A transvaginal ultrasound is a safe, radiation-free scan that provides clear, detailed images of the pelvic organs, helping diagnose symptoms, assess early pregnancy, and guide personalised gynaecological care.
What is a transvaginal ultrasound scan?
A transvaginal ultrasound is a diagnostic imaging procedure that uses high-frequency sound waves to create detailed images of the pelvic organs, including the uterus, ovaries, and surrounding soft tissues. The fallopian tubes are usually only visible if they are enlarged or filled with fluid. It provides essential insight for diagnosing and managing a range of gynaecological conditions. Unlike X-rays, it does not involve radiation exposure, making it a safe and effective method for evaluating pelvic structures.
Why you might need a transvaginal ultrasound
A transvaginal ultrasound is commonly performed for a variety of reasons. Abnormal menstrual bleeding is a frequent symptom that prompts the need for this test, as it helps to identify underlying causes such as fibroids, polyps, or structural abnormalities.
Early pregnancy assessment is another key indication, allowing clinicians to confirm pregnancy status, evaluate for potential complications, and monitor related pelvic conditions. The scan can also assess factors that may affect fertility, such as ovarian follicle count and uterine structure. Additionally, a transvaginal ultrasound can be used to evaluate complications during pregnancy, such as confirming the location of the pregnancy or assessing for signs of miscarriage.
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Ways to payBefore the scan
Before your transvaginal ultrasound, you will be asked to undress from the waist down and may be provided with a hospital gown to wear during the procedure. It is vital to empty your bladder beforehand, as a full bladder can compromise image clarity. Preparation for the scan does not require any special dietary restrictions or fasting. However, if you are having a scan to investigate menstrual problems, abnormal vaginal bleeding, or pregnancy-related concerns, it is helpful to inform your healthcare provider of your current symptoms and medical history. If you have any questions or concerns before the scan, do not hesitate to discuss them with your healthcare provider or the sonographer performing the examination. You can request the presence of a chaperone or a family member during the examination.
During the scan
You will lie on an examination table, typically with your knees bent and legs apart to allow easy access to the pelvic area. A health professional, such as a gynaecologist, ultrasound technician, or sonographer, will explain the procedure clearly and obtain your verbal consent before beginning the scan.
The ultrasound probe is gently inserted, covered with a protective sheath and lubricating gel to ensure comfort throughout the scan. Some women may feel mild pressure or slight discomfort during the scan, but this is usually brief, and the procedure is very safe.
This probe transmits high-frequency sound waves to create detailed images of your uterus and ovaries. The fallopian tubes are typically only seen if they are abnormally enlarged. Your sonographer will be looking for any abnormal findings that could explain symptoms you may be experiencing, such as pelvic pain or abnormal vaginal bleeding.
In some cases, your gynaecologist may recommend a special transvaginal ultrasound method called saline infusion sonography (SIS). This technique involves gently introducing saline into the uterus, which helps outline the uterine cavity and improves visualisation of the endometrium and related structures.
The entire process usually takes between 15 and 30 minutes, depending on the specific assessment needed.
After the scan
Once your transvaginal ultrasound examination is complete, your gynaecologist will carefully review the acquired images.
If your ultrasound scan reveals an abnormal result, your doctor may recommend further investigation, which could include additional diagnostic tests or a biopsy to better understand the underlying cause and determine the most appropriate course of action.
It’s essential to discuss your results thoroughly with your gynaecologist, who can explain precisely what the findings mean for your overall health and outline any necessary next steps in your care. Your doctor will also inform you if any specific treatment options or follow-up appointments are needed based on the particular findings from your ultrasound examination, ensuring you receive the most appropriate and timely care for your condition.
Abnormal findings and what they mean
Abnormal findings identified during a transvaginal ultrasound can indicate a variety of conditions affecting the reproductive system, such as signs of an ectopic pregnancy or pelvic inflammatory disease. Some types of endometriosis, such as ovarian endometriomas or deeper lesions, may also be visible.
The ultrasound may also detect cysts, tumours, or other growths developing on the ovaries or uterus, which could potentially impact your fertility or overall reproductive health.
If your ultrasound examination reveals any abnormal findings, your gynaecologist will thoroughly explain what these results mean for your specific situation.
Other diagnostic tests you may need
Based on your specific symptoms or the findings from your transvaginal ultrasound scan, your healthcare provider may recommend additional diagnostic procedures to obtain a more comprehensive assessment of your pelvic organs and overall health.
A standard follow-up examination is a transabdominal ultrasound, in which the ultrasound probe is placed on your lower abdomen. This provides a broader overview of the pelvic region and complements the more detailed images obtained through a transvaginal scan.
In some instances, your gynaecologist might determine that a biopsy is necessary to examine tissue samples from the uterus or ovaries more thoroughly.
Additional tests, including a comprehensive pelvic examination or specific blood tests, can provide your consultant with valuable information to assess your overall health status and help pinpoint the precise cause of any unusual or concerning findings detected during your initial scan.
Appointment and Treatment Plan
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Preparing for the Scan
You will undress from the waist down and may be given a gown. Your bladder should be empty to allow clearer images. No fasting or dietary changes are needed. Let your clinician know about any symptoms, medical history, or concerns, and you may request a chaperone or bring a support person if you wish.
Ultrasound Scan
You’ll lie on an examination table with your knees bent. After the procedure is explained and you give consent, a lubricated, covered ultrasound probe is gently inserted into the vagina. You may feel slight pressure, but it should not be painful. The probe uses sound waves to create detailed images of the uterus and ovaries, and in some cases, a saline infusion sonography (SIS) may be used to improve visibility. The scan usually takes 15-30 minutes.
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Results
Your gynaecologist reviews the images and discusses the findings with you. If anything abnormal is seen, such as cysts, fibroids, endometriosis, enlarged fallopian tubes, or signs of infection or ectopic pregnancy, your doctor will explain what it means and whether further tests or treatment are needed.
Further Tests (If Needed)
Depending on your symptoms and scan results, additional investigations may include a transabdominal ultrasound for a wider pelvic view, blood tests, a pelvic examination, or a biopsy to assess tissue more closely. Your consultant will guide you through any recommended next steps and arrange appropriate follow-up care.
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Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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FAQs
Transvaginal means that the ultrasound probe is inserted through the vagina to obtain detailed images of the pelvic organs and structures. This approach allows for closer proximity to the female reproductive organs compared to an abdominal ultrasound, resulting in clearer and more precise imaging.
The procedure is generally considered mildly uncomfortable rather than painful. The ultrasound probe is covered with a protective cover and lubricating gel to ease insertion. Most women experience only mild discomfort or pressure during the examination, which usually lasts between 15 and 30 minutes.
You will be asked to undress from the waist down and empty your bladder before the scan to improve image clarity. No special dietary restrictions or fasting are required. Inform your healthcare provider of any symptoms or medical history relevant to your pelvic health.
This ultrasound can identify a range of conditions affecting the pelvic structures, such as ovarian cysts, fibroids, polyps, ectopic pregnancy, and some forms of endometriosis (such as endometriomas). It can also assess the health of an unborn baby during early pregnancy and detect certain congenital anomalies.
A transvaginal ultrasound is a very safe procedure that does not involve ionising radiation. There are no known harmful effects on the patient or foetus. Some of the lubricating gel may leak out after the scan, which is normal and usually stops within a few hours.
A trained healthcare professional, such as a gynaecologist, an ultrasound technician, sonographer, radiologist, or obstetrician, carries out the examination. You may request a chaperone or family member to be present during the procedure for added comfort.
The scan usually takes between 15 and 30 minutes, depending on the complexity of the assessment and the pelvic structures being examined.
If abnormal results are found, your gynaecologist may recommend further investigation, such as additional imaging tests, blood tests, or a biopsy. Treatment options will be discussed based on the specific diagnosis to ensure appropriate care.
Yes, the scan can be performed during menstruation and may even provide advantages in evaluating certain gynaecological conditions.
Unlike an abdominal ultrasound, a full bladder is not required for a transvaginal ultrasound. In fact, you will usually be asked to empty your bladder before the procedure for better image quality.