Most people are familiar with transdermal ultrasound exams, during which the ultrasound transducer is passed over the surface of the skin to produce images of internal structures. To assess issues related to the female reproductive system, however, doctors sometimes recommend a transvaginal ultrasound (TVUS). This procedure involves placing a specially designed transducer into the vagina to produce clearer images for the assessment of some conditions.
It’s not uncommon for women to approach a TVUS exam with apprehension. However, understanding why the exam was recommended, how it can benefit you, and what to expect during the procedure can help ease any anxiety and give you a greater sense of control over your health care. Don’t hesitate to ask your doctor or radiologic technologist any questions you have about the exam.
Why is TVUS recommended?
A doctor may recommend a transvaginal ultrasound to investigate a variety of issues. For example, TVUS can be used to investigate the cause of infertility, unexplained pain, or abnormal bleeding, to check for proper IUD placement, or to identify cysts, polyps, fibroids, or other tumors. During pregnancy, TVUS allows earlier detection of the fetal heartbeat and can help identify potential complications.
If you are unsure why your doctor has recommended TVUS over other imaging modalities, be sure to ask. Alternatives may be available but may not offer the same benefits as a transvaginal ultrasound exam. As a patient, it’s your right to get the information you need to fully understand the reasons and potential benefits and risks of any procedure you undergo.
How is TVUS performed?
A transvaginal ultrasound exam is in some ways similar to a regular gynecologic exam. Typically, the patient’s feet rest in stirrups as the radiologic technologist gently inserts the lubricated transducer (which is smaller than the speculum used for Pap tests) two or three inches into the vagina to obtain images. Sometimes, the patient is directed to drink water prior to the exam because a full or partially full bladder can help the technologist obtain clearer images of some structures. The entire exam usually takes 15–30 minutes.
For some TVUS assessments, called sonohysterograms or saline infusion sonograms, saline solution is introduced into the uterine cavity through a small, flexible catheter, allowing for clearer imaging of the uterine lining. Ultrasound images are taken both before and after the saline solution is introduced. This procedure is not performed during pregnancy but can be helpful in identifying the cause of repeated miscarriages, infertility, or abnormal bleeding.
How should I prepare?
Little preparation is necessary for a transvaginal ultrasound, but you can be more comfortable with the procedure by asking any questions and expressing any concerns you have prior to the exam. Your doctor may instruct you to drink water or to come to the exam with an empty bladder, so make sure you fully understand any instructions you’re given. If you’re undergoing sonohysterography, the appointment will be scheduled for a specific time in your menstrual cycle, but an ordinary TVUS can be performed at any time.
It’s important to take steps to ensure your comfort during the exam. Feel free to ask the imaging provider who will be performing the exam and to request a female technologist if you prefer. If you become uncomfortable during any part of the exam (and especially if you experience pain), let the technologist know. A good imaging center will take care to help you be as comfortable as possible. If imaging center staff ever seems dismissive of your concerns or ignores you when you express discomfort, you should report the problems you experience to the clinic director and consider finding a different imaging provider.
At Iowa Radiology, we take our commitment to exceptional patient care very seriously. We welcome questions and will do what we can to make every procedure at our clinics as comfortable and beneficial as possible for our patients.