A transvaginal ultrasound (TVUS) uses high-frequency sound waves to create detailed pictures of the female pelvic organs. Unlike a standard abdominal ultrasound, this method involves inserting a specialized probe, called a transducer, into the vagina. This internal approach provides a clearer, closer view of the uterus, ovaries, fallopian tubes, and cervix. A TVUS is often ordered to investigate pelvic pain, unexplained bleeding, or to confirm and monitor early pregnancy.
The Necessary Medical Referral
Securing a transvaginal ultrasound requires obtaining a physician’s order, often called a referral or prescription for imaging. This document is required for most diagnostic procedures and ensures the scan is medically appropriate for your condition. The referral outlines the medical reason for the scan and provides the sonographer and radiologist with relevant clinical history. Your primary care physician (PCP) or a specialist, such as an Obstetrician-Gynecologist (OB-GYN), typically issues this order following a consultation. You are then responsible for selecting an imaging facility and scheduling the appointment, as the facility requires the written order to proceed and process insurance claims.
Options for Imaging Facilities
The location where you have your TVUS performed can significantly affect the cost, convenience, and speed of your appointment. You generally have a choice between a hospital outpatient department, a dedicated independent imaging center, or a specialized medical clinic.
Hospital-based imaging departments handle complex or urgent medical cases and provide integrated access to other hospital services. However, these facilities tend to have higher operational costs, which frequently translates into higher out-of-pocket expenses for the patient. Scheduling is often less flexible, and wait times may be longer due to the prioritization of inpatient and emergency cases.
Dedicated, independent imaging centers focus solely on diagnostic services, offering a streamlined patient experience. These centers are often more cost-effective, with prices potentially 30% to 50% lower than the same scan performed in a hospital setting. They typically offer faster scheduling, shorter wait times, and a more comfortable environment for routine procedures.
Specialized clinics, such as your OB-GYN’s office or a fertility clinic, may also have in-house ultrasound equipment. Having the scan here offers the convenience of receiving the procedure and discussing the results with your ordering physician shortly after the exam. This option is often favored for follow-up scans or time-sensitive monitoring.
Preparing for Your Appointment
Proper preparation helps ensure the sonographer can capture the highest quality images during the procedure. The most common instruction for a TVUS is to arrive with an empty bladder, which differs from a standard abdominal ultrasound. An empty bladder allows the probe to be positioned closer to the pelvic organs, yielding clearer visualization.
You should wear comfortable, loose-fitting clothing, such as a two-piece outfit. If you are menstruating, the scan can still be performed, but you must remove any tampon before the examination begins. Your ordering physician will specify the ideal timing of the scan if it is needed to assess the endometrial lining during a particular phase of your menstrual cycle.
What Happens During the Transvaginal Ultrasound
When you arrive for your appointment, a trained sonographer will explain the procedure and answer any questions you may have. You will be asked to undress from the waist down and cover yourself with a sheet or wear a gown before lying down on the examination table. You will lie on your back, often with your knees bent and feet placed in stirrups, similar to a standard gynecological exam.
The sonographer prepares the transducer, a thin, wand-like device that is slightly larger than a tampon. The probe is covered with a disposable protective sheath, typically latex or non-latex, and a sterile, water-based lubricating gel is applied for smooth insertion. The sonographer will gently insert the transducer a short distance into the vagina.
During the scan, the sonographer rotates and angles the transducer to capture images of the uterus and ovaries from various perspectives. You should feel pressure as the probe moves, which is generally not painful, but communicate any significant discomfort. The device emits high-frequency sound waves that bounce off your internal structures, and the returning echoes are converted into real-time images visible on a monitor.
The entire imaging process typically takes between 15 to 30 minutes. The TVUS procedure is considered safe, as it uses sound waves rather than ionizing radiation. After the images are captured, a radiologist will interpret them, and the final report will be sent to the doctor who ordered the scan, usually within a few days.