FAQ

On what day of the cycle is a pelvic ultrasound done?

Survey pelvic organs Ultrasound is recommended to be performed in the initial phase of the menstrual cycle - 5-7 days from the start of menstruation. In preparation for in vitro fertilization (IVF), an ultrasound can be scheduled on days 2-4 of menstruation.

Is preparation required for an ultrasound?

Features of preparation for ultrasound scanning of the pelvic organs depend on the method used to conduct the study (transabdominal, transvaginal or transrectal diagnosis). General recommendations for preparation include following a gentle diet and taking enzyme preparations to improve digestion.

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

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

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

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

How much does a pelvic ultrasound cost?

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

How can I sign up for a pelvic ultrasound?

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

Ultrasound of the pelvic organs - what it shows, types (transabdominal, transvaginal), on what day of the cycle it is performed in women, indications and contraindications, preparation and conduct of the procedure, explanation, where to do it, reviews, price

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Ultrasound of the pelvic organs is a method instrumental examination, during which organs located in the pelvis are visualized on a monitor using ultrasound waves.

What is pelvic ultrasound?

Ultrasound (ultrasound examination) the pelvic organs are instrumental method diagnostics various diseases, based on obtaining an image of the pelvic organs on a monitor after ultrasonic waves pass through them. Ultrasonic waves have a very high vibration frequency, so the human ear is not able to hear them, but various equipment tuned to the appropriate frequencies perfectly receives these vibrations. Next, the vibrations perceived by the equipment are translated into an image on the monitor, similar to how waves are translated into sound in a radio.

That is, the essence of ultrasound examinations of any organs, including the pelvis, is the following - a special device (ultrasound scanner) emits waves with a high frequency of vibrations that pass through biological tissues, where part of them is absorbed, scattered or reflected back, after which the same the device captures the returning waves and converts them into the form of an image on the monitor. As a result of using an ultrasound scanner, the doctor can see images of the organs being studied on the screen.

By appearance organs and surrounding tissues, the doctor takes measurements of length, width and other dimensions, evaluates the structure, condition of tissues, large blood vessels and lymphatic vessels, the presence of physiological and pathological inclusions in them, etc. And after such a detailed analysis of images of organs from various angles, he makes a conclusion about the presence or absence of pathology. If there are any pathological changes, their nature is described in detail and an assumption is made as to what they may be caused by (what pathological processes).

When an ultrasound scanner, according to its technical characteristics, allows this to be done, the doctor can additionally switch it to Doppler scanning mode and evaluate the blood flow in the vessels of the studied area of ​​the body.

Using a pelvic ultrasound, you can assess the condition and presence of diseases of organs located within the pelvis (genital and urinary organs). Thus, ultrasound determines the presence of an inflammatory process, tumors, diffuse changes, deformations, incorrect positioning, etc.

Sensitivity and informativeness of ultrasound in diagnosing diseases genitourinary organs quite high, so the method is prescribed and used very often. And given its complete painlessness and safety, it is one of the main and frequently used diagnostic methods, including in pregnant women, children and the elderly.

The duration of an ultrasound of the pelvic organs is usually 10–20 minutes. During the study, the person usually does not experience any discomfort, so ultrasound is easily tolerated.

Ultrasound of the pelvic organs can be performed both for diagnostic purposes and for preventive examination when a person has no complaints from the genitourinary organs. Diagnostic ultrasound is performed when a person has any complaints indicating a disease of the genitourinary organs (for example, pain in the lower abdomen, urinary disorders, irregular menstruation, infertility, etc.). In such situations, ultrasound is necessary to clarify the diagnosis, as well as the nature and extent of pathological changes in tissues. But a preventive ultrasound can be carried out as part of a routine annual examination, when nothing bothers the person at all, or after undergoing serious illnesses, when the state of health must be periodically monitored so as not to miss a relapse of the pathology.

Ultrasound of the pelvic organs in women and men

When it comes to ultrasound of the pelvic organs, in almost all cases this study is meant to be performed exclusively on women. This state of affairs is due to the anatomical features of the female and male pelvis.

So, in the pelvis in women there is a bladder, sigmoid and rectum, ureters, uterus, ovaries and fallopian tubes. Moreover, all these pelvic organs can be clearly examined using ultrasound. However, in practice, ultrasound is rarely used to diagnose intestinal diseases, since there are more informative methods, such as colonoscopy, sigmoidoscopy, irrigoscopy, etc. Therefore, ultrasound of parts of the colon is practically not used, and even if prescribed, it is done separately and specifically to identify the pathology of only this organ. As for the bladder and ureters, ultrasound of these organs is also usually prescribed separately and specifically if a person is bothered by complaints from the urinary system. Thus, it turns out that the term “ultrasound of the pelvic organs” means the study of only the female genital organs, such as the uterus, ovaries, and fallopian tubes. These organs are well visualized using ultrasound, and therefore the method is often prescribed for diagnosing the most various diseases internal genital organs in women.

The small pelvis of men contains the bladder, ureters, rectum and sigmoid colon, prostate gland, that is, the urinary organs, sections of the large intestine and internal genital organs. In order to clearly examine the bladder and ureters in men using ultrasound, it is necessary to use a special modification of the study, since the usual method used for women is not suitable for the stronger sex due to anatomical features. Because of this, ultrasound of the bladder and ureters is always prescribed for men separately and specifically. As for direct and sigmoid colon, then to diagnose their pathology, as in women, other methods are used. And if an intestinal ultrasound is prescribed, it is only for a specific purpose. Thus, from the pelvic organs in men, only the prostate gland remains. Ultrasound of this organ is performed quite often, as it is highly informative, but ultrasound of the prostate is done through anus, therefore this study is also always prescribed separately. Thus, it turns out that in men for the study different organs pelvis, it is necessary to use various modifications of the method and approaches (through the anus, through the abdominal wall, etc.), due to which it is simply impossible to conduct a general ultrasound of all pelvic organs.

Based on the above, it is clear that men do not undergo ultrasound of the pelvic organs, since for each organ of this localization it is necessary to use a separate modification of the ultrasound method or special access. Therefore, most often, men are given a referral not for an ultrasound of the pelvic organs, if it is necessary to study the condition of the bladder, prostate and intestines, but three separate referrals for the study of each anatomical structure separately.

What does an ultrasound of the pelvic organs show?

Ultrasound of the pelvic organs allows you to assess the condition, structure, size, location, presence of pathogenic inclusions and formations of the uterus, ovaries, fallopian tubes and cervix. Based on the data obtained during ultrasound, the doctor can identify the following pathologies and physiological processes in the female genital organs:

• Pregnancy, its duration and location of the fetus (in the uterus, ectopic);
• Pathology of the fetus, placenta or cervix during pregnancy;
• Follicle growth and ovulation;
• The size and condition of the corpus luteum of the ovary after ovulation;
• Malformations and structural anomalies of the internal genital organs of a woman (for example, bicornuate or saddle uterus, aplasia of the uterus and vagina, vaginal atresia, children's uterus, duplication of the uterus, agenesis, septum in the uterine cavity, etc.);
• Tumor and cystic formations in the uterus and ovaries (fibroids, cysts, cystomas, polycystic disease, etc.);
• Malignant tumors of the internal genital organs or metastases in them;
• Inflammatory diseases of various genital organs (endometritis, adnexitis, salpingitis, cervicitis, etc.);
• Pathology of the fallopian tubes (hydrosalpinx, pyosalpinx);
• The presence and correct installation of an intrauterine device;
• The genitals have a normal or abnormal location and size.

Transabdominal and transvaginal ultrasound of the pelvic organs - essence, similarities, differences

Ultrasound of the pelvic organs in women can be performed in two ways - transabdominal and transvaginal. The essence of both methods is exactly the same - diagnostics various pathologies according to the image obtained on the monitor of the ultrasound machine. But the differences between them lie in the access used and information content.

Thus, transvaginal ultrasound is performed by inserting a scanner probe into the woman’s vagina. In this case, special sensors with a frequency of 4 - 10 MHz are used, which allow you to see images of tissues and organs only at a distance of 10 cm from them. Therefore, transvaginal ultrasound allows you to obtain a highly accurate image in which you can see even small details, but, unfortunately, the method makes it possible to “see” only objects located within a maximum of 10 cm from the sensor.

Transabdominal ultrasound is performed by placing a transducer on the anterior abdominal wall and obtaining an image of the organs on a monitor through the lower abdomen. The study is carried out with a full bladder, which is necessary for better visualization of the uterus. For transabdominal ultrasound, sensors with a frequency of 3–6 MHz are used, which make it possible to obtain images of organs located at a distance of up to 20 cm from the sensor. Thus, it is clear that transabdominal ultrasound allows one to obtain a kind of overview picture of the pelvic organs, but does not always make it possible to examine small details.

Considering the features of transabdominal and transvaginal ultrasound, it is clear that the first method allows you to see the picture at a glance, create general idea about the condition and relative position of organs, and the second, on the contrary, makes it possible to examine small details and clarify the nature of the existing pathological process. That is why transabdominal and transvaginal ultrasound of the pelvic organs complement each other.

There are no other differences or features between transvaginal and transabdominal ultrasound. Moreover, the norms and principles for deciphering the data obtained during their implementation are exactly the same.

Which pelvic ultrasound is best?

Due to the fact that the transvaginal ultrasound method makes it possible to examine the tissues in more detail, but with its help it is impossible to see big picture and large volumetric formations, and the transabdominal method, on the contrary, allows you to consider a “panorama” of the small pelvis, it is impossible to say unequivocally which method is better. Both methods of ultrasound of the pelvic organs complement each other, and therefore it is impossible to choose between them clearly the best or the worst. Indeed, in some cases more the best method It turns out to be a transvaginal ultrasound, and in others - transabdominal.

Since transvaginal ultrasound allows you to see finer details, but does not provide an overview, it is better to prefer in cases where you need to see something small, for example, growing follicles, the corpus luteum of the ovary, the cervix, etc. But transabdominal ultrasound should be preferred when you need to see an overview picture of the pelvis and identify possible neoplasms or enlargement of organs (fibroids, ovarian cysts, ovarian appendages, etc.), since in such cases only such access is informative. Transvaginal ultrasound does not always manage to “find” ovaries, cysts, cystomas or fibroids, since they are large and extend beyond the boundaries of the small pelvis, where the sensor simply does not “reach” them (they are further than 10 cm from the sensor).

In each specific case, the doctor must decide which ultrasound method will be best. Perhaps, for the most complete and informative diagnostics Both methods of pelvic ultrasound will be required.

Indications for ultrasound of the pelvic organs

The indications for transabdominal and transvaginal ultrasound are generally the same, since they allow one to detect the same pathologies, but the doctor decides what type of examination is necessary in each specific case.

An ultrasound scan of the pelvic organs in women is indicated in the presence of the following conditions or symptoms of genital diseases:

• Pain in the lower abdomen;
• Pain on the right or left in the area of ​​the iliac wing;
• Discomfort or pain during sexual intercourse;
• Bleeding or abnormal discharge (with unpleasant smell, with admixtures of pus, mucus, blood, with flakes, yellowish, grayish, greenish in color, etc.) from the genitals;
• Infertility;
• Miscarriage (several miscarriages, missed pregnancies or premature births in the past);
• Menstrual irregularities ( irregular cycle, heavy or scanty periods, etc.);
• Carrying out folliculometry and tracking ovulation for problems with conception;
• Carrying out cervicometry for cervical pathology (isthmic-cervical insufficiency, etc.);
• Suspicion of pregnancy;
• Suspicion of ectopic pregnancy, rupture or torsion of a cyst, etc.;
• Monitoring pregnancy after using assisted reproductive technologies (IVF, ICSI, etc.);
• Suspicion of inflammatory processes in the uterine appendages (adnexitis, salpingitis);
• Suspicion of inflammatory processes in the uterus and cervix (endometritis, myometritis, parametritis, cervicitis, pyometra, hematometra, etc.);
• Suspicion of pathology of the fallopian tubes (obstruction, hydrosalpinx, pyosalpinx);
• Suspicion of endometriosis;
• Suspicion of polycystic ovary syndrome;
• Suspicion of tumors of the pelvic organs (cystadenomas, teratomas, any cystomas, fibroids, polyps, fibromas, etc.);
• Suspicion of malignant tumors of the pelvic organs;
• Vulvovaginitis revealed by the results of tests and examination;
• Control of the location of the inserted intrauterine device;
• Assessment of the condition of the pelvic organs after gynecological manipulations(abortions, operations, cauterization of erosions, etc.).

Contraindications to ultrasound of the pelvic organs

Transvaginal ultrasound is contraindicated in the following cases:

• Childhood;
• Whole hymen (girl or woman is a virgin);
• A large space-occupying formation in the pelvis, clearly felt during a gynecological examination by hand;
• Old age (not always).

In addition, transvaginal ultrasound should be postponed for 2 to 5 days after any gynecological therapeutic and diagnostic manipulations involving the vagina (for example, cauterization of cervical erosion, hysterosalpingography, hysteroscopy, diagnostic curettage, abortion, etc.).

For transabdominal ultrasound no absolute contraindications, because this type The study is safe and does not involve the penetration of instruments into body cavities. However, transabdominal ultrasound is recommended to be postponed for some time if there are wounds on the skin of the abdomen, a large number of pustular rashes, burns, severe dermatitis, urticaria or any other damage skin, since in similar situations sliding of the sensor can provoke either an increase in the severity of the pathological process or its spread over a large area. When there is any damage to the skin in the lower abdomen where the transducer will slide, it is recommended to postpone the transabdominal ultrasound until the skin condition returns to normal.

If a woman is bothered by severe abdominal pain, against the background of which she cannot take the position necessary for an ultrasound scan, then the study can also be considered conditionally contraindicated.

However, if an ultrasound needs to be done for urgent reasons, then it is performed despite the presence of damage to the skin and severe pain in a stomach.

After various gynecological procedures (abortions, laparoscopic operations, etc.), it is advisable to perform an ultrasound several days (2 – 5) after the intervention.

On what day of the cycle should I do a pelvic ultrasound?

Typically, an ultrasound of the pelvic organs is recommended to be performed on days 5–10 menstrual cycle, that is, in the first half of the cycle after the end of menstruation. However, in some cases (for example, folliculometry, ovulation control, measurement of endometrial thickness, suspicion of endometriosis, etc.), ultrasound is required at other periods of the cycle, for example, on days 12–15, in the second phase (days 15–30), etc. .d. In some cases, for example, if fibroids are suspected, ultrasound is performed twice during the cycle - after the end of menstruation and 1 - 2 days before the onset of the next menstruation. In general, in each specific situation, the doctor tells the woman exactly when to go for an ultrasound.

Ultrasound of the pelvic organs during menstruation

In principle, it is not recommended to routinely perform an ultrasound of the pelvic organs during menstruation, except in cases where the study needs to be carried out specifically during menstruation.

Cases where it is recommended to routinely perform an ultrasound during menstruation include the following:

• Significant blood loss during menstruation (to identify the cause of severe menstrual bleeding It is advisable to examine the endometrium during menstruation);
• Suspicion of nodes, polyps or endometrial hyperplasia (in such cases, ultrasound is recommended to be performed on days 1–3 of the cycle, that is, during menstruation);
• Determination of ovulation and folliculometry (ultrasound is performed several times from days 1 to 15 of the cycle in order to measure the size of the growing follicle and accurately record the time of ovulation).

In addition, there are situations when an ultrasound of the pelvic organs during menstruation is not only possible, but necessary. Moreover, it is shown because we are talking about the development severe conditions threatening a woman's life. Thus, an ultrasound during menstruation should be done in case of complications of inflammation of the ovaries or fallopian tubes, after an abortion, or gynecological surgery. That is, an ultrasound scan during menstruation is done only in emergency cases, and in all other situations, the examination should be postponed until the end of menstruation.

In all other cases, routine ultrasound during menstruation is not recommended, since the diagnosis of many pathological conditions turns out to be difficult. Therefore, when performing a routine ultrasound during menstruation, a woman runs the risk that an existing disease will be missed or a completely different pathology will be diagnosed. Such difficulties in diagnosing pathology of the pelvic organs during menstruation are due to the following factors:

• The accumulation of blood and epithelial clots in the uterine cavity creates interference and difficulties for diagnosing uterine pathologies;
• Against the background of bleeding or heavy menstruation often it is not possible to examine small space-occupying formations (cysts, polyps, fibroids);
• Against the background of menstruation, it is impossible to determine the thickness of the endometrium, which is very important for the diagnosis of endometritis, endometriosis, hormonal disorders and chronic inflammatory processes.

Preparation for ultrasound of the pelvic organs

The basic preparation for an ultrasound of the pelvic organs through transabdominal and transvaginal approaches is the same, and consists in reducing as much as possible the amount of intestinal gases that stretch the intestine and create interference, preventing the doctor from examining the genitals. For such preparation, it is necessary, 1–2 days before the date of the ultrasound, to exclude from the diet foods and dishes that increase gas formation in the intestines, such as beans, peas and any other legumes, vegetables with coarse fiber (radish, cabbage, radishes, bell pepper, onions, garlic, etc.), carbonated drinks, alcohol, coffee, wholemeal or bran bread, whole grain cereals, dairy products, hot and spicy sauces and seasonings (mustard, pepper, etc.), pasta, fatty fish and meat, fruits (melon, bananas, sweet apples, etc.), etc. In addition, in addition to reducing the amount of gases in the intestines, you can take medications that have a carminative effect, such as, for example, products with simethicone (Espumizan, Disflatil, etc.), enzyme preparations(Mezim, Panzinorm, Unienzym, etc.), sorbents (Smecta, Filtrum, Polyphepan, Activated carbon, Karbolen, etc.). On the day of the study, it is advisable to cleanse the intestines using a regular enema, Microlax microenema or glycerin suppositories. To cleanse the intestines, you can also drink a mild laxative in the evening, on the eve of the examination, for example, Duphalac, Mucofalk, etc. Cleansing the intestines is necessary to minimize the number of possible interferences during the upcoming ultrasound.

Then the doctor or nurse asks you to remove clothing from the lower half of your body, place a sheet on the couch, and lie on your back on it. Next, the woman needs to bend her legs apart at the knees, and, depending on the technical equipment of the office, place her feet either on the edge of the same couch, or on chairs installed next to the couch, or on stirrups for lithotomy (similar to stirrups on a gynecological chair , but the feet are placed on them with feet). The doctor may place a pillow under the buttocks.

After the woman takes the position required for the study, the doctor puts gloves on her hands, lubricates the sensor head with a special gel, puts a condom on top of it, and again applies the gel on top of it, which is necessary to obtain a good quality image. Next, carefully spreading the labia to the sides, the doctor inserts the ultrasound scanner sensor into the woman’s vagina with a gentle movement and minimal effort.

After this, the doctor makes sliding and rotating movements in the vagina with a sensor to direct it in the desired direction and obtain an image of the uterus, fallopian tubes, ovaries, cervix and retrouterine space on the screen. When all organs have been examined and measured, the procedure is completed and the doctor removes the sensor from the vagina. After this, you can get up from the couch and get dressed.

While the woman is getting dressed, the doctor writes a research report, which reflects everything that he was able to see during the ultrasound.

Normal ultrasound of the pelvic organs

Parameters studied during ultrasound of the pelvic organs

During the study, the doctor must evaluate the condition, location and size of the following organs:

• Uterus – describes the position, shape, contours, dimensions (body length, width, anteroposterior size) of the organ. The homogeneous or heterogeneous structure of the myometrium is also indicated, and whether there are volumetric formations of the myometrium (fibroids, etc.);
• Endometrium – describes the thickness, demarcation from the myometrium (clear or unclear), echostructure (homogeneous, heterogeneous), the presence of formations in the uterine cavity (polyps, septa, etc.), whether the uterine cavity is dilated or not;
• Cervix - length, anteroposterior size, diameter of the internal canal of the cervix (endocervix) are measured, echogenicity is determined;
• Right and left ovary (described separately) - the length, width, thickness, approximate volume of the organ, its contours, shape, location are measured, the presence or absence of follicles is indicated, and the number, size of the dominant follicle, and also volumetric formations (cysts, cystomas, etc.), if, of course, there are any;
• Fallopian tubes - it is indicated whether they are visible or not, and if visible, then the accumulation of what is most likely in them (fluid or pus);
• Free fluid in the pouch of Douglas and the retrouterine space - whether it is present or not is indicated, and if present, the approximate volume;
• The veins of the small pelvis are dilated or not, tortuous or not.

Normal ultrasound parameters of the pelvic organs

Below we will indicate what normal ultrasound parameters the pelvic organs have:

Uterus. The echostructure is homogeneous, medium intensity, smooth, clear contours, pear-shaped, position slightly deviated anteriorly (anteversio), body length 4.5 - 6.7 cm, width - 4.5 - 6.2 cm, anteroposterior size (thickness) 2 .8 - 4.0 cm. In women who have given birth, the size of the uterus is 1 - 2 cm larger than in those who have not given birth, so you should not be surprised if after childbirth, according to ultrasound, the uterus turns out to be slightly larger than it once was. In women in menopause The size of the uterus is 1–2 cm smaller than indicated due to the involution of the organ.

Endometrium. Normally visible in the form of a clear, homogeneous hyperechoic strip with smooth edges along inner surface uterus, which is noticeably different from the lighter myometrium. After ovulation, a light hypoechoic stripe of unknown origin (hallo) appears between the hyperechoic endometrium and myometrium. Endometrial thickness in women reproductive age varies and depends on the day of the menstrual cycle: on days 1 – 4 – 2 – 4 mm, on days 5 – 10 – 3 – 10 mm, on days 11 – 14 – 8 – 15 mm, on days 15 – 23 – 10 – 20 mm, on days 23–28 – 10–17 mm. In menopausal women, the thickness of the endometrium is normally 1–2 mm, but sometimes it can reach up to 4 mm.

The edges of the uterine cavity are normally smooth, the cavity itself is homogeneous, not dilated, with no formations in it. There may be a small amount of fluid in the uterine cavity, which is normal. But the accumulation of a large amount of fluid or pus is a sign of pathology.

Cervix. The echogenic structure is homogeneous; before menstruation or during ovulation, the cervical canal can be filled with mucus or fluid, the length of the neck is 35–40 mm, the anteroposterior size is 25 mm, the diameter of the internal canal is no more than 3 mm. In women who have given birth, the anteroposterior size of the cervix may increase by 10 mm compared to women who have not given birth.

Ovaries. Visible in the form of oval formations with a homogeneous structure, with foci of fibrosis and with a few anechoic inclusions (no more than 12), representing follicles. The contour of the ovaries is clear, but not even, often lumpy due to protruding follicles. Normally, in the first half of the cycle, the dominant follicle is clearly visible, from which the egg will be released during ovulation. In the second half of the cycle, the corpus luteum is determined in place of the dominant follicle. The width of the ovary is 20 - 30 mm, length - 25 - 30 mm, thickness - 15 - 20 mm, and volume 30 - 80 mm 3. In women in menopause, the ovaries have a clear, uneven contour, but they lack anechoic inclusions, and their sizes are smaller than the specified norms for women of reproductive age.

The fallopian tubes. Normally they are not visible on ultrasound.

Douglas and retrouterine space. Normally, during the period of ovulation (days 12–15 of the menstrual cycle), it may be visible a small amount of fluid released from the ruptured follicle from which the egg was released.

Veins of the small pelvis. Normally, they are not dilated or tortuous.

Interpretation of ultrasound of the pelvic organs

Below we will look at what the various ultrasound characteristics of the pelvic organs identified during an ultrasound may mean, and what pathologies this may indicate.

Uterus

Ultrasound allows you to detect abnormalities in the structure of the uterus, myomatous nodes, adenomyosis, endometriosis, cancer, etc.

An irregular shape of the uterus with one, two or more cavities, or greatly reduced size, indicates an abnormal structure of the organ due to developmental defects.

The presence of hypoechoic or hyperechoic homogeneous nodes of a round shape with a blurred contour with a large number of vessels in the capsule surrounding them, combined with an increase in the size of the uterine body and the heterogeneity of its contours, indicate the presence of fibroids.

Small multiple cystic areas in the myometrium with a diameter of 1–2 mm to 1–2 cm in combination with an enlarged uterus may indicate adenomyosis.

Severe posterior deviation of the uterus may be a sign of widespread pelvic endometriosis. In addition, signs of endometriosis may include numerous anechoic tubular structures with a diameter of 1 mm in the fallopian tubes and cervical canal, thickening of the endometrium with its deformation, areas in the uterine cavity with absent endometrium, asymmetry and thickening of the walls of the uterus.

An increase in the size of the uterus may be a sign of pregnancy, benign or malignant tumor. At the same time, the heterogeneous echostructure of the uterine body speaks in favor of the tumor.

Endometrium

Ultrasound can detect polyps, cancer, endometrial hyperplasia.

The presence of isoechoic or hyperechoic formations with cystic inclusions inside them indicates endometrial polyps. In addition, signs of endometrial polyps are the expansion of the uterine cavity and the presence of fluid in it.

Endometrial cancer is characterized by an increased thickness of the endometrium, poorly demarcated from the myometrium, its edges are uneven, increased echogenicity, and there may be fluid in the uterine cavity.

If the endometrium is thicker than normal, especially in women in menopause, and this is combined with bleeding, then most likely we are talking about endometrial hyperplasia.

Cervix

Based on the results of an ultrasound of the cervix, endometriosis, cancer, Nabothian cysts, fibroids, polyps, etc. can be detected.

An increase in the diameter of the cervical canal of more than 3 mm indicates endometriosis or cancer.

The presence of single or numerous round anechoic formations with a diameter of 5–10 mm indicates nabothian cysts.

Hyperechoic homogeneous nodes in the cervical area may be fibroids or polyps of the cervical canal.

An increased size of the uterus, accumulation of blood or pus in its cavity, combined with enlarged pelvic lymph nodes, may be signs of cervical cancer. However, ultrasound is a very unreliable method for diagnosing this formidable pathology.

Ovaries

According to ultrasound data, it is possible to identify cysts, polycystic ovaries, cystomas, cancer, serosocele, adnexitis, etc.

If a thin-walled single-chamber formation filled with fluid is visible on the ovary, sometimes with hyperechoic dense inclusions of various sizes, without papillary growths on the walls, then this indicates a cyst.

If the ovary shows a single-chamber or multi-chamber dense round formation with thick walls and papillary growths, hypoechoic or anechoic structure, of any size, then this may be a sign benign tumor– cystomas (cystadenomas, teratomas) or ovarian cancer.

A dense hypoechoic homogeneous formation on the ovaries, sometimes with anechoic inclusions, may be a fibroma.

Multi-chamber formations of various sizes and uncertain shapes that appear after gynecological operations or inflammatory processes in the pelvis can represent serosoceles (cysts of the peritoneum adjacent to the ovaries).

If the ovaries have a large volume, more than 12 follicles (anechoic inclusions) are identified in them, randomly located throughout the tissue of the organ, and the dominant follicle is not visible, then this indicates polycystic ovaries.

If the ovaries are enlarged in size, their contours are unclear, and their echogenicity is heterogeneous, then these are signs of adnexitis (inflammation of the ovaries).

The fallopian tubes

If the doctor sees fallopian tube on an ultrasound, this may indicate an ectopic pregnancy, an inflammatory process in the organ area (salpingitis) or an accumulation of fluid in the tube (hydrosalpinx) and/or pus (pyosalpinx).

Free fluid in the space of Douglas and retrouterine space

Normally, a small amount of fluid in the pelvis and pouch of Douglas can be detected on days 12–15 of the menstrual cycle (ovulation period). But the appearance of a large amount of fluid in the pelvis and pouch of Douglas on any day of the menstrual cycle is a sign of the following diseases:

• Ectopic pregnancy;
• Endometritis;
• Endometriosis;
• Adnexitis;
• Ovarian cyst;
• Purulent salpingitis;
• Internal bleeding;

Pelvic veins

If they are expanded or tortuous, this may indicate stagnation of blood circulation in the pelvis or malignant tumors.

Where to do an ultrasound of the pelvic organs

Ultrasound of the pelvic organs can be done in almost any municipal city or district clinic on the basis of the department functional diagnostics or in antenatal clinics. Also, ultrasound of the pelvic organs can be performed in hospitals with gynecological or urological departments or specialized research institutes. IN government institutions, if you have a referral from a doctor, ultrasound of the pelvic organs is performed free of charge on a first-come, first-served basis.

On a paid basis, ultrasound of the pelvic organs can be performed in public clinics and hospitals out of turn or in numerous private medical centers.

Sign up for pelvic ultrasound

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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, but should she worry in advance? An indication for prescribing a study may be the doctor’s uncertainty about the preliminary diagnosis. In order to eliminate 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 pelvic ultrasound

One of the most high-precision and safe methods diagnostics used in gynecological practice, is an ultrasound examination of the pelvic organs (USP). The essence of this method is the reflection of the sound wave sent by the sensors by the internal organs. The reflected radiation is converted with the help of technical instruments into a graphic image, which is interpreted by a diagnostician. Using ultrasound, you can track the pelvic organs over time, which allows you to make accurate conclusions.

What is included in the female pelvic organs

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 system includes the bladder and rectum, which are the same in men and women. The organs of the reproductive system are individual for each sex, for women they are:

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

Indications

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

• menstrual irregularities;
• 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 others gynecological diseases(adnexitis, endometritis, cervicitis, vulvitis, colpitis);
• infertility (to determine the cause, folliculometry is performed, i.e., identifying disorders of the ovulatory mechanism);
• previous surgical interventions (to control the condition).

What does it show

During the examination, the specialist performing the procedure evaluates the anatomical structure of the organs. The assessment is based on a comparison of the observed picture with established standards. Deviations cannot clearly indicate pathology; to confirm the diagnosis, you should take a necessary tests. The following main indicators are used for diagnosis:

Index	Meaning
	An increase in the size of the uterus occurs during the inflammatory process, a decrease occurs during fibrosis.
	A change in the natural shape may indicate structural defects of the uterus
Wall thickness	Thickening of the walls of the uterus may be a sign of the presence of malignant tumors or an inflammatory process
Echogenicity	Tissue density increases in the presence of pathology
Structure	Heterogeneity may indicate fibrosis of the uterus or prostate gland
Presence of neoplasms, compactions, stones	This indicator identifies tumors, stones

How to prepare

Preparation for an 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. Prepare for a transrectal ultrasound, which involves examining the pelvic organs through the rectum, and for a transabdominal ultrasound as follows:

• two days before the procedure, stop consuming foods and drinks that contribute to gas formation (legumes, dairy, carbonated and alcoholic drinks, fresh vegetables and fruits);
• eat in small portions;
• 3 hours before the procedure, cleanse the intestines (using an enema or taking laxatives);
• an hour before the diagnosis, you should fill your bladder (drink 1 liter - 1.5 liters of still water);
• On the day of the examination, you must refrain from smoking and taking medications.

Is it possible to eat before an ultrasound?

Eating on the day of a transabdominal examination is not recommended if the procedure is scheduled for the morning. If the research time is scheduled later than 2 o'clock in the afternoon, it is allowed light breakfast, which must be no later than 11 a.m. During transvaginal examination of the pelvic organs, there are no restrictions on eating time.

On what day is an ultrasound performed?

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

How to do a pelvic ultrasound

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

Transvaginal ultrasound

The transvaginal ultrasound procedure is practically painless (except in cases acute inflammation genitals or organs abdominal cavity). The research proceeds as follows:

1. The woman frees the lower part of her body from clothes and lies down on the gynecological chair.
2. The specialist places 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 device screen.
5. The doctor deciphers the resulting picture, dictating his observations to the assistant.

Transabdominal ultrasound

Transvaginal pelvic ultrasound is not prescribed for young girls whose hymen is not broken, so in such cases a transabdominal examination is used, which is indicated for both women and men. You must prepare for this procedure in advance by following your doctor's instructions. The sequence of actions when carrying out diagnostics is as follows:

1. Diagnosed takes horizontal position on the couch and frees his stomach from clothes.
2. Conductive gel is applied to the skin of the abdomen and the sensor.
3. The specialist moves the sensor over the surface of the abdomen, studying the indicators of the internal organs.
4. After the procedure is completed, the remaining gel is removed and the patient can immediately return to their normal lifestyle.

Decoding 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 gynecologist must make an accurate diagnosis based on the diagnostic results. Deviations from the established norm may indicate that individual characteristics the subject and the presence of pathologies. During the examination of organs, their size, echogenicity, and structure are assessed:

		Deviations
	Dimensions (length, width) – 70, 60 mm, no thickenings	Thickening of the walls was noted, heterogeneity of the structure was revealed, the size was reduced or increased, there were abnormal formations, cavities
	Dimensions (width, length, thickness) – 25, 30, 15 mm, uniform structure	Increased size, presence of cysts, fluid-filled cavities
Bladder	Free flow of urine through the ureters, complete emptying occurs after urination	Presence of stones, changes in size and position
The fallopian tubes	Not viewed	There are oval, round formations, adhesions, thickening of the walls

For men

During an ultrasound scan of a man’s pelvic organs, the diagnostician determines the correspondence of the size and structure of the prostate gland and bladder normal indicators. When interpreting the research results, the following data is 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 or prostate adenoma.
• The structure is homogeneous, there are no inclusions or compactions. The presence of compactions or thickenings indicates the possibility of tumor formations.

Price

The cost of an ultrasound examination procedure differs in different diagnostic centers in Moscow. This examination can be carried out at a price from 1000 to 6000 rubles:

Medical institution	Cost of transabdominal examination, rub.	Cost of transvaginal examination, rub.
Affordable Health
MedicCity
SM-Clinic
Center V.I. Dikulya
Best Clinic
Ramsey Diagnostics
Perinatal Medical Center
Eurasian clinic

Video

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The most common and safest research method is ultrasound diagnostics. You can use it to identify possible diseases and pathologies of internal organs and start treatment in a timely manner. Unlike other examination methods, ultrasound diagnostics has virtually no contraindications.

Thanks to ultrasound diagnostics of organs, it is possible to assess the condition of a woman’s reproductive system and identify possible pathologies.

An examination is ordered when the following symptoms and diseases:

• Painful sensations in groin area and lower back.
• Pain during or difficulty emptying the bladder.
• Blood clots or mucus in the urine.
• Menstrual irregularities.
• Inflammation of the genital organs.
• Gynecological inflammatory diseases.

In addition, an ultrasound is required to confirm pregnancy if there was a difficult birth or abortion, surgical intervention on the uterus and appendages, when installing an intrauterine device.

Ultrasound is prescribed to exclude ectopic pregnancy. If conception has occurred, then the control dates for ultrasound diagnostics are in the first trimester from 12 to 14 weeks, in the second from 20-24 weeks, and in the third from 30-32 weeks.

Ultrasound diagnostics of the pelvis is performed not only for women, but also for men. Main indications for research in men:

• Problems with urination.
• Pathologies.
• Bladder diseases.

The examination can be prescribed for children and adolescents with deviations in the development of the genital organs, early or late puberty, etc.

More information about ultrasound of the pelvic organs can be found in the video:

Transvaginal ultrasound is not performed in case of heavy bleeding or in virgins. It is prohibited to perform it in the second and third trimester of pregnancy, as this can lead to uterine tone and provoke contractions.

Contraindications to rectal ultrasound examination are: the presence of cracks in the rectum, exacerbation of hemorrhoids, after rectal surgery.It should be remembered that ultrasound is not performed after the procedure. Distortion of results may occur due to the introduction of contrast agents. In this case, it is better to postpone the ultrasound for a while.

Preparation for the procedure

Preparation for the examination depends on the diagnostic method: through the vagina, abdominal wall and rectum. The doctor will tell you in advance about the chosen technique for performing an ultrasound of the pelvic organs.

It is necessary to prepare for an ultrasound if the examination will be carried out through the outer abdominal wall or through the intestine.

A few days before the transabdominal examination, you should:

• Eliminate foods that cause gas and bloating from your diet. These products include: cabbage, legumes, bread, apples, grapes, milk, etc. For 3-4 days, it is advisable to eat porridge, lean meat, steamed vegetables, and omelettes.
• It is recommended to drink 1-2 days before the test Activated carbon which will help get rid of gases if dietary food did not help.
• You should not eat food the morning before the procedure. Last appointment should only be in the evening. For prevention purposes, it is necessary to do a cleansing enema in the evening. If you have persistent constipation, you must do an enema in the evening and in the morning before the test.
• An hour before the procedure you need to drink 1-1.% liter clean water to fill your bladder.

If a transvaginal ultrasound is performed, the bladder should be empty. The study can be carried out on any day. The procedure is not performed on menstruation days. The most informative results will be after an ultrasound scan after menstruation. You will need a condom for the test.

An ultrasound scan with a vaginal probe may be performed several times a month to determine the maturation of the follicles and assess the condition and functioning of the ovaries.

3 hours before performing a rectal ultrasound, it is necessary to do a cleansing enema. For this purpose, you can use 1.5 liters of water at room temperature or special drugs that cause defecation: Norgalax, Microlax, glycerin suppositories.

In case of pathology, infertility or erectile dysfunction, it is necessary to fill the bladder. The patient should drink 4 glasses of water one hour before the examination.

Features of the examination

There are several methods of ultrasound diagnostics of the pelvis:

• Transvaginal method. It is carried out using a vaginal sensor. The length of the sensor is about 12 cm, and its diameter is 3 cm. This research method allows you to determine pregnancy in the early stages, diseases of the uterus and others gynecological problems. A transvaginal examination is carried out as follows: the woman takes off her clothes below the waist and lies down on the couch. Legs are bent at the knees and spread apart. The doctor who conducts the study puts a condom on the sensor and lubricates it with gel. A homogeneous gel is a conductor between the sensor and the body, thanks to which it creates favorable conditions for visibility of the organ being examined. Next, the sensor is inserted into the vagina and the organs are displayed on the screen. With careful and slow insertion of the transducer, unpleasant and painful sensations a woman shouldn't feel it. The duration of the procedure is no more than 5 minutes.
• Transabdominal method. This research method involves sending ultrasound waves through the abdominal wall. This method allows you to assess the condition of not only a specific organ, but also those located nearby. As a result, the doctor receives a general picture of the pelvic organs, which allows him to make the correct diagnosis and decide on treatment tactics. Transabdominal ultrasound is performed while lying on your back. The doctor moves the sensor over the patient’s abdomen, examining the necessary organs. The gel is first applied to the skin.
• Transrectal method. This is a common way to examine the male genital organs. Thanks to the rectal method, it is possible to examine the bladder, prostate gland and seminal vesicles. It can be performed not only for men, but also for women. The patient takes off underwear, lies on his left side and pulls his knees to his chest. Next, the doctor lubricates the sensor with a water-soluble gel and inserts it into the rectum. The procedure does not cause any discomfort.

Explanation: norm and pathology in women

When examining the bladder, its walls should be uniform and the same thickness, about 2-4 mm. There should be no stones in the bladder cavity. If you suspect urolithiasis You can detect dark areas with regular and clear boundaries.

If there is thickening of the bladder wall, this may indicate tuberculous inflammation or hematoma. When the entire wall of the bladder thickens, cystitis and amyloidosis are diagnosed. Deviation from the norm may be due to blockage of the internal opening of the urethra with a stone or due to a neoplasm.

Vaginal ultrasound provides more accurate information about the condition of the female reproductive system.

In this case, you can find out the location, structure, size of the cervix and the condition fallopian tubes. A change in the condition of these organs leads to discharge, pain in the lower abdomen and other symptoms.

Normal examination results in women:

• Normally, the length of the uterus should be 40-75 mm, and the width should be between 45-60 mm. The contours of the uterus in women and the prostate gland in men should be clear and even, the echogenicity of these organs should be uniform.
• Depending on the menstrual cycle, the inner layer of the uterus - or pus in the tube

If the echogenicity of the uterus is reduced and the organ is increased in size, then this indicates the development of myomatous nodes.With endometriosis, the echogenicity of the myometrium increases, and uterine bending is observed. Due to an increase in the anteroposterior size, the uterus becomes rounded and the thickness of the walls is uneven; small endometrial nodes are present in the walls.

The diagnosis of polycystic ovary syndrome is made when the ovaries increase in size, as well as the presence of many small follicles.An ovarian cyst on ultrasound looks like a small round bubble. The size can range from a few millimeters to tens of centimeters.

Decoding ultrasound scanning in men, as in women, it is carried out according to the following indicators: location, shape, size, structure of the genital organs and bladder.

Normally, the length of the prostate in men is 25-35 mm, the width is 25-40 mm, and the thickness is no more than 2 mm. The volume of the prostate is in the range of 20-27 cubic meters. cm. The bladder should be of normal size and have the correct shape.

Normally, there should be no compaction or enlargement of the seminal vesicles. Their cross-sectional size should be 8-10 mm.

In men, ultrasound can detect the development of a tumor of the prostate, seminal vesicles or their inflammation.

When conducting an abdominal examination in men, the testicles should not be present, and fluid should not accumulate between them. Depending on age and lifestyle, the size of the genital organs will vary.

One of the most highly accurate and safe diagnostic methods used in gynecological practice is ultrasound examination of the pelvic organs (ultrasound examination 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 is converted with the help of technical instruments into a graphic image, which is interpreted by a diagnostician.

Using ultrasound, you can track the pelvic organs over time, which allows you to make accurate conclusions.

Ultrasound research method female organs is completely safe, as it does not involve invasive intervention in the body.

The result of the condition of tissues and organs is obtained due to the influence of ultrasound waves. Using a sensor and an acoustic transducer, the health status of the pelvic organs and other organs and systems is diagnosed. This device is very often used in gynecology.

Ultrasound signals pass through tissue, undergo different periods of vibration, and are also characterized by different lengths and frequencies. These parameters are directly dependent on the density and elasticity of the tissues through which they pass.

Therefore, when passing through certain organs, the parametric value of the waves changes. The reflected echo signals are received using the sensor.

In order to create best conditions To ensure full contact of the body with the ultrasound machine and guarantee accuracy, it is necessary to use a gel that is intended for this study.

First, part of the body is exposed to access the organs located in the pelvis. Then it is lubricated with gel and a sensor is applied.

An image appears on the screen, and the specialist assesses the condition of the organs. When using a vaginal probe, it is inserted directly into the vagina.

In some cases, this method is more informative.

This examination method is absolutely painless and does not cause discomfort or discomfort. It does not carry radiation exposure, unlike X-rays and computed tomography, in which the radiation is especially powerful.

And at the same time, it is ultrasound that allows us to give a correct assessment of the condition of the organs. That's why this method examinations are given priority.

The principle of ultrasound research is echolocation. Body tissues have different acoustic properties.

The ultrasound sensor first sends and then receives signals reflected from various tissues of the body. Based on these data, a visual series is built on the monitor, from which a specialist can thoroughly study internal organs and draw appropriate conclusions.

1 Types of ultrasound of pelvic organs

There are three main classifications of ultrasound of the female genital organs.

The first is based on the peculiarities of the conduct. From this point of view, ultrasound is divided into:

• Transabdominal is most often practiced. Provides for the passage of waves through the peritoneal wall. The sensor is placed in the lower abdomen. It does not apply if there is damage to this area of ​​the skin (abrasions, scratches, purulent lesions, burns), as well as obesity, which is an obstacle to the passage of waves and can significantly distort the picture.
• Transvaginal involves inserting a sensor with a condom on it into the woman’s vagina. It is considered more informative than transabdominal. It is not carried out for girls who have not yet had sexual experience. It is often used in obstetrics in the early stages of pregnancy, when it is impossible to see the fetus through the abdominal wall. The method requires maximum caution, as it can provoke a miscarriage.
• Transrectal involves inserting a thin sensor into the anus. It is not performed on women who do not have a rectum, or in the presence of inflammatory processes in this area. This type is indicated for virgins when transabdominal ultrasound is for some reason impossible or impractical.

Ultrasound in gynecology can be performed in three ways. The following types are distinguished: gynecological ultrasound:

• transrectal ultrasound (performed through the rectum in girls who are not sexually active);
• transvaginal ultrasound (carried out by inserting a sensor into the vagina for an accurate examination of diseases of the pelvic organs);
• transabdominal (or simply abdominal) ultrasound, or simply abdominal ultrasound (performed through the abdominal wall when signs are detected pelvic inflammation or girls who are not sexually active).

For what indications is an ultrasound of the pelvic organs performed in women?

Regardless of the purpose of a gynecological ultrasound (routine examination or pregnancy management), diagnosis is made using 3 methods. These are transabdominal, transvaginal and transrectal examinations.

During pregnancy, only the first two methods are used. At medical examination All types of ultrasound are used, depending on the age and physiological condition of the patient.

1. Transabdominal (external) scanning.

This method is best for general examination at the gynecologist. It is done through the lower abdomen, that is, the abdominal wall.

This ultrasound is the most comfortable for a woman; it is suitable for all patients, but requires special training. During pregnancy, external scanning is used starting from the 12th week.

1. Transvaginal (cavitary scanning).

like this ultrasound diagnostics Today it is carried out in three main ways.

1. Transvaginal (internal) ultrasound.

This method is used most often and is recognized as the most accurate and informative for examining the female pelvic organs. Internal echography is done using a special vaginal sensor, onto which a condom is placed.

The biggest advantage of such an ultrasound is that you practically do not need to specially prepare for it.

But this method is not suitable for girls who are not sexually active and patients with large tumors in the area under study.

1. Transabdominal (external) ultrasound.