Transvaginal ultrasound

This page was reviewed under our medical and editorial policy by

Ruchi Garg, MD, Chair, Gynecologic Oncology, City of Hope Atlanta, Chicago and Phoenix

This page was reviewed on November 23, 2021.

An ultrasound is an imaging technique that uses sound waves to create images. In some instances, the care team may perform this procedure using a wand inserted into the patient’s vagina to visualize the patient’s internal organs better. This is called a transvaginal ultrasound or an endovaginal ultrasound.

What is a transvaginal ultrasound?

A transvaginal ultrasound is an imaging technique that allows the care team to view a woman’s pelvic organs in more detail than a pelvic ultrasound allows. 

During a transvaginal ultrasound, a wand-like device known as a transducer is inserted a few inches into the patient's vaginal canal. The wand sends sound waves through the patient's body and the waves bounce back like echoes. A microphone picks up the sound, and the echoes are converted into images that can be viewed on a computer monitor.

What does a transvaginal ultrasound show?

A transvaginal ultrasound is used to look at a woman’s reproductive organs, including the uterus, ovaries, fallopian tubes and cervix.

During a transvaginal ultrasound, the sonographer or physician performing the ultrasound can see the patient's internal organs and tissues. The patient may see the images as well if she's able to watch the monitor from where she's lying.

Why the care team may order a transvaginal ultrasound

A transvaginal ultrasound is one of two tests used most often to evaluate for ovarian cysts which may be related to ovarian cancer. The other one is a CA-125 test, a blood test that looks for high levels of the protein CA-125 in the patient's blood.

During a transvaginal ultrasound, the doctor looks at the patient's ovaries, uterus, cervix and fallopian tubes. If a mass is found, it’s not possible to determine through this test alone whether it’s benign or malignant. It usually requires further follow-up and determination by a gynecologist.

It’s important to remember most masses found during such ultrasounds aren’t malignant.

A transvaginal ultrasound is also helpful for detecting endometrial cancer, which is cancer of the lining of the uterus. The imaging technique may be used to evaluate women who experience bleeding after menopause. Specifically, a transvaginal ultrasound is used to determine the thickness of the endometrium. A transvaginal ultrasound may also be used to help detect cervical abnormalities.

Other reasons a cancer patient may have a transvaginal ultrasound include:

A patient may not be able to undergo a transvaginal ultrasound if:

  • She recently had vaginal surgery
  • She has no opening in her hymen, a congenital anomaly of the genital tract

How to prepare for a transvaginal ultrasound

There is no special preparation or diet required.

The patient may wish to wear something comfortable and loose-fitting the day of the transvaginal ultrasound.

She will need to empty her bladder just before the scan.

How is a transvaginal ultrasound done?

The patient may have this scan at a hospital, an imaging center or her gynecologist’s office. For the test:

  • The patient may be asked to remove any clothing from her waist down and put on a hospital gown.
  • She’ll lie on her back on the examination table with her knees bent. She may be asked to put her feet in stirrups, just as she would during a pelvic exam.
  • The transducer is covered with a sheath and lubricated. The wand is inserted into the vagina.
  • Sonographers or physicians performing the ultrasound will gently move the probe around to view the patient's pelvic organs.
  • The patient may be able to watch the same display as the person performing the ultrasound.

The patient is given a tissue to wipe away any lubricating gel from the wand that was left on her body.

She should be able to return to her normal activities immediately afterward.

How long does a transvaginal ultrasound take?

The transvaginal ultrasound takes about 15 minutes to complete, plus time before and after for setup and dismantling, so the patient should set aside about 30 minutes for the whole exam.

Benefits of a transvaginal ultrasound

  • A transvaginal ultrasound is a safe procedure with no ionizing radiation and it is safe during pregnancy.
  • It may be performed in the doctor’s office.
  • Soft tissue appears clearer on an ultrasound than X-rays.
  • The procedure is completed within about 30 minutes.
  • It provides the care team with valuable insight to make recommendations about the patient's care going forward.

Is transvaginal ultrasound painful?

The patient may feel some discomfort, but shouldn’t find it painful. The patient may take over-the-counter pain relief before the procedure to head off any discomfort.

The patient may experience some vaginal spotting after the procedure. This is considered normal.

Transvaginal ultrasound results

A radiologist who specializes in ultrasound reads the images and sends a report to the doctor who requested the test. Most scans are read within one to two days.

Depending on the results, the patient's doctor may order further testing including a biopsy to help determine the next steps in her treatment.

Expert cancer care

is one call away.
appointments in as little as 24 hrs.