Transabdominal versus Transvaginal Ultrasound of The Pelvis

Transabdominal ultrasound of the pelvis is an exam of the pelvic organs done by placing the ultrasound transducer on the abdomen. A transvaginal ultrasound of the pelvis is done by placing a small probe covered with a latex sheath and gel into the vagina to examine the female pelvic organs.

Ultrasound uses high frequency sound waves to create a picture based on how those sound waves travel through the tissues.  A gel placed on the skin is used for more smooth movements of the ultrasound transducer and to have better contact with the skin.    A specially trained technologist performs the test.  The images obtained will than be sent to a radiology doctor for interpretation.  He will issue a report which will than go to your doctor.

The disadvantage of the  transvaginal ultrasound is that it is more invasive and may result in some discomfort.  The transvaginal ultrasound allows a closer look at the uterus and ovaries. The transabdominal ultrasound is often done together with the transvaginal ultrasound.

The transabdominal ultrasound offers a nice survey view of the pelvis.  It allows a wider look.  While it picks up some abnormalities of the uterus and ovaries, it’s better at picking up anything else in the pelvis than the transvaginal ultrasound.  It’s also better for big abnormalities, like big cysts or masses.  It’s good at determining the extent of fluid and bleeding.  It’s better at demonstrating relationships between an abnormality and adjacent structures.

Transvaginal ultrasound is a more focused look at the female pelvic organs.  It allows a close up view of the uterus, the uterine cavity, the cervix, the ovaries, and any abnormalities.  Often abnormalities seen on the transabdominal ultrasound will be seen in more detail on the transvaginal ultrasound.  For example, a cyst seen on the transabdominal ultrasound may look more complex when you look at it using the transvaginal ultrasound.  Another example may be the endometrium.  It may look normal on the transabdominal ultrasound, but a polyp or mass may be seen on the transvaginal ultrasound.

The transabdominal and transvaginal ultrasounds are complimentary. The transabdominal giving a nice survey of the pelvis while the transvaginal hones in on the structures and any abnormalities.   The transvaginal ultrasound is more invasive requiring insertion of a probe through the vagina.  Both tests done together provide for the most comprehensive assessment of the female pelvis.