Your doctor has requested that you have a
pelvic ultrasound. What can you expect? Well, first of all, some
of the reasons that you may get a pelvic ultrasound include:
Abnormal uterine or vaginal bleeding
Check the status of a pregnancy
Evaluating the cervix during pregnancy
A family history of ovarian cancer or some
other risk for ovarian caner, such as BRCA mutations.
An ultrasound is like any other medical imaging test. It must be
prescribed by your doctor. You can't go to an ultrasound department
and request that they scan you. There has to be a medical
Ultrasound should never be used to further a political agenda, such
as passing laws requiring an ultrasound, especially a vaginal
ultrasound, be performed prior to having an abortion.
Ultrasound also shouldn't be used for entertainment purposes.
When the ultrasound appointment has been
scheduled, you will probably be told that you need to drink at least
32 ounces of water and not empty your bladder. This is important
because your uterus resides behind your bladder and when the
technologist is scanning you from your abdomen, a full bladder is
necessary to visualize your uterus and ovaries.
Once you have checked in at the ultrasound
department, which is usually within the radiology department, you
may be asked to complete some standard forms dealing with your
medical history and insurance.
The technologist will come to the waiting room
and call out your name, usually just your first name or last name.
By now you will probably need to empty your bladder, but your
technologist is aware of your discomfort and will be as efficient as
Once you are in the exam room you may be asked
to remove everything below your waist and put on a backless hospital
gown, or you may be asked to lie on your back on the exam table and
lower your pants and underwear just a bit.
The technologist will apply some warm
ultrasound gel to the transducer and begin
scanning your lower abdomen. Please let the technologist know if he
or she is pushing too hard.
Ultrasound works by transmitting high frequency
sound waves through the transducer. The transducer then listens for
those returning echoes coming from the tissues inside your body.
Ultrasound looks at soft tissue organs but is unable to evaluate
intestines or bone.
The technologist will be taking images of your
uterus and ovaries, measuring them, and making note of any
Normally there are two parts to having a pelvic
ultrasound. The first part is the abdominal scan which was just
described. The second part is called an endovaginal or transvaginal
ultrasound. A transvaginal ultrasound probe works the same way as
the abdominal probe does but it's long and thin. It is generally a
higher frequency probe which means that it generates images of a
higher resolution and is closer to the uterus and ovaries once
inserted into your vagina. Think of the forest and the trees. The
abdominal scan looks at the forest giving an overall view of your
pelvis. The vaginal scan looks at the individual trees (uterus and
ovaries) in greater detail.
If you haven't been sexually active a vaginal
ultrasound is not usually performed.
The vaginal ultrasound probe will be covered
with a condom and will have been soaked in a disinfectant between
The good news is that you have to have an empty
bladder for the vaginal ultrasound. The technologist will ask you
to use the bathroom and empty your bladder completely. As important
as it was that it be full for the abdominal part, it's equally
important that it be empty for the vaginal part.
If you're having bleeding and are wearing a
tampon, you will need to remove it. If you're bleeding heavily just
let the technologist know that she an absorbent pad will be placed
on the table for you. Don't be embarrassed. Their only interest is
trying to help your physician figure out what problems there might
Some ultrasound exam rooms have tables equipped
with stirrups on the table. The will be in place and you will be
asked to put your feet in them and slide all the way down to the end
of the table. If the table doesn't have stirrups, you may be asked
to place a pillow or booster under your hips so that they are
The technologist will insert the probe, or ask
you to do it. It isn't painful and isn't much bigger than a
tampon. The technologist will move the probe around taking pictures
of your uterus and ovaries, measuring them, and documenting any
abnormalities. You may hear sounds similar to a heart beat. The
technologist is using Doppler ultrasound to demonstrate that there
is normal blood flow in your ovaries.
After taking all the necessary pictures the
technologist will remove the probe and remove the booster from under
your hips or ask you to take your feet out of the stirrups and make
In many departments, the technologist will need
to show the images to the radiologist who actually interprets the
images. You may be asked to wait while this is done to make sure
that no more pictures are needed. If there are questions, the
technologist may need to take more images, or the radiologist may
come in and either scan or watch the technologist scan. Some
departments allow the technologist to let the patient go if they are
satisfied with the quality of the study.
An ultrasound technologist is a highly trained
medical professional. They are accredited by the American Registry
of Diagnostic Medical Sonographers. In order to be accredited they
must have passed at least two very difficult registry exams. In the
past, many sonographers were trained on the job. Today a
technologist must go to an accredited ultrasound school which can be
one to four years long. One year programs are hospital based and
require the applicant to have a medical background (often radiologic
technology) and a college degree. Two to four year programs grant
associate degrees or bachelor degrees upon completion. Look for
RDMS after your technologist’s name on their name badge. In order
to pass the registry exams, the technologist has to know how to
operate the ultrasound machine, know the anatomy they are scanning,
and know the pathology of the organs they are scanning. If your
technologist doesn’t reveal the results of your scan to you, please
understand that the department where they work may prohibit that or
the technologist may not be familiar with your medical history to
provide a complete answer. Your physician knows all that and is the
one who will provide you with the results and treatment.