Pelvic Ultrasound: What It Checks and Why Your Doctor Ordered One

A pelvic ultrasound is one of the most frequently ordered imaging studies — and one that patients often have the most questions about. If your doctor has ordered one, here is everything you need to know.

What Does a Pelvic Ultrasound Examine?

A pelvic ultrasound uses sound waves to create images of the organs and structures in your pelvis:

In women: - Uterus — size, shape, position, and any abnormalities - Ovaries — cysts, masses, size, and follicle activity - Fallopian tubes — usually only visible if inflamed or fluid-filled - Cervix - Endometrium — the uterine lining (thickness and pattern) - Bladder

In men: - Bladder - Prostate (transrectal approach) - Seminal vesicles

Common Reasons for a Pelvic Ultrasound

Abnormal Bleeding Irregular periods, heavy bleeding, bleeding between periods, or postmenopausal bleeding are the most common reasons. Ultrasound can identify: - Fibroids (benign uterine growths) - Polyps (growths in the uterine lining) - Thickened endometrium (which may need further evaluation) - Adenomyosis (endometrial tissue growing into the uterine wall)

Pelvic Pain Chronic or acute pelvic pain may prompt an ultrasound to look for: - Ovarian cysts (most are benign and resolve on their own) - Endometriosis (endometriomas or "chocolate cysts") - Pelvic inflammatory disease (PID) - Ectopic pregnancy

Ovarian Cysts Many cysts are found incidentally or cause pain. Ultrasound characterizes them: - Simple cysts — fluid-filled, almost always benign - Complex cysts — contain solid components, may need follow-up - Dermoid cysts — contain tissue like hair or teeth (benign but may need removal) - Hemorrhagic cysts — contain blood, usually resolve spontaneously

Fertility Evaluation Ultrasound is central to fertility workups: - Follicle counting (ovarian reserve) - Monitoring ovulation - Evaluating uterine anatomy for implantation - Checking for polyps or fibroids that could affect fertility

Monitoring Known Conditions If you have known fibroids, ovarian cysts, or endometriosis, your doctor may order periodic ultrasounds to monitor changes.

Two Types of Pelvic Ultrasound

Transabdominal - The transducer is placed on your lower abdomen - Provides a wide overview of the pelvis - Requires a full bladder — the fluid acts as an "acoustic window" to see the pelvic organs clearly - Drink 32 ounces of water 1 hour before your appointment and do not urinate

Transvaginal - A slim, lubricated transducer is gently inserted into the vagina - Provides much higher-resolution images of the uterus and ovaries - Performed with an empty bladder (you will be asked to empty your bladder after the transabdominal portion) - Not painful — mild pressure is normal - You are always in control and can stop the exam at any time

Most complete pelvic ultrasound exams include both approaches. The transabdominal scan provides the big picture; the transvaginal scan provides the detail.

What to Expect

1. You will change into a gown from the waist down
2. Transabdominal first: Gel is applied to your lower abdomen, and the sonographer moves the transducer to capture images
3. Bathroom break: You empty your bladder
4. Transvaginal: You lie on the exam table with your feet in stirrups. The lubricated transducer is gently inserted. The sonographer captures images while angling the transducer.
5. Total time: 20-30 minutes

After the Exam

Our radiologist reviews every image and sends a detailed report to your physician, typically within 48 hours. Common findings and their significance:

• Simple ovarian cyst < 3 cm — Normal finding, especially in premenopausal women. No follow-up needed.
• Fibroids — Extremely common (up to 80% of women by age 50). Most do not require treatment.
• Thickened endometrium — Normal ranges vary by menstrual cycle phase and menopausal status. Your doctor will interpret this in context.
• Free fluid in the pelvis — A small amount is normal, especially around ovulation.

At AMI

We perform pelvic ultrasounds daily with experienced, compassionate sonographers. Your comfort and dignity are our priority.

Call (727) 398-5999 or schedule online.