US PELVIS SPECIAL STUDY

If your doctor has recommended a Transvaginal Ultrasound (TVS), you may have questions about what the test involves. At Cadabams Diagnostics, we want you to feel informed and comfortable. A TVS is a common, safe, and highly effective imaging test that provides a detailed view of the female pelvic organs. While it is an internal procedure, it is minimally invasive and provides much clearer and more detailed images than a standard ultrasound performed on the abdomen. This precision is crucial for your doctor to make an accurate diagnosis and create the best treatment plan for you.

What Is a Transvaginal Ultrasound?

A Transvaginal Ultrasound, often abbreviated as TVS, is a diagnostic imaging procedure that uses high-frequency sound waves to create real-time images of your internal pelvic structures. Unlike a traditional abdominal ultrasound, a TVS uses a small, specialized probe called a transducer, which is about the size of a finger.

This probe is gently placed inside the vaginal canal, allowing it to be much closer to the pelvic organs like the uterus, fallopian tubes, and ovaries. This proximity bypasses skin, muscle, and body fat, resulting in exceptionally clear and detailed images. One of the key benefits of this procedure is its safety profile; a Transvaginal Ultrasound (TVS) does not use any ionizing radiation, making it a safe choice for evaluation, including during early pregnancy.

Types of Transvaginal Ultrasound

A Transvaginal Ultrasound (TVS) can be used for several specific purposes, though the core technology remains the same.

Standard Diagnostic TVS

This is the most common type, used for a general evaluation of the uterus, ovaries, cervix, and endometrium. It aims to identify structural abnormalities or investigate symptoms like pain or bleeding.

Follicular Study Ultrasound

This involves a series of TVS scans performed at specific times during the menstrual cycle. The goal is to track the development and growth of ovarian follicles (the small sacs that contain eggs). This is a crucial component of fertility assessment and treatment, helping to predict ovulation.

Sonohysterography (Saline Infusion Sonogram)

This is a specialized type of TVS where a thin catheter is used to introduce a sterile saline (saltwater) solution into the uterus. The fluid gently expands the uterine cavity, allowing for a much clearer, more detailed view of the uterine lining (endometrium). This is particularly effective for identifying issues like polyps, fibroids, or scar tissue inside the uterus.

During the scan, the radiologist and sonographer meticulously evaluate several key parameters to assess the health of your pelvic organs.

Uterus

Its size, shape, position (e.g., anteverted or retroverted), and myometrial texture are examined. The scan looks for abnormalities like uterine fibroids [Link to: Uterine Fibroids Page] or adenomyosis.

Endometrium (Uterine Lining)

The thickness and appearance of the endometrium are measured and documented. This lining naturally changes throughout the menstrual cycle. The scan checks for abnormalities like endometrial polyps or excessive thickness (hyperplasia).

Ovaries

Each ovary is measured for size and volume. The presence of any cysts or other masses is noted. For fertility assessments, the sonographer will perform an antral follicle count, which helps estimate ovarian reserve. A characteristic "string of pearls" appearance can be a feature of PCOS [Link to: PCOS Condition Page].

Fallopian Tubes

In a healthy state, fallopian tubes are often not visible on an ultrasound. A TVS can, however, detect problems such as a fluid-filled tube (hydrosalpinx) or help in diagnosing an ectopic pregnancy located within a tube.

Cervix and Adnexa

The cervix is evaluated for abnormalities, and the adnexa (the area next to the uterus) is examined for any masses or fluid collections.

Your doctor has specific reasons for ordering a TVS, as it provides vital diagnostic information for numerous conditions. Key reasons include:

• Investigating the source of chronic or acute pelvic pain or pressure.
• Diagnosing the cause of abnormal uterine bleeding, including heavy menstrual flow, bleeding between cycles, or any bleeding after menopause.
• Evaluating infertility and monitoring treatments. A Follicular Study Ultrasound is a specialized TVS used for this purpose to track ovulation.
• Diagnosing conditions with a detailed ultrasound for uterus and ovaries, such as fibroids, ovarian cysts, tumors, and endometrial polyps.
• Confirming the correct placement of an intrauterine device (IUD) to ensure it is effective.
• Evaluating a suspected ectopic pregnancy, which is a medical emergency.
• Assessing the health and development of a pregnancy in its very early stages (typically the first trimester).

When and Who Needs to Take a Transvaginal Ultrasound?

A doctor may recommend a TVS for women experiencing a variety of symptoms or as part of specific medical evaluations. Common indications include:

• Unexplained pelvic pain
• Abnormal vaginal bleeding (such as heavy periods, bleeding between periods, or post-menopausal bleeding)
• Fertility challenges or monitoring for infertility treatments
• Checking for suspected uterine fibroids, ovarian cysts, or endometrial polyps
• Confirming an early pregnancy and checking its viability
• Locating an intrauterine device (IUD)

The patient groups who most often undergo a Transvaginal Ultrasound (TVS) include women of reproductive age who need diagnostic evaluation, women undergoing fertility treatments like IVF, and post-menopausal women experiencing bleeding. It can be performed as part of a routine gynecological check-up or ordered as a specific diagnostic test to investigate a particular concern.

Benefits of the US Pelvis Special Study Test

Choosing to have a Transvaginal Ultrasound (TVS) at Cadabams Diagnostics offers several distinct advantages for your health assessment:

• Superior Image Quality: Provides highly detailed and significantly clearer images of the pelvic organs compared to an external, transabdominal scan.
• Accurate Diagnosis: The high-resolution images lead to a more accurate and definitive diagnosis, allowing your doctor to recommend the most effective treatment.
• Essential for Fertility: This scan is indispensable for guiding fertility treatments and monitoring follicular development.
• Safety: The procedure is non-invasive because it does not use radiation and is considered very safe for all patients, including during pregnancy.
• Efficiency: The test is generally quick, typically taking only 15–30 minutes to complete.

Illnesses Diagnosed with US Pelvis Special Study

The detailed images from a TVS are instrumental in diagnosing or evaluating a wide range of gynecological conditions:

• Uterine Fibroids
• Ovarian Cysts and some Ovarian Tumors
• Polycystic Ovary Syndrome (PCOS), as part of a comprehensive diagnosis
• Endometrial Polyps
• Ectopic Pregnancy
• Evidence of Pelvic Inflammatory Disease (PID), such as abscesses or fluid-filled tubes
• Endometriosis (specifically, it can identify ovarian endometriomas, also known as 'chocolate cysts')

Preparation for a TVS is very simple and straightforward.

Diet

There are no dietary restrictions. You can eat and drink normally before your appointment.

Bladder

Unlike an abdominal pelvic ultrasound where a full bladder is needed, for a TVS you will be asked to empty your bladder just before the test begins. This improves image quality and significantly increases your comfort during the procedure.

Clothing

It is best to wear comfortable, loose-fitting clothing. A two-piece outfit (like a shirt and pants/skirt) is often more convenient than a one-piece dress, as you will only need to undress from the waist down.

Pre-requisites

• A doctor's referral or prescription is typically required to undergo the scan.
• It is very helpful to inform the clinic staff about the first day of your last menstrual period. This information is crucial for the radiologist to correctly interpret the findings, especially regarding endometrial thickness and ovarian activity.

Best Time to Take the Transvaginal Ultrasound

For general diagnostic purposes (like investigating pain or fibroids), the scan can be performed at any time during your menstrual cycle. However, if the scan is for fertility tracking or assessing the uterine lining, your doctor will advise you on the specific days of your cycle to schedule the appointment for the most relevant results.

Eligibility

The test is suitable for most adult women, and your consent will always be obtained before the procedure begins. For patients who are not sexually active or who have medical reasons or personal preferences against an internal scan, a transabdominal (on the belly) ultrasound can be performed as an alternative. However, it's important to understand that the images from a transabdominal scan may not be as detailed.

Procedure for Taking a Transvaginal Ultrasound

Understanding the step-by-step process can help alleviate any anxiety. Our team at Cadabams Diagnostics is dedicated to ensuring your comfort throughout the Internal Pelvic Ultrasound Procedure.

Step 1: Arrival & Preparation

Upon arrival, you will check in. The sonographer will greet you, confirm your details, and lead you to a private room. They will ask you to undress from the waist down and will provide a gown or sheet to cover yourself. You will be directed to use the restroom to completely empty your bladder.

Step 2: Positioning

You will be asked to lie on your back on a comfortable examination table, similar to how you would for a Pap smear. You may be asked to bend your knees and place your feet flat on the table or in stirrups.

Step 3: The Scan

The sonographer will explain the procedure again. The slender ultrasound probe will be covered with a new, sterile, single-use sheath. A generous amount of water-based lubricating gel will be applied to the covered probe to ensure easy and comfortable insertion. The sonographer will then gently insert the probe a few inches into the vagina.

Step 4: Imaging

Once inserted, the sonographer will carefully and slowly move the probe to capture images of your pelvic organs from different angles and orientations. The sound waves create live images that are displayed on a monitor, which the sonographer watches to ensure a complete study. You may be asked to hold your breath for a few seconds at a time to get a still image.

Step 5: Completion

The entire imaging process typically lasts between 15 and 30 minutes. Once all necessary images are captured, the probe is gently removed. You will be given tissues to clean off the lubricating gel and can then get dressed in private.

Caution Before Taking the Test

Your safety and comfort are our top priorities. Please remember to:

• Inform the sonographer if you have a latex allergy. We can use a latex-free probe cover.
• Communicate openly during the scan. If you feel any significant pain or discomfort, please let the sonographer know immediately.
• Let our staff know if this is your first pelvic exam. They will take extra care to explain everything and proceed at a pace you are comfortable with.