Transvaginal pelvic ultrasound is a test that uses reflected sound waves to produce a picture of the uterus and other structures inside the pelvis. It does not use X-rays or other types of radiation.

A small ultrasound device (transducer) is inserted into the vagina. High-pitched sound waves emitted from the transducer bounce off the uterus and ovaries. The sound waves send out high-pitched sounds (above the range of human hearing) that are reflected back to the transducer. A microphone analyzes the sound waves and converts them into a picture that is displayed on a video monitor. The picture produced by ultrasound is called a sonogram, echogram, or scan.

Why It Is Done

Transvaginal ultrasound is used to evaluate women with dysfunctional uterine bleeding and to determine whether an abnormal area (such as an endometrial polyp or uterine fibroid) is present in the uterus before hysteroscopy is performed. In postmenopausal women, the thickness of the uterine lining is evaluated to check for overgrowth (hyperplasia) or cancer of the lining of the uterus (endometrium). If no abnormal areas are found, a hysteroscopy or an endometrial biopsy may not need to be performed.

After the pelvic exam, a transvaginal ultrasound is often the next step in diagnosing dysfunctional uterine bleeding.

Results

Ultrasound results may be normal or abnormal.

Normal

No abnormal areas are found in the uterus.

Ultrasound may not detect small lesions (less than 1 inch or 2.5 cm). The likelihood of finding smaller lesions is improved if 10 to 15 mL of fluid is placed in the uterus before the exam (sonohysterography).¹

Abnormal

An abnormal area (lesion) is found.

What To Think About

A treatment plan can be developed based on the results of the pelvic exam and ultrasound. Knowing the size, number, and location of lesions helps determine:

• Which treatment method might be most successful.
• Which surgical method is most appropriate to control dysfunctional uterine bleeding.

If bleeding is severe and fertility is a concern, hysteroscopy or laparoscopy may be needed to determine a treatment plan. See Exams and Tests.

Complete the medical test information form (PDF)(What is a PDF document?) to help you prepare for this test.

Citations

1. Mishell DR Jr, et al. (2001). Abnormal uterine bleeding. In MA Stenchever et al., eds., Comprehensive Gynecology, 4th ed., pp. 1079–1097. St. Louis: Mosby.