Pelvic Ultrasound in Gynaecology

Ultrasound has been used for decades to assess the health of the female pelvic organs – mainly the uterus, and ovaries.

Vaginal Ultrasound

Gynaecological ultrasound examination usually requires a vaginal scan.  A narrow ultrasound probe is placed in the vagina to optimise views of the internal organs. An empty bladder is best for a vaginal scan.

A vaginal scan can be performed at any time of the menstrual cycle, although our preference is to perform it just after the period has finished.

Abdominal Ultrasound

If you have never had sexual intercourse then your scan will most likely be an abdominal scan with a full bladder. Please discuss with WUMe staff when booking your ultrasound.  You will need to attend with a full bladder if an abdominal scan is best for you.

Indications for gynaecological ultrasounds at different life stages:

Young girls and adolescents

This is performed as an abdominal ultrasound so please attend with a full bladder.  Please attend with a responsible adult if possible.

Reasons for ultrasounds in this age group may include delayed periods, abdominal pain and abnormal bleeding.

Your Wume Doctor who performs the ultrasound will explain the findings and answer any of your questions at the time of your scan.

The menstrual years

This is the most common age group in which ultrasounds are performed, as ultrasound is excellent for assessing menstrual cycle problems.

Common reasons for referral include:

• Bleeding between periods
• Heavy or painful periods
• Pelvic pain at any time of the cycle
• Absent or irregular periods
• Pelvic mass and assessment of fibroids
• Cyst diagnosis and follow up
• Fertility issues

Common findings may include fibroids, adenomyosis, endometrial polyps, ovarian cysts and hydrosalpinx.

Postmenopausal years

Bleeding, ovarian cancer screening and pelvic pain are the commonest reasons for referral.

With post menopausal bleeding, on or off Hormone Replacement Therapy (HRT), the endometrial lining of the uterus is assessed for thickness and polyps or internal fibroids.

A thin endometrial lining is reassuring and reflects the lack of estrogen after menopause.

The ovaries will also be assessed, if visible.  After menopause, the ovaries become small and inactive and may not always be seen.

Ovarian cancer screening is another common referral, particularly in women with a family history of ovarian cancer or previous breast cancer.

Pelvic discomfort, bloating or pain are other reasons for  a gynaecological ultrasound.

Common Gynaecological Pathology

Endometrial polyps

Endometrial polyps commonly occur during the menstrual years and tend to cause heavy periods and bleeding between the periods. They are found in the lining of the womb or endometrium, which is the tissue that bleeds each month with the period. They are usually benign and easily removed by a gynecologist.

Fibroids

Fibroids are common uterine muscle tumours and almost always are benign. They sometimes cause menstrual irregularities and may be monitored as they can grow significantly over a number of years. They may enlarge the uterus and create a “lump” of feeling or pelvic pressure.

Ovarian cysts

The ovaries are active organs that naturally develop small “cysts” during the menstrual cycle.  These are cysts of normal ovarian function. These natural “cysts” are usually easily recognised.  More significant cysts can be diagnosed and assessed during the scan and any significant findings described in the report for your doctor as well as discussed with you at the time of your ultrasound.

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a condition associated with irregular and usually infrequent periods. Some women have marked acne +/or weight gain as their manifestation of PCOS. Many of the ultrasound features of PCO help in the diagnosis and monitoring of this condition.

Adenomyosis

Adenomyosis usually occurs in women in their later menstrual years and causes heavier periods and pain. This condition is due to the endometrium, or lining layer, extending into the muscle layer of the uterus, which over time gradually causes uterine enlargement, pain and cystic change.

Endometriosis

Endometriosis is a condition that causes significant pain and fertility issues. Ultrasound diagnosis has improved and the extent of the endometriosis is now better appreciated.

Endometriosis assessment with bowel preparation can allow the diagnosis of smaller lesions in the pelvis and the presence of bowel involvement. Your doctor will request this if it is necessary.

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Hydrosalpinx

Hydrosalpinx means fluid in the fallopian tube. This is a common finding in older women and women with fertility issues. This can be diagnosed with a pelvic ultrasound examination.