Transvaginal ultrasound

An ultrasound is an imaging technique that uses sound waves to create images. During a transvaginal ultrasound, a wand-like device known as a transducer sends sound waves through your body. 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.

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

Endovaginal ultrasound is another name for this imaging test.

During a transvaginal ultrasound, the transducer is inserted inside the vagina. As the waves reflect off your internal organs and tissues, the ultrasound machine creates images that are displayed on a screen and that the sonographer or physician performing the ultrasound can see. You may see the images as well if you’re able to watch the monitor from where you’re lying.

Why your doctor 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 your blood.

During a transvaginal ultrasound, your doctor will look at your 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:

• To find the cause of pelvic pain
• To monitor cancer treatments 

How to prepare for a transvaginal ultrasound

There is no special preparation or diet required.

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

You will need to empty your bladder just before the scan.

What to expect during a transvaginal ultrasound

You can have this scan at a hospital, an imaging center or your gynecologist’s office. For the test:

• You may be asked to remove any clothing from your waist down and put on a hospital gown.
• You’ll lie on your back on the examination table with your knees bent. You may be asked to put your feet in stirrups, just as you 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 your pelvic organs.
• You may be able to watch the same display as the person performing the ultrasound.

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

You will be given a tissue to wipe away any lubricating gel from the wand that was left on your body.

You should be able to return to your normal activities immediately afterward.

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 done in your doctor’s office.
• Soft tissue appears clearer on an ultrasound than through X-rays.
• The procedure is completed within about 30 minutes.
• It provides your care team with valuable insight to make recommendations about your care going forward.

Risks of transvaginal ultrasound

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

You may not be able to undergo a transvaginal ultrasound if:

• You recently had vaginal surgery
• You have no opening in your hymen, a congenital anomaly of the genital tract

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

What the results mean

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

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