TRANSVAGINAL ULTRASOUND: indications, contraindications and risks

Transvaginal echo: here is the probe that, through the vagina, rests on the uterine cervix and allows you to view the uterus and ovaries.
L'transvaginal ultrasound is a type of ultrasound, which helps to understand the state of health and the conformation of female internal genital organs. L'transvaginal echo is done through a ultrasound probe inserted into the vagina, thanks to which they are displayed in real time uterus, uterine cervix, ovaries is tube of Fallopio. Transvaginal ultrasound is performed during the pregnancy, but also in non-pregnant women to evaluate conformation and health of the internal genital organs.

What is transvaginal ultrasound?

L'transvaginal ultrasound, called ance TVS (from English Trans-Vaginal Sonography) is one of the most common diagnostic imaging tests and is designed to assess the health of the female genital system from the inside. It's a kind of gynecological ultrasound, can be regarded as a routine examination, prescribed by the doctor in the normal periodic prevention process, or it may be requested to highlight the cause of any problems affecting the genital system.

Transvaginal echo is sometimes loosely defined with the terms of vaginal ultrasound, transvag ultrasound or echo transvag. It is considered a very useful examination, and allows you to have defined and clear images of the internal situation of the female internal genital organs: it exploits the potential of high frequency sound waves (ultrasound), which are not perceived by the human ear, which are produced by an elongated ultrasound probe that is inserted into the body through the vagina, without causing any particular problem to the woman. It is not considered an invasive examination and has a variable duration, but usually never requires more than half an hour.
Unlike other gynecological diagnostic tests, transvaginal ultrasound it does not require abstention from sexual intercourse.

How is transvaginal ultrasound performed?

How is the transvaginal echo done? How you do it?

Transvaginal ultrasound is done in a patient's office gynecologist and the woman is asked to recline on the cot in supine position (belly up), exposing the body from the waist down. To give better access to the doctor and the probe, the woman is asked to hold them legs slightly apart, so that the probe can easily penetrate inside the body: to facilitate the entry of the ultrasound probe, this is covered with a disposable lubricated cap, very similar to a condom, which promotes sliding inside the vagina creating as little discomfort as possible to the patient.

Unlike other ultrasound and tomographic examinations, transvaginal ultrasound can be performed at any time during the menstrual cycle and is executed even with an empty bladder, which results in less discomfort for the patient. The modalities in which it takes place are completely similar to those of a normal routine gynecological examination and no specific preliminary preparation is usually required by the doctor to perform the examination.

The ultrasound probe is inserted inside the vaginal canal, until it rests against the uterine cervix, that is the initial part of the uterus. Once activated, the probe begins to emit ultrasound which, exploiting the echo phenomenon, spread inside the uterine environment, hitting the walls and coming from these reflections based on their specific density: the result of this system are the images in real time that the doctor interprets from a monitor connected to the probe.

The transvaginal echo is theultrasound for theuterus which guarantees greater diagnostic accuracy. In fact, thanks to this examination, the doctor has the opportunity to explore the state of health of the uterus and cervix, ovaries and all the appendages of the genital system.
Up to 40 years A transvaginal ultrasound is recommended per year, exceeded 40instead, doctors advise their patients to have a transvaginal exam every 6 months.

Difference between transvaginal ultrasound and transabdominal pelvic ultrasound

Pelvic echo and transvaginal echo, what are the differences? Although both are very important gynecological examinations of diagnostic imaging, between the two there are substantial differences in the methods of examination. In fact, intransabdominal pelvic ultrasound the probe is not inserted inside but is placed and slipped on the abdomen.

The operating pattern is almost the same, because the doctor also in this case has a return image due to the reflection of the wave by the internal tissues. Obviously, it doesn't have the same definition as a 'transvaginal ultrasound, since it does not take place from the inside, but it is still useful for studying macropathologies. Also, transvaginal ultrasound does not require a full bladder, unlike transabdominal pelvic ultrasound.

Please note: thetransabdominal ultrasound is always performed in sostitution oftransvaginal ultrasound in patients virgins (i.e. who have not yet had their first sexual intercourse) and in patients beyond 3 months of pregnancy.

Transvaginal echo: here is the probe that, through the vagina, rests on the uterine cervix and allows you to view the uterus and ovaries.

Transvaginal echo: here is the probe that, through the vagina, rests on the uterine cervix and allows you to view the uterus and ovaries.

When to perform transvaginal ultrasound?

When it is necessary to perform a transvaginal echo? What are the indications? Transvaginal ultrasound should be considered by women as a 'routine examination, sometimes annoying, but essential for the prevention and treatment of the reproductive system from the moment of the beginning of sexual life.

The trans-vaginal echo is also employed in the evaluation of the internal genitals and the fetus in the first three months of pregnancy. The transvaginal echo is preferred toabdominal pelvic echo for the ability of the former to first highlight the images relating to the embryo and internal structures, with a diagnosis of higher quality and definition than the latter.

In addition to being a periodic routine examination and as an examination in the first trimester of pregnancy, transvaginal ultrasound is also required of patients as diagnostic examination for the detection of any problems affecting the reproductive system, in particular when the patient shows symptoms of some pathology or anomalies in the correct functioning of the system.

Specifically, the indications of transvaginal ultrasound I'm:

  • Fibroids: they are benign tumors that affect the uterus and are quite common in women, especially between 30 and 50 years old. It causes severe pain and heavy bleeding. They appear as nodules of various sizes, made up of muscle tissue and fibrous tissue. They often require pharmacological treatment to control the size but surgery for removal is frequent, especially in the most severe cases, in which the fibroid reaches significant dimensions. Surgical treatment involves the removal of only the fibroid when it has not reached a considerable size, otherwise a hysterectomy is necessary, i.e. the removal of the entire uterine organ. Internal ultrasound it can give information on the presence, size and location of any uterine fibroids.
  • Polyps: they are foreign formations, soft growths that form on the endometrial wall of the uterus or on the cervical one. The causes of these formations are not yet known precisely, but they are thought to be due to hormonal changes in women approaching the period of menopause. Polyps cannot always be identified for a symptomatology, because they often do not give any sign of their presence but are identified through transvaginal ultrasound. Therapy is usually pharmacological, when necessary, but in cases where the polyps reach significant dimensions it is necessary to proceed with surgical removal.
  • Ovarian cystsOvarian cysts are small bags of tissue that form inside or outside the ovaries, which can fill with liquid or, more rarely, solid material. In most cases they are not considered as a problem but, when a possible ovarian growth, initially considered a cyst, increases in size, they must be promptly investigated, because in addition to causing severe pain in the woman, it could actually turn out to be a ovarian tumor formation. Smaller cysts are able to absorb themselves autonomously, without any drug or surgical treatment, while in other cases it is necessary to provide for the removal and histological analysis, to avoid more serious consequences. The transvaginal echo it is a very useful examination to investigate the conformation and possible origin of an ovarian cyst.
  • Difficulty of procreation: in the event that the woman has difficulty in becoming pregnant or has suffered a miscarriage, the reasons for this problem must be evaluated. The causes are many and with the transvaginal ultrasound the doctor is able to identify any critical issues affecting the genital system that may in some way be the causes of such an important problem. Fibroids, cysts, polyps and malformations are the main physiological causes, to which, however, others can be added. In the event that morphologically and physiologically the genital apparatus does not present anomalies, the cause is to be sought elsewhere.
  • Uterine malformations: the uterine malformations they are anomalies, often congenital, which, despite what one might think, affect a large number of women. The most frequent malformations concern the position of the uterus (retroverted uterus) or its shape (septum uterus, bicornuate uterus, arcuate uterus). In most cases the deviations and anomalies are minor and do not cause any problems for the woman but, in some cases, they cause spontaneous abortions and infertility. It is not a symptomatic problem, so much so that it is not diagnosed until after a miscarriage or vain attempts to become pregnant, unless the woman undergoes a pelvic or transvaginal ultrasound. One of the possible symptoms can be intense menstrual pain or a marked premenstrual syndrome, but a deviation of the uterus is not always the cause.
  • Amenorrhea: it is the absence of the menstrual cycle. We talk about amenorrhea even when the woman begins the gestation period or enters menopause but, more generally, we refer to cases of unjustified absence. We can refer to amenorrhea in the event that a girl, around the age of 15, has not yet had menarche (first menstruation) or when, in fertile age, the cycle disappears for one or more months. The symptom of amenorrhea is amenorrhea itself but, depending on the cause, it can be accompanied by acne, headache, pain in the lower abdomen, etc. Among the causes, in addition to menopause and pregnancy, are the use of medicines and contraceptives, mental and physical stress, excessively low body weight, hormonal imbalance or excess physical activity. It can lead to infertility or early osteoporosis, e transvaginal ultrasound helps clarify the causes.
  • Menorrhagia or metrorrhagia: bleeding between one cycle and another (metrorrhagia) or the presence of so-called heavy menstruation (menorrhagia) can be symptomatic of the presence of a pathology of the genital system. They can result from obesity, anorexia, fibroids, inadequate intake of vitamins and proteins, from polycystic ovary syndrome.
  • Dysmenorrhea: the presence of dysmenorrhea (painful menstruation) is often an indication to perform an ultrasound evaluation with transvaginal ultrasound or an ultrasound of the lower abdomen and pelvic.

Risks of transvaginal ultrasound

Broadly speaking, the transvaginal ultrasound does not present particular risks for women's health. The probe is always covered with a disposable cap that eliminates any type of bacterial biological contamination. Furthermore, the cap is lubricated, which facilitates the sliding of the probe inside the vagina and does not cause the woman any specific discomfort, if not a slight discomfort. The gynecologist makes gentle and careful movements for the insertion of the probe and, in case the patient presents pain, evaluates with her the best method of insertion.

In the case of transvaginal ultrasound during pregnancy, however, it is advisable to avoid it once the 3 months of gestation have passed, especially for a matter of comfort for the baby. However, there is no risk in carrying out transvaginal ultrasound in gestation and it should not be assumed that this could be the cause of an abortion. The waves emitted by the probe have no effect on the fetus and, therefore, do not undermine its health.

The only problem, if it can be called that, could be represented by a slight persistent discomfort after the visit, which however does not last more than a few hours.
Transvaginal ultrasound is not performed in women who have not yet had the first sexual intercourse to avoid rupture of the hymen, the membrane that partially covers the opening of the vaginal canal.
For the rest, if the doctor performs the correct prophylaxis, there is no risk or contraindication for carrying out transvaginal ultrasound.

  1. Sonia 2 years ago

    Hi two years ago I performed a breast surgery x fibroadenoma removal since then I noticed a change in the menstrual cycle, that is, having always been precise every 28 days very often it was wrapped in advance so wrapped little wrapped 2 times in a month until March April May of this year have not really appeared
    Arriving then in June On the 5th of July on the 14th, and in addition after 14 days returned but of little dark spots and when I clean myself I highlight them leaving me the panty liner let's say clean ... I specify that I am 49 years old and the doctor tells me that it could be beginning menopause can you elucidate me with qlk advice…. Thanks

    • Author
      Testlevels 2 years ago

      Hi, your doctor may be right given your age and presentation… in any case the most appropriate thing to do is a gynecological examination with transvaginal ultrasound. Best regards

  2. emma 4 years ago

    hi, I have been menstruating for 15 days, with very abundant flow, the doctor scored me a transvaginal pelvic ultrasound, I was wondering if this exam could be done, with menstruation in progress.
    also last month the menstruation went on for about twenty days, while the month before it still did not arrive.

    • Testlevels 4 years ago

      Hi, you can take the exam at any time during your period, best regards

  3. Ste 5 years ago

    Hi I am in the tenth week of pregnancy yesterday I had a transvaginal echo at the end of which I had a somewhat abundant loss of blood. In addition to his indelicacy, I am afraid of having lost the child or that in any case it has caused damage to him. Can you help me?

  4. Fabiana 5 years ago

    I did a transvaginal it was the first time, at the insertion of the probe I felt a strong pain, I had to ask the doctor to stop, then she put more gel on the probe and with a lighter discomfort she entered the vagina, from there she did not I had problems ... after the echo the probe was stained with blood, during the day it no longer showed up, but I still had a burning sensation where the probe entered, the pain is external and is felt only when I pee is normal all this ...

    • Testlevels 5 years ago

      Hi, a slight burning sensation can be normal after a transvaginal ultrasound. If the disorder persists or there is blood loss, contact your doctor or your gynecologist. Best regards

  5. Clara 5 years ago

    Hi, I read your very interesting article, I am really worried, I have to perform an internal ultrasound I did not understand if it is a pelvic ultrasound or a transvaginal ultrasound. I searched for images of vagina on google and wikipedia but did not understand what kind of ultrasound is done during pregnancy. When is the first ultrasound done? and can the gynecological examination be done with the menstrual cycle? How is a gynecological examination done? And what is the cost of a transvaginal ultrasound? thanks a lot

    • Testlevels 5 years ago

      Hi, the first ultrasound can be a transvaginal ultrasound, in the following trimesters instead the transabdominal obstetric ultrasound is done because transvaginal ultrasound is no longer indicated. It can be done during your period and is free if done at the hospital and with the pregnancy exemption. Your gynecologist or your doctor will be able to confirm these answers. kind regards

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