What preparation is needed for a pelvic ultrasound?
You will need to come with a full bladder. One hour before your appointment time, empty your bladder then drink 750mL of water and hold on. You need to finish drinking this water 45 minutes before your appointment time. If you feel desperately that you need to go to the bathroom, you can go and release a small amount of urine so you are more comfortable. But don’t empty your bladder completely!
Why does my bladder need to be full?
Having a full bladder allows the sonographer to see your deeper pelvic organs – uterus and ovaries. If your bladder is empty, these organs are obscured by overlying bowel and they lie at an angle not accessible with ultrasound. Everyone has gas in their bowel – it’s normal and there’s nothing you can do to make ultrasound travel through bowel any better. Luckily, this problem can be overcome by filling your bladder!
When your bladder is full, it pushes the bowel out to the sides of your pelvis thus allowing soundwaves to travel through the fluid in there (urine) and reach your uterus. We can then gather information about your pelvic organs.
What do you look at in a pelvic ultrasound?
A pelvic ultrasound will assess your cervix, uterus, endometrium, ovaries and the area around them. The sonographer will extend the examination if clinically indicated.
What will happen during the exam?
You will need to lie on the ultrasound table and expose your abdomen. The sonographer will tuck paper towel into your trousers and put gel on the skin of your lower abdomen. She will glide a transducer over your skin to look at your anatomy from different angles and acquire the necessary images. You will more than likely also be scanned with an internal ultrasound which you can read about below.
What is an internal ultrasound and will I need one?
An internal ultrasound is a routine part of a pelvic exam. We believe this is the best test to perform in some situations but you have the right to decline an internal exam and we will document all that we can externally. If you would feel more comfortable with a chaperone in the room during the test, we can provide one here. Alternatively, you are welcome to bring a partner, family member or friend to the exam.
Before having an internal ultrasound, the sonographer will direct you to the bathroom where you can empty your bladder completely. You will then return to the ultrasound room and be given privacy to prepare for the scan. You will need to remove any clothes from the waist down, lie on the ultrasound bed and cover yourself with a sheet provided. The sonographer will then return to the room. She will place a firm wedge under your hips to elevate your pelvis.
The ultrasound probe used for the internal scan is long and thin and will be placed in the vagina. Please inform the sonographer if you are allergic to latex as the probe will be covered with a latex cover. In the event a patient has an allergy an alternative cover will be used. The sonographer will offer you the choice of inserting the probe yourself or allowing her to insert it for you. It is generally easier if the sonographer does this. The probe does not need to interfere with the cervix so this test is generally not painful. Rest assured, it is not like a smear test! Please inform the sonographer if you feel pain during the scan and know that you are able to stop the examination at any point by asking the sonographer to stop. The internal scan will only take a few minutes.
Once the probe is inserted, the sonographer will move it from side-to-side and up-and-down to examine all the relevant anatomy. The internal probe gets closer to what we need to see than the external probe, therefore the resolution and quality of the image is generally much better internally than externally. There are a few exceptions to this rule and the external scan provides us with an important global view of your pelvic anatomy.
When is an internal ultrasound not appropriate?
The sonographer will not perform an internal ultrasound on anyone who either:
- Has never been sexually active
- Cannot give informed consent
- Is less than 6 weeks post-partum
- Declines the exam
What happens after the exam?
You will be given time and privacy to get comfortable and dressed. The sonographer will tell you any significant findings from the exam. She will write a report and that will be emailed to you and your referring doctor within 24 hours.
How long does a pelvic ultrasound take?
The whole appointment will take approximately 20-30 minutes. The actual scan time will be much shorter than this.