A gynaecological ultrasound is an ultrasound assessment of the female pelvis, focussed mainly on the uterus and the ovaries, although other structures may be seen.
When should the test be done?
If the ultrasound is done to determine the cause of abnormal bleeding, our preference is to perform the scan shortly after the period has finished. The lining of the uterus is then thin and pathology can more easily be seen. Just before a period, the lining of the uterus is thick and appears quite bright on ultrasound. Some causes of abnormal bleeding, such as small polyps can then be missed and a reassessment just after the period may be necessary.
If the ultrasound is done for another reason such as pain, absence or irregular periods, possible fibroids, subfertility or suspected pelvic mass or ovarian cyst, it can be organised at any time during the menstrual cycle, even when you are bleeding. It is not necessary to change your appointment if this happens, unless you feel uncomfortable having a vaginal scan then.
- Period or pelvic pain
- Bleeding between periods
- Heavy periods
- Irregular periods
- Absence of periods
- Difficulty conceiving
- Possible fibroids
- Suspected ovarian cyst
- Suspected pelvic mass felt on clinical examination
- Postmenopausal bleeding
- Screening for ovarian cancer
Vaginal ultrasound provides much clearer views and more detail of the pelvic structures. A narrow, gel covered probe is gently introduced into the vagina. Most patients experience no pain or only very mild discomfort. The examination takes approximately 10-20 minutes.
In young girls, women who have not been sexually active or women who don't feel comfortable having a vaginal ultrasound, a transabdominal ultrasound, or an ultrasound through the abdominal wall can be performed. A very full bladder is needed.
Are additional tests sometimes needed?
Sometimes it becomes obvious during the ultrasound examination that a Saline Infusion Sonography or SIS would give important additional information. SIS is basically an ultrasound performed after a little saline (salt water) has been injected into the uterine cavity via a fine plastic catheter that is passed through the cervix. The discomfort is similar to that of a PAP smear. The saline dilates the uterine cavity slightly and outlines the lining of the uterus well, making it easier to detect certain pathology like polyps.
An SIS is rarely necessary, but if it would be beneficial, we will discuss the test in detail with you. This will allow you to make an informed decision as to whether you want to have the test or not.
Saline Infusion Sonography
SIS is basically an ultrasound performed after a little saline (salt water) has been injected into the uterine cavity via a fine plastic catheter that is passed through the cervix.
First the vagina is disinfected with an antiseptic solution. A speculum is placed in the vagina like for a PAP smear and the cervix is visualised. A fine catheter is inserted through the cervix.
The speculum is removed and the vaginal ultrasound probe is inserted in the vagina.
A small amount of saline (salt water) is injected through the catheter. The saline allows accurate assessment of the uterine cavity. The saline dilates the uterine cavity slightly and outlines the lining of the uterus well, making it easier to assess the endometrium accurately and detect certain pathology like polyps.
The procedure takes approximately 5-10 minutes and is generally not more uncomfortable than a PAP smear.
The results can be discussed with you during and after the examination. Don't hesitate to ask questions. Abnormal results requiring more urgent attention will promptly be discussed with your referring gynaecologist. Some doctors receive the report electronically in which your doctor will have the result the same day. Otherwise a written copy of the result is sent in the mail and should reach your doctor 2 days after your ultrasound. Please advise us if you see your doctor earlier than that so we can fax the results.