WHAT WILL I SEE ON MY PELVIC ULTRASOUND?

WHAT WILL I SEE ON MY PELVIC ULTRASOUND?

The pelvic ultrasound will usually examine a number of anatomic structures:
  • The uterus. Common disorders affecting the uterus include uterine fibroids (benign muscular growths) and adenomyosis (benign infiltration of the endometrium into the surrounding uterine muscle). Both these conditions are commonly associated with heavy and/or painful periods.
  • The endometrium (the lining of the uterus). The endometrium changes appearance throughout the menstrual cycle. It is usually thin just after the periods have finished and before ovulation (the proliferative phase). The endometrium becomes progressively thicker and whiter on ultrasound as the menstrual cycle progresses after ovulation (the secretory phase).
    The endometrial thickness is measured and the appearances of the endometrium are noted.
    A common disorder causing abnormal vaginal bleeding is an endometrial polyp (a growth of the endometrium).
    Sometimes a saline sonohysterogram may be suggested to better view the endometrium and any suspected problems.
  • The cervix. The cervix lies at the lower end of the uterus, very close to the tip of the transvaginal ultrasound probe. Problems affecting the cervix that ultrasound may detect include cervical fibroids or polyps, and advanced cervical cancer. Ultrasound will not detect precancerous changes in the cervix known as CIN – these changes require a pap smear for diagnosis.
  • The ovaries. The ovaries change appearance throughout the menstrual cycle, with ovulation occurring midcycle. Follicles of varying size and number are seen within the tissue of the ovary. Follicles are a normal part of the ovary, and the structure within which eggs mature. Counting the number of follicles and measuring their size is important in fertility treatments, including IVF.
    Problems affecting the ovaries include endometriosis (a condition which may cause pelvic pain and infertility), ovarian cysts (both benign and malignant), polycystic ovaries (an appearance which may be associated with irregular periods, acne, hirsutism and altered serum hormone levels) and pelvic adhesions (scar tissue causing the ovaries to adhere to surrounding structures such as the uterus).
  • The fallopian tubes. A normal fallopian tube is very thin and not usually seen on a pelvic ultrasound.
    A fallopian tube which is blocked and filled with fluid (called a hydrosalpinx) may be detected. If the patency of your fallopian tubes need to be assessed, your doctor may request a HyCoSy procedure.
  • The adnexae. The adnexae are the areas on each side of the uterus, around where your ovaries are located.
    Problems in the adnexae include hydrosalpinx (blocked fallopian tubes), ectopic pregnancy (pregnancy abnormally located in the fallopian tube) and appendicitis (this is sometimes detected during a pelvic scan if the appendix lies in this area).
  • The kidneys. A routine pelvic ultrasound will often briefly review your kidneys. This is done during the transabdominal ultrasound.
    Sometimes a large pelvic mass like a uterine fibroid can obstruct flow of urine from the kidney into the bladder (called hydronephrosis).

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