Transvaginal

The procedure is very much like an internal exam that is performed at your doctor's office. This involves the insertion of a transducer into the vagina after emptying your bladder. The tip of the transducer is smaller than the standard speculum used when performing a Pap test. A protective cover is placed over the transducer, lubricated with a small amount of sterile gel and then inserted into your vagina which allows for better visualization of your pelvic organs. Then the required images are captured at various planes. When the exam is over the sonographer will wipe off the gel and disinfect the transducer.

Gynecologic ultrasonography or Gynecologic sonography refers to the application of medical sonography to the female pelvic organs, specifically the uterus, the ovaries, the Fallopian tubes, as well as the bladder,the adnexa, the Pouch of Douglas, and any findings in the pelvis of relevance outside of pregnancy[1].

Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries, uterus and endometrium (the fallopian tubes are generally not seen unless distended), but is limited to depth of image penetration. whereas larger lesions reaching into the abdomen are better seen transabdominally. Having a full bladder for the transabdominal portion of the exam is helpful because sound travels through fluid with less attenuation to better visualize the uterus and ovaries which lies posteriorly to the bladder. The procedure is regarded as not painful, noninvasive, and relatively safe as no radiation is used. Scans are performed by health care professionals call sonographers, or gynecologists trained in ultrasound.[1]

Gynecologic sonography is used extensively:

• to assess pelvic organs,
• to diagnose and manage gynecologic problems including endometriosis,leiomyoma, adenomyosis, ovarian cysts and lesions,
• to identify adnexal masses, including ectopic pregnancy,
• to diagnose gynecologic cancer in infertility treatments
• to track the response of ovarian follicles to fertility medication (i.e. Pergonal).

Through transvaginal sonography ovarian cysts can be aspirated. This technique is used to obtain human eggs (oocytes) through sonographic directed transvaginal puncture of ovarian follicles in IVF.[1]

Sonohysterography is a specialiced procedure by which fluid, usually sterile saline, is installed into the uterine cavity, and gynecologic sonography performed at the same time. The procedure delineates intrauterine pathology such as polyps, Asherman's syndrome, or submucous leiomyoma. [1]

[1] Gynecologic ultrasonography, (last visited Nov. 25, 2007