How to properly prepare a woman for a pelvic ultrasound, methods of performing the procedure, indications and contraindications - Medsi. Ultrasound of the pelvic organs in women: preparation and main indications Rules for conducting a pelvic ultrasound

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. Organs reproductive system for each gender are individual, for 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 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);
• Availability intrauterine device(to control its position);
• transferred inflammatory diseases and other gynecological diseases (adnexitis, endometritis, cervicitis, vulvitis, colpitis);
• infertility (to determine the cause, folliculometry is performed, i.e., identifying disorders of the ovulatory mechanism);
• transferred surgical interventions(for status monitoring).

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 female organs small pelvis undergo changes throughout the menstrual cycle, it is important to carry out diagnostics 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. A 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 an accurate diagnosis must be made by a gynecologist 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

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Ultrasound examination (ultrasound) is medical procedure using high frequency sound waves.

The device, which doctors call a “sensor,” sends and receives these sound waves, which produce images on a computer screen in real time and in real time.

These images include various body parts, organs, and blood flow.

Usually an ultrasound is performed 1-2 days after the end of menstruation, but you can visit a doctor 8-12 days after the end of menstruation.

In case of bleeding that is not related to menstruation, an ultrasound is performed regardless of the day of the cycle. For endometriosis, it is advisable to perform an ultrasound of the pelvic organs in the second half of the cycle.

A pelvic ultrasound is performed using one or both of the following methods:

1. Transabdominal (through the abdominal cavity).
2. Transvaginally (through the vagina).

In rare cases, transrectal ultrasound, also known as TRUS, is also used. Performed by inserting a small ultrasonic transducer into the anus. Indications for this type of ultrasound include: deep pelvic endometriosis with (or without) infiltration of the intestinal wall, uterine fibroids, adenomyosis, obstruction of the fallopian tubes, cysts and polycystic ovaries, cancer cervix, endometrial cancer, tumors on the fallopian tubes and inflammation of the fallopian tubes. The type of ultrasound procedure depends on the reason for the patient's visit.

Only one method or both methods may be used if they may be necessary to provide information required for diagnosis or treatment. Other diagnostic procedures which can be used to evaluate pelvic problems include: hysteroscopy, colposcopy and laparoscopy. However, they are more invasive than pelvic ultrasound in women, and preparation for them also takes longer.

Ultrasound of the female pelvic organs is useful in that it allows assessment of:

• The size, shape and position of the uterus and ovaries.
• Thickness, echogenicity (darkness or brightness of the image associated with tissue density), and the presence of fluid or mass in the endometrium, myometrium (uterine muscle tissue), fallopian tubes, or in or near the bladder.
• Length and thickness of the cervix.
• Changes in the shape of the bladder.
• Blood flow in the pelvic organs.

Ultrasound examination is often performed after childbirth or surgery in order to avoid possible complications. In the early stages of pregnancy, an experienced specialist can identify some problems associated with pregnancy.

note

Pelvic ultrasound can provide more information about the size, location and structure of the pelvic organs, but cannot provide a 100% reliable diagnosis.

The big advantage is that with an ultrasound of the pelvic organs in women, preparation for the procedure is minimal, and its implementation does not carry any risks. The only unpleasant moment may be slight discomfort when inserting a transvaginal sensor into the vagina. The transvaginal method requires covering the ultrasound transducer with a plastic or latex sheath, which may cause a reaction in patients with latex allergies. During a transabdominal ultrasound, the patient may experience discomfort from having to keep the bladder full.

Pelvic ultrasound can be used to diagnose and help treat the following problems:

• Anomalies in anatomical structure uterus, including endometrium, fibroid tumor (benign formation), cyst and other types of tumors within the pelvis.
• The presence and position of an intrauterine contraceptive device (IUD).
• Pelvic inflammatory disease and other types of inflammation or infection.
• Uterine bleeding during menopause.
• Monitoring ovarian size to assess infertility.
• Aspiration of follicular fluid and eggs from the ovaries for in vitro fertilization.
• Ectopic pregnancy (pregnancy occurs outside the uterus, usually in the fallopian tube).
• Monitoring fetal development during pregnancy.
• Transvaginal ultrasound may be used for sonohysterography, a procedure in which the uterus is filled with fluid to stretch it for better imaging.

After an ultrasound of the pelvic organs in women, a gynecologist or phlebologist prepares the results for the patient if the examination was carried out after complaints of varicose veins. Further diagnosis for various diseases may include a general blood and urine test, gynecological examination on the chair and smear analysis for flora.

Certain conditions may affect test results. These include: obesity, gases in the intestines, insufficient filling of the bladder (with transabdominal ultrasound). A full bladder helps move the uterus up and the bowel out to the side, giving a better image.

Preparation for pelvic ultrasound for women using different techniques

Preparing for a pelvic ultrasound for women is very simple: you need to drink 2-3 glasses clear liquid at least one hour before the scheduled time. And do not empty your bladder until the ultrasound is performed. Two days before the examination, it is better to avoid eating foods that can lead to flatulence, as this condition can distort the results of the ultrasound. The diet two to three days before the examination should consist of: lean fish, cheeses, cereals, beef and poultry. It is advisable to take activated carbon.

Preparation for pelvic ultrasound for women before transabdominal ultrasound and its features

This type of ultrasound is done with complete bladder. You will be asked to remove any clothing, jewelry, or items that obstruct the inspection. You will lie on your back, on a couch or on an examination table. The doctor will apply a gel-like substance to your stomach. It doesn't hurt, but it can be slightly uncomfortable because the substance is cold.

The sensor will be pressed against the skin and the specialist will move it around the area being examined. Images of body structures will be displayed on the computer screen. After the ultrasound is completed, the gel can be wiped off with a tissue. You will be able to empty your bladder when the procedure is finished.

Preparation for pelvic ultrasound for women before transvaginal ultrasound and its features

There is no need to fill the bladder before this type of ultrasound. You will be asked to remove any clothing, jewelry, or items that may interfere with the inspection. You will lie on your back, on an examination table or on a couch. This type of ultrasound uses a long, thin transvaginal transducer that is covered with a plastic or latex sheath and lubricated to prevent discomfort.

The tip of the sensor will be inserted into the vagina. It may be a little uncomfortable, but it doesn't hurt. The doctor will gently rotate the probe at an angle so that the areas to be examined are in focus. You may feel a slight pressure as the sensor moves. Images of organs and structures will be displayed on the computer screen. Once the ultrasound is complete, the probe will be removed.

Preparation for pelvic ultrasound for women before transrectal ultrasound and its features

7-10 days before the start of TRUS, you must stop taking blood thinning medications. TRUS is done on an empty stomach, 1-4 hours before the procedure you need to do an enema (or take a laxative) to cleanse the intestines. And immediately before the procedure you need to urinate to empty your bladder. During the examination, you will likely be asked to lie on your side and pull your knees toward your chest.

The doctor puts on a protective cover (usually a condom) and applies lubricant to the ultrasound probe. Then a probe, no wider than the width of a finger, is passed into the rectum. You may feel pressure in your rectum when the probe is in place. TRUS takes 10 to 15 minutes. What happens after a pelvic ultrasound? There is no special type of care that is required after a pelvic ultrasound. You can resume normal activities and eat normal foods.

note

There is no confirmed evidence of adverse biological effects of ultrasound at the intensity levels used in diagnostic ultrasound.

How to prepare for a pelvic ultrasound in a woman, and which doctor to go to with the results

How a woman can prepare for a pelvic ultrasound depends on the type of procedure being planned. It is best to avoid foods that cause bloating for several days before the test, as gas in the intestines may reduce image quality.

A full bladder is essential for successful transabdominal examination of the lower abdomen. On the day of the test, you can take your regular daily pills if needed.

Popular questions

How does a pelvic ultrasound work?

The patient lies on his back on the couch. The ultrasound machine is next to the couch. It consists of a monitor, a computer and a converter (sensor), which is connected to the device via a cable. While the doctor moves the ultrasound probe over the lower abdomen, the organ being examined is displayed on the monitor.

To obtain a more accurate assessment, it may be necessary to insert a special probe into the vagina. In many countries this study is called endovaginal ultrasound; in Russia it is usually called transvaginal ultrasound.

Is medical examination necessary to do a pelvic ultrasound?

No, this procedure can be performed on an outpatient basis. You can go home after the examination. This also applies to other types of ultrasound, for example ECHO CG.

What should I bring with me?

A napkin or soft cloth to remove the gel remaining after the ultrasound.

How to prepare for a pelvic ultrasound in a woman during pregnancy

In pregnant women, ultrasound is no different from the same procedure in non-pregnant women. The results of the ultrasound are sent either to the doctor who referred you for a routine examination, or are evaluated by the doctor who performed the ultrasound diagnostics.

He will give a written report of the examination results to either you or the doctor who referred you for the ultrasound. Procedures such as CT scan and magnetic resonance imaging can be used to further examine ultrasound findings, which are not conclusive. These methods allow you to identify and evaluate even the most minor changes in the body.

The simplest and available method identifying gynecological diseases- This ultrasound examination. It is based on a method of converting reflected sound waves into an image on the screen, which a special sensor can read. Ultrasound of the pelvis in women and its subsequent interpretation is an important measure in the framework of health control.

The method of performing the manipulation has a significant impact on the completeness and reliability of the information received by the doctor. Eg, with an ultrasound scan using a vaginal probe, the uterus, tubes and ovaries are visible much more clearly than in studies performed through the abdominal wall. But if it is necessary to assess the condition of the bladder and abdominal wall, then it is better to choose the transabdominal method, discussed in detail earlier.

The data obtained is interpreted by a diagnostician, but the final diagnosis must be made by the attending physician, since ultrasound alone may not be enough to provide a complete picture of the disease. In this case, the doctor additionally prescribes tests or other diagnostic procedures that can confirm or refute the preliminary diagnosis. At the stage of deciphering an ultrasound of the pelvic organs, pregnancy, abnormalities in fetal development or diseases of the female genital organs can be detected.

At the beginning of the examination, the sonologist evaluates the development and general state the patient's pelvic organs. During the procedure, their location, shape and structural features of the tissue are studied. In addition, the doctor takes the necessary measurements that will allow him to record existing deviations from the norms or establish compliance with them.

Reference! If the echostructure of the tissues is not disturbed, then the ultrasonic waves pass freely through the pelvic cavity, and a uniform echographic picture will be reflected on the screen. This means that visually the organs will have a uniform color without light and dark areas.

If the clinic’s equipment allows, and the doctor deems it necessary, the ultrasound procedure can be supplemented with color Doppler mapping to obtain data:

• about the resistance index;
• about the speed and volume of blood flow;

Uterus

The female uterus is a pear-shaped organ consisting of a cervix, fundus and body. Physiologically normal is the position of the uterus in which it is slightly tilted forward. U healthy organ not blurred external contours, their blurriness on the screen may indicate the development of inflammation of the tissue adjacent to the uterus.

Echostructure normal uterus distinguished by homogeneity and average intensity. Ultrasound also identifies the following parameters, which must comply with the specified standards:

• neck length – 35 – 40 mm;
• anteroposterior size – up to 28 – 30 mm;
• diameter of the endocervix (internal canal of the cervix) – up to 3 mm;
• uterine length – 4.5 – 7.6 cm;
• organ thickness – 2.9 – 4.2 cm;
• width – from 4.5 to 6.2 cm.

For women who have entered the menopause, slightly different parameters are adopted, due to age-related changes in the organ: length - up to 4 cm, width - up to 4.3 cm, thickness - up to 3.0 cm.

If it is necessary to assess the thickness of the inner mucous membrane of the uterus using ultrasound, then a special M-mode is used. The thickness parameters of this layer depend on what period of the cycle the woman is in:

• From days 1 to 4 the norm will be 1 – 4 mm;
• From 5 to 10 days – from 3 to 10 mm, and the endometrium has an anechogenic structure;
• From 11 to 14 days – thickness normal endometrium should be from 8 to 15 mm;
• From 15 to 23 days – 10 – 20 mm;
• From 24 to 28 days - from 10 to 17 mm, however, the structure changes and becomes hyperechoic.

Ovaries

The ovaries are part endocrine system, performing the series essential functions in the female body:

• regulatory – regulate the course of the menstrual cycle;
• producing – they produce not only eggs, but also hormones without which conception and normal pregnancy are impossible.

On ultrasound they appear as oval formations with uniform reflective properties and minor fibrous inclusions. Normally, the dimensions of the ovaries are as follows: width - from 20 to 30 mm, length - 25-30 mm, anteroposterior size - 17-25 mm, and the volume of the organ should be from 30 to 80 mm³.

Bladder

The pelvic ultrasound procedure allows you to get an idea of:

• condition and functioning of the bladder;
• the thickness of its walls;
• the presence or absence of neoplasms in the cavity;
• volume of residual urine.

Norms

The wall thickness is 2-4 mm, this indicator is the same for patients of any age. The organ cavity should be homogeneous and hypoechoic without foreign inclusions. But the volume of residual urine in children and adults differs and is:

• for children – no more than 10 ml;
• for adults - no more than 18 - 20 ml.

To calculate this parameter, a universal formula is used: of the primary volume of the bladder, the volume of residual urine should occupy no more than 10%.

Pathologies

There is a whole list of pathologies that are detected on ultrasound of the pelvic organs:

• various anomalies of organ formation (saddle or infantile uterus, aplasia, duplication, etc.);
• myomatous formations;
• endometriosis;
• chorionic carcinoma and other malignant tumors in the female genital area;
• bladder diseases;
• polycystic or single cysts and their complications.

Uterine malformations

For aplasia of the uterus and vagina(the second name is Rokitansky-Küstner syndrome) it is typical that these organs are not detected on an ultrasound machine. If hypoplasia is noted, then all parameters of the uterus are reduced, and at the same time, underdevelopment of the cervix is ​​noted.

Vaginal atresia(in case of disease, the entrance hole is covered with a fibrous film) is detected on ultrasound using a hematometer varying degrees expressiveness, which means accumulation bloody discharge in the cervix and uterine cavity due to obstacles to its separation.

Infantile uterus characterized by a significant lag in the thickness of the organ from the norm (and is no more than 15 mm) with a length corresponding to the length of the normal organ.

Saddle uterus is a type of bicornuate uterus; with this pathology, the bottom of the organ is split in the shape of a saddle. On ultrasound it is determined by the bulging of the membrane within the uterine fundus and if the readings exceed 10 mm, then the diagnosis is considered confirmed. The full form of a double uterus is characterized by a significant divergence of two “horns”, the length of which does not exceed two-thirds of the normal size.

Anomalies of the structure of the uterus

Ultrasound makes it possible to recognize abnormalities in the development of the genital organs.

Duplication of the uterus– an extremely rare pathology, which is characterized by the presence of a double set of vaginas and cervical canals. The function of pregnancy and birth is preserved.

Bicornus– this anomaly in the structure of the uterus gives the baby developing in the womb less space, otherwise the woman’s reproductive functions do not suffer.

Arc-shaped structure of the uterus– characterized by the presence of a “pit” at the bottom of the organ, while its upper part corresponds to the norm.

One-horned– the anomaly consists in the small size of the uterus (half the usual size) and the presence of one fallopian tube. However, if its patency is normal and the ovary is healthy, then the prognosis for pregnancy is favorable.

Formation of the septum– characterized by the formation of an additional wall inside the uterus, formed from muscle or fibrous tissue. May interfere with pregnancy.

Agenesia– a very rare pathology in which the uterus is either completely absent or has a small size. The vagina is also seriously underdeveloped. The complex of pathologies associated with this anomaly makes conception impossible.

Myomatous formations in the uterine cavity are considered benign and are formed from smooth muscle cells under the influence of an imbalance between estrogen and progesterone. On ultrasound this pathology is determined by the enlargement of the uterine body and the heterogeneity of its contours; in addition, one or more nodes are fixed in the endometrium. The diagnostician notices a neoplasm with reduced echogenicity, the contours of which are blurred.

When deciphering, the doctor determines the parameters and localization of formations. In addition, ultrasound examinations help to track the dynamics of the growth of nodular formations in order to make a timely decision about surgical intervention. Patients with a history of fibroids must repeat an ultrasound examination of the pelvis twice a year.

An essential criterion for diagnosing fibroids is the layering of the formation, that is, more pronounced echogenic properties of each of the subsequent contours. According to Doppler, the resistance index and blood flow velocity are lower than normal.

Endometriosis

This pathology means that the epithelium, which normally lines only the uterus, spreads to other organs and appears in the vagina, on the walls of the pelvis and in the abdominal cavity. The disease poses a threat to pregnancy and may cause infertility, therefore, interpretation of ultrasound for endometriosis is carried out at the stage of preparation for conception.

During an ultrasound examination of the uterus and appendages, the sonologist can pay attention to small bubbles in the structure of the muscles of the tubes and cervical canal. In addition, focal formations or endometrioid cysts may be detected in the ovarian cavity. Ultrasound can also detect adenomyosis of internal organs, that is, penetration of the endometrium into the uterine wall.

The disease goes through several stages of development and at the first it is noted:

• the appearance of anechoic tubular structures with a diameter of up to 1 mm;
• local thickening of the endometrium;
• slight deformation of the endometrial layer;
• the appearance of small areas where the uterine epithelium is absent.

An advanced form of the disease is characterized by an increase in the thickness of the uterus, asymmetry of its walls and the appearance of anechoic cavities in the myometrium, with a diameter of about 3 mm.

Polycystic ovary syndrome

Signs of this disease are physiological changes in the structure of ovarian tissue, which are manifested by the formation of multiple cysts, hormonal imbalance and pathological proliferation of fibrous tissue.

In this case, the parameters of the uterus are reduced, and the ovaries, on the contrary, increase. Corpus luteum or the dominant follicle is not detected, and the ovaries themselves are diffusely located follicles with fibrous cords between them.

Cystitis and stones in the bladder

A great advantage of ultrasound examination of the pelvic organs is the identification of pathologies of the bladder. There are many of them, and they all have certain ultrasound signs. Thus, uniform thickening of the walls indicates cystitis in chronic form. But local thickening is a symptom of a tumor or polyp.

Stones in bladder are formations that are characterized by:

• mobility;
• roundness;
• hyperechogenicity;
• distal ultrasound amplification.

Ovarian cysts

Cystic formations in the ovaries are determined by ultrasound as round hypoechoic (anechoic) structures, the contours of which are smooth and clear. The neoplasm, up to 20 cm in diameter, is filled with fluid and attached to the wall of the ovary. Cysts are divided into functional, endometriotic and germinal.

Important! A large formation (more than 5 cm in diameter) poses a danger to women's health! If the doctor prescribed hormone replacement therapy, but it turned out to be ineffective, then surgery is indicated for the patient.

To obtain an accurate and informative picture of the disease, an ultrasound scan performed immediately after the end of the menstrual cycle is deciphered. It must be remembered that a number of gynecological diseases are asymptomatic and they are discovered by chance - on preventive examination or when studying the picture of other pathologies. If the doctor finds lumps in the cyst, then most likely he will consider it necessary to refer the patient for additional tests of tumor markers, for example CA-125.

Conclusion

Despite all the information content of ultrasound and other advantages of this method, the final diagnosis is not made based on the results of ultrasound diagnostics alone. However, the conclusion of the diagnostician plays a significant role in determining the strategy and tactics of further treatment.

Under any circumstances, a correctly interpreted and timely ultrasound is the most important factor:

• maintaining women's health;
• early detection of tumors;
• timely detection of pathologies.

The safest, most accessible and precise method research in our time is ultrasound (ultrasound). This method examinations are used for almost all diseases of internal organs, systems, blood vessels and tissues. Examination of certain organs requires special preparation.

Pelvic ultrasound may be prescribed to men and women for diagnostic testing for a variety of reasons. When pathological changes appear on early stages this method allows them to be identified and carried out timely treatment. The accuracy of the diagnostic examination is more than 90%.

What is a pelvic examination?

Ultrasound examination, or scanning (also called ultrasonography), is performed using high-frequency sound waves to produce images on a monitor of body structures and internal organs.

The principle of the examination is to use a sonar system: sound wave collides with an obstacle and is reflected from it, creating an echo. Computer processing of such data visualizes them on the monitor screen and shows the final appearance of the object being examined (density, amount of liquid, contours, shape, dimensions).

The sensor of the ultrasonic device sends sound signals and simultaneously receives them, a reflected echo and records the data in the computer.
Modern equipment allows for some types of studies to take color photographs of the state of internal organ systems.

The ultrasound examination does not use ionizing radiation, as in x-ray examinations. By obtaining images of organs in real time, the study allows you to see the state of internal organs, tissue structure, movement and condition of organ walls, filling blood vessels, blood flow quality and valve condition.

Ultrasound is non-invasive (no tissue penetration) and helps make an accurate diagnosis, making patient care and treatment more effective.
When performing an ultrasound of the pelvic organs, you can easily examine (make an image and save on media) the organs and adjacent tissues of the lower sections in the abdominal cavity and pelvis. Ultrasound examinations of pelvic organs and systems are performed abdominally, vaginally, rectally.

In some cases, simultaneously with the main examination, Doppler sonography is performed, which makes it possible to assess the condition of the vessels (veins or arteries) and the filling of organs with blood (whether a sufficient amount enters the organ or whether there is a small flow of blood and why). Impaired blood supply to organs can also cause their pathological condition.

Indications for pelvic ultrasound

Organs examined

An examination of the pelvic organs may be prescribed routinely if painful conditions, after various injuries for diagnostic assessment or extent of damage.
By using this study you can examine: the uterus, ovaries, appendages, the fallopian tubes, vagina, urethra, bladder, prostate gland, tissues between these organs.

In women, ultrasound of the pelvic organs is recommended for the following conditions:

• preventive medical examinations during puberty or menopause;
• examination of patients reproductive age before pregnancy;
• if there are complaints about painful sensations in the abdomen, perineum, pelvis;
• abnormalities in the menstrual cycle, bleeding or spotting between cycles or menopause;
• the presence of problems with urination of various origins (difficulty, painful, bloody, other);
• to monitor the condition of the contraceptive device;
• after a gynecological examination, when the doctor detects a change in the condition of the genital organs (thickening, enlargement, change in the contour of the organs) or detects tumor processes;
• to check for pregnancy;
• routine scanning during pregnancy;
• to control the treatment process in the treatment of infertility or to determine the required period for conception;
• various injuries of the abdominal cavity or pelvic organs.

For men, there are the following indications for examination:

• pain in the pelvic area, including when urinating;
• infertility;
• problems with potency;
• urethral discharge and urinary disturbances;
• identification of various types of changes in the pelvis after examination by a urologist;
• injuries of the perineum, lower abdomen and abdominal cavity.

Examination of the pelvic organs can be performed by three methods: transabdominal, transvaginal, transrectal. For certain types of examinations, it is necessary to carry out preparations on certain days, which are described in detail by the doctor who refers patients for an ultrasound examination of the pelvic organs.

How is the procedure done?

Ultrasound of the pelvic organs is simple and fairly quick. The patient's position is supine. Transabdominal ultrasound is mainly performed; other methods are used less frequently depending on the patient's condition.

A special conductive gel is applied to the area under study and distributed evenly over the surface of the skin. It does not cause allergies, is easy to wash and does not leave marks on clothes (in case of incomplete removal from the skin).

This type of examination is convenient because it is not invasive, i.e. during examination, the sensor does not penetrate into the natural environment of the body

Then the research begins. Using a special ultrasonic sensor, the doctor gently presses the skin to ensure tight contact with the surface and proper signal transmission. If you press a little harder, you may feel the urge to empty your bladder (when it is completely full). Others discomfort does not appear during the study. The exception is injuries; pain may occur when changing position or examination.

Transvaginal or transrectal ultrasound of the pelvic organs is an uncomfortable procedure for patients, as they have to undress to the waist and leave intimate areas exposed. The diagnostician tells you what position you should be in during the examination.

Transvaginal examination allows you to study the condition of the cervix in more detail, however, this method is used quite rarely due to the complexity of the procedure in the postpartum period

If necessary, the patient may need to turn on his side or hold his breath - all this will be clarified by the specialist conducting the examination. If desired and accessible, the patient can observe everything on the monitor of an ultrasound machine or on a large special screen.

Depending on the research method, additional manipulations may be necessary. After completing the examination, the gel must be wiped off because it will leave a flaky feeling on the skin once it dries. If possible, it is better to wash off the gel from the skin.

Routine examinations for women are carried out on certain days, for pregnant women - at appropriate times. In emergency situations, diagnosis is carried out regardless of these indicators, that is, according to vital indications.
The procedure time ranges from 3-5 minutes to 15-20 minutes, depending on the complexity of the health condition and the identified abnormalities.

When and how can I get the test result?

After completing an ultrasound examination on an outpatient basis, you can get the results almost immediately. The doctor describes the examination data and records them in the computer. Also, information about the condition of internal organs can be saved on a floppy disk, special photographs can be taken and a conclusion can be obtained on paper.

While undergoing the procedure while on inpatient treatment, the data is transmitted to the attending physician. All inspection results can be clarified and discussed with him individually.
Sometimes additional consultations with related specialists and other types of diagnostic examinations of the body are required. Also, after a course of treatment, a repeat examination or a clarifying examination after some manipulations is prescribed.

The following indicators are considered normal results in studies of women:: the shape of the uterus is pear-shaped with clear, even contours, size 5 centimeters in length, homogeneous echogenicity. The cervix is ​​2-3 centimeters in length and width, with smooth contours and uniform echogenicity.
Endometrium (inner layer of the uterus) in different days the cycle normally has different thicknesses, making up three normal values: 1–4, 4–8, 8–16 mm. Healthy ovaries normally also measure no more than three centimeters in length and no more than two in width.

Normal indicators for men The dimensions of the prostate gland are considered to be 25–35 mm in length, 25–40 in width, thickness no more than 2 mm, volume no more than 2.5–3 cubic cm. The echogenicity is homogeneous, the seminal vesicles are unchanged.
The bladder and ureters should have an even contour, clear boundaries with equal wall thickness along the entire perimeter. Women have a slightly thinner bladder, and men have slightly thinner ureters, so the normal values ​​are different. Also, no additional inclusions or neoplasms should be detected anywhere.

What can be revealed during research?

Ultrasound of the pelvic organs allows you to determine the presence of diseases, the onset pathological conditions, degree of illness or the following conditions:

• stones of the bladder and lower ureters;
• inflammatory diseases genitourinary system;
• vascular pathologies in the pelvic organs;
• congenital developmental or structural abnormalities
• various types of formations (tumors, cysts, seals, nodes, abscesses, ectopic pregnancy);
• the state of blood flow in the prostate gland, its structure, as well as the state of the seminal vesicles;
• gestational age or fetal condition;
• find out the residual amount of urine in the bladder to determine the correct functioning of the system;
• condition of the lymph nodes;
• monitor the condition of uterine fibroids (whether there is an increase or active growth or not);
• cervical polyposis;
• polycystic ovary syndrome;
• the presence of fluid behind the uterus (indicates internal bleeding due to rupture of the ovary or tube, or other painful conditions);
• the condition of endometriosis, determine its degree.

Contraindications for the procedure

There are no specific contraindications for ultrasound.

Relative contraindications are: improper preparation of the patient (presence of a large amount of gases in the intestines, small amount of urine in the bladder), pregnancy (too frequent examinations), minor childhood(the procedure is carried out with a special apparatus for diagnosing children), a large layer of fatty tissue (the result may be incomplete, another type of diagnosis is recommended), inappropriate behavior of patients.
No complications were identified after the ultrasound procedure.

Pelvic ultrasound is a simple, painless and absolutely harmless technique for studying the organs of the lower abdominal cavity. It is often used to examine men, women and children. The diagnostician’s capabilities during the procedure are unlimited - there are several methods that allow for the most thorough examination of the internal pelvic organs (PIO).

Features and types of research

Ultrasound diagnostics is based on the principle of echolocation, that is, wave vibrations emitted by the device’s sensor are reflected from tissue structures and transmitted to a computer. Then the information is processed by a special program, and the resulting image of the organ under study is displayed on the monitor screen and becomes available for study.

The difference in the anatomical structure of tissues and changes in their structure when diseases occur allows us to draw conclusions from the resulting image or photo of the organ about the presence or absence of pathological processes in the area under study. To get the most accurate results, doctors try to choose the most suitable technique. That is why ultrasound examination of organs located in the pelvis is carried out in three ways, allowing the procedure to be performed as efficiently as possible. These include abdominal, transrectal and transvaginal OMT ultrasound.

Abdominal ultrasound examination OMT

This type of technique is the most common and comfortable for both the patient and the diagnostician. Therefore, if there are no contraindications for the procedure, it will be prescribed. Because in this case, a pelvic ultrasound is performed by simply moving the emitter along the lower abdomen, capturing projections of all organs of interest. This pelvic ultrasound allows you to examine the bladder, uterus, fallopian tubes, ovaries in women, and the prostate gland and seminal vesicles in men.

In order for the examination to give a complete picture, the patient needs to prepare in advance, and 3-4 days before the procedure, exclude foods that cause flatulence from the diet. These products include legumes, raw vegetables and fruits, fatty meats, fish, cheeses, dairy products, except low-fat cottage cheese, smoked meats, pickles and spicy foods. You should also avoid alcohol, carbonated drinks and water. Otherwise, gases will accumulate in the intestines, which may distort the results of the examination.

In addition to the diet, you can take medications containing pancreatic enzymes for a day or two, such as Mezim, Festal or their analogues. This will help digest food, which will reduce the formation of gas in the intestines. Also, if you are prone to constipation, you need to take laxatives to regularly pass stool. You must come to the procedure with a full bladder - this will ensure high-quality visualization of the uterus, ovaries, the bladder itself, the prostate gland and seminal vesicles in men.

The filled bladder will lift the intestinal loops, allowing the doctor to examine hard-to-reach areas of the organs.

Transrectal ultrasound (TRUS)

The most common indication for transrectal ultrasound examination is the need to examine the prostate and seminal vesicles. Only in some cases the procedure is performed on women if it is necessary to examine their genitals or bladder. This may be due to damage to the surface of the skin in the pelvic or vaginal area, which does not allow more suitable diagnostic techniques to be performed.

The principle of performing TRUS in men

To carry out the examination, it will be necessary to cleanse the intestines, because a pelvic ultrasound is performed using the transrectal method by inserting a special emitter into the rectum. The procedure is not painful, since the diameter of the sensor is small, it enters easily and painlessly, and to reduce discomfort, the diagnostician applies a special gel to it.

During such an examination, the bladder should be empty, since, otherwise, it will only interfere with examining the organs, squeezing them. The procedure, like the other two, lasts approximately 20 minutes; only in some cases it may be delayed due to detailed study controversial area of ​​the organ under study.

Transvaginal ultrasound

This technique is used quite often, because it shows an ultrasound of the pelvis a large number of diseases of the female reproductive system, as well as the urinary system. The procedure is carried out by inserting a specially designed emitter into the vagina, the diameter of which does not exceed 3 cm. This method does not require a completely filled bladder; it will be enough to simply not urinate for two hours before the test.

The transvaginal method allows you to assess the condition of the endometrium (inner uterine layer), myometrium (muscular membrane) and ovaries. A method that studies the thickness of the endometrium and its deviations from the norm is called M Echo, and is considered mandatory when carrying out diagnostic measures for preventive purposes. The examination makes it possible to identify abnormal development of female reproductive organs, the presence of polyposis and cystic formations, as well as oncological formations. The procedure, with a probability of up to 98%, will reveal the causes of infertility that other examinations could not determine.

For women of childbearing age who have not yet reached menopause, there are certain recommendations for when to be diagnosed. It will be optimal if it is carried out in the first 7–10 days of the cycle, since it is at this time that it is easiest to identify diseases of the uterus, ovaries, and recognize polycystic disease, erosion and other disorders. In case of suspicion of fibroids ( benign tumor muscle layer) of the uterus, an ultrasound scan is best done at the end of menstruation.

To detect endometriosis, it is necessary to be examined before menstruation. When planning pregnancy and other situations that require monitoring of folliculogenesis, the procedure is performed on days 5, 9 and 14–17 of the cycle. In case of irregular periods or after menopause, the day of diagnosis does not matter. The same principle applies in case of emergency situations requiring urgent medical care.

Ultrasound allows you to find out about pregnancy at 1–2 weeks

For women of childbearing age, such a procedure can sometimes be a cause for joy, because an ultrasound of the pelvic organs shows pregnancy in the early stages, sometimes even earlier than tests. And then, to monitor the development of the fetus, the procedure is carried out at least three times during the gestation period - once in each trimester. And if necessary, it can be carried out more often - after all, ultrasound does not have any effect harmful effects neither on the mother’s body nor on the baby.

When is ultrasound diagnostics necessary?

The procedure for examining the pelvic organs is used for the following manifestations, indicating the possible presence of pathological processes in the organs. These include:

• pain of a pulling, stabbing, cutting nature in the lower abdomen;
• traumatic injuries genitourinary system and pelvic organs;
• frequent false urge to empty the bladder:
• violation reproductive function;
• an admixture of pus or blood in the urine;
• pain when urinating.

In addition, in women:

• bleeding not associated with normal menstrual cycle;
• violations of the regularity of the cycle and its other pathologies.

And also for men:

• decreased sexual activity;
• erectile disfunction.

The procedure is also carried out if it is necessary to monitor benign and malignant neoplasms located in the pelvis. For children, an examination is prescribed to look for the causes of premature puberty or its delay and to study OMT anomalies (for example, hermaphroditic genitalia). Among other things, ultrasound is prescribed during OMT biopsy, puncture and various surgical interventions, as well as when prescribed to women hormonal contraceptives and installation of intrauterine devices.

What pathologies can be detected

During the diagnostic process, it is possible for a doctor to detect a fairly wide range of diseases of organs located in the pelvis. Such pathologies include:

• inflammatory processes– adnexitis, salpingoophoritis, endometritis, urethritis;
• benign neoplasms – cyst, fibroid, fibroma, adenoma;
• endometriosis, endometrial hyper- or hypoplasia;
• stones in the ureters and bladder.

Ovarian cyst is a fairly common pathology of the female reproductive system.

When performing an OMT ultrasound with Dopplerography, the doctor can study the nature and characteristics of blood circulation in the area under study, and establish the causes of its disturbance, such as the formation of thrombotic masses blocking the lumen of blood vessels, stenosis of blood vessels due to atherosclerotic plaques, congenital vascular malformations, and oncological processes.

Such voluminous information makes it possible to obtain a complete picture of the OMT organs, and based on the results obtained, it will be easy for the doctor to make a conclusion and make a final diagnosis.

Transcription of research materials

Based on the resulting image as a result of recording the displayed ultrasound waves, the diagnostician assesses the condition of the examined areas of the pelvic organs. During the procedure, the size and echogenicity of the structure are studied. As a rule, such a study is carried out not by a general sonologist, but by a urologist or gynecologist.

The diagnostician evaluates the size, structure, location of the uterus and cervix, ovaries and bladder. Determines the presence of follicles in the ovaries, stones in the kidneys and bladder, as well as pathological formations in the above organs and the large intestine. In the medical report, the doctor describes in detail all existing violations or indicates that no deviations from the norm have been identified.

If compaction of the uterine walls or tubes is detected, the doctor will most likely conclude that there is an oncological process. Oval or round areas on the image usually turn out to be fibroids or cysts. A decrease in the size of the uterus and at the same time an increase in the ovaries indicates the formation of polycystic disease. Changes in echogenicity in the layers of the uterus will confirm the presence of fibroids or endometriosis.

But, of course, a non-specialist will not be able to understand the results of an ultrasound, and even the diagnostician does not make a final diagnosis. He just describes the picture of the state of the organs, and all conclusions are already made by the attending physician, specializing in a specific area. Therefore, the patient is given the results in photographs and on electronic media and is sent for consultation to a specialized specialist for an appointment, if necessary, therapeutic measures.

It should be remembered that any even minor symptom can be a consequence of developing pathological process, and there is no need to convince yourself that it will pass on its own. OMT ultrasound is a simple and completely painless procedure that is likely to give highly informative results. And if you have doubts or concerns, then you can read multiple reviews of those who have passed it and go for an examination with peace of mind.