A pelvic ultrasound uses sound waves to create real-time images of the organs inside your pelvis. The exam typically takes 15 to 30 minutes, involves no radiation, and can be done one of two ways: externally through your lower abdomen or internally through the vagina. Sometimes both methods are used in the same appointment.
How the Imaging Works
The handheld device your technician uses, called a transducer, both sends out high-frequency sound waves and listens for the echoes that bounce back. When those sound waves hit a boundary between different tissues (fluid and soft tissue, or tissue and bone, for example), the echoes return to the transducer and generate electrical signals. A computer then uses the speed of sound and the return time of each echo to calculate distances, assembling those measurements into a two-dimensional image on a screen in real time.
What a Pelvic Ultrasound Can Show
In women, the exam images the uterus, cervix, ovaries, fallopian tubes, and bladder. A transvaginal approach gives especially detailed views of the uterine lining, the muscular walls of the uterus, and the ovaries. Common reasons for ordering one include evaluating abnormal bleeding, checking for ovarian cysts or fibroids, assessing pelvic pain, monitoring early pregnancy, and measuring endometrial thickness.
In men, a pelvic ultrasound focuses on the bladder, prostate, and seminal vesicles. For both men and women, the exam can also help identify kidney stones, bladder tumors, and other urinary bladder disorders.
Preparing for the Exam
If you’re having the external (transabdominal) version, you’ll need a full bladder. A full bladder pushes the intestines out of the way and creates a fluid-filled “window” that helps sound waves travel to the pelvic organs more clearly. The standard preparation is to drink 32 ounces of water, about four glasses, one hour before your appointment. You can use the bathroom to relieve yourself as long as you keep drinking water to maintain that full feeling.
For a transvaginal ultrasound, the preparation is simpler. You’ll typically be asked to empty your bladder beforehand, since the probe is close enough to the organs that a full bladder isn’t needed and would actually make the exam less comfortable.
The Transabdominal Method
You’ll lie on your back on an exam table. The technician applies a warm gel to your lower abdomen. This gel eliminates the air gap between the transducer and your skin, which would otherwise block the sound waves. The technician then presses the transducer against your skin and slides it across different areas of your lower belly, angling it to capture images of each organ.
Most women don’t feel pain or discomfort from the transducer itself during this part. The main source of discomfort is the full bladder, which can feel like increasing pressure as the technician presses down on your abdomen. Some people also find lying still on the exam table uncomfortable. The whole process is relatively quick, and you can use the restroom as soon as the transabdominal portion is finished.
The Transvaginal Method
For a transvaginal ultrasound, you lie on the exam table with your feet in supports, similar to a standard pelvic exam. The technician uses a thin, wand-shaped transducer that’s about two to three centimeters wide. It gets covered with a disposable plastic or latex sheath and coated with lubricant before the tip is gently inserted into the vagina.
Once inside, the technician slowly turns and angles the transducer to bring different structures into focus on the screen. Because the probe sits much closer to the uterus and ovaries than an external transducer can, the images are significantly more detailed. This is why your provider may order a transvaginal exam even if a transabdominal scan has already been done.
The sensations vary from person to person. Some women feel only mild pressure as the transducer is repositioned. Others experience a brief, dull pain during insertion or when the probe is angled toward a particular side. It’s generally described as uncomfortable rather than painful, and it doesn’t last long. If you feel significant discomfort at any point, you can tell the technician, who can adjust the angle or pause.
What Happens Afterward
There’s no recovery time. You can go back to your normal activities immediately. The gel wipes off easily, and you won’t have any lingering side effects from either type of exam.
During the scan, the technician captures still images and sometimes short video clips. These get sent to a radiologist or your ordering provider for interpretation. Results are usually available within a few days, though the exact timeline depends on your clinic. The technician performing the scan typically can’t share results with you during the appointment, since a physician needs to formally review the images first.