Ultrasound - pelvic and abdominal

About ultrasound

You may need to have an abdominal ultrasound to help your doctor identify problems with your liver, gallbladder, pancreas, spleen or kidneys. Pelvic ultrasound can help your doctor identify problems in your lower abdominal and pelvic organs, such as your bladder.

In women, a pelvic ultrasound may be used for a number of reasons, including those listed below.

  • To find the cause of pelvic pain, heavy or painful periods or other abnormal vaginal bleeding.
  • To look for any unusual growths in the ovaries or womb, such as ovarian cysts, fibroids or cancer.
  • To find the cause of infertility, such as damaged fallopian tubes or endometriosis.
  • To monitor the effects of fertility treatment.
  • To check fetal development during pregnancy.

Sometimes, ultrasound is used to help guide procedures, such as taking a biopsy (a small sample of tissue). It can also help check for blood clots or narrowing of blood vessels. This is done using a Doppler ultrasound, which monitors flow in blood vessels. The procedure is similar to having a standard ultrasound (see our common questions for more information).

Ultrasound is usually performed by a sonographer. Sonographers are technicians specially trained in taking ultrasound scans. Ultrasound scans can also be performed by a radiologist (a doctor who specialises in using imaging methods to diagnose medical conditions). 

Preparing for an ultrasound

Ultrasound scans are usually done as out-patient procedures in hospital. Please read your appointment letter for instructions on how to prepare for your scan. The instructions will vary depending on your examination.

For some scans you may be asked to fast for a number of hours beforehand, whereas for others you may need to drink water an hour beforehand. A full bladder helps to lift your large bowel out of the pelvis so it’s easier to examine your pelvic organs.

Your sonographer will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during an ultrasound

The scan usually takes 10 to 15 minutes and you may be asked to wear a gown.

The ultrasound scanner looks a bit like a home computer system. There is a hard-drive, keyboard and a display screen, and a hand-held sensor. The sensor sends out sound waves and picks up the returning echoes. Pictures of the inside of your body are displayed on the screen. These pictures are constantly updated, so the scan can show movement.

Depending on your medical condition you may have a scan of your abdominal or pelvic organs, or both.

Abdominal scan

You will usually need to lie on your back on a couch. Your sonographer will apply gel to the skin on your abdomen (tummy) over the area to be examined. The gel allows the sensor to slide easily over your skin and helps to produce clearer pictures. Your sonographer will hold the sensor firmly against your skin and move it over the surface.

                                                       Abdominal ultrasound

Pelvic scan

There are three ways in which a pelvic scan may be done. 

  • Transabdominal scan. This is performed in the same way as an abdominal scan; the only difference is your sonographer will place the sensor over your lower abdomen.
  • Transvaginal scan. This is used to examine the womb, fallopian tubes and ovaries in women. You will need to lie on your back with your knees raised and your sonographer will insert a slim-line sensor (the size of a tampon) into your vagina. This procedure is safe to perform during a period (menstruation).
  • Transrectal scan. This is usually used to examine the prostate gland in men. The prostate is a gland that produces the liquid part of semen. You will need to lie on your left-hand side and your sonographer will insert a slim-line sensor into your rectum. You will usually also have a biopsy of your prostate gland at the same time, which will be sent to a laboratory for testing.

For the transvaginal and transrectal scan, a protective cover is placed over the sensor and it’s well lubricated. The procedure isn’t painful, although it may cause slight discomfort. If you have a latex allergy, tell your sonographer so that he or she uses a suitable cover.

After an ultrasound, your sonographer will wipe the gel from your skin and you will usually be able to go home when you feel ready.

Getting the results

The details of your scan may be explained to you straight after the examination. Alternatively, your results may be sent in a report to the doctor who requested your scan. This can take several days to reach your doctor.

What are the risks?

Ultrasound examination is safe. It doesn’t use radiation and so carries none of the risks associated with this.

Standard diagnostic ultrasound has no side-effects. You may feel slight discomfort as the sensor is pressed against the area being examined, especially if this area is tender.

Do I need to take laxatives before a transrectal ultrasound?

Answer

You may need to take a laxative 24 hours before your scan as you will need to have an empty bowel for the scan.

Explanation

A transrectal ultrasound is usually done along with a biopsy of the prostate gland in men. To examine the prostate a sonographer will pass a lubricated sensor into your rectum.

You will need to make sure you have emptied your bowel before your scan. You may be given laxatives to take the evening before, or on the morning of the procedure, and you may be given an enema (a liquid injected into your rectum) about four hours before the examination. Your doctor will explain how to prepare for your scan.

What is an ultrasound-guided procedure?

Answer

An ultrasound-guided procedure is when your doctor uses ultrasound to make sure he or she is reaching the right area inside your body.

Explanation

Ultrasound produces pictures of the inside your body. It's a safe and painless examination that is very helpful during procedures such as collecting fluid, draining cysts or taking tissue samples. Below are some examples of ultrasound-guided procedures.

  • Biopsy. This is when a doctor inserts a fine needle into an area inside your body to remove a sample of tissue. Examples include breast biopsy, lymph node biopsy and prostate biopsy.
  • Fine needle aspiration. This is similar to biopsy but your doctor will insert a smaller needle and draw cells out into a syringe.
  • Amniocentesis. This is when a doctor inserts a fine needle into your womb to take a sample of the amniotic fluid surrounding your baby
  • Egg retrieval. This is when a fine needle is passed through your vagina into each ovary to collect eggs during in vitro fertilisation (IVF) treatment.

What is a Doppler ultrasound?

Answer

A Doppler ultrasound monitors blood flow in blood vessels, including major arteries and veins in your abdomen, arms, legs and neck.

Explanation

A Doppler ultrasound is done in the same way as an ordinary ultrasound procedure. Your radiologist or sonographer will apply a lubricating gel on your skin and move a sensor against your skin. High-frequency sound waves from the sensor bounce off the red blood cells and the returning echoes are picked up and sent to a computer. Any change in the pitch or frequency helps to estimate how fast the blood is flowing.

A Doppler ultrasound can help detect blood clots or narrowing of blood vessels. It's often used to diagnose:

  • heart disease and heart valve defects
  • venous insufficiency (poor blood flow) in the legs
  • deep vein thrombosis
  • narrowing of an artery

Doppler ultrasound is a useful alternative to procedures, such as angiography. Angiography involves injecting dye into blood vessels and taking X-ray images. The dye helps to show the blood vessels more clearly on X-ray images.

Doppler ultrasound can also be used during pregnancy to check placenta function and blood flow along the umbilical cord, and blood vessels in the baby's brain, lungs, heart and kidneys.