London Gynaecology

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30th March 2023

Everything you need to know about a Transvaginal Scan

Feeling anxious about an upcoming transvaginal scan appointment?

Stylist Magazine writer Abbi Henderson recently underwent her first transvaginal scan. Although the thought of the scan itself didn’t cause her much mental anguish (though, it very commonly can), She did have a lot of other, unanswered concerns. Did she need to do anything special – food and drink-wise – beforehand? What, exactly, would be picked up on the scan? And, were the treasure hunt successful, would she receive info on the whereabouts of the sneaky thread or even be able to have the IUD removed same-day? So she turned to our expert consultant gynaecologist Mrs Pradnya Pisal to provide the answers.

Can you give an outline of what actually happens at a transvaginal ultrasound? What’s the process from start to finish?

For an internal (vaginal) ultrasound scan, you will be advised to empty your bladder and then undress completely from the waist down. A hospital gown or sheet will be given to cover you. You will be asked to lie on your back on the ultrasound couch. A chaperone is always present for this scan. Your knees will be bent and your feet will be on movable feet rests. The knees will then be raised in a way that allows the scan to be performed easily. A thin elongated ultrasound probe is used for this procedure. It will be covered with a protective sheath and lubricating gel and then gently inserted into the vagina.

The ultrasound probe will need to be moved into different positions in order to visualize the uterus and ovaries clearly. Ultrasound scans are generally painless, although you may experience some discomfort as the probe is inserted into your body.

An ultrasound scan takes around 15-20 minutes. It will be carried out in the ultrasound department or in the consulting rooms of the clinic.

What is the ultrasound looking for? What info can it obtain (obviously, someone may be having one for many reasons but for those feeling anxious about it, can it locate cysts/endo tissue/cancers/irregularities/awkwardly positioned contraceptives, etc)?

An ultrasound scan is an investigation to create an image on a screen of the organ or body part being examined using sound waves. It is used to help in making a diagnosis so that appropriate treatment can be offered. It is carried out by medical doctors and specially trained health care professionals (sonographers). The scan is performed using an ultrasound probe that gives out high frequency ultrasound waves. These sound waves cannot be heard. The size and shape of the ultrasound probe depends on the part of the body being examined.

The internal (vaginal) ultrasound scan allows the probe to be placed inside the vagina so that it is closer to the pelvic organs being examined. This provides clearer pictures of the uterus, ovaries and abnormalities that may lie deep in the pelvis.

What happens after? Do patients receive results straight away or is there a wait? If there is a wait, is there anything that can be done for those with anxiety to make the wait less stressful for them?

The person performing the scan will usually inform you of the findings or arrange for you to see your doctor. If your scan is performed by a sonographer, if appropriate, they will tell you if any abnormality is detected.

You will be given a report immediately or the report will be emailed to you. For pregnancy scans, you will be given a copy of the images of your baby. Your consultant will explain the scan findings, make a diagnosis and then discuss further investigations and treatment options.

What if someone is allergic to latex?

If you’re having an internal (vaginal) scan and are allergic to latex, it’s important to let the sonographer or doctor carrying out the scan know this so they can use a latex-free probe cover.

If someone has sexual trauma, how is that handled?

Please inform the clinic / person carrying out the scan of this. You can also ask to take a friend with you and request a female sonographer. You can also request a local anaesthetic gel to be used to make the scan less uncomfortable. If you think that you may not be able to go through a transvaginal scan, you can request a transabdominal scan (you will need a full bladder) or an MRI scan.

Why aren’t virgins allowed to have a transvaginal ultrasound?

A transvaginal scan involves insertion of a probe which can be uncomfortable and also not appropriate. Hence, a transabdominal scan is preferred.

Are there alternatives if someone absolutely doesn’t want to have a transvaginal ultrasound?

The three types of ultrasound scans commonly used in obstetrics and gynaecology are:
1. External abdominal ultrasound scan – the probe is moved over the skin
2. Internal (vaginal) ultrasound scan – the probe is inserted into the body (vagina)
3. HyCoSy or Aqua scan – this scan is performed to assess the uterine cavity and patency of fallopian tube

An external ultrasound scan is most often used to examine your unborn baby (after 10 weeks of pregnancy) or when an internal scan cannot be performed to examine the pelvic organs. A small handheld probe is placed on your skin and moved over the part of the body being examined. A lubricating gel is put on your skin to allow the probe to move smoothly. This also ensures there’s continuous contact between the probe and the skin. You shouldn’t feel anything other than the probe and gel on your skin (which is often cold). If you’re having a scan of your womb or pelvic area, you may have a full bladder that causes you a little discomfort.

In some cases, ultrasound scanning has no alternatives but an MRI or CT scan can be used instead or in addition to ultrasound scanning.

Anything else to know to make the experience less uncomfortable? Any specific questions to ask the gynae/info to disclose to them? Advice on what to wear/what to eat or drink before and after?

Before having some types of ultrasound scan, you may be asked to follow certain instructions to help improve the quality of the images produced. You may be advised to drink water and not go to the toilet until after the scan – this may be needed before a scan of your unborn baby or your pelvic area. You can eat as normal and you do not need to starve. There will be a toilet nearby to empty your bladder once the scan is complete. If you are using a tampon, this will need to be removed before a vaginal scan.

Patients can bring a friend or relative with if it makes them feel more comfortable.

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