Ultrasound: Gynecologic

WHAT is an Ultrasound and WHY is it done?

Ultrasound (Sonogram) uses high frequency sound waves rather than x-rays to take pictures of the uterus, ovaries, and other abdominal organs. Most women are familiar with ultrasound due to the widespread use of ultrasound in pregnancy to evaluate a developing fetus. There are also a number of gynecologic conditions in which ultrasound is useful. If there is abnormal bleeding, ultrasound measures the thickness of the lining of the uterus and can also detect the presence of fibroids or polyps. If the lining of the uterus is unusually thick, your doctor may recommend a sample of the lining of the uterus to ensure their are no pre-cancerous or cancerous cells. If fibroids and/or polyps are present, ultrasound is useful to measure the size and map their location. It is also used to visualize the ovaries if there is a suspicion of an abnormal growth or as a screen for ovarian cancer. Sometimes ultrasound is helpful in detecting the cause of pelvic pain.

3-D ultrasound and color flow Doppler are sometimes useful to determine the nature of an ovarian growth or to enhance the reading of difficult studies. Our ultrasound machines are the most up to date “state of the art” models on the market and are capable of performing advanced imaging. The technician and/or radiologist will proceed with 3-D or color Doppler if it is needed to get the best study possible. Sometimes a Saline Ultrasound is needed to give further information. Your doctor will tell you if that is the case.

WHAT you should do to prepare

Transabdominal ultrasound requires a full bladder. Therefore, in preparation for your ultrasound you should drink 24 oz of water (or any other drink) one hour prior to your appointment time. No other preparation is necessary. We generally run on time, but if you are miserable, or we are running late, it is fine to go to the washroom and release a small amount (about a cupful) of urine. Do not empty your bladder completely.

WHAT to expect during the procedure

While lying on a table, a transducer is gently pressed to your lower abdomen over your uterus and ovaries. A gel is placed between the transducer and your skin to improve contact and transmission of sound waves. Ultrasounds are painless besides the discomfort of pressure against a very full bladder. Once the technician has completed the abdominal portion of the exam, she will ask you to go to the washroom and empty your bladder completely. You then return to the ultrasound suite, lie on the table and place your heels in the stirrups. Transvaginal ultrasound involves a thin condom covered wand (probe) that is inserted in the vagina. The gel is placed in the condom, not in your vagina. Transvaginal ultrasound has the advantage of not requiring a full bladder and gives a better image of the cavity of the uterus. It is also generally more useful to evaluate endometrial (uterine lining) thickness. Generally you can place the probe yourself with the help of the technician.

A full evaluation usually includes both transvaginal and transabdominal ultrasounds. Some women only need a transabdominal or a transvaginal ultrasound. Your doctor will inform the technician in advance if that is the case.

Images can be seen (and stored) on the computer monitor. Our ultrasound suites all have wall-mounted monitors so that you can see what the technician is seeing. Ultrasound pictures can also be printed as a permanent record or recorded on a CD.

WHAT to expect after the procedure

Rarely, women are slightly sore from the transvaginal probe or have a light pink discharge for a day or two. In most cases there are no after effects and you can return to your normal activities immediately.

RESULTS

Our technician will digitally send the ultrasound to the radiologist at Northwestern Memorial Hospital who will interpret the ultrasound and prepare a preliminary report. The doctors who interpret our ultrasounds are experts who read ONLY Obstetric and Gynecologic ultrasounds. We generally have a written report within 20 minutes. We recommend that when you schedule your ultrasound you also schedule an appointment with your doctor immediately following the ultrasound. She can then sit down with you and review your results. If you have not scheduled an appointment with your doctor she will either call you to discuss results or ask that you schedule an in-office consultation. If your ultrasound was performed at the hospital or another outside location, we generally will not have results for 2-3 days. The technician who performs the ultrasound will not discuss results and we appreciate if you do not ask her to do so.

FAQS

What if the final report is different from the original report?
This rarely occurs, but in the case that the final report has new or different information, your doctor will contact you within a week.

If I don’t have an ultrasound scheduled, but need one, can it be done while I am there or will I need to return on another day?
If it is determined at your appointment that an ultrasound is needed, we will do our best to accommodate you on that day. If there is no availability, you may need to return on another day.

Can I request an ultrasound when I make my appointment if I am concerned about something even if I have not seen my doctor yet?
If you think you may need an ultrasound as part of your visit, call or email us prior to your visit and let us know why you would like an ultrasound. It may be that another test might better address your concerns. If you do not medically need an ultrasound but would like one for “peace of mind”, you are welcome to schedule one but please be aware that insurance may not cover it and it will be an “out of pocket” expense.

What if it is too difficult for me to have a full bladder or my ultrasound is scheduled "last minute" and there is no time to fill my bladder?
Do the best you can. If your bladder is not full enough, the technician will proceed directly to a transvaginal scan.

My daughter is scheduled for an ultrasound. She is 15 years old and a virgin. Will she need to have a vaginal probe?
No. If someone is a virgin or has medical conditions that would make a vaginal probe difficult, painful, or dangerous, the vaginal portion of the procedure will be eliminated. Sometimes the technician will perform a “perineal” ultrasound in which case the probe is held outside the vaginal opening, but not inserted. If there is any question as to the need or appropriateness of a vaginal probe, the technician will ask a doctor before proceeding.

Can I bring someone with me?
An adult friend or relative may accompany you but small children are not permitted in the ultrasound suite.

What if I have my period or am bleeding?
An ultrasound can be performed if you are bleeding. Please remove your tampon in the bathroom before you enter the ultrasound suite. The medical assistant or ultrasound tech will provide a pad if you need one. You can reinsert your tampon immediately following the exam.