A transvaginal ultrasound, also known as an endovaginal ultrasound, is an internal imaging test that uses high-frequency sound waves to create detailed pictures of the pelvic organs. This procedure involves inserting a small, specialized probe, called a transducer, a short distance into the vaginal canal. The primary goal is to provide a clear, close-up view of the female reproductive structures. Because the transducer is closer to the organs, it offers clearer images of the uterus, fallopian tubes, and ovaries compared to an abdominal scan.
What to Expect: The Standard Duration and Variations
The actual ultrasound portion of the procedure is relatively brief. Most scans take between 15 and 30 minutes to complete, covering the period from when the transducer is inserted until it is removed. Depending on the complexity of the medical question, the process can sometimes extend up to an hour. The duration depends on factors unique to each patient and the purpose of the examination.
The complexity of required measurements often causes variations in time, especially when precise documentation of structures like the endometrial lining or ovarian follicles is needed. Using color Doppler studies to assess blood flow also adds to the overall time. Finding an abnormality, such as a complicated ovarian cyst or a fibroid, will extend the scan, as extensive documentation from multiple angles is necessary for proper diagnosis and reporting. Patient cooperation, including the ability to remain still, is another factor that influences how quickly images are obtained.
The Procedure Explained: Step-by-Step Guide
Preparation for the transvaginal ultrasound typically begins with the patient undressing from the waist down and putting on a gown. In most cases, the patient is instructed to empty their bladder immediately before the procedure. This is often done after an initial transabdominal scan, if one is performed. An empty bladder allows the transvaginal probe to get closer to the pelvic structures for a sharper image. The patient then lies on the examination table, often in a position similar to a gynecological exam, with knees bent and feet in supports or stirrups.
The sonographer prepares the transducer, which is a thin, wand-like instrument. A sterile protective cover is placed over the probe, and a small amount of lubricating gel is applied to the tip to ensure comfortable insertion. The sonographer will then gently insert the transducer into the vagina. Once inside, the transducer emits high-frequency sound waves that bounce off the organs, creating real-time images displayed on a monitor.
The patient will feel pressure as the probe is carefully maneuvered to capture different views of the pelvic anatomy. To obtain a comprehensive picture, the sonographer rotates the transducer, angling it to view the uterus in both the long (sagittal) and short (transverse) axes. They then sweep to visualize the ovaries and other adjacent structures. After all necessary images and measurements are taken, the probe is gently withdrawn, and the patient may get dressed.
Common Medical Applications
A transvaginal ultrasound is a preferred diagnostic tool because its proximity to the reproductive organs allows for superior image resolution. It is commonly used for early pregnancy assessment, confirming the location of the gestation, monitoring the fetal heartbeat, and accurately estimating gestational age. This high-resolution imaging is also invaluable for investigating the causes of unexplained pelvic pain or abnormal vaginal bleeding.
Uterine and Ovarian Evaluation
The scan is frequently ordered to evaluate the uterus for structural abnormalities such as fibroids (benign muscle growths) or polyps (growths in the lining). It also provides detailed information about the ovaries, helping to identify and monitor cysts or other masses.
Fertility and Monitoring
For women experiencing fertility challenges, the transvaginal approach is utilized to assess the thickness of the endometrial lining and monitor the development of ovarian follicles during ovulation tracking. It is also employed to confirm the correct positioning of an intrauterine device (IUD).