Women’s Pelvic Ultrasound—Transabdominal vs. Transvaginal

Jul 1, 2019 4:23:00 PM Posted by Iowa Radiology

women's ultrasound

patientIf your doctor orders a pelvic ultrasound exam, images can be captured in two different ways: transabdominally (through the abdomen) and transvaginally (through the vaginal canal). Depending on the patient and the condition being assessed, either one or both of these methods can be used.

When you hear the word “ultrasound,” it’s likely that you picture transabdominal ultrasound, where a flat or rounded transducer is passed over the abdomen. During a transvaginal exam, the transducer is wand-shaped and inserted two to three inches into the vagina to obtain images. The transducer used in this type of ultrasound is smaller than a speculum, and the procedure tends to be less invasive than a typical annual pelvic exam.


How do doctors choose which exam to use?

Which type of ultrasound exam a doctor recommends depends primarily on what information is being sought. A transabdominal exam provides a wide view of the pelvic organs, while a transvaginal exam is capable of providing greater detail in a smaller area. In some cases, a transabdominal ultrasound may be performed initially and then followed by a transvaginal exam if more detailed images are needed. 

Patient comfort is also an important consideration. If you have never had an internal exam before, or if the thought of undergoing a transvaginal exam is causing you distress, talk to your doctor to determine if there is another method that can be used to obtain the information needed to provide you with appropriate medical care.


A transvaginal ultrasound is commonly used to assess

  • Uterine fibroids
  • Endometrial polyps
  • Abnormal vaginal bleeding
  • Uterine scarring
  • Fertility issues
  • Ovarian cysts or tumors
  • Conditions of the vagina, cervix, urinary bladder, or fallopian tubes
  • Pelvic infection
  • IUD placement
  • Ectopic pregnancy or miscarriage
  • Placental placement

This is not a complete list of the uses of transvaginal ultrasound. If you’re not sure why your doctor has ordered a transvaginal exam, feel free to contact their office and ask.


What should I expect?

Like an annual pelvic exam, a transvaginal ultrasound is typically performed with the patient lying on her back on the exam table with her feet in stirrups. Depending on the information needed, you may be instructed to drink water prior to the exam to fill or partially fill your bladder. Either type of exam can be uncomfortable with a full bladder; if this is necessary, the technologist should let you know as soon as possible when you can take a break to use the restroom without compromising the test results. The entire exam typically takes 15–30 minutes.

In some cases, a pelvic ultrasound exam will include a sonohysterogram. This involves introducing a sterile saline solution into the uterus via a catheter during the exam; images are taken both before and after the saline solution is introduced. By expanding and outlining the uterine cavity, the saline solution makes it easier to visualize features of the endometrium (uterine lining).


TV Ultrasound and Patient Comfort

It’s important to find health care providers who make your comfort a priority. If you need a transvaginal ultrasound, do a little research to learn about the imaging providers in your area and choose one you’re comfortable with. Feel free to call ahead to ask questions about the procedure and, if you prefer, request a female technologist. If a clinic seems hesitant to accommodate your needs or take steps to ensure your personal comfort, consider other options. Make your comfort a priority, and find a quality provider who will, too.


Iowa Radiology is a patient-centered imaging practice that promotes a more compassionate approach to medicine. We offer expertise in a broad range of imaging procedures, including pelvic ultrasound, sonohysterography, and a broad range of breast imaging services.

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