Pelvic Ultrasound

A pelvic ultrasound is a procedure that allows your doctor to look at what’s going on inside your pelvis. This is the space between your hip bones that contains the large triangle-shaped bone at the bottom of your spine (sacrum), your tailbone, bladder, sex organs, and rectum.

Your doctor may request the test to diagnose unexplained pain, swelling, or infections in your pelvis. A pelvic ultrasound is the best test to examine a growth in your pelvis. It helps your doctor determine if the growth is a fluid-filled cyst, a solid tumor, or another kind of lump.

A pelvic ultrasound is a safe procedure that can be a little uncomfortable. The test is performed on men and women of all ages. The ultrasound looks at different things for men and women.

During the test, a trained medical technician will squirt a small amount of warm gel on your skin over your pelvic area. The technician will move a handheld device (called a wand) through the gel and across your pelvis. The technician will monitor the images on a nearby screen and record the images for the doctor. The probe is connected to an ultrasound machine. As the device moves across your pelvis, it produces high-frequency sound waves. Those sound waves create real-time photos and video of the inside of your pelvis. The images look like an X-ray. However, ultrasound technology picks up things that aren’t seen by an X-ray.

Path to improved health

A pelvic ultrasound can be done one of three ways:

• Abdominally (the outer stomach)
• Vaginally (inside a woman’s vagina)
• Rectally (the area between the bottom of your large intestine and your anus).

The approach your doctor recommends for your ultrasound depends on the reason for your test and whether you are a man or a woman. A pelvic ultrasound can be used to look at the bladder for both men and women. Your doctor may recommend a pelvic ultrasound of your bladder if you are having difficulty going to the bathroom. It is used on men and women to guide a doctor during a biopsy procedure (inserting a needle into the pelvis to take samples of fluid or tissue).

A transabdominal ultrasound is commonly used to monitor the development of a baby in pregnant women at or before 14 weeks in their pregnancy. For this type of ultrasound, the technician will squirt a small amount of warm gel onto your stomach and move the probe or wand back and forth over your stomach. It will check the baby’s growth, such as height, the length of the baby’s arms and legs, head size, and more.

This type of ultrasound can check several factors during pregnancy, including:

• How far along the pregnancy is
• The baby’s position in the uterus
• The number of babies the mother is carrying
• The amount of amniotic fluid that surrounds the baby
• The baby’s heart

In some cases, it may be used to screen for certain conditions, such as Down syndrome. A transabdominal ultrasound also can be used to look for tumors in your uterus and other issues related to the female body, whether you are pregnant or not.

A transvaginal ultrasound is only used on women. It uses a specially shaped probe that can fit inside a woman’s vagina. The probe is covered with a latex condom. If you are allergic to latex, tell your doctor. The probe will be inserted into your vagina. If it makes you more comfortable, you can ask to insert it yourself.

This kind of ultrasound is used in early pregnancy to determine how far along a mother is and a due date. This method brings the probe closer to the uterus. This provides a clearer view of a fetus during a mother’s first trimester.

Your doctor may recommend a transvaginal ultrasound for other reasons, including:

• Locating an intrauterine device used for birth control
• Determining the cause of infertility (or to guide your doctor during a fertility treatment or procedure)
• Looking for (ovarian) cysts or other growths in your pelvis
• Determining the cause of abnormal vaginal bleeding or problems with your menstrual period
• Diagnosing unexplained pelvic pain
• Looking for an ectopic pregnancy (when a fertilized egg begins to develop outside of the uterus)

A transrectal ultrasound is used on men. The end of the probe for this type of ultrasound is shaped to partially fit inside a man’s rectum. The end of the probe is covered with a latex condom. This can be used to examine problems with the prostate (the gland that makes semen). It can also look at the glands that secrete some of a man’s semen (seminal vesicles).

Depending upon the type of pelvic ultrasound you are having, preparing may be different. For example, a transabdominal ultrasound to view your bladder requires a full bladder. Your doctor will tell you to drink four to six glasses of water one hour before your test. A full bladder moves your intestines aside to give the technician a better view.

If you are a woman, your only preparation for a transvaginal ultrasound is to let your doctor and technician know if you are allergic to latex. The same applies to transrectal ultrasounds for men.

Men also may need to take an enema one hour before a transrectal ultrasound to empty their bowels or intestines. This will improve the quality of the ultrasound pictures. For a prostate biopsy, men may be required to take an antibiotic to protect against an infection.

Tell your doctor if you had an X-ray that included a dye two days before the pelvic ultrasound. The dye will remain in your intestines and prevent the technician from getting quality photos and videos.

In all pelvic ultrasounds, you will be asked to put on a light hospital gown. This makes it easy for the technician to access your pelvis. You will lie on your back unless the technician needs you to turn to get a better picture. The procedure usually takes about 30 minutes. Your doctor or doctor’s office will call you with the results one to two days after the procedure. You might have mild discomfort from the pressure of the probe on your belly or near where the probe was inserted. Your body is not exposed to radiation during a pelvic ultrasound.

Things to consider

A pelvic ultrasound involves time and expense. It’s possible you may have to repeat the procedure because the first test didn’t produce clear photos. This can happen for several reasons:

• Being severely overweight may prevent the ultrasound from seeing deep enough into your pelvis
• Not having a full bladder
• Not having empty bowels, intestines, or rectum
• Having excess gas in your intestines (which blocks the view of your pelvic organs)
• Moving too much during the procedure
• Having an open wound in your belly

You may also have to repeat the procedure if you are undergoing fertility tests and treatment, which requires regular ultrasounds.

Repeat ultrasounds may also be needed if your doctor discovers a lump in your pelvis that requires further testing. Your doctor may require you to repeat the test in six to eight weeks to see if the lump has changed in size or appearance.

If you are a man, you may have to repeat a pelvic ultrasound of your prostate if your prostate is larger than normal. In that case, an ultrasound may not be an option. You may have to undergo a digital rectal exam (when your doctor inserts his glove-covered finger into your rectum), a blood test, or a biopsy.

Because they are done inside your body, there is a slight risk of infection with transvaginal and transrectal ultrasounds. See your doctor if you have abnormal discharge or fever after your ultrasound.

Questions for your doctor

• Will the probe from a transvaginal ultrasound harm my pregnancy?
• Should I take an over-the-counter pain reliever before I have a transvaginal or transrectal ultrasound to ease the discomfort?
• What else do I need to know to prepare for the test?

Resources

National Institutes of Health, MedlinePlus: Pregnancy Ultrasound

National Institutes of Health, MedlinePlus: Transvaginal Ultrasound