examination is one of them.

Conditions for prescribing pelvic ultrasound

The examination, which is carried out using ultrasound, is a widespread and safest diagnostic method; it is no coincidence that it is used even when monitoring the course of pregnancy in women. The human body is capable of reflecting and absorbing ultrasonic waves to varying degrees, which makes it possible to conduct ultrasound examinations. Using special sensors, waves directed at any organ scan the area under study, after which the signals are converted into an image on the monitor.

The advantages of the ultrasound method include high information content, painlessness of the procedure, the ability to see deviations from the norm in the early stages of the disease, in addition, during this examination the skin is not damaged and no medications are introduced into the body. An ultrasound does not take much time and does not cause any discomfort in the patient.

An ultrasound examination of the pelvic organs allows us to determine the condition of the bladder, ovaries, uterus, cervix and fallopian tubes in women, and in men the condition of the prostate gland and seminal vesicles.

Indications for a pelvic ultrasound may include groin pain, detection of blood in the urine, problems with urination, infertility, menstrual irregularities in women, decreased potency in men. In addition, ultrasound of the pelvic organs allows you to see the patient’s anatomical features, congenital pathologies, age-related changes, and monitor the effectiveness of a particular treatment method. It is also very important to regularly conduct this examination for preventive purposes, as this allows you to detect the slightest deviations from the norm, diagnose tumors and inflammatory diseases in a timely manner and begin to treat them.

This is interesting
Modern women have long stopped turning to signs to find out who will be born - a boy or a girl. Today, expectant mothers can determine the sex of the baby in advance and with a high degree of accuracy. The genital tubercle appears in the fetus at the 7th week of pregnancy; after the 20th week, parents can already find out who they are expecting. When using 3D and 4D technologies, it is possible to determine the sex of the child from the 15th week.

Before an ultrasound, or Preparation for a pelvic examination procedure

Preparation for the study depends on how the procedure will be performed. In both men and women, ultrasound of the pelvic organs can be performed transabdominally, that is, through the anterior abdominal wall. This examination method is indicated even for virgins and pregnant women. Two days before the ultrasound, it is important to exclude carbonated drinks, legumes, dairy products, raw vegetables and fruits from the diet, and also avoid large meals. This is necessary in order to prevent gas formation in the intestines, which can interfere with an accurate diagnosis. In addition, you should cleanse your intestines. To do this, you need to give an enema or glycerin suppository 2-3 hours before the examination of the pelvic organs, or take a laxative the day before. 1 hour before a transabdominal pelvic ultrasound, you should drink a liter of plain still water to keep your bladder full.

Examination of the pelvic organs in women is also carried out transvaginally. This procedure does not require any preliminary preparation.

When diagnosing the pelvic organs in both women and men, ultrasound can be performed transrectally, that is, through the anus. The bladder should be full and the intestines should be cleansed. This method of diagnosis in men allows the most accurate examination of the prostate gland and seminal vesicle, and in women - to identify diseases of the urinary tract. This type of ultrasound is also indicated when performing a biopsy.

During pregnancy, women undergo a so-called obstetric ultrasound - it allows you to monitor the condition of the genital organs of the expectant mother and the development of the fetus. Ultrasound during pregnancy does not require special preparation, however, on the eve of a pelvic examination, you should still refrain from eating foods that contribute to gas formation and come for the procedure 3-5 hours after eating.

Ultrasound of the pelvic organs has no contraindications, so this procedure is allowed for everyone.

When is it better to do a pelvic ultrasound and the procedure?

To obtain the most accurate diagnostic results, it is important to undergo examination within a strictly established time frame. Thus, in women of reproductive age, pelvic ultrasound is performed on the 5-8th day of the cycle - it is during this period that the clinical picture is most clearly presented. Obstetric ultrasound usually done three times - during each trimester of pregnancy. For what period and why is it carried out?

11-13th week– the main function of the first ultrasound is to diagnose the possible presence of malformations of the embryo.
18-21st week– one of the most important tasks of ultrasound remains the identification of congenital malformations of the fetus; the size of the fetus itself, its organs and systems is measured. During this period, you can determine the sex of the baby.
30-34th week– the size of the fetus is assessed, its correspondence to the gestational age; The position of the fetus in the uterine cavity is determined, which is important for the subsequent determination of labor management tactics.

Pelvic ultrasound in men can be done at any time.

It is recommended that both men and women undergo a preventive ultrasound examination once a year in order to detect hidden pathologies, and if abnormalities are detected, strictly according to the schedule prescribed by the attending physician.

During the procedure of performing an ultrasound of the pelvic organs using any of the methods described above, the patient does not experience any discomfort or pain - modern medical equipment takes into account the anatomical features of the person, and in order to protect the patient from infections, condoms are used with sensors inserted into the vagina or rectum .

At transabdominal method To conduct an ultrasound examination, the patient lies on the couch on his back, the doctor moves the sensor over the area of the body being examined. A special gel is applied to the skin in the area of the examined organ, which prevents the formation of air sinuses that prevent the penetration of waves, this allows you to display the clearest image on the monitor.
During transvaginal ultrasound pelvis in women, the sensor is inserted into the vagina, and the patient experiences much less discomfort than during a regular gynecological examination.
Transrectal ultrasound carried out when the patient lies on the couch on his side, with his knees bent. A small sensor is painlessly inserted directly into the rectum. A pelvic ultrasound lasts on average 15-20 minutes and is performed by specialist sonologists. During an ultrasound, the patient is sometimes asked to bring wet wipes, a towel and a diaper.

What does a pelvic ultrasound show in women and men?

Diagnosis of the pelvic organs using ultrasound waves makes it possible to determine the condition of the examined organs and make an accurate diagnosis. To draw a conclusion, the doctor just needs to study the picture displayed on the monitor. Images can be printed if necessary. Pelvic ultrasound in women allows us to diagnose many diseases, for example, uterine fibroids, endometriosis, salpingoophoritis, endometritis, ovarian cysts, tumors, as well as early pregnancy. In men, a pelvic examination shows a picture of the condition of the prostate gland and bladder, allows you to identify prostate adenoma and other tumors, makes it possible to detect benign hyperplasia of the gland and much more.

The patient can find out the results of the examination immediately. If deviations from the norm are detected with a conclusion drawn up by a sonologist, the patient is sent to the attending physician (gynecologist, urologist), who determines the necessary course of treatment.

Monday, 04/23/2018

Editorial opinion

A timely diagnosis allows you to avoid complications in the treatment of the disease, and sometimes even increase life expectancy. Unfortunately, few of us take care of our health with a high degree of responsibility and turn to preventive diagnostic methods. Think about it, life is so changeable and fleeting! We advise you to never delay visits to the doctor and undergo all necessary examinations on time.

Ultrasound of the pelvic organs in women is a widespread diagnostic method in gynecological practice.

Ultrasound is characterized by absolute painlessness and safety for health, and is also highly informative in the field of research and detection of diseases of the reproductive and urinary systems of women.

An ultrasound of the pelvis in women looks at:

uterus and cervix;
the fallopian tubes;
ovaries;
bladder.

What does a pelvic ultrasound show in women?

During a standard examination, the ultrasound specialist assesses the condition of the internal organs according to the following parameters:

the location of the uterus in the pelvic cavity, as well as relative to neighboring organs;
external dimensions of the uterus and its contours;
the structure of the muscular (myometrium) and mucous (endometrium) layers of the uterus;
internal dimensions of the uterine cavity, smoothness of its walls;
the size of the cervix, its position, integrity;
size and structure of the ovaries and fallopian tubes;
condition of surrounding tissues and organs.

Indications

Which doctor and why does he refer for a pelvic ultrasound?

A referral for an ultrasound examination of the pelvic organs is prescribed by a gynecologist if the following indications are present:

inflammatory diseases - endometritis, parametritis, adnexitis, vulvovaginitis, cystitis, etc.;
suspicion of a neoplasm in the pelvic cavity - fibroids, uterine cancer, bladder tumor, etc.;
pregnancy (uterine and ectopic);
folliculometry - determining the supply of follicles, tracking the ovulatory process in the ovaries;
cervicometry - assessment of the condition of the cervix (during pregnancy and after childbirth);
control of the position of the IUD (intrauterine device);
monitoring the patient's condition in the postoperative period, including after medical abortions.

Timing of pelvic ultrasound in women

An ultrasound may be prescribed if the patient complains of irregular menstruation for a long time, pain in the lower abdomen, changes in the intensity of uterine bleeding, or problems with conception.

In such cases, the date of the ultrasound depends on the task and is prescribed by the attending physician.

Typically, an ultrasound examination is performed 5-7 days after the first day of menstrual bleeding.

In order to monitor the functionality of the ovaries, ultrasound is performed repeatedly during one monthly cycle:

8-10 days
14-16 days.
22-24 days.

Timing of pelvic ultrasound during pregnancy

10-14 weeks,
20-24 week
30-34 weeks.

If necessary, the gynecologist can make changes to the diagnostic plan, and then the number of examinations can be increased.

You can read more about ultrasound during pregnancy in our separate article.

Preparing for a pelvic ultrasound

Ultrasound examination is performed transabdominal or transvaginally. Usually the doctor warns the patient in advance about the planned diagnostic method and tells the woman how to prepare for an ultrasound of the pelvic organs:

Transabdominal ultrasound is performed using an external probe through the abdominal wall with a full bladder. To do this, a woman needs to drink about 1 liter of water an hour before the examination and not urinate.

Transvaginal - for a more detailed study of the condition of the uterus and ovaries, a special sensor is used, which is inserted into the vagina. No preparation is required for this procedure.

Methodology

Ultrasound is performed on an outpatient basis in an office specially equipped for this purpose by an ultrasound specialist. While viewing the image on the computer monitor, the doctor reads out loud the main characteristics of the internal organs and the detected pathologies. According to the doctor, the nurse present here makes notes on the examination form.

The ultrasound specialist can turn the monitor towards the patient so that she can see for herself the processes occurring inside her. Typically, this practice is used when diagnosing pregnant women, especially in the later stages, when the sex of the unborn child is determined.

How is a pelvic ultrasound done in women?

The patient is positioned on the couch lying on her back with her knees bent (to relax the abdominal wall muscles). The lower abdomen must be freed from clothing (for a transvaginal ultrasound, remove underwear and slightly spread your legs, providing the doctor with access to the external genitalia).

Then the doctor lubricates the woman’s skin and the device’s sensor with medical gel and begins to move it over the abdomen, applying slight pressure in some places (transabdominal ultrasound).

If the examination is performed vaginally, a probe, which is much thinner than standard speculum, is inserted into the vagina. This type of examination does not cause pain or discomfort to the patient, with the exception of slight psychological inconvenience for particularly shy women.

Complications

Since ultrasound of the pelvic organs is a non-invasive examination (without injections or punctures) and completely safe, there are no complications or any other side effects after diagnosis.

results

The examination conclusion is given to the woman almost immediately after the procedure.

When interpreting an ultrasound of the pelvic organs, the doctor takes into account the individual structural features of the woman’s internal organs, concomitant diseases, age, the presence and number of children and many other factors.

Ultrasound standards

There was no pathology identified in the size, shape, or location of the uterus, ovaries, or fallopian tubes, and no abnormal inclusions (growths, cysts, fistulas, or tumors) were found.
In women of childbearing age, the presence of follicular cysts in the ovaries is considered normal.
The installed IUD is fixed in place.
Determination of the amniotic sac during pregnancy for up to 3 months is not a pathology.
The size and shape of the bladder are normal.
There are no stones, polyps, cysts, tumors or other formations.
Urine flows freely through the ureters into the bladder.
After urination, complete emptying of the bladder is observed.