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Do a transvaginal ultrasound. Ultrasound of the pelvis with an internal sensor: vaginal and transvaginal - Medsi

Often women are faced with the need to perform a vaginal ultrasound, which causes fear and embarrassment before performing the procedure. This diagnosis is completely painless and does not take much time, but the data obtained allows us to identify the development of abnormalities in the genitourinary system at an early stage.

Ultrasound of the pelvic organs, performed transvaginally, is considered the most informative way to study the female reproductive system, especially if there is a possibility of developing inflammatory processes or neoplasms in the genital organs. How is the procedure performed and what needs to be done in preparation for it? In this article you will find answers to questions.

The main factors that prompt a doctor to prescribe a transvaginal ultrasound to a patient are suspicion of the development of pathological processes in the pelvic organs, the development of emergency conditions requiring urgent medical intervention, as well as monitoring of the therapy being carried out.

Ultrasound examination through the vagina is performed in the following cases:

pain attacks developing in the lower abdomen;
detection of inflammatory diseases of the reproductive system;
determining the causes of urological problems, including enuresis, urethritis, and other disorders of the urinary organs;
when carrying out ;
monitoring the condition of the endometrium of the uterus with regular use, installation and;
diagnosing tumors and neoplasms of the genitourinary system (and other conditions);
determination of the reasons that caused it.

An important question: is it possible to perform a vaginal ultrasound during pregnancy? Yes, this diagnostic method allows you to determine whether fertilization has occurred at 2-4 weeks, and gives a clearer picture on the monitor than standard ultrasound diagnostics of the uterus through the abdominal wall. In addition, this method is most reliably determined starting from a three-week period.

Another common topic of concern to expectant mothers is whether transvaginal ultrasound is harmful for the development of the baby? Inserting a sensor into the vagina during pregnancy is absolutely harmless, since it does not come into contact with the fetus, and the ultrasound waves emanating from it do not affect the growth and formation of the child. In this way, it is possible to determine the presence of pathology in the early stages and take timely measures to eliminate it.

It is also relevant to perform a transvaginal examination using an ultrasound sensor in women suffering from severe obesity, when standard abdominal diagnosis becomes uninformative.

Are there any contraindications?

The only direct contraindication to transvaginal ultrasound is the presence of an intact hymen, therefore, in order not to disrupt its integrity, diagnosis is carried out using the standard method through the anterior abdominal wall or by introducing a transducer into the rectum (transrectal).

As for performing intravaginal ultrasound during pregnancy, its use is justified until a period not exceeding 12 weeks. Starting from the second trimester, examination through the vagina becomes less informative than the standard method of ultrasound diagnostics in expectant mothers.

How to prepare for a vaginal ultrasound and how it is performed

Like abdominal, transvaginal ultrasound does not require specific preparation. Before the procedure, the woman is recommended to take careful hygienic care of the external genitalia. When visiting the ultrasound room, you will need to bring a disposable diaper or towel with you to lay on the couch before lying down on it for the procedure. Also, in the case of transvaginal ultrasound, the patient needs to have it with her.

If you need to use this diagnostic method during pregnancy, then to make the results more informative, it is better for the bladder to be moderately full. To do this, the expectant mother is advised to drink about half a liter of water 60 minutes before the start of the test.

A mandatory requirement when performing a transvaginal ultrasound of the pelvic organs is the absence of excessive accumulation of gases in the loops of the large and small intestine, as they can create additional interference during the examination, causing the results to be unreliable or uninformative.

To do this, a couple of days before the procedure you need:

refuse food that causes fermentation in the intestines and flatulence;
limit consumption of fruits, dairy products and sweet pastries;
take medications that adsorb excess gases from the gastrointestinal tract.

It is not recommended to perform a cleansing enema before the study.

How is a transvaginal ultrasound performed? To carry out the diagnosis, the doctor asks the patient to sit on the couch on her back, with her legs slightly spread apart and bent at the knees to provide free access to the perineal area.

Progress of the study:

The doctor must put a condom on the transducer and apply a special lubricant to it, which ensures more comfortable passage of the device.
Inserting the sensor into the vagina.
Studying the results reflected on the monitor.

The duration of the procedure usually does not exceed 5-10 minutes.

Decoding the results

All data obtained during the study is entered into a special protocol, which is filled out during the diagnosis.

Vaginal ultrasound during pregnancy allows you to determine some features already at a short period of time:

the size of the uterus and its cervix;
the location of the ovaries, their parameters and structure, as well as the presence or absence of pathological changes in them;
condition of the fallopian tubes;
the amount of fluid in the abdominal cavity.

The physiological indicators of the health of the organs of the female reproductive system are described below.

Uterus:

Position is a slight forward deviation of the organ from the sagittal axis.
The outlines are clear, evenly outlined.
Parameters – length 7 cm, width 6 cm, diameter 4 cm.
The tissue structure (echogenicity) is homogeneous.
Cavity structure – without elements of pathological lesions, homogeneous, clear.

Thickness of the endometrial layer (parameter varies depending on the day of the menstrual cycle):

in the first 3-4 days - very thin;
5-7 days – up to 6 mm;
12-14 days – up to 13 mm;
15-19 days of the cycle – up to 16 mm;
before the onset of menstrual bleeding - 10-20 mm, which depends on the day.

According to transvaginal ultrasound, there should be no free fluid in the uterine cavity; only a few days after ovulation, a small amount of fluid may accumulate.

During an ultrasound examination, the cervix is defined as a homogeneous formation with clear outlines, having a length of about 4 cm. The cervical canal is normally filled with mucus, and its lumen is 2-3 mm. Vaginal ultrasound does not visualize the fallopian tubes.

Ovaries:

Parameters – 26 x 30 x 14 mm. The volume does not exceed 8 cm3.
The outlines are lumpy and blurry.
The echo structure is the same throughout.
The presence of a follicle, the size of which depends on the phase of the menstrual cycle.

Is the study related to the menstrual cycle?

There is a direct relationship between the results obtained and the critical days when performing diagnostics, so in order to decide when it is best to do a transvaginal ultrasound, you should know exactly what you are doing. The reliability of the sensor readings will depend on how much time has passed since the last one, which is observed on days 12-14 of the cycle, after which changes occur in the uterus.

The first few days after the end of your period are best for performing a routine transvaginal pelvic ultrasound. To determine endometriosis, it is better to schedule a diagnosis in the second phase of the menstrual cycle.

Transvaginal ultrasound is a method of examining a woman’s pelvic organs using ultrasound delivered using a special sensor. This type of study is as informative as possible for studying the pathology of the uterus and its cervix, fallopian tubes, ovaries and bladder.

It is superior in diagnostic reliability to any other type of ultrasound, since the sensor is located as close as possible to the organs being examined.

Indications for transvaginal ultrasound

Vaginal ultrasound has significantly expanded the diagnostic capabilities of gynecologists, obstetricians and urologists.

It is often indispensable for detecting diseases at their early stages, when changes in the organ are still minimal, and other diagnostics are uninformative.

The study is indicated for the following symptoms:

Discharge of blood in any quantity and any color outside of menstruation.
Inability to become pregnant while having regular sexual activity for more than six months.
Pain in the lower abdomen not associated with menstruation.
Menstruation that lasts longer than 7 or less than 3 days.
For early diagnosis of ectopic pregnancy (not informative before 3 weeks after missed menstruation).
If pain or discomfort in the lower abdomen is felt during sexual intercourse.
As an annual preventive examination.

Transvaginal ultrasound helps diagnose the following diseases and conditions

ovarian cysts
endometriosis
pregnancy – both uterine and ectopic
the presence of inflammatory fluid, pus or blood in the fallopian tubes (without differentiation of these fluids)
uterine fibroids
endometrial polyposis
abnormal development of the internal genital organs
hydatidiform mole - partial or complete
malignant tumor of the uterus
chorionepithelioma
ovarian cyst rupture
fluid in the lower abdomen and pelvis
ovarian cancer.

A vaginal ultrasound will help assess the number and quality of maturing follicles. When a contrast agent is injected into the fallopian tubes, it helps to diagnose fallopian tube obstruction and its degree. This is an important test for your doctor who is helping you diagnose and treat infertility.

If the estimated gestational age is about 5 weeks or more, but there is a suspicion that the fetus is not developing, transvaginal ultrasound is the method of choice. It is in this case that the doctor will see on the monitor how the first contractions of the fetal heart occur (up to 5 obstetric weeks the procedure is not carried out for this purpose).

How to prepare for this examination

Vaginal ultrasound is performed only on women who have begun to be sexually active. The study is not carried out for virgins. In their case, a transabdominal ultrasound will help to study the pelvic organs, that is, the same painless and safe procedure, but the sensor is moved along the abdominal wall.

If, due to severe obesity or flatulence, it is impossible to examine the necessary organs in a virgin, the doctor may recommend an examination through the rectum (transrectal ultrasound).

Conducting a transvaginal examination (tvUS) does not require preparation. The bladder, which needs to be filled before the abdominal examination, must be empty during this procedure. The doctor may even ask you to go to the toilet if you urinated more than an hour ago.

The only thing you need to prepare is to reduce the amount of gas in the intestines if you suffer from flatulence. To do this, an hour and a half before the procedure, you need to drink either 5 Espumisan tablets or a packet of Smecta (depending on tolerance).

If an abdominal examination is to be performed, the bladder must be filled as preparation.

Relationship between the time of the study and the menstrual cycle

It is very important to compare a vaginal ultrasound with the day of the menstrual cycle, because the results of the study depend on this. So, after ovulation, which usually occurs 12-14 days after the first day of the last menstruation, almost all genital organs undergo changes. This is necessary in order to be ready for conception and implantation of a fertilized egg.

A planned TVUS is usually performed at the beginning of the cycle, preferably after the end of menstruation on the very next day (5-7 days of the cycle), but it can also be done on days 8-12.

If endometriosis is suspected, it is recommended to undergo the procedure, on the contrary, in the second half of the cycle. If you need to assess the dynamics of follicle maturation, it is carried out several times in dynamics (8-10, then 15-16, after 22-24 days of the cycle). If spotting or bleeding not associated with menstruation occurs, it is carried out regardless of the day of the cycle - immediately after the occurrence of this symptom.

During pregnancy, transvaginal ultrasound can be performed only in the first trimester and according to indications. In the future, due to the risk of miscarriage, examination is carried out only through the abdominal wall.

It is informative to perform an abdominal ultrasound on any day of the cycle, except for the period when menstrual bleeding occurs. If it is necessary to clarify the diagnosis, then it is advisable to do it when the gynecologist prescribes it.

How is the procedure performed?

Normally, the procedure is painless. A woman comes to the diagnostic room, where she will need to undress as if for a gynecological examination.

The woman lies on the couch with her back or on the gynecological chair, spreads her legs apart and bends at the knees.
A disposable condom is put on the transvaginal sensor (transducer), and the doctor applies a little special gel on top.
It serves both as a lubricant and helps in conducting the ultrasonic wave.
A transducer for vaginal examination looks like a rod with a diameter of about 3 cm, a length of about 12 cm. They often have a beveled handle, as well as a channel into which a biopsy needle can fit.
The sensor is not inserted into the vagina to a very great depth; it does not cause pain. During the procedure, the sonologist can move the transducer up, down, and sideways. If this makes a woman uncomfortable, she should report it immediately.
The abdominal sensor, unlike the vaginal one, has a wide emitting surface of a curved shape. In order to conduct a gynecological examination with this type of sensor, you need to fill your bladder.

How to decipher research data

Transvaginal ultrasound allows us to evaluate the following parameters in more detail than abdominal ultrasound:

body and cervical dimensions
location of the uterus
uterine structure
size and location of the ovaries
ovarian structure
places where the fallopian tubes exit (the tubes are completely visible only when they are filled with liquid, which is a contrast for ultrasound)
follicle: size, number of mature and emerged
free fluid in the abdominal cavity.

Normal echo picture of the pelvic organs

Uterus

The position is anteflexio, that is, the organ should be inclined anteriorly. Retroflexio is not a pathology, but a developmental option. This is bad for pregnancy. It can cause not only infertility, but also the occurrence of ectopic implantation of the fertilized egg. Also, due to this arrangement, a woman may suffer from chronic constipation.
Contours of the uterus. Should be designated as “smooth” and “clear”. Their unevenness means inflammation of the uterine muscle or surrounding tissues. Blurredness indicates a benign or malignant tumor.
Dimensions. Length – 70 mm, width – about 60 mm, diameter – 40-42 mm. If these indicators are less, it is called an “infantile uterus”; if more, it is pregnancy, fibroids, or a malignant neoplasm.
Echogenicity of the walls. It should be uniform. If this is not the case, it may be a sign of a tumor.
Endometrial thickness. This is what changes depending on the phase of the cycle:
-3-4 days of the cycle – thickness is minimal
-5-7 days – 3-6 mm
-11-14 days – 8-15 mm
-15-19 days – 10-16 mm
-before menstruation – 10-20 mm depending on the day of the cycle.
-if there is the term “decidualization of the endometrium”, this indicates a possible pregnancy.
Cavity structure. Normally, it is homogeneous, its edges are smooth and clear. Polyps, myomatous nodes, and cancerous tumors are referred to as “hyperechoic formations.” Heterogeneity of the structure or blurred contours is a sign of endometritis.

Cervix

Dimensions: length – 3.5-4 cm, anterior-posterior size – 2.5-3 mm.
The echostructure is homogeneous.
Endocervix (cervical canal): 2-3 mm in diameter, filled with mucus of a homogeneous echostructure. If these sizes are larger or the structure is heterogeneous, this may indicate inflammation, cancer, and endometriosis.

Free liquid

A few milliliters of it in the space behind the uterus is normal only for a few days after ovulation (days 13-15 of the cycle). In other cases, the fluid is a sign of infection.

Ovaries

Transvaginal ultrasound is performed using this device

Dimensions: 25x30x15 mm (width, length and thickness). The normal volume is 2-8 cm3. Their increase is a sign of polycystic lesions or inflammation.
The contours are fuzzy, but lumpy.
The echostructure is homogeneous, with small areas of fibrosis. If the foci of fibrosis are large, this indicates inflammation.
There should be several follicles measuring 4-6 mm, one up to 20 mm in the middle of the cycle. If the size of this one (it is called dominant) follicle is more than 25 mm, they speak of a follicular cyst.

Fallopian tubes

They should be either not visible at all or barely noticeable. If they are visible without contrast, this is a sign of either inflammation or an ectopic pregnancy.

Echo signs of uterine pathology

Myoma. The size of the body (less often the neck) is increased. The contours have been changed. There is a node in the muscle (myometrium), which is designated as the “hyperechoic zone”.
Endometriosis: "bubbles" in the tubes, uterus or cervix.
Polyps are designated as volumetric formations in the cavity, changes in the internal contours of the organ.
Cancer can have a similar description to polyps, but usually there is also swelling. This diagnosis is confirmed only by the results of a biopsy (if possible).
Endometritis: an increase in the size of the organ, as well as thickening and swelling of the endometrium.
Tumor of the neck: increase in its size, deformation of the neck.
Ovarian cyst: a fluid formation that has a diameter of more than 2.5 cm.
Adnexitis (inflammation of the uterine appendages). In this case, the fallopian tubes are thickened, the ovaries are enlarged, their boundaries are blurred, and mobility is limited.
Ovarian cancer: the organ itself is enlarged, and its contours are deformed.

The price of a transvaginal examination is about 1000-1500 rubles.

So, transvaginal ultrasound helps to make a timely diagnosis of inflammatory and oncological diseases of the female genital area. The examination also allows you to detect pregnancy in the early stages and establish its pathology. No preparation is required for the test; you will receive results immediately after the procedure.

Watch a video about the features of an ovarian cyst and its diagnosis using ultrasound.

One of the accessible and informative ways to examine the internal organs of a woman’s reproductive system is transvaginal ultrasound, which requires a special sensor and physician skills. The technique is used to diagnose diseases of the uterus and pathologies of the urogenital tract of inflammatory or tumor nature. It is also indispensable when performing ultrasound in the early stages of pregnancy.

Advantages and Disadvantages

Being a type of pelvic ultrasound, this method has its advantages and disadvantages.

The first is that the sensor is located as close as possible to the objects under study, since the vaginal wall is a thin formation and practically does not interfere with the passage of high-frequency ultrasonic waves. Intravaginal ultrasound does not require special preparation and can be performed at any time and day, the only exception being during menstruation. In addition, due to the closer contact of the sensor, this method is more informative and reliable than, for example,.

The disadvantages are that not all structures of the pelvis can be examined, so it is not possible to examine the bladder and individual walls of the lower “floor” of the abdominal cavity. Also, for some women, this examination is accompanied by some discomfort and requires psychological preparation, despite the fact that the technique is practically no different from a regular examination in the mirror by a gynecologist.

Preparation and timing

Any procedure has its own characteristics in preparation and deadlines.

Preparation rules

Preparation for a transvaginal ultrasound is simple and does not require much effort on the part of the patient. The bladder does not need to be filled, so the last act of urination should be immediately before the procedure.

The only point that should be discussed with your doctor is the presence of frequent constipation and bloating. In this case, it is necessary to bring the intestines to a normal functioning state using a cleansing enema or laxatives (Duphalac, Senadexin). To prevent bloating, take Espumisan or Lactofiltrum 2-3 days before the examination, the dose of which is determined by the doctor who prescribed the ultrasound.

An important point in preparation for the woman herself is careful hygiene of the external organs of the reproductive system. If, before performing a transvaginal ultrasound, the organs were examined through the abdominal wall, which requires a full bladder, then it must be emptied and intimate hygiene products used.

Event days

Transvaginal ultrasound is performed on certain days of the menstrual period. Over the course of a month, the female body undergoes cyclic changes in the internal organs of the reproductive system, therefore, to obtain the most reliable results, one should correctly correlate the menstrual day and the pathology that needs to be identified or excluded.

In a significant number of women, on the 13-15th day of the menstrual period, the egg is released into the uterine cavity, which is called ovulation. At this moment, the epithelial, muscular lining of the uterus and ovaries undergo maximum changes under the influence of hormones. Routine transvaginal ultrasound of the uterus and appendages is performed immediately after the end of menstruation. Often this is the 5-7th day of a new cycle.

If a woman has a clearly established menstrual cycle and also knows the approximate day of ovulation, then the examination can be carried out on the 9-12th day, strictly before the moment of ovulation.

If genital endometriosis is suspected, the study should be carried out after the ovulatory day. If the purpose of ultrasound is folliculometry (dynamic monitoring of the development and maturation of follicles), which is carried out three times in one cycle, then it is prescribed on the 8-10th, 15-16th and 23-24th days of the month.

If there are complaints about periodic intermenstrual bleeding and prolonged bleeding in the middle of the menstrual cycle, an ultrasound examination is possible any day, preferably immediately after the appearance of unpleasant symptoms.

Execution technique

It is important to know that intravaginal ultrasound is performed only on women who are sexually active.

To reduce discomfort, the woman lies correctly on the gynecological chair, that is, she lies on her back and slightly spreads her legs, bent at the knee joints. The doctor puts a special sensor on the transvaginal sensor and applies a transparent gel to it, which removes the air gap between the organs and the transducer, and also acts as a lubricant for easy penetration into the vaginal cavity.
Next, the device is slowly inserted into the vagina no more than 5-6 cm. The examined structures immediately begin to be displayed on the screen, the condition of which is assessed by a diagnostician.

If the woman does not make sudden movements, the procedure will not cause discomfort and will take no more than 10 minutes.

When performing an ultrasound with a vaginal sensor, the latter has the form of a small rod with a diameter of no more than 3 cm and a length of 13-14 cm. It is also equipped with an oblique handle and a narrow channel, if necessary, into the cavity of which a special needle can be inserted to take biopsy material.

Indications and contraindications

Ultrasound examination through the vaginal cavity should be performed strictly as prescribed by the doctor, therefore the following indications for its implementation are distinguished:

Constant or recurring pain in the lower abdomen.
As a diagnosis of the organic cause of female infertility.
Monitoring the formation and maturation of follicles in the ovary.
Long-term use of oral hormonal contraceptives.
Search for the cause that led to deviations in the menstrual cycle.
Inflammatory diseases in the internal organs of the female reproductive system.
Copious pathological discharge from the vaginal cavity.
Before planning a pregnancy.
Detection of malignant or benign neoplasms of the uterus, ovaries and pelvic walls.
Pathology of the urogenital tract (symptoms of dysuria, urinary incontinence, etc.).
A transvaginal ultrasound is also performed during pregnancy to determine its duration.

Contraindications are few:

virginity;
late stages of pregnancy;
period of menstruation.

Visible pathology

Since intravaginal ultrasound examination is highly informative, it can be used to identify the following pathological conditions:

Ovarian cancer, in which an increase in their size, erased and uneven contour, a change in the echostructure or the appearance of pathological inclusions is detected.
Ovarian cysts are represented by round, dense, echo-negative formations of varying diameters.
Endometriosis. In this case, heterotopic foci of the endometrium are detected in the uterus, ovaries or pelvic walls.
Malignant neoplasms in the uterus - tuberosity and blurring of the organ contour, changes in the echostructure, the appearance of nodular or infiltrative formations.
Free fluid localized in the uterine cavity or lower abdominal cavity.
Malformations of the organs of the reproductive system.
Normal and ectopic pregnancy, in which the fertilized egg can be found in the fallopian tube, on the ovary, the wall of the bladder or pelvis.
Hydatidiform mole, chorionepithelioma.

Transvaginal ultrasound is an analysis of the condition of internal organs using ultrasonic waves. Thanks to the special design of the sensor, the gynecologist examines the structure and structure of the patient’s uterus, fallopian tubes, ovaries, vaginal surface, and so on in various projections.

Is transvaginal ultrasound performed during pregnancy?

One of the significant advantages of vaginal ultrasound scanning is that the method allows you to examine organs without traumatic intervention in the body, non-invasively. The vaginal examination method is completely non-traumatic and painless, including for the fetus during pregnancy.

The doctor records even minimal changes in fetal development when examining pregnant women, due to the fact that the sensor is “selected” as close as possible to the uterus and ovaries. The transducer is separated from the organ being examined only by the vaginal septum.

The resolution of the transvaginal method is such that a viable fetus in the uterus is determined already from 5 obstetric weeks. At the same time, the heartbeat is heard and the embryo is visualized.

What is an ultrasound examination used for?

For examination from the inside of the pelvic organs and genital organs, a special type of sensor is used - intracavitary. They are used inside a woman's natural orifices, the vagina, or inserted rectally.

When a transvaginal ultrasound of the uterus is performed, the transducer is carefully and slowly inserted into the vagina to a depth of 10 cm, with a focal depth of 2–7 cm. The sensors have high resolution with an operating frequency of 5–7.5 MHz. They provide a view of 90-110 degrees, and if the transducer design has a rotating transducer, then 240. Average length is 19 cm, diameter is 3 cm, many models include a biopsy adapter. Shorter ultrasound probes are used to examine virgins and older women.

When is a transvaginal examination performed?

Almost all types of vaginal ultrasound are done in the first half of the menstrual cycle. The reason is that the processes in a woman’s body occur cyclically; the first half, before ovulation, is considered hormonally calm. If uterine endometriosis is suspected, an ultrasound examination is performed in the second phase of the menstrual cycle. Ultrasound for ovulation or folliculometry is prescribed strictly by day until the dominant follicle matures from the 10th day of the menstrual cycle.

Examination of the pelvic organs and bladder is carried out regardless of the day of the cycle. Routine screenings assessing the developmental conditions of pregnancy and the fetus are prescribed once per trimester.

The transvaginal method of examination during pregnancy is effective only until the uterus extends beyond the pelvis, up to 12 obstetric weeks. During the rest of the fetal development, it is examined transabdominally.

The ultrasound examination process includes preparation and a diagnostic session. This ultrasound method has virtually no contraindications. It is equally used for internal examination procedures during pregnancy, for gynecological diseases, and is also suitable for girls who are not sexually active.

How to prepare for an ultrasound?

For a transvaginal ultrasound examination, if any preparation is needed, it is small. It consists of taking your own women's calendar, since the doctor will be interested in:

Date of the first day of the last menstruation;
Cycle duration;
The age at which a woman began menstruating;
Duration of bleeding.

For hygienic purposes, you must have a diaper for the couch and a condom. The sensor must be protected; sometimes medical centers have special condoms without lubricant intended for ultrasound. However, not all ultrasound rooms have them, so you need to bring a regular condom for diagnosis.

If the vaginal examination is preceded by a superficial one, then a napkin will be needed to remove the medical gel from the skin; it is also recommended to bring it with you to the diagnosis. The woman frees the lower part of her body from clothes.

Diagnostic session using ultrasonic waves

Examination during pregnancy and pelvic diseases, scanning is done through the anterior abdominal wall and vaginally.

You need to prepare for an examination through the anterior abdominal wall in advance; drink at least a liter of water 60–90 minutes before the procedure. During this period, you must refrain from urinating. The fluid inside the bladder will act as a screen.

Gases accumulated in the intestines can interfere with the image on the screen, so doctors recommend taking anti-flatulence medicine (espumisan, smecta, etc.) an hour and a half before the ultrasound diagnosis.

In some cases, ultrasound diagnostics are performed using two of the above methods at once. After the abdominal examination, the woman is allowed to have a bowel movement, after which the session of examination of the uterus is continued transvaginally.

Unlike the superficial method, a vaginal examination does not require a full bladder; liquid will interfere with the ability to see small features on the screen.

For free ultrasound monitoring, the patient takes a horizontal position on a couch or on a special gynecological chair. In this case, for the required angle of penetration, the legs are bent at the knees, the feet are pressed against the couch.

The gynecologist puts a medical condom on the transducer and squeezes a little colorless glycerin-based gel onto the surface of the sensor for better gliding.

This ensures better sliding of the transducer inside, and the patient does not experience any discomfort. The gel is hypoallergenic, safe, leaves no marks, and is completely absorbed.

What diseases are detected with a vaginal transducer?

Using transvaginal ultrasound, pregnancy and gynecological diseases are detected. Ultrasound examination shows:

Inflammatory diseases of the oviducts, ovaries;
Endometriosis;
Accumulation of liquids;
Cysts and polyps;
Uterine fibroids;
Benign or malignant formations;
Pathologies of the cervix;
Hydatidiform mole (partial or complete).

In addition, ultrasound diagnostics with a vaginal transducer is effective:

In the treatment of infertility and problems of conception;
When determining pregnancy at the embryonic stage of gestation;
To clarify the number of fertilized eggs and their locations;
If an ectopic pregnancy is detected;
In confirming the fetal heartbeat;
When determining the sex of a child;
When conducting the first screening for genetic and chromosomal pathologies of the fetus.

This ultrasound scanning method is also used in the following cases:

Uterine bleeding of unknown origin;
Sharp or nagging pain in the abdomen and at the pelvic level;
Timely medical preventive examinations.

Thanks to their special design, high efficiency and resolution, transvaginal sensors have become indispensable in obstetrics when monitoring pregnancy in gynecology in the treatment and prevention of diseases of the pelvic organs. Most diseases of the female genital area are detected at an early stage, which makes it possible to begin timely treatment of patients and, accordingly, a high percentage of positive outcomes.

In modern medicine there is an excellent way to get a complete picture of the condition of the pelvic organs - this is transvaginal. It is this that makes it possible to accurately diagnose female urological and gynecological pathologies.

If the doctor suspects the development of a pathological process in the pelvic organs, he will most likely prescribe a transvaginal ultrasound. The reasons for prescribing such an examination may be:

the need to learn about the fixation of the fertilized egg in the fallopian tube;
control of the treatment;
prevention of a whole range of diseases and pathological conditions.

pain in the abdomen;
searching for the causes of infertility;
control of follicle maturation;
hormonal disorders, including cycle disorders;
inflammatory processes in the appendages;
problems with the patency of the fallopian tubes;
bleeding;
fibroids and cysts;
endometriosis;
monitoring the presence of pregnancy after artificial procedures such as ICSI, IVF;
suspicion of pathological attachment of the fetus (outside the uterus);
abnormal discharge;
oncological neoplasms;
the need to clarify or confirm a previously made diagnosis.

There are certain restrictions on performing a transvaginal procedure. So, this type of examination is not suitable for girls who are not sexually active, pregnant women whose term exceeds 12 weeks, and women with pelvic inflammation. Most likely, the doctor will recommend a transrectal ultrasound.

Preparation

Before visiting the ultrasound room, you need to prepare a diaper or towel to lay on the trestle bed (if the procedure is carried out for a fee, the provision of a disposable sheet is usually included in the cost of the ultrasound).

Preparation for an ultrasound examination includes taking medications that reduce gas formation (smecta, filtrum, activated carbon and others). On the eve of the ultrasound, it is advisable to limit the consumption of foods that can cause flatulence.

Reference! It is not necessary to fast before a pelvic examination.

If you need to be examined urgently, you can do without preparation, but the content and accuracy of the procedure will suffer.

How do they do it?

Scanning of the reproductive system occurs through a sensor that is inserted into the woman’s vagina.

Before the examination, you need to be naked from the waist down and take a comfortable position on the couch. The doctor puts a medical condom on the sensor, then lubricates it with gel and, after insertion, begins examining the internal organs. The sensor is a plastic rod with a diameter of 3 cm and a length of about 12 cm with a beveled handle. At its end there is a channel with a needle for collecting material during a biopsy.

Internal examination of the uterus and adjacent pelvic organs greatly simplifies the diagnosis, which is why the procedure has received such wide recognition in medical circles.

Important! If necessary, the study can be done many times without harming the patient's health.

Ultrasound using a vaginal sensor is considered more informative and more meaningful than traditional examination through the abdominal wall. During the manipulations, the patient should feel quite comfortable, but if unpleasant sensations arise, they should be reported to the doctor immediately.

Video. Transvaginal pelvic ultrasound: order of execution.

Norms and decoding

Transvaginal ultrasound provides a unique opportunity to timely detect the development of a number of diseases of the female genital organs, both inflammatory and oncological etiologies. And when used together with Doppler ultrasound (Dopplerography) is an excellent opportunity to timely identify the potential risk of thrombosis, find out about the presence of atherosclerosis and examine blood flow in the pelvis.

The ability of ultrasound waves to detect pregnancy at its very beginning is of great importance for women awaiting IVF results.

Normal ultrasound results of the reproductive area look like this:

Uterus. Normally, it is deviated anteriorly, outlined evenly and clearly. Parameters: 71 mm (length) x 62 mm (width) x ~40 mm (diameter). The tissue is homogeneous in density, the thickness of the inner layer of the mucous membrane ranges from a few millimeters to 1-2 cm.
Cervix. The normal length is about 4 cm, the anteroposterior size is about 2.5 mm, the structure is homogeneous. On the eve of menstruation, the cervical canal fills with fluid (mucus).
Ovaries. The length of each organ is 30 mm, width – 25 mm, thickness – 15 mm. Lumpy contours can be visualized, tissue density is mostly homogeneous, fibrous areas are acceptable. Several follicles are observed, among which the dominant one stands out.
Fallopian tubes. Normally, they do not differ on ultrasound or are barely noticeable.
Free fluid – on days 13-15 of the cycle can be observed in small quantities, this is not a pathology.

Contraindications

As a diagnostic method, transvaginal ultrasound has virtually no contraindications. However, the doctor may refuse to refer you for the procedure if the patient is in serious condition or requires urgent surgery.

Where to do it and how much does it cost?

The cost of a diagnostic pelvic ultrasound is determined by the level of the medical center, the qualifications of its specialists and the cost of equipment. In the capital, an examination with a vaginal sensor will cost women 1000-1600 rubles, in St. Petersburg they will have to pay 800-1300 rubles for the procedure.

Conclusion

A transvaginal gynecological examination can be performed as an independent procedure, or can serve as an addition to a traditional (transabdominal) examination.