Pelvic ultrasound and transvaginal scan (TVS) show the uterus, ovaries and nearby structures. Learn when each is used, how to prepare and what findings mean.
A pelvic ultrasound shows the uterus, ovaries, cervix and bladder. It can be done over the lower belly (transabdominal, with a full bladder) or with a slim probe inside the vagina (TVS, transvaginal, with an empty bladder), which gives a closer, clearer view. Doctors use it for period problems, pelvic pain, fibroids, cysts, PCOS and early pregnancy.
When Is It Advised?
- Heavy, irregular or painful periods
- Pelvic pain or pressure
- Suspected fibroids, ovarian cysts or PCOS
- Infertility work-up
- Bleeding after menopause
- Early pregnancy, to confirm location and heartbeat. See first trimester dating scan
How to Prepare
- For transabdominal scans, drink 4 to 6 glasses of water an hour before and do not pass urine.
- For TVS, empty your bladder before the scan.
- Wear comfortable clothes.
- Tell the sonologist about pregnancy, allergy to latex and discomfort with internal scans.
What Is TVS Like?
A thin probe covered with a clean sheath and gel is gently placed in the vagina. It may feel like mild pressure, and it is usually not painful. A female attendant is present if you ask. TVS is safe in early pregnancy and gives much clearer pictures of the early baby and ovaries.
Common Findings
- Fibroids: round muscle lumps in the uterus, very common.
- Ovarian cysts: most are simple and settle on their own.
- PCOS: many small follicles in the ovaries with symptoms such as irregular periods.
- Thick endometrium: may need further tests in some cases.
- Adenomyosis and endometriosis: may be suggested; MRI can add detail. See MRI for fibroids and endometriosis.
Limits
Ultrasound may miss small deep endometriosis and cannot fully classify some masses. If an ovarian mass looks unclear, MRI or tumour markers may be added. See MRI for ovarian cysts and masses.
A Practical Example
Anjali, 29, has irregular periods and acne. A TVS shows enlarged ovaries with many small follicles, typical of PCOS. Her gynaecologist advises weight and diet changes, exercise and medicines for periods. In another woman with heavy bleeding, the same scan shows a fibroid inside the uterine cavity, which is treated with a minor procedure.
After the Scan and Next Steps
Take the report to your gynaecologist. Many findings, such as small cysts, need only observation. PCOS and fibroids are managed with lifestyle changes, medicines or procedures, based on your symptoms and plans for pregnancy. Report heavy bleeding, severe pain, fever or fainting early.
Questions to Ask Your Doctor
- Do any findings need treatment?
- Do I need MRI or blood tests as well?
- Which scan phase of my cycle is best?
- How does this affect my plans for pregnancy?
Common Mistakes to Avoid
- Passing urine before a transabdominal scan.
- Having a full bladder for TVS.
- Ignoring bleeding after menopause.
Booking, Timing and Report
Ultrasound is usually available without a long wait, and many scans can be done the same day. Carry your doctor's prescription and old ultrasound reports, and follow the instructions about a full or empty bladder or fasting. The scan takes 15 to 30 minutes, and the report is usually ready the same day.
Key Facts at a Glance
- Transabdominal scan needs a full bladder; TVS needs an empty bladder
- TVS is safe and gives clearer images of the uterus and ovaries
- Most cysts and fibroids are harmless
- Unclear masses may need MRI or tests
Care Tips After the Scan
Keep a diary of your periods, pain and any bleeding between periods, which helps your gynaecologist interpret the scan. Maintain a healthy weight and exercise regularly. Report severe sudden pelvic pain, fever or heavy bleeding without delay.
Frequently Asked Questions
What is the difference between pelvic ultrasound and TVS?
TVS uses an internal probe for closer images.
Is TVS painful?
Usually only mild pressure.
Is TVS safe in pregnancy?
Yes.
Do I need a full bladder?
For transabdominal, yes; for TVS, no.
Can it detect PCOS?
It can show features, with symptoms and blood tests.
Can I have it during periods?
Yes, unless advised otherwise.
Can ultrasound detect cancer?
It can show suspicious masses, but more tests are needed.
How long does it take?
About 15 to 20 minutes.
When is the report ready?
Usually the same day.
Book Your Test at Ganesh Diagnostic
Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.
This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.
