Pelvic Ultrasound
What Is a Pelvic Ultrasound?
A pelvic ultrasound, also known as a lower abdominal ultrasound, is an imaging test used to investigate conditions and symptoms related to the organs of the pelvic cavity. It is performed using ultrasound waves, is completely non-invasive and painless, and does not use radiation.
Unlike a transvaginal ultrasound, which is part of a routine gynecological exam, a pelvic ultrasound is usually ordered by a doctor for a specific reason, in response to a symptom, finding, or clinical suspicion that requires investigation.
When does the doctor recommend it?
A gynecologist orders a pelvic ultrasound when there are symptoms or clinical signs that require further investigation. The most common cases include:
Bleeding disorders
Abnormal vaginal bleeding, heavy or irregular periods, spotting outside the menstrual cycle, and postmenopausal bleeding are common indications for referral for a pelvic ultrasound.
Pelvic pain
Chronic or acute pain in the lower abdomen, pain during sexual intercourse, or pain associated with the menstrual cycle are indications that warrant imaging evaluation.
Suspected pathology
When, during a clinical examination, the gynecologist palpates something concerning or when there is clinical suspicion of an ovarian cyst, fibroid, polyp, or endometriosis, a pelvic ultrasound is the first and most reliable diagnostic step.
Infertility Evaluation
As part of the evaluation of difficulty conceiving, a pelvic ultrasound provides important information about the condition of the uterus, ovaries, and ovarian reserve.
Monitoring of a diagnosed condition
Women with a pre-existing condition such as fibroids, cysts, or endometriosis require regular ultrasound monitoring to track its progression.
What does the test detect?
A pelvic ultrasound provides the gynecologist with valuable diagnostic information about the organs of the pelvic cavity. The most common findings it may reveal include:
Uterine pathology
Fibroids, endometrial polyps, thickened endometrium, congenital uterine abnormalities such as a bicornuate uterus or uterine septum, as well as signs of adenomyosis.
Ovarian pathology
Various types of ovarian cysts, endometriomas, pathological masses requiring further investigation, as well as assessment of ovarian reserve through follicle counting.
Fallopian tube pathology
Hydrosalpinx or other pathological changes in the fallopian tubes that are not visible on ultrasound under normal conditions.
Free fluid
The presence of free fluid in the pelvic cavity may indicate inflammation, a ruptured cyst, or another condition requiring immediate evaluation.
Pregnancy
In women of reproductive age, a pelvic ultrasound can confirm or rule out pregnancy, including ectopic pregnancy, which is a medical emergency.
Important: A pelvic ultrasound is an extremely useful diagnostic tool; however, it does not always replace other tests. In some cases, the gynecologist may recommend additional tests, such as an MRI or hysteroscopy, to obtain a more complete diagnostic picture.
How it works
A pelvic ultrasound is usually performed in two ways, which are often combined to provide a more complete picture. The doctor applies a special gel to the abdomen and glides the transducer over its surface. In a transvaginal ultrasound, a thin probe is inserted into the vagina, providing a more detailed view of the organs. An empty bladder is required for greater comfort.
The exam is painless, does not require fasting, and usually takes 10 to 20 minutes.
What do the findings mean?
Some of the most common findings you may see in the test report are:
Normal findings
This means that the uterus and ovaries are of normal size, shape, and structure, with no pathological changes. These findings confirm the absence of visible pathology.
Endometrial hyperplasia
The thickness of the endometrium is assessed in relation to the phase of the menstrual cycle. Abnormally increased thickness may indicate the presence of polyps, hyperplasia, or another condition requiring further investigation.
Ovarian Cyst
This does not automatically indicate a problem. The gynecologist evaluates the characteristics of the cyst (size, contents, walls) to determine whether monitoring or further treatment is necessary.
Free fluid in the pelvis
A small amount of free fluid after ovulation is normal. A larger amount or fluid detected outside the expected phase of the cycle requires clinical evaluation.
Suspicious finding
When the report mentions suspicious features, the gynecologist will recommend additional tests for clarification. The word “suspicious” does not automatically mean malignancy, but that further investigation is needed.
Important: Never interpret the results on your own. Every finding is evaluated in the context of your clinical history and symptoms.
Frequently Asked Questions (FAQ)
A typical exam usually lasts 10 to 20 minutes, depending on whether it involves an abdominal ultrasound alone or a combination of abdominal and transvaginal ultrasounds. In cases where a finding is detected that requires further evaluation, the exam may take a little longer.
Yes, a pelvic ultrasound can be performed even during menstruation. In fact, in some cases—such as when investigating endometriosis or monitoring the menstrual cycle for fertility purposes—the exam is intentionally scheduled for specific days of the cycle.
A pelvic ultrasound can detect suspicious masses or abnormal changes that may be related to cancer. However, it cannot diagnose cancer on its own. A definitive diagnosis requires a histological examination. If a suspicious finding is detected, the gynecologist will recommend further testing.
A suspicious finding on an ultrasound does not automatically indicate a serious condition. It means that the gynecologist needs more information to reach a diagnosis. Depending on the finding, they may recommend a follow-up ultrasound in the near future, blood tests, an MRI, or a hysteroscopy. The important thing is not to postpone your next appointment and to discuss the next steps in detail with your gynecologist.
A normal ultrasound does not necessarily rule out the presence of a medical condition. Certain conditions, such as early-stage endometriosis, adhesions, or chronic pelvic pain of neurological origin, do not always show up on an ultrasound. If symptoms persist despite a normal result, the gynecologist may recommend further investigation.
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