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Transvaginal ultrasound

Definition

Transvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix, and pelvic area.

Transvaginal means across or through the vagina. The ultrasound probe will be placed inside the vagina during the test.

How the Test is Performed

You will lie down on your back on a table with your knees bent. Your feet may be held in stirrups.

The ultrasound technician or doctor will introduce an ultrasound probe into your vagina. It may be mildly uncomfortable, but will not hurt. The probe is covered with a condom and a gel.

• The probe transmits sound waves and records the reflections of those waves off body structures. The ultrasound machine creates an image of the body part.

• The image is displayed on the ultrasound machine. In many offices, the person having the test can see the image also.

• The health care provider will gently move the probe around the area to see the pelvic organs.

In some cases, a special transvaginal ultrasound method called saline infusion sonography (SIS) may be needed to more clearly view the uterus.

How to Prepare for the Test

You will be asked to undress, usually from the waist down. A transvaginal ultrasound is done with your bladder empty or partly filled.

How the Test will Feel

In most cases, there is no pain. Some women may have mild discomfort from the pressure of the probe. Only a small part of the probe is placed into the vagina.

Why the Test is Performed

Transvaginal ultrasound may be done for the following problems:

• Abnormal findings on a physical exam, such as cysts, fibroid tumors, or other growths

• Abnormal vaginal bleeding and menstrual problems

• Certain types of infertility

• Ectopic pregnancy

• Pelvic pain

This ultrasound is also used during pregnancy.

Normal Results

The pelvic structures or fetus is normal.

What Abnormal Results Mean

An abnormal result may be due to many conditions. Some problems that may be seen include:

• Birth defects in an unborn baby

• Cancers of the uterus, ovaries, vagina, and other pelvic structures

• Infection, including pelvic inflammatory disease

• Benign growths in or around the uterus and ovaries (such as cysts or fibroids)

• Endometriosis

• Pregnancy outside of the uterus (ectopic pregnancy)

• Twisting of the ovaries

Risks

There are no known harmful effects of transvaginal ultrasound on humans.

Unlike traditional x-rays, there is no radiation exposure with this test.

References

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Hur HC, Lobo RA. Ectopic pregnancy: etiology, pathology, diagnosis, management, fertility prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.

Kelly CM. Ectopic pregnancy. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier; 2024:1288-1291.

Wei PK, Savicke AM, Levine D. The uterus. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 6th ed. Philadelphia, PA: Elsevier; 2024:chap 28.

Review Date: 4/16/2024

Reviewed By: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.