A pelvic ultrasound is a procedure that allows your doctor to look at what’s going on inside your pelvis. Your doctor may request the test to diagnose unexplained pain, swelling, or infections in your pelvis, which 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 (the final portion of your large intestine that connects to your anus). 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 slightly uncomfortable. The test is performed on men and women of all ages. Since the pelvis contains your sex organs, 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 similar to 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), or 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 (urinating). 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. It will be used to check how far along the mother is in her pregnancy, the baby’s position in the uterus, the number of babies the mother is carrying, and the amount of amniotic fluid that surrounds the baby. It can be used to look at the baby’s heart. In some cases, it may be used as a screening method for certain birth defects and developmental abnormalities, 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 (so tell your doctor if you are allergic to latex). The probe will be inserted into your vagina. (If it makes you more comfortable, you can ask to insert it yourself.) It is commonly used in the early weeks of a pregnancy to determine how far along a mother is in her pregnancy and a due date. This method brings the probe closer to the uterus and provides a clearer view of a fetus during a mother’s first trimester. Outside of pregnancy, your doctor may recommend a transvaginal ultrasound for the following reasons:
- To locate an intrauterine device used for birth control.
- To determine the cause of infertility (or to guide your doctor during a fertility treatment or procedure).
- To look for (ovarian) cysts or other growths in your pelvis.
- To determine the cause of abnormal vaginal bleeding or problems with your menstrual period.
- To diagnose unexplained pelvic pain.
- To look 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. A doctor will recommend a transrectal ultrasound to examine problems with the prostate (the gland that makes semen) and 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 slightly 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 to make it easy for the technician to access your pelvis. You will lie on your back the entire time 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. The only mild discomfort you might have is from the pressure of the probe on your belly (abdomen) 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. Reasons for this might be because you are severely overweight and the ultrasound could not see deep enough into your pelvis; your bladder was not full; your bowels, intestines, or rectum were not empty; you had excess gas in your intestines (which blocks the view of your pelvic organs); you moved too much during the procedure; you had an open wound in your belly (abdomen); or because you are undergoing fertility tests and treatment, which requires regular ultrasounds. You may have to repeat the test 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.
- There is a slight risk of infection with transvaginal and transrectal ultrasounds, since they are done inside your body. 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?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.