Transvaginal Ultrasound

A transvaginal ultrasound is an imaging test that lets your provider see your uterus, cervix, fallopian tubes and ovaries. It can show abnormal growths and help find the cause of pain or irregular bleeding. Your provider may also use it to check if you’re pregnant or monitor your pregnancy.

During a transvaginal ultrasound, your provider inserts a small, thin wand into your vagina. The wand is covered with gel to make it go in comfortably. The wand uses sound waves to create pictures that your healthcare provider can view.

Why would I need a transvaginal ultrasound?

You may need one if you’re having pelvic pain, unusual vaginal bleeding or other symptoms that your provider wants to check. They may also recommend one if something unusual is found during a pelvic exam or when they’re planning for pelvic surgery.

A transvaginal ultrasound can show things like:

• Cysts
• Fibroids
• Polyps
• Signs of cancer
• Signs of ectopic pregnancy or miscarriage
• Potential causes of fertility issues
• If an intrauterine device (IUD) is in the right position

Healthcare providers use transvaginal ultrasound in early pregnancy, too. It can:

• Confirm the location of your pregnancy
• Determine how far along you are in your pregnancy
• Measure the heartbeat
• Identify early pregnancy complications

How does a transvaginal ultrasound work?

A transvaginal ultrasound uses sound waves to create images of your pelvic organs. An ultrasound technician or another healthcare provider inserts a wand-like instrument called a transducer into your vagina. The wand releases sound waves that bounce off the various structures inside your pelvis. The sound waves travel back to the transducer, where they’re converted into signals. These signals project images onto a screen that your provider can view.

What does the ultrasound wand look like?

The ultrasound wand or probe that your provider uses is made specifically for your vagina. It’s round at the top. It’s thin — less than 1.5 inches in diameter. Your provider covers it with a protective cover and gel. This makes it slide in easier. It may feel like you’re inserting a larger-than-normal tampon.

How long does it take?

A transvaginal ultrasound can take anywhere from 15-30 minutes, depending on what your provider is looking for and how easily they can see your structures.

How do I prepare for a transvaginal ultrasound?

Transvaginal ultrasounds don’t require much preparation. The procedure is quick and relatively painless, with little risk of side effects.

To prepare:

• Wear clothes that you can slip out of easily. You’ll have to remove your pants and underwear, and you may have to wear a gown.
• Remove your tampon before the procedure if you’re on your period.
• Follow your provider’s instructions about when to drink fluids and go to the bathroom. Having a full or empty bladder affects the way your organs appear on an ultrasound.

What should I expect?

Here’s what you can expect during the test:

1. You’ll lie on an exam table as if you were having a pelvic exam — with your knees bent and legs apart, and your feet possibly in stirrups.
2. Your provider will place a sterile cover and sterile gel on the transducer and gently insert it inside your vagina. The gel may be cold.
3. Once it’s inside, the transducer releases sound waves that record pictures of your pelvic organs. These images get projected onto a screen. They’ll move the transducer a little bit inside your vagina to get different angles.
4. The technician will remove the transducer once they have enough images.

Is a transvaginal ultrasound painful?

It may be uncomfortable, but it shouldn’t be painful. The transducer is shaped to fit the curve of your vagina to make the procedure comfortable. A lubricating gel also helps it glide in easily. You might still feel some pressure or mild discomfort, though. This usually goes away quickly.

What are the risks?

Transvaginal ultrasounds are safe, even during pregnancy.

You may feel slight discomfort or pressure from the transducer. And you can have discharge from the lubricating gel used during the procedure. That should disappear after 24 hours.

What can I expect after a transvaginal ultrasound?

You can go about your day as normal after the test. You may bleed a little or feel a little cramping. This is temporary and uncommon. Contact your provider if you have pain, heavy bleeding or other symptoms.

How long does it take to get results?

If your provider performs the procedure, they may discuss your results with you that same day.

A full report usually takes a few hours to a few days. It depends on how quickly the images are read. Your provider will contact you once they have all the results and discuss what they mean.

What type of results do you get?

It depends on why you had one. Sometimes, the results can be enough to diagnose a condition or determine the cause of your symptoms. Other times, your provider may need to order additional tests, like an MRI, to get them closer to a diagnosis.

If you’re having one in early pregnancy, the results can show your provider if the fetus is in the correct location, depending on the age of the pregnancy.

Your provider will review the results with you and explain what they mean for your care.