Ultrasound investigation - determination of pathological changes in tissues and organs using ultrasound. Ultrasound is based on the echolocation mechanism, that is, the reception of sent signals and then reflected from the interfaces of tissue media with different acoustic characteristics. An ultrasound examination of the pelvic organs is done to visually determine by the echographic properties of the presence of a disease in a woman (with obstetric ultrasound in the fetus). Such an examination in gynecology is basic, that is, its results underlie other diagnostic procedures.
Methods of carrying out the procedure
Modern methods of conducting such diagnostics generally exclude discomfort and pain. An ultrasound examination of the pelvic organs should be done for all women if there are suspicions of various reproductive pathologies.
Certain methods of ultrasound diagnostics are used.
- Transabdominal examination. The organs that are in the small pelvis are examined through the wall of the peritoneum, while the sonologist guides the sensor over the skin of the abdomen, due to which he can obtain information about the state of a particular organ. During the procedure, you need to have a full bladder. During the study, the doctor can establish the specific structure of the genital organs from the inside, see in them the formation and deviation.
- Transvaginal ultrasound examination of the pelvic organs - examination of the gynecologist is carried out through a special sensor inserted into the woman's vagina. Such a diagnostic method allows you to see in detail the structure of the analyzed organs and determine their size.
- Combined diagnosis first requires a transabdominal diagnosis when the bladder is full. After emptying, the doctor conducts a transvaginal examination.
- A transrectal examination requires the introduction of an ultrasound transducer into the rectum. This method is used when the girl still does not live sexually.
The specifics of the procedure
Ultrasound examination of the pelvic organs is carried out either by the vaginal (vaginal) or abdominal (through the abdomen) sensor. In the pelvis, patients with ultrasound examine the bladder, ovaries, vagina, fallopian tubes and uterus.
- Uterus: the shape, position, structure of the walls and the main dimensions of the organ are established. In addition, with ultrasound (ultrasound examination of the pelvic organs), the middle structures of the uterus are examined separately: the endometrium and the uterine cavity. If a woman is not pregnant, her uterine cavity is slit-like. The endometrium, that is, the internal functional layer, is characterized by a change during the menstrual cycle.
- Ovaries: the position relative to the uterus, the size of the ovaries, the corpus luteum (the structures that remain in place of the follicles when the egg leaves the ovary) and the follicles are determined. Compared with the period of the menstrual cycle. When formations are diagnosed in the ovaries, they are also described (size, structure, shape). In addition, the presence of free fluid is established (after leaving the ovary, the egg normally has a little) and the presence of a tumor in the pelvic cavity. In addition to the structure of the ovaries and uterus, during an ultrasound, the condition of the bladder is examined (if it is sufficiently full).
Many are interested in where you can do an ultrasound of the pelvic organs. About it below.
Advantages of the procedure
Ultrasound examination is carried out quickly, such a method is not burdensome, accessible and visual, can be used repeatedly, requires minimal preparatory conditions before the procedure. It is reliably confirmed that ultrasound is completely safe even for pregnant women.
Indications for the procedure
The ultrasound method is widely used, if there is a suspicion of pregnancy, gynecological diseases, for monitoring the treatment of a woman and the course of pregnancy.
Through ultrasound, you can diagnose the patient's position in the early stages. In women, pelvic ultrasound should be performed in case of malfunctions of the menstrual cycle (beginning of menstruation ahead of schedule, delay of critical days, bleeding in the middle of the cycle), with scanty or heavy menstruation, if menstruation is absent, with different vaginal discharge, unpleasant sensations in the lower abdomen, if they appear discharge during menopause.
Using ultrasound in gynecology, various diseases are determined: from gynecological inflammatory diseases to malignant and benign formations of the ovaries and uterus (including ovarian cysts, salpingoophoritis, endometriosis and others).
A study of the uterus allows you to diagnose uterine fibroids at an early stage.
Pelvic ultrasound is used to monitor the follicular apparatus of the ovaries if pregnancy is planned, as well as in the treatment of infertility.
The procedure is required when taking hormonal and contraceptives, if there is a contraceptive inside the uterus (spiral) in order to control and to avoid complications.
A study during pregnancy, that is, obstetric ultrasound, makes it possible to monitor the normal development of the baby and determine the pathology in a timely manner.
Pelvic ultrasound in urology is necessary to determine the causes of urinary disorders, diseases of the urethra (urethra) and urinary incontinence. There are no contraindications for ultrasound examination.
Preparation for the procedure
Ultrasound of the pelvic organs can be done in any medical institution where there is technical equipment.
If you plan to conduct ultrasound diagnostics, then after the examination, to remove the gel residues from the skin, you will need to have a napkin or towel, and a diaper that is laid on the couch during the procedure.
In non-pregnant women, a simple gynecological ultrasound is performed on a full bladder, unless the doctor has agreed otherwise. To ensure maximum reliability and accuracy of the results, it is necessary to adhere to the accuracy of the established norms of preparation for the ultrasound procedure:
- transabdominal - requires preparation: you need to use from a liter to one and a half still water 60 minutes before the examination and do not urinate before the procedure;
- transvaginal, the study is done with an empty bladder;
- obstetric (during pregnancy) is done with a moderately full bladder (you need to drink two glasses of liquid an hour before the examination).
What does the protocol for ultrasound examination of the pelvic organs require ? If the organs of the genitourinary system (ovaries, uterus, prostate, bladder) are studied, you need to drink half a liter of fluid an hour and a half before the procedure or not urinate for two hours. This is necessary to fill the bladder, which will push out the studied organs.
For a successful study, a prerequisite is the absence of gas in the intestine. That is why preparing for an ultrasound should be done in advance: 2-3 days before the proposed procedure, follow a diet, limit the diet of foods that cause gas formation or constipation. It is recommended to remove products from the menu that provoke the formation of gases: milk, confectionery, raw vegetables, fruits, brown bread. It is advisable to take enzyme preparations: Creon, Enzystal, Panzinorm, Festal.
Cleansing enemas are undesirable because they often increase gas production. In addition, it is allowed to drink dill water, Espumisan and activated charcoal. In case of constipation in a patient, it is advisable to drink a laxative, especially if it is necessary to conduct a study using a rectal sensor.
The procedure is done on an empty stomach (8-12 hours before the ultrasound should be the last meal) and immediately after emptying.
What days should pelvic ultrasound be done? Let's figure it out. Examination of the uterus, mammary glands, appendages is preferably carried out in the first half or middle of the cycle of menstruation. Ultrasound for folliculogenesis is done on the fifth, ninth, from eleventh to fourteenth and on the fifteenth days of the cycle.
Ultrasound of the pelvic organs is a very accurate procedure, but in many respects the accuracy of the results will be determined by the correctness of preparation for the study. In emergency situations, an ultrasound scan is done without preparation, but its effectiveness will be reduced.
Procedure
A woman lays on the couch, having previously spread the diaper to the doctor's head (that is, to the ultrasound machine), exposes the lower abdomen and the stomach itself. The doctor lubricates the ultrasound probe with a special gel (if the ultrasound is transvaginal, a condom is put on the probe and is also lubricated with gel). Then the specialist leads the sensor, sometimes pressing to view the pelvic organs from different angles. Such a procedure is completely painless, in addition to the diagnosis of acute inflammatory processes in the body. The procedure lasts from ten to twenty minutes, which depends on the goals of ultrasound of the pelvic organs. On which day of the cycle this study is carried out, it must be taken into account.
Ultrasound complications
After ultrasound, no complications are observed. However, during pregnancy, transvaginal ultrasound (especially in the early stages) is carried out only after assessing the danger to the baby.
The main indicators of the norm with ultrasound
Information about the norm of indicators of ultrasound examination of the pelvic organs in women will be useful and interesting to patients.
- Normally, the uterus is located in the center of the pelvis, closer to the anterior wall. When conducting a longitudinal scan, the organ has a pear-shaped, transverse - egg-shaped. The normal uterus is characterized by moderate echogenicity. Its internal structure is homogeneous, has linear and point objects. The size is about 5.2 centimeters, the width is five centimeters, the body thickness is 3.8 centimeters.
- The ovary cannot always be visualized. It is normally oval, average echogenicity. Inside there are echo-negative point blotches.
- The vagina has a tubular shape that connects to the uterine neck. With the transverse passage of the scan, it has an egg-shaped shape. The thickness of the vaginal wall is normal from three to four millimeters.
- Ultrasound endometrial parameters vary, depending on the cycle of menstruation. When compiling the protocol, the day is taken into account.
These indicators normally reflect a good ultrasound of the pelvic organs.
If there are other objects on the ultrasound scan and the echogenicity changes by certain organs, thickness and other indicators, this indicates the presence of certain diseases in the female body. If dubious results appear, the patient needs to do additional examinations. Most often, a woman can be referred for computed tomography or MRI. In some cases, an ultrasound is prescribed repeatedly.
Decoding of ultrasound examination of the pelvic organs is carried out by the same specialist.
What can the procedure diagnose?
An ultrasound can diagnose certain conditions.
- Congenital developmental disorders. The use of ultrasound, especially three-dimensional, allows you to see abnormalities of uterine development (organ doubling, one-horned, saddle-shaped, two-horned). The presence of abnormalities from birth can provoke infertility, increase the likelihood of premature birth, intrauterine death of the baby, termination of spontaneous pregnancy, improper position of the fetus and defects in labor.
- Uterine fibroids, that is, a benign tumor of the female reproductive system. During the ultrasound, the number, presence, size and location of myomatous nodes are diagnosed. In addition, ultrasound makes it possible to monitor the dynamics of their growth rate. That is why an ultrasound scan is done several times a year. The diagnosis of fibroids in preparation for pregnancy is very important, since its presence can affect the course of pregnancy.
- The pathological process of the spread of the endometrium beyond the uterine cavity is endometriosis (in the peritoneum, on the ovaries, uterine walls). The study determines adenomyosis (when the endometrium grows into the uterine wall) or internal endometriosis, endometrioid ovarian cysts. Diagnosis of the disease is very important in predicting pregnancy (due to endometriosis, there may be infertility) and its gestation.
- During pregnancy: thanks to ultrasound, pregnancy can be diagnosed from 3-4 weeks. For short periods, it is determined exclusively by means of a transvaginal sensor, since the device has a good resolution. Different types of ectopic pregnancy are determined (cervical - when the fetal egg attaches to the uterine cervix, tubal - when the fetal egg attaches to the uterine tube area, cervical - when the fetal egg attaches to the ovary), which helps to maintain female health.
- Intrauterine protection: through ultrasound, you can control the installation and elimination of the contraceptive inside the uterus, determine the wrong location, complete or partial loss of the IUD from the uterine cavity, and the contraception of the uterus growing into the uterine wall. When planning pregnancy after removing the contraceptive from the uterus, the doctor will advise you to conduct an ultrasound scan.
- In addition, hyperplastic endometrial processes (malignant tumors, polyps, hyperplasia), large ovarian masses are determined.
What is included in pelvic ultrasound for prevention?
Ultrasound for prophylactic purposes
For preventive purposes, healthy women are advised to do a pelvic examination with ultrasound once every one to two years, after forty years of age - once a year to determine hidden diseases. Preventive ultrasound is usually done in the first phase of the monthly cycle, specifically from 5 to 7 days.
We examined what is included in ultrasound of the pelvic organs.