Ultrasound of the pelvic organs. Ultrasound of the pelvic organs in women: why is this examination so important? Ultrasound of the pelvic organs: indications

Men are tested if they have the following symptoms:

• erectile dysfunction;
• atypical discharge from the urethra;
• pain in the lower abdomen, in the lower back;
• blood in ejaculate or urine;
• violations of the process of urination (change in the frequency of urination and the amount of urine, pain).

For women, the following signs indicate the need to pass:

• atypical bleeding;
• pain in the lower abdomen;
• disruption of the menstrual cycle.

Ultrasound methods

Surveys can be carried out in three ways:

• transabdominal - through the wall of the abdominal cavity;
• transvaginal - through the vagina;
• transrectal - through the rectum.

If necessary, the methods can be combined.

Transrectal and transvaginal ultrasound provide more information than transabdominal. However, the first two methods have contraindications. Some patients are shown only transabdominal ultrasound.

Contraindications

In itself, ultrasound has no contraindications. Ultrasound does not harm children, pregnant women, or elderly patients. However, the research method must be taken into account.

There are no contraindications for transabdominal ultrasound, except that the patient's obesity makes the examination difficult. The fatty layer significantly reduces the clarity of the image.

Transvaginal ultrasound of the pelvic organs is not done in the second and third trimester of pregnancy. In the first trimester, a transvaginal examination can be performed.

Transrectal examinations are contraindicated:

• with intestinal obstruction;
• after surgical operations on the rectum;
• with hemorrhoids;
• in the presence of chronic sphincter fissures.

Virgins do either transrectal or transabdominal ultrasound.

Ultrasound is not recommended after X-ray examination with contrast. The contrast agent may interfere with the reliability of the results. It is better to go for an x-ray after an ultrasound.

Also, ultrasound examination of the pelvic organs may be uninformative after colonoscopy and gastroscopy. These procedures increase gas formation in the intestines.

Training

Preparation for the study depends on the type of procedure. However, there are general measures: before all types of ultrasound, it is necessary to clear the intestines from gases. To do this, 3 days before the examination, you need to abandon gas-forming products:

• flour;
• sweet;
• raw vegetables and fruits;
• legumes;
• dishes with cabbage;
• whole milk and dairy products;
• carbonated, caffeinated and alcoholic drinks.

You can eat boiled lean meat (turkey, chicken, beef), cereals, hard-boiled eggs (one per day).

Also in these 3 days, with increased gas formation, enterosorbents are welcome. However, do not "assign" them to yourself arbitrarily. Let the doctor determine the need for such a measure.

Features of preparation for different types of procedures:

• Transabdominal ultrasound is performed with a full bladder. An hour before the procedure, drink 1-1.5 liters of pure non-carbonated water and do not empty the bladder.
• On the eve of transrectal ultrasound, the intestines are emptied using an enema or glycerin suppositories. Cleansing actions are repeated in the morning, before the examination.

Diagnosis of pathologies using ultrasound

For women, the procedure is carried out in order to identify:

• inflammation;
• dysfunction of the organs of the reproductive system;
• neoplasms;
• diseases of the ovaries and uterus.

Men are examined for the purpose of diagnosing diseases of the prostate gland.

Ultrasound is used for both women and men in the diagnosis of:

• tumors;
• diseases of the bladder and urinary tract;
• pathology of other internal organs.

When is the best time to do a pelvic ultrasound?

For men, the study can be performed at any time period according to the indications.

But the question is, when is it better to do an ultrasound of the pelvic organs in women - not idle, since the phase of the cycle significantly affects many indicators, for example, the thickness of the endometrium.

On what day of the cycle is it better to do an ultrasound of the pelvic organs depends on the diagnostic task.

Most often, scanning is carried out for a period up to the 10th day of the cycle. However, there are other schemes for its purpose.

When diagnosing the causes of infertility, three ultrasound examinations are prescribed in different phases of the monthly cycle:

1. From 8 to 10 days. The choice of the optimal and dominant follicle is made.
2. From 14 to 16 days. Its volume is measured.
3. From 22 to 24 days. The presence of a corpus luteum and the presence or absence of ovulation are determined.

Before IVF planning, the procedure is performed on the first 2 days of the cycle to determine the number of follicles, regardless of the abundance of menstruation.

In menopausal women, the study is performed at any time.

Deciphering the results of the study

The conclusion of the ultrasound is performed according to the following characteristics of the organ under study: size, volume, uniformity of its structure, echogenicity, clarity of contours. There are many parameters for evaluating the results of ultrasound of the pelvic organs, here are some of them.

Uterus.The shape is pear-shaped or oval. Average echogenicity of the myometrium. The endometrium with well-defined contours, of uniform thickness, with high echogenicity, is located in the center of the uterus. Normative indicators of the size of the organ depend on such factors - the day of the monthly cycle, the number of pregnancies and childbirth in history, the age factor (menopause).

Standards for the size of the uterus

Separately measured the size of the cervix and its ratio to the body of the uterus.

Ovaries. Their size varies greatly depending on the day of the monthly cycle, the age of the woman, the use of hormonal drugs, including contraceptives.

Shape, length, width and thickness are measured. For the ovaries, the volume and number of follicles is determined.

Norms of the size of the ovaries

What does a pelvic ultrasound show in women?

We list some examples of pathological changes:

• The pathological increase in the size of the uterus, together with the presence of rounded areas with heterogeneous echogenicity, is in favor of fibroids.
• Sarcoma is similar to myoma, but the neoplasms have reduced echogenicity and internal cystic inclusions.
• Uneven wall thickness, increased size of the uterus, increased echogenicity of the myometrium indicates endometriosis.
• A decrease in the uterus with a simultaneous increase in the ovaries may indicate their polycystic ovaries (PCOS).
• The inflammatory process in the ovaries - oophoritis, can be diagnosed with a decrease in echogenicity and a spherical shape of the organs.

Some diagnoses should be clarified with the help of additional studies. For example, the diagnosis of "uterine sarcoma" can only be made based on the result of a histological examination.

With the help of ultrasound, indirect signs of erosive processes of the cervix can be detected, but colposcopy is necessary to confirm the diagnosis. Also, this study will be needed to diagnose dysplasia and cervical cancer - ultrasound does not detect them.

How is a pelvic ultrasound performed?

All types of ultrasound of the pelvic organs are carried out in approximately the same way:

1. The patient lies on his back (during transrectal examination - on his side).
2. In a transabdominal ultrasound, a gel is applied to the areas to be examined, then a probe is passed over the body. For transvaginal and transrectal examinations, a transducer placed in a condom is treated with a gel and then inserted into the vagina or rectum.

Ultrasonic waves, reflected from the examined tissues, make it possible to study the image of organs on the monitor in real time. This is very important if it is necessary to assess the movements of internal organs and the characteristics of blood circulation.

Ultrasound examination (ultrasound) - recognition of pathological changes in organs and tissues of the body using ultrasound. Ultrasound is based on the principle of echolocation - the reception of signals sent and then reflected from the interfaces of tissue media with different acoustic properties.

Ultrasound of the pelvic organs is performed in order to visually determine the presence of a particular pathology in a woman (or a fetus with obstetric ultrasound) by echographic signs.

Ultrasound of the pelvic organs can be performed with an abdominal probe (through the abdomen) or vaginal (vaginal). In the pelvis of a woman, ultrasound examines the uterus, fallopian tubes, vagina, ovaries and bladder.

• Uterus: The position, shape, main dimensions of the uterus and the structure of its walls are determined.
  In addition, median uterine structures are examined separately: the uterine cavity and endometrium (M-echo). In a non-pregnant woman, the uterine cavity is slit-like. The endometrium - the functional inner layer - changes during the menstrual cycle.
• Ovaries: The position relative to the uterus, the size, size of the follicles and the corpus luteum (the formation that remains in place of the follicles after the release of the egg from the ovary) is assessed. A comparison is made with the phase of the menstrual cycle.
  When formations are found in the ovaries, they are also described (shape, structure, size).
• The presence of free fluid is also determined (it is normal after the release of the egg from the ovary, it is in a small amount) and the presence of tumor formations in the pelvic cavity.
• In addition to the structure of the uterus and ovaries, during ultrasound, the condition of the bladder is assessed (if it is sufficiently filled).

Advantages of ultrasound diagnostics

Ultrasound examination is carried out quickly, the ultrasound method is clear, economical and not burdensome, it can be used repeatedly and with minimal effort to prepare for the study. It has been reliably confirmed that Ultrasound is absolutely safe even for a pregnant woman.

Indications for pelvic ultrasound

The ultrasound method is widely used for suspected gynecological diseases, pregnancy, to monitor the treatment and cure of the patient.

• With the help of ultrasound of the uterus, it is possible to diagnose pregnancy in the early stages.
• Ultrasound of the pelvis in women should be performed for menstrual disorders (delayed menstruation, early onset of menstruation, bleeding in the middle of the cycle), with heavy or scanty menstruation, in the absence of menstruation, with various vaginal discharges, with pain in the lower abdomen, with the appearance of discharge during menopause.
• With the help of gynecological ultrasound, various diseases are detected: from inflammatory gynecological diseases to benign and malignant tumors of the uterus and ovaries (including endometriosis, salpingo-oophoritis, ovarian cysts, endometritis, etc.).
• Ultrasound of the uterus enables early diagnosis of uterine fibroids.
• Pelvic ultrasound is widely used to monitor the ovarian follicular apparatus in the treatment of infertility and pregnancy planning.
• An ultrasound examination of the small pelvis is prescribed when taking contraceptive and hormonal drugs, in the presence of an intrauterine contraceptive ("spiral") to control and prevent complications.
• Ultrasound during pregnancy (obstetric ultrasound) allows you to monitor the normal development of the fetus and timely detect pathology.
• In urology, pelvic ultrasound is necessary to identify the causes of urinary disorders, urinary incontinence and pathology of the urethra (urethra).

Contraindications for pelvic ultrasound

There are no contraindications for ultrasound examination.

Preparing for an ultrasound of the pelvic organs

When visiting the ultrasound diagnostics room to remove the remaining gel from the skin after the examination, you must have a towel or napkin with you, as well as a diaper on which you will lie down for the study.

In non-pregnant women, a routine gynecological ultrasound is performed on a full bladder, unless otherwise instructed by a doctor. To ensure maximum accuracy and reliability of the results, it is necessary to strictly adhere to the established rules for preparing for ultrasound of the pelvic organs:

• for transabdominal (through the abdomen) gynecological ultrasound, bladder preparation is necessary: ​​drink 1-1.5 liters of non-carbonated liquid 1 hour before the procedure and do not urinate until the examination;
• for transvaginal (through the vagina) gynecological ultrasound, special preparation is not required, the study is carried out with an empty bladder;
• obstetric ultrasound (ultrasound during pregnancy) is performed with a moderately filled bladder (drink 2 glasses of liquid 1 hour before the procedure).

When examining the organs of the genitourinary system (bladder, prostate, uterus, ovaries), it is necessary to drink 0.5 liters of liquid 1-1.5 hours before the examination or not urinate for 2 hours. This is necessary in order to fill the bladder, which pushes the examined organs.

A prerequisite for a successful ultrasound- empty intestines and the absence of gases in it. Therefore, preparation for ultrasound should be started in advance: it is important to follow a diet with restriction of foods that cause constipation or gas formation 2-3 days before the upcoming ultrasound. It is recommended to exclude from the diet foods that cause increased gas formation (black bread, fruits, raw vegetables, confectionery, milk). Enzyme preparations are recommended: festal, panzinorm, enzistal, creon, etc. Cleansing enemas are not recommended, as they often increase gas formation. In addition, you can take activated charcoal, espumizan, dill water. If you are constipated, it is recommended that you take a laxative, especially if you need a rectal probe test.

Ultrasound is performed on an empty stomach (the last meal 8-12 hours before the examination) and immediately after a bowel movement.

Examination of the mammary glands, uterus and appendages is recommended to be performed in the first half or middle of the menstrual cycle.

An examination for folliculogenesis is performed at 5; 9; 11-14 and 15 days of the menstrual cycle.

The accuracy of the results obtained largely depends on how you prepare for the ultrasound..

In emergency cases, ultrasound is performed without preparation, but its effectiveness is lower.

How is a pelvic ultrasound performed?

You lie down on the couch (after spreading the diaper) with your head towards the doctor (to the ultrasound machine) and expose your stomach and lower abdomen. The ultrasound doctor will lubricate the ultrasound transducer with gel (for a transvaginal ultrasound, put a condom on the transducer and lubricate it with gel) and drive the transducer over you, occasionally pressing to view the pelvic organs from a different angle. The procedure is absolutely painless, except for the diagnosis of acute inflammatory processes of the pelvic organs. An ultrasound examination takes from 10 to 20 minutes, depending on the purpose of the examination.

Complications of pelvic ultrasound

After ultrasound, complications are not observed, but transvaginal ultrasound during pregnancy, especially in early pregnancy, is performed only after assessing the risk to the fetus.

Deciphering the results of ultrasound of the pelvic organs

Only an experienced doctor can correctly decipher the results of an ultrasound scan.

What Can a Pelvic Ultrasound Find?

Congenital anomalies of development: The use of ultrasound, especially three-dimensional, makes it possible to diagnose anomalies in the development of the uterus (bicornuate, saddle-shaped, unicornuate, duplication of the uterus).

The presence of congenital malformations can cause infertility, increase the risk of preterm birth, spontaneous abortion, fetal death, malposition of the fetus and disruption of labor.

Endometriosis: Endometriosis is a pathological process that is characterized by the spread of the endometrium outside the uterine cavity (walls of the uterus, ovaries, peritoneum, etc.). An ultrasound of the pelvic organs reveals internal endometriosis or adenomyosis (growth of the endometrium into the wall of the uterus) and endometrioid ovarian cysts.

Diagnosis of endometriosis is important for predicting the possibility of pregnancy (endometriosis can be the cause of infertility), its bearing.

Uterine fibroids: Uterine fibroids are benign tumors of the female reproductive system. Ultrasound determines the presence, number, location and size of myomatous nodes. In addition, ultrasound allows you to monitor the dynamics of their growth rates. Because ultrasound is done several times a year. Diagnosis of fibroids is extremely important in preparing for conception, since the presence of fibroids can affect the course of pregnancy.

Diagnosis of pregnancy: Ultrasound can diagnose pregnancy from 3 to 4 weeks. Small terms of pregnancy are determined only with the help of a transvaginal sensor, a device with good resolution. Various types of ectopic pregnancy are diagnosed (tubal - the fetal egg is attached to the fallopian tube, cervical - the fetal egg is attached to the cervix, ovarian - the fetal egg is attached to the ovary), which allows the woman to maintain her health.

Intrauterine contraception: With the help of ultrasound, the process of setting and removing an intrauterine contraceptive is monitored. timely detect incorrect location, partial or complete prolapse of the IUD from the uterine cavity, ingrowth of parts of the contraceptive into the uterine wall. If you are planning a pregnancy, then after removing the intrauterine contraceptive, the doctor will recommend that you do an ultrasound.

Also, hyperplastic processes of the endometrium (hyperplasia, polyps, malignant tumors of the endometrium), volumetric formations of the ovaries are detected.

Preventive ultrasound of the pelvic organs

Healthy women, for preventive purposes, need to do an ultrasound of the pelvic organs once every 1-2 years, and after the age of 40 - once a year in order to identify hidden pathology. Preventive ultrasound of the pelvic organs is usually performed in the first phase of the cycle (5-7th day from the onset of menstruation).

Ultrasound is of key importance in gynecological practice. The widespread use of the method is associated with high information content, painlessness of the procedure, as well as the absence of contraindications and economic availability. In addition, the availability allows for dynamic monitoring at any required frequency.

Ultrasound examination is included in the list of recommended annual examinations for women of reproductive age and after the onset of menopause. Annual echography of the pelvic organs helps to diagnose pathology at the preclinical stage, as well as diseases that may be asymptomatic.

It is also impossible to manage pregnancy. The need for this study may also arise in pediatric practice with suspected congenital malformations of the reproductive system.

• • Scope of study

    With a standard ultrasound examination of the pelvic organs, the study and evaluation of the structures of the uterus (body, cervix), endometrium, ovaries, retrouterine space is carried out. During the procedure, organs are measured, the structure of tissues and their blood supply are assessed, and if a pathology is detected, a thorough study and description of the identified focus is carried out.

    Additionally, if there are indications, a study of the pelvic vessels can be carried out with the determination of the type of blood flow and speed indicators, lymph nodes, and retroperitoneal space. It is possible to conduct ultrasound with the use of contrast agents - echohysteroscopy. Such a study allows you to assess the condition of the uterine cavity and the patency of the fallopian tubes. Such a study is especially relevant in the diagnostic search for the causes of infertility due to the fact that during a standard ultrasound examination, the fallopian tubes are not visualized.

    Methodology

    Ultrasound diagnosis of OMT is carried out in two ways - transabdominally and transvaginally. These two methods may be used in conjunction or may be used separately.

    Conventional convex probe through the anterior abdominal wall. This method allows for ultrasound diagnosis of the pelvic organs in women of all age groups. Transabdominal examination is also used in pediatric practice to diagnose abnormalities in the development of the genitourinary system. This method allows you to review the organs and tissues of the area under study, measure the main indicators, detect volumetric formations located in the internal genital organs and outside the organ.

    A vaginal sensor, which allows you to study the necessary organs in more detail, but this study may not be used in all groups of patients (for example, it is not used in pediatric practice). The method has a higher resolution due to the closer location of the structures under study and the use of higher frequencies. However, structures located along the periphery are poorly visualized and a diagnostic error is possible.

    Therefore, the joint use of these methods is optimal.

    Study preparation

    Before transabdominal ultrasound examination of the pelvic organs in women, a good filling of the bladder is a prerequisite. To do this, before the study, you need to drink about a liter of liquid (in 30-50 minutes). Ultrasound is done when the urge to urinate appears. If there is a tendency to increased gas formation, then 2-3 days before the procedure, it is necessary to exclude products that stimulate increased gas formation (yeast breads, whole milk products, raw fruits and vegetables, carbonated drinks).

    A transvaginal ultrasound is performed without prior preparation, and the bladder, on the contrary, should be empty. But in preparing for this type of research, the psychological aspect is important. Due to the intimate nature of the procedure, it is necessary to explain to the patient before the start of the study what will happen and how.

    If both types of research are planned, then a transabdominal study is first performed on a full bladder, and then, after micturition, a transvaginal one is done. This order of conduction will allow obtaining the maximum amount of reliable information in a short period of time.

    The common stage of preparation for both methods is the choice. Usually, ultrasound is recommended to be performed on the 5-7th day of the cycle, however, some pathological processes require examination during the second phase or several times per menstrual cycle. For the correct choice of the day for the study, it is necessary to consult with a gynecologist.

    Detectable pathology of the pelvic organs in women

    Pathology of the uterus and endometrium

    A bicornuate uterus is considered the most common OMT anomaly. The sonographic picture of this anomaly depends on the severity of the separation of the uterus. In most cases, two identical masses are visualized during a transverse scan with a separate M-echo.

    

    The saddle uterus is diagnosed with an increase in the width of the fundus of the uterus and the presence of an impression in the region of the bottom during transverse scanning. With a one-horned variant of the anomaly, the uterus is determined, displaced relative to the midline and having a width in the bottom area less than normal.

    uterine fibroids

    The most common benign tumor of the reproductive system in women. The location is variable, but the ultrasound picture is identical: a round or oval formation of reduced echogenicity, with feeding vessels along the periphery, having a capsule and clear contours. As the nodes grow, the size of the uterus increases with deformation of the contours, degenerative processes inside the node are possible.

    

    Leimomyoma was found in a 46-year-old patient who complained of vaginal bleeding. The picture clearly shows isoechoic formation.

    Sarcoma of the uterus

    This is a rare malignant tumor that has a similar ultrasound picture with fibroids.

    Distinctive features are the lobulation of the internal structure, fuzzy contours, increased blood flow, as well as cystic degeneration and intensive growth during the study in dynamics.

    Internal endometriosis

    In women, it has various forms: diffuse, focal, nodular. hyperechoic areas, the contours are often uneven, there are hypoechoic inclusions. The walls of the uterus become asymmetrical and its shape is rounded. The nodular form is characterized by the presence of round or oval hyperechoic lesions with anechoic inclusions of various diameters. The focal form is very similar in echographic pattern to the nodular form, and their differential diagnosis is extremely difficult.

    endometrial hyperplasia

    It is characterized by a thickening of the endometrium, a discrepancy between its size and the day of the menstrual cycle. The structure of the endometrium is hyperechoic, often there are hypoechoic and anechoic inclusions.

    small polyps

    They do not change the thickness of the endometrium and have a heterogeneous hyperechoic structure. With an increase in the size of polyps, a similarity with myomatous nodes appears. Differential diagnosis is carried out on the basis of ultrasound with the use of contrast agents. have a tendency to malignancy.

    Cervical cancer

    

    Cervical cancer

    One of the most common cancers in women. During sonography, this malignant process is detected when the tumor reaches a size of 3 mm or more. Ultrasound markers of cervical cancer: an increase in the size of the cervix, the appearance of small structures of varying echogenicity, the appearance of fluid in the uterine cavity or cervical canal, changes in blood flow during color flow.

    Ovarian pathology

    The absence of ovaries on the sonogram has many reasons: congenital aplasia, previous surgical removal of the ovary, degenerative changes in postmenopause, incorrect preliminary preparation due to which the ultrasound picture is uninformative (increased intestinal gas, insufficient filling of the bladder during transabdominal examination).

    

    ovarian ultrasound

    Multifollicular ovaries

    It is characterized by a moderate increase in their size, the presence of (more than 10) with a diameter of about 10 mm. In this case, there should be no clinical picture of polycystic ovaries.

    Polycystic ovaries

    Manifested by an increase in size, an increase in the echogenicity of the stroma. Hormonal imbalance also leads to the formation of multiple anechoic formations up to 10 mm in diameter, which deform the contour of the ovary. Additionally, there is a discrepancy between the thickness of the endometrium and the phase of the menstrual cycle.

    Follicular cyst

    

    Ultrasound of the left ovary, cyst of the corpus luteum.

    Formed from a non-ovulated follicle. Ultrasound examination visualizes a rounded anechoic formation with a thin capsule, 2–10 cm in size, unilateral location.

    Cyst of the corpus luteum

    It is formed from an ovulated follicle and has a similar ultrasound picture with a follicular cyst. The differences are a thicker capsule, the presence of inclusions and partitions inside the cyst, the unevenness of the internal contour. Both types of cysts undergo involution and disappear within a few menstrual cycles.

    Inflammatory diseases of the pelvic organs

    Including inflammatory processes of the ovaries, a fairly common pathology. The ultrasound picture of oophoritis is characterized by an increase in size, blurring of the contours of the ovary, a decrease in echogenicity, an increase in blood flow and a decrease in resistance to CDI. The follicular apparatus is either not defined or does not correspond to the menstrual cycle. Perhaps also in the pelvic cavity, inflammatory changes in other organs of the reproductive system.

    Timely is essential for women. After all, untimely detection and treatment of these diseases can lead to negative consequences, including infertility. Ultrasound of the pelvic organs helps to identify pathological processes in the organs of the reproductive system, to conduct a differential diagnosis of possible pathologies, including during dynamic observation, to track the results of the treatment.

    Modern devices can detect foci of a few millimeters. The similarity of the sonographic picture of the main pathological processes requires the researcher to be attentive, clinically thinking and experienced.

Frequently asked Questions

On what day of the cycle do pelvic ultrasound

An ultrasound examination of the pelvic organs is recommended to be carried out in the initial phase of the menstruation cycle - on the 5-7th day from the onset of menstruation. In preparation for in vitro fertilization (IVF), ultrasound can be scheduled for 2-4 days of menstruation.

Do I need to prepare for an ultrasound?

Features of preparation for ultrasound scanning of the pelvic organs depend on the method by which the study is carried out (transabdominal, transvaginal or transrectal diagnostics). General recommendations for preparation include following a sparing diet and taking enzyme preparations to improve digestion.

What does an ultrasound of the pelvic organs in women show?

In women, ultrasound examination of the pelvic organs is performed to visualize the anatomical features and pathological disorders of the bladder, uterine cavity, ureters and other organs of the genitourinary system. During pregnancy, ultrasound allows you to monitor the development of the fetus and assess the condition of the reproductive organs of the future woman in labor.

Where is the best place to do a pelvic ultrasound in women

The Gynecologists.Moscow website contains contacts and addresses of medical centers in Moscow where you can do a pelvic ultrasound. After reading the reviews of patients, finding out the cost of the procedure and other necessary information, you can sign up for the study. The most popular metro stations in Moscow for the pelvic ultrasound service are:,.

How much does a pelvic ultrasound cost?

The price for an ultrasound examination of the small pelvis in women is formed taking into account several factors: the pricing policy and the location of the chosen medical center, the quality of the equipment used, the qualifications of the specialist, the methodology for the procedure, as well as the goals and objectives of the diagnosis.

How can I book a pelvic ultrasound?

To sign up for an ultrasound of the pelvic organs, first you need to choose a suitable clinic. The questionnaire of each medical center contains the necessary contact information, work schedule and telephone number where you can contact the consultants of the medical institution and sign up for the study.

Content

Sometimes, after a gynecological examination, a woman receives a referral for a transvaginal ultrasound of the pelvic organs, which becomes a cause for concern for her, but should we worry in advance? An indication for the appointment of a study may be the uncertainty of the doctor in the preliminary diagnosis. In order to exclude the slightest possibility of risk, it is necessary to listen to the recommendations of the gynecologist and undergo the procedure as soon as possible.

What is a pelvic ultrasound

One of the most accurate and safe diagnostic methods used in gynecological practice is ultrasound examination of the pelvic organs (ultrasound of the pelvic organs). The essence of this method is the reflection of the sound wave sent by the sensors by the internal organs. The reflected radiation with the help of technical devices is converted into a graphic image, which is interpreted by the diagnostician. With the help of ultrasound, you can track the pelvic organs in dynamics, which allows you to make accurate conclusions.

What is included in the pelvic organs of a woman

The space that is limited by the pelvic bones is called the small pelvis. The organs located in it belong to the reproductive and excretory systems. The excretory organs include the bladder and rectum, which are the same in men and women. The organs of the reproductive system for each sex are individual, in women it is:

• vagina;
• uterus (cervix, cervical canal);
• ovaries;
• fallopian (or fallopian) tubes;
• rectum;
• bladder.

Indications

It is recommended to undergo this procedure, regardless of the presence of indications (for prevention purposes) every year, since some diseases of the organs of the reproductive and excretory systems may be asymptomatic. The reason for the appointment of an ultrasound examination after a gynecological examination is the gynecologist's suspicion of the presence of neoplasms (fibroids, cancer, tumors, cysts). In addition, the indications for the study are:

• violation of the menstrual cycle;
• signs of inflammation of the uterine appendages;
• pregnancy (a cervicometry procedure is prescribed to assess the condition of the cervix);
• the presence of an intrauterine device (to control its position);
• past inflammatory diseases and other gynecological diseases (adnexitis, endometritis, cervicitis, vulvitis, colpitis);
• infertility (to determine the cause, folliculometry is performed, i.e., the identification of violations of the ovulatory mechanism);
• transferred surgical interventions (to control the condition).

What shows

During the study, the specialist performing the procedure evaluates the anatomical structure of the organs. Evaluation occurs on the basis of comparison of the observed picture to the established norms. Deviations cannot unequivocally indicate a pathology; necessary tests should be taken to confirm the diagnosis. When diagnosing, the following main indicators are used:

How to prepare

Preparation for ultrasound for women depends on how the diagnosis will be carried out. The transvaginal method does not require preliminary preparation, but it is better that the bladder is emptied before the study. To prepare for a transrectal ultrasound, which involves examining the pelvic organs through the rectum, and for a transabdominal ultrasound, follow these steps:

• two days before the procedure, stop eating foods and drinks that promote gas formation (legumes, dairy, carbonated and alcoholic drinks, fresh vegetables and fruits);
• eat fractionally in small portions;
• 3 hours before the procedure, cleanse the intestines (using an enema or taking laxatives);
• an hour before the diagnosis, the bladder should be filled (drink 1 l - 1.5 l of non-carbonated water);
• on the day of the examination, you must refrain from smoking, taking medications.

Is it possible to eat before an ultrasound

Eating on the day of the transabdominal examination is not recommended if the procedure is scheduled for the morning. If the time of the study is scheduled after 2 pm, a light breakfast is allowed, which should be no later than 11 am. With a transvaginal examination of the pelvic organs, there are no restrictions on the time of eating.

What day is the ultrasound done?

Due to the fact that the female pelvic organs undergo changes throughout the entire menstrual cycle, it is important to diagnose in the phase in which the clinical picture is more accurate. The most favorable period for conducting research of the pelvic organs is 5-7 days after the start of the last menstruation. In order to assess the functions of the ovaries, the procedure is prescribed several times in one cycle. Men can have the procedure at any time.

How is a pelvic ultrasound done?

During a gynecological or urological examination, the doctor prescribes an ultrasound scan if possible abnormalities are identified. The method of diagnosis depends on the proposed diagnosis and can be transvaginal, transabdominal and transrectal. The ultrasound procedure lasts 10-20 minutes. and is carried out in the absence of direct contraindications, which may include an allergy to latex (with transvaginal) or open skin lesions on the abdomen (with transabdominal).

Transvaginal ultrasound

The transvaginal ultrasound procedure is practically painless (except in cases of acute inflammation of the genital organs or abdominal organs). The study proceeds as follows:

1. The woman releases the lower part of the body from clothing and lies down on the gynecological chair.
2. The specialist puts a disposable condom on the tip of the vaginal sensor (transducer), lubricating it with a special gel.
3. The transducer is inserted into the vagina.
4. The sensor sends a signal to the screen of the device.
5. The doctor deciphers the received picture, dictating his observations to the assistant.

Transabdominal ultrasound

Transvaginal pelvic ultrasound is not prescribed for young girls who do not have a broken hymen, therefore, in such cases, a transabdominal examination is used, which is indicated for both women and men. It is necessary to prepare for this procedure in advance, following the instructions of the doctor. The sequence of actions during the diagnostics is as follows:

1. The diagnosed takes a horizontal position on the couch and frees the stomach from clothes.
2. A conductive gel is applied to the skin of the abdomen and the transducer.
3. The specialist moves the sensor along the surface of the abdomen, studying the indicators of internal organs.
4. After the end of the procedure, the remains of the gel are removed, and the patient can immediately return to their normal lifestyle.

Deciphering the results

The patient has the opportunity to receive the results with their interpretation immediately after the end of the procedure. During the procedure, the diagnostician voices sonological conclusions regarding the observed picture, but the exact diagnosis should be made by the gynecologist based on the results of the diagnosis. Deviations from the established norm may indicate both the individual characteristics of the subject and the presence of pathologies. During the study of organs, their size, echogenicity, structure are evaluated:

For men

During an ultrasound scan of the pelvic organs in a man, the diagnostician determines whether the size and structure of the prostate and bladder correspond to normal values. When deciphering the results of the study, the following data are taken into account:

• The normal size of the prostate gland is 30/25/1.7 mm (length, width, thickness). An upward deviation in size may indicate prostatitis, prostate adenoma.
• The structure is homogeneous, inclusions and seals are absent. The presence of seals or thickening indicates the possibility of tumor formations.

Price

The cost of the ultrasound procedure in different diagnostic centers in Moscow is different. You can conduct this examination at a price of 1000 to 6000 rubles:

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