Pelvic Ultrasound Procedure Overview

By Nancy Bowers

(Ultrasound-Pelvis, Pelvic Ultrasonography, Pelvic Sonography, Pelvic Scan, Lower Abdomen Ultrasound, Gynecologic Ultrasound, Transabdominal Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound)

Procedure overview

What is a pelvic ultrasound?

A pelvic ultrasound is a noninvasive (the skin is not pierced) procedure used to assess organs and structures within the female pelvis. A pelvic ultrasound allows quick visualization of the female pelvic organs and structures including the uterus, cervix, vagina, fallopian tubes, and ovaries. Doppler ultrasound may also show blood flow in certain pelvic organs.

Ultrasound uses a transducer that sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the organs and structures within. The sound waves bounce off the organs like an echo and return to the transducer. The transducer picks up the reflected waves, which are then converted into an electronic picture of the organs.

Different types of body tissues affect the speed at which sound waves travel. Sound travels the fastest through bone tissue, and moves most slowly through air. The speed at which the sound waves are returned to the transducer, as well as how much of the sound wave returns, is translated by the transducer as different types of tissue.

A clear conducting gel is placed between the transducer and the skin to allow for smooth movement of the transducer over the skin and to eliminate air between the skin and the transducer for the best sound conduction.

By using an additional mode of ultrasound technology during an ultrasound procedure, blood flow can be assessed. An ultrasound transducer capable of assessing blood flow contains a Doppler probe. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel by making the sound waves audible. The degree of loudness of the audible sound waves indicates the rate of blood flow within a blood vessel. Absence or faintness of these sounds may indicate an obstruction of blood flow.

Pelvic ultrasound may be performed using one or both of two methods:

  • Transabdominal (through the abdomen). A transducer is placed on the abdomen using the conductive gel

  • Transvaginal (through the vagina). A long, thin transducer is covered with the conducting gel and a plastic/latex sheath and is inserted into the vagina

 The type of ultrasound procedure performed depends on the reason for the ultrasound. Only one method may be used, or both methods may be needed to provide the information needed for diagnosis or treatment.

Other related procedures that may be used to evaluate problems of the pelvis include hysteroscopy, colposcopy, and laparoscopy. Please see these procedures for additional information.

What are female pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium. The lining of the uterus

  • Uterus. Also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries. Two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sex hormones estrogen and progesterone are produced.

  • Cervix. The lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body

  • Vagina. The passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia).

  • Vulva. The external portion of the female genital organs

Reasons for the procedure

Pelvic ultrasound may be used for measurement and evaluation of female pelvic organs. Ultrasound assessment of the pelvis may include, but is not limited to, the following: