When a woman discovers unpleasant symptoms, she may not even suspect how serious an illness they indicate. Worst of all, the most severe diseases are often asymptomatic.
Basically, diseases of the pelvic organs in women are divided into two categories: diseases of the uterus and appendages.
The most common problems of the main female organ include endometriosis. When it occurs, the uterine tissue begins to grow. Endometriosis can lead to complications in the form of fibroids and various adhesions. All of these diseases are common causes of infertility in women. A seemingly harmless problem can result in a very serious complication. Endometriosis is asymptomatic, so an annual gynecological examination is very important. If you have symptoms in the form of ointments at the beginning of women's days or heavy bleeding, then endometriosis may be in an advanced stage. Then you just need to contact a gynecologist and undergo an ultrasound of the uterus and appendages.
The disease is best detected in the second part of the menstrual cycle, because it is at this time that the size of the uterus is slightly increased, which gives the doctor the opportunity to take a good look at it during an ultrasound.
A very terrible disease of the female pelvic organs is cervical cancer. This is a very common disease, which is in second place in occurrence, both in women of childbearing age and in elderly women. There are many reasons for its appearance. Among them are smoking, taking oral contraceptives, herpes and HPV. Among the main symptoms of cervical cancer in women are spotting and pain, swelling of the limbs and problems with urination. But most often, cervical cancer is discovered completely by accident during routine examinations. In this case, an ultrasound examination is necessary to assess the growth of the tumor and determine the operability of cervical cancer.
Among diseases of the pelvic organs in women, uterine fibroids, a so-called benign tumor, are very common. Its main symptoms are heavy menstruation. If the fibroid is allowed to grow, then surgery is inevitable, and very often the uterus is removed along with the tumor. Ultrasound should be done in the first half of the menstrual cycle.
Among diseases of the uterus and appendages, ovarian problems are common. These include the formation of numerous cysts, ovarian cancer, adnexitis and apoplexy. The doctor performs an ultrasound of the ovaries on the seventh day after the end of the menstrual cycle. However, in order to assess their functioning, see their size, and draw a conclusion about the correct functioning of the organs, ultrasound is performed from the eighth to the tenth, from the fourteenth to the sixteenth and from the twenty-second to the twenty-fourth days of the cycle.
Ultrasound examination methods
In medicine, there are three methods by which you can do an ultrasound of the uterus and appendages, as well as the cervix.
The most common method is transabdominal, which the doctor does through the abdomen using a special sensor and gel. In this case, certain preparation is required: in order for the female internal organs to be clearly visible, the bladder must be filled before the ultrasound. You should drink about a liter of water. Preparation may also include a special diet that avoids bread and legumes. These products may cause excess gas and interfere with testing.
The second ultrasound method is called transvaginal, in which the doctor inserts a sensor into the vagina. It is done when conducting a conventional study is difficult to implement. For example, if the patient is overweight, when layers of fat obscure visibility during the transabdominal method. Women do not require special preparation for this type of ultrasound.
Transrectal ultrasound is done in the same way as transvaginal ultrasound, but through the anus. The doctor does it when a regular ultrasound does not show reliable information, and a transvaginal ultrasound cannot be done. It is usually prescribed to girls who have not yet had sexual intercourse. There is also no preparation required, which means there is no need to fill the bladder.
In addition, according to the purposes of the study, ultrasounds are divided into special types. Detection of diseases of the female organs is one of its main tasks. But besides this, there is, for example, folliculometry. The doctor recommends doing this ultrasound in order to recognize changes that occur during the menstrual cycle in the ovaries.
Most often, folliculometry is prescribed to women who cannot get pregnant for more than six months, and to those who are preparing for the IVF procedure.
The importance of ultrasound examination is also invaluable for pregnancy management, during which the doctor can find out both the progress of fetal development and the condition of the mother’s organs.
A gynecological ultrasound does not require any special preparation. Only the transabdominal method requires it, but it is also minimal. Ultrasound examinations in gynecology must be done once a year in order to timely identify diseases of the female organs, or, on the contrary, to maintain peace of mind about your health.
Examinations of female organs are done not only during pregnancy and for preventive purposes, but also after abortions and installation of an IUD.
Every woman should have her uterus and appendages checked every year using an ultrasound. This procedure is considered safe, painless and helps to identify various pathological processes in the pelvic organs. The examination has no contraindications or age restrictions. Thanks to diagnostics, the doctor assesses the condition of the uterus and appendages (fallopian tubes, ovaries), their structure, shape and size. The results obtained allow the specialist to make the correct diagnosis and prescribe effective treatment.
Let us consider in more detail when and in what cases an ultrasound of the uterus and appendages is performed, how to properly prepare for such a procedure and what pathologies can be identified.
Examination of the female reproductive system using ultrasound should be carried out regularly. Ultrasound of the uterus and ovaries or appendages should be performed once a year for a healthy woman of reproductive age and once every two years during menopause. Why is it important to do this?
Examination on the chair and taking smears is mandatory and does not in any way replace an ultrasound. But with the help of ultrasound, the doctor receives a more complete picture of the structure of the uterus, its cervix, appendages, vaginal vaults, vessels and periuterine tissue.
If a woman is overweight, especially one suffering from abdominal obesity, then it is very difficult for a doctor to find the uterus and appendages by manual examination, not to mention identifying pathological processes in the pelvis.
In addition, some gynecological diseases have a similar clinical picture, but have different causes. For example, acyclic bleeding can occur with endometrial hyperplasia, endometrial polyp, frozen pregnancy, uterine cancer, submucous myoma, ovarian cyst, and inflammatory process of the cervix. Ultrasound helps to establish the cause and make an accurate diagnosis.
Very often, diseases of the uterus and ovaries, especially malignant ones, do not manifest themselves for years. The full picture of symptoms begins to appear only when they last for a long time, when the disease takes on a neglected form. Thanks to an annual ultrasound examination, cancer can be detected at an early stage.
Kinds
Ultrasound examination of the uterus and appendages is carried out in the following ways:
When should research be conducted?
Ultrasound of the uterus and appendages is desirable carried out on days 5–7 of the cycle. It is during this period that the endometrium is thinnest, making it possible to accurately assess such ailments as fibroids, hyperplasia of the inner lining of the uterus, etc. If such a study is carried out in the second half of the cycle, then the growing endometrium hides small defects and neoplasms, contributing to the distortion of information.
In addition, in the second half of the cycle, a corpus luteum cyst or follicle is usually detected in one of the ovaries. In this case, it is quite difficult for a specialist to assess whether the cyst is functional or pathological. Small cystic inclusions in the ovaries appear with the onset of menstruation and are present until days 5–7 of the cycle.
To assess the functionality of the ovaries, ultrasound examination is performed three times during the cycle. If pregnancy is not determined by the test, and the temperature in the rectum remains elevated for 10–14 days, then an ultrasound is prescribed to rule out cystic formations.
Preparation for the procedure
Since the study is carried out in several ways, therefore, you should properly prepare for each of them. If a woman is undergoing a transabdominal study, then the bladder must be full for such a procedure. An hour before the ultrasound, you need to drink at least half a liter of water. Thanks to a full bladder the intestinal walls are pushed back, which allows a much clearer look at the condition of the organs. Without this condition, such research will be uninformative.
If a woman suffers from chronic constipation, flatulence and other intestinal problems, this may interfere with the diagnosis. In order to prepare for a transabdominal ultrasound in this case, for two days you need to follow a diet that improves digestion and take medications that help eliminate gases and feces.
Before performing a transvaginal ultrasound, the bladder, on the contrary, should be emptied. Before inserting it into the vagina, a latex nozzle or condom is placed on the surface of the sensor scanner and a gel is applied that conducts sound. If you are allergic to latex, you should notify your doctor.
If you have to transrectal ultrasound, it is recommended to have a bowel movement 6 hours before the procedure. For this purpose, a woman can use a ready-made microenema (Norgalax, Microlax), take a laxative (glycerin suppositories, Senade) or give a cleansing enema.
No special preparation is required before performing an intrauterine ultrasound. The study is carried out with an empty bladder.
How is an ultrasound of the uterus and appendages performed? Most often, a transabdominal examination is performed. To do this, the patient lies down on the couch and releases the abdomen, onto which the gel is applied. The doctor moves the ultrasound scanner sensor over the abdomen, examining the condition of the organs and diagnosing possible pathologies. The procedure usually lasts 20 minutes.
On ultrasound, the cervix is visible very well. Normally, its length is 20–40 mm, and the anteroposterior size is 25–35 mm. The structure of the organ must be homogeneous. filled with mucous contents and has a diameter of 3 mm. If the canal or neck is dilated, then the doctor can judge the inflammatory process.
Appendages include:
The ovaries are located on the sides of the uterus and are clearly visible in healthy women. Their structure is represented by follicles or liquid vesicles in large numbers. Normal ovarian parameters are:
- length – 24 – 40 mm;
- thickness – 15 – 25 mm.
Such numbers can vary greatly depending on what phase of the cycle and what size of follicles in the ovary.
Ultrasound of the fallopian tubes is examined separately, assessing their functionality. It is prescribed to women suffering from infertility. During the procedure, the doctor fills the uterine cavity and tubes with a contrast agent and evaluates the patency of the latter on the monitor. With a conventional ultrasound, it is impossible to assess the condition of the fallopian tubes, since their lumen is not visible.
Pathologies detected by ultrasound
When conducting such a study, various diseases are identified. If they are detected in a timely manner, the doctor selects the most effective drugs that will help to quickly overcome the disease. Let's take a closer look at some of the identified pathologies.
Endometriosis. This is a disease of the uterus in which the endometrium forms outside the uterine cavity. The endometrium is the inner lining of the uterus, which is necessary for the attachment of a fertilized egg. This disease manifests itself as painful periods, pain during sexual intercourse, bloody discharge from the genital tract outside of menstruation, infertility, and a change in the smell of vaginal discharge.
Endometrial polyps. This diagnosis is made if the mucous membrane of the inner layer of the uterus begins to grow excessively. The disease may be asymptomatic, but it may also be accompanied by bleeding from the vagina. Infertility may also develop.
Malformations of the uterus. An ultrasound can clearly determine whether the uterus is normally developed. It may have an irregular position, size, and also be bicornuate, saddle-shaped or double. There is also a “baby uterus”, that is, an underdeveloped one.
Salpingitis. In this case, the fallopian tubes and the ovaries themselves become inflamed. Symptoms of the disease are pain during sexual intercourse, menstruation, and cycle disorders.
Ovarian cyst. This is the most common disease among women. The cyst can go away on its own, or it can reach very large sizes. On ultrasound it is clearly visible against the background of healthy tissue. Symptoms are pain and cycle failure.
Thus, women need to undergo ultrasound of the uterus and appendages regularly, since thanks to such research it is possible to identify various diseases at the initial stage of development. If the doctor prescribes effective treatment, you can get rid of both pain and infertility.
Ultrasound of the uterus and appendages is a simple and effective way to obtain a sufficient amount of information about a woman’s reproductive organs. Due to its availability, it has gained wide popularity among the population. The method is considered absolutely safe, therefore it is actively used in diagnosing pregnancy and assessing its development during screening studies.
Teratogenic or other effects of ultrasound on the fetus have not been proven. Ultrasound examination of the female reproductive organs is used both for routine examination and for diagnosing emergency conditions. However, despite all the advantages of the method, it is necessary to understand that its capabilities are limited. In addition, you need to carefully prepare for the study and make the right choice of its date in the context of the menstrual cycle. Compliance with these requirements allows you to reduce the risk of diagnostic errors and increase the effectiveness of the method.
When is ultrasound indicated?
Ultrasound of the uterus and ovaries is used to diagnose diseases of a woman’s reproductive organs, for follow-up examinations after therapy, to monitor pregnancy, and for other purposes. The scope of application of this method is quite wide.
A pelvic ultrasound should be ordered by your doctor. However, there are times when it is impossible to get to the doctor, then knowledge of when implementing this method can help can come to the rescue. An ultrasound of the female genital organs may be performed if:
- pain of varying nature and intensity in the pelvis;
- before the in vitro fertilization procedure;
- diagnosis of pregnancy and determination of its duration;
- checking the patency of the fallopian tubes;
- polyps and endometrial hyperplasia;
- large blood loss during menstruation;
- prolonged menstruation;
- bloody or brown discharge between periods;
- neoplasms of the uterus and appendages;
- screening studies during pregnancy;
- complaints during pregnancy;
- ovarian dysfunction;
- infertility.
What is the essence of the procedure
An ultrasound of the pelvic organs is performed while lying on your back on a couch. The light in the office is dim for better visualization of the picture on the screen. The procedure varies slightly depending on the examination method chosen. Currently, there are 4 types of ultrasound examination of female reproductive organs:
- transabdominal,
- transvaginal,
- transrectal,
- intrauterine.
When performing transabdominal ultrasound, the ultrasound sensor is placed on the anterior abdominal wall. The study is carried out using a special gel that improves ultrasound performance. This method is actively used in the second and third trimesters of pregnancy, in women who are not sexually active, and also to identify gross gynecological pathology.
Transvaginal ultrasound obtains the necessary information using a sensor inserted into the vagina. This procedure is painless, but a woman may feel discomfort during it. To reduce discomfort, the patient is advised to relax. Transvaginal ultrasound is used to diagnose ectopic pregnancy, during short gestation, for endometrial polyps, endometriosis and other gynecological pathologies. There is no need to be afraid of transmission of infection, since a condom is used during the examination.
In difficult diagnostic situations, transrectal and intrauterine ultrasound are used.
How to prepare
Compliance with all the rules of preparation for ultrasound examination of the uterus and appendages is necessary to obtain reliable results. The mandatory conditions vary and depend on the type of ultrasound used:
- 1-2 hours before the transabdominal examination, you need to drink 1-1.5 liters of water in order to fill the bladder. The woman should have a moderate desire to urinate.
- If your doctor has prescribed a transvaginal ultrasound, it is advisable to go to the toilet before the procedure.
- An enema is recommended before transrectal ultrasound.
Excluding products that increase gas formation two days before the examination is necessary for any examination method. These products include:
- baking;
- legumes;
- black bread;
- raw vegetables and fruits.
When is the best time to do it?
The effectiveness of the examination depends on which day of the cycle an ultrasound of the uterus is performed. A woman's reproductive organs work in a cyclical mode. This determines the timing of the survey. The doctor, depending on what he wants to see with the help of the study, chooses the day for it individually for each woman. The main selection criterion here is the purpose of the study.
- On the 2-3 third day of the menstrual cycle, an ultrasound is recommended to assess the ovarian reserve. Most often, this is necessary before using assisted reproductive technologies. In most cases, performing an examination during menstruation is undesirable. Ultrasound during this period is difficult and can cause diagnostic errors.
- The best time to perform an ultrasound examination of the female genital organs is the 5-7th day of the menstrual cycle. During this period, the results of ultrasound of the uterus are the most informative. There are several reasons for this. On the 5-7th day, the thickness of the internal mucous layer of the uterus is still small, which creates favorable conditions for diagnosing formations in the uterine cavity (polyp, submucosal uterine fibroids). At the same time, follicle growth in the ovaries is just beginning. The dominant follicle will begin to be determined a little later. Therefore, this time is considered the best for diagnosing pathology of the appendages (ovarian cysts and neoplasms).
- When performing folliculometry after an ultrasound following menstruation, a follow-up examination is carried out on the 10th day of the cycle. The goal at this point is to register the dominant follicle, which reaches a size of up to 25 mm in diameter. Next, the study is repeated every 2 days in order to register ovulation by such signs as the disappearance of the dominant follicle and the appearance of a small amount of fluid in the retrouterine space.
- When performing an ultrasound in the second phase of the menstrual cycle, the condition of the endometrium and the corpus luteum are assessed. Sufficient thickness of the inner mucous layer of the uterus in combination with a well-functioning corpus luteum ensures successful implantation of the egg and the development of pregnancy. In case of emergency situations (bleeding, suspected ectopic pregnancy, cyst rupture, ovarian apoplexy, etc.), the examination is carried out urgently on any day of the menstrual cycle.
- To diagnose pregnancy, it is recommended to do an ultrasound on the 7-10th day of the delay, so that the fertilized egg has time to descend into the uterine cavity and the embryo has become large enough to be visualized during examination.
What can an ultrasound tell you?
An ultrasound scan of the uterus can only be interpreted by the attending physician. The same study results in different women can indicate both normality and pathology. In addition to the day of the menstrual cycle, it is necessary to take into account the woman’s age, taking hormonal medications, etc.
The size of the uterus is individual for each woman and is determined by age (from the onset of puberty, the uterus increases, and when the amount of hormones during menopause decreases, subinvolution of the organ is observed), the number of births and pregnancies in the history. The organ enlarges with fibroids, adenomyosis and pregnancy and decreases with infantilism.
The endometrium according to ultrasound should correspond to the day of the menstrual cycle. M-echo in the menopausal period should be linear or not exceed 4 mm in thickness, otherwise this may indicate endometrial hyperplasia, endometrial tumor.
Ultrasound of the cervix allows you to evaluate its structure and features of the cervical canal. Using these data, it is possible to diagnose inflammatory processes and polyps of the cervix, and isthmic-cervical insufficiency during pregnancy. Examination of the appendages helps identify cysts, neoplasms, and ectopic pregnancy.
How is an ultrasound of the fallopian tubes performed?
The patency of the fallopian tubes can be checked by ultrasound using a contrast agent. This research method is called “ultrasound metrosalpingography”. The examination is carried out after menstruation on days 7-12 of the cycle.
For a woman on a gynecological chair, a thin and flexible catheter is inserted into the uterine cavity. A warm, sterile solution of contrast agent flows through it. On the monitor screen, the doctor observes how the solution is evenly distributed in the uterine cavity and fallopian tubes. The appearance of contrast fluid in the retrouterine space indicates patency of the fallopian tubes.
Why do you need a gynecological ultrasound with colorectal dosage?
Color Doppler Imaging stands for Color Doppler Imaging. Ultrasound using this method allows you to register different speeds of blood flow. Ultrasound examination with color circulation gives an assessment of blood flow in the uterine and ovarian arteries, in the endometrium, appendages and pathological formations. It is actively used for the diagnosis of neoplasms and inflammatory processes of the female genital organs, as well as during pregnancy.
In modern medicine, special attention is paid to diagnostics, which allows the doctor to obtain valuable information about the condition of the patient’s internal organs, make the correct diagnosis, carry out treatment and monitor the course of the disease. Ultrasound diagnostics is considered a common examination method, which is widely used in various branches of medicine, is completely safe, has a high degree of information content and is accessible to people with minimal financial resources.
Ultrasound examination is widely used in gynecology; it allows one to evaluate the structure of the pelvic organs and identify disorders and diseases of the woman’s genitourinary system. Diagnosis of the pelvic organs consists of studying the uterine cavity, cervix, ovaries, and the doctor also examines the bladder, the walls of the uterus and its appendages.
During the examination, the position of the uterus, shape, structure, its structure, the presence of deformations or deviations from the norm are initially determined. When the ovaries are examined, their location, size, inflammatory processes or pathological changes are studied. The diagnostic results are compared with the phase of the menstrual cycle.
Changes occur in the uterus and appendages throughout the menstrual cycle, so diagnosis is recommended on days 5-7. If the functionality of the ovaries is being assessed, then it is recommended to do ultrasound repeatedly during one menstrual cycle. Ultrasound does not contain x-rays, so it is completely safe for the patient and can be done several times. When examining the ovaries, ultrasound is recommended to be performed at least 3 times a month.
For preventive purposes, ultrasound should be done 1-2 times a year, this will prevent the development of gynecological diseases or, if there are disorders, provide timely treatment. Ultrasound of the uterus and ovaries is recommended for women with a history of genital diseases or the following symptoms:
- irregular menstruation;
- long, heavy and painful menstruation;
- absence of menstruation;
- nagging pain in the lower abdomen;
- infertility;
- spotting between periods;
- pregnancy.
Indications for the procedure
During an ultrasound examination, the doctor has the opportunity to assess the functionality of a woman’s reproductive system and identify diseases, such as:
- uterine fibroids;
- endometriosis;
- inflammation of the internal genital organs;
- endometrial hyperplasia;
- polycystic ovary syndrome;
- salpingitis;
- ovarian tumors or cysts;
- confirm or deny pregnancy;
- pathology of the cervix.
In addition to the above diseases, diagnostics of the uterus and ovaries allows us to identify other disorders caused at the hormonal level, monitor the course of pregnancy, embryo development and other abnormalities in the female genitourinary or reproductive system.
Ultrasound methods
In gynecology, ultrasound can detect changes in the uterine appendages and ovaries, as well as pathological formations in tissues and vessels, such as tumors or cysts. For gynecological examination of the uterus and ovaries, two diagnostic methods are used: transabdominal or transvaginal.
- The transabdominal method is carried out through the anterior wall of the lower abdomen using a sensor, which is pressed tightly to the skin and moved at various points, examining the necessary organs. Ultrasound waves penetrate deep into organs, allowing the doctor to receive a clear image on the monitor screen and read the necessary information, which is recorded in the examination protocol.
- The transvaginal method is similar to a gynecological examination, but allows the doctor to see the pelvic organs much better. For this examination, a special sensor is used, which is inserted into the vagina. A disposable condom is placed on the tip of the sensor and a small amount of gel is applied. The advantage of this examination is the ability to examine the uterine appendages, structure and functionality of the ovaries from different angles. To carry out the transvagrinal diagnostic method, no preliminary preparation is required and can be carried out at any convenient time, except during menstruation.
The transvaginal examination provides a clearer picture than the transabdominal examination method because the transducer is closer to the organs being examined, but the vaginal probe can only examine a smaller portion of the pelvic organs, unlike the transabdominal examination. Therefore, the choice of examination remains with the attending physician. To study the uterus and ovaries, it is better to use a transvaginal diagnostic method; also, for a more accurate picture, the doctor may prescribe Dopplerography or hysterography.
- Dopplerography– allows you to measure the movement of cells and the speed of blood through the vessels. It is performed together with an ultrasound when there is a suspicion of neoplasms or during pregnancy in the 3rd trimester. The results of Doppler ultrasound allow you to create a graph of blood flow through the vessels to the pelvic organs. Vaginal scanning is combined with color Doppler mapping and Dopplerography, this allows for better visualization of the walls of the uterus, ovarian function, and identification of physiological or pathological changes. It is also recommended to do an ultrasound when the doctor suspects the presence of a tumor process in the pelvic organs.
- Hysterography– allows you to get a clear image of the organs of the genitourinary system. This method is carried out using a contrast agent, which is injected into the vagina; it is completely safe for the female body. Ultrasound hysterography is prescribed when the doctor suspects malignant gynecological diseases, such as fibroids, uterine cancer. This diagnostic method requires preparation, so the doctor must warn the woman and familiarize her with the rules of the procedure.
Preparation
Depending on the chosen ultrasound diagnostic method, you need to adhere to some rules that will help the doctor examine the necessary organs well. Preparation for the examination consists of the following rules:
- On the eve of the procedure, it is recommended to follow a slag-free diet; you can also take 30 ml of castor oil.
- For two days before the procedure, it is not recommended to eat foods that increase gas formation.
- 2-4 hours before the examination you need to fill the bladder with one liter of liquid. Bladder filling is performed only during transabdominal examination.
- if the ultrasound is transvaginal, then no preparation is required, and examinations are scheduled on certain days of the menstrual cycle (5 - 7 days). If the examination is aimed at assessing the functionality of the ovaries, then the diagnosis can be performed 3–4 times during the entire menstrual cycle.
Proper preparation will allow the doctor to obtain more detailed and accurate information, on the basis of which a final diagnosis is often made and treatment is prescribed.
How to perform an ultrasound of the pelvic organs
During the procedure, the patient lies down on the couch, exposing the stomach and lower abdomen. If the procedure is performed using the transabdominal method, then the doctor applies a special gel to the skin, which allows the sensor to move better across the skin. The procedure is completely painless and takes from 15 to 30 minutes.
During transvaginal diagnostics, a vaginal sensor is inserted into the vagina, this allows you to examine the pelvic organs from different angles, identify inflammatory processes in the ovaries or pathological disorders of the uterus and its appendages. The vaginal sensor is small in size and does not cause discomfort. Before an ultrasound is performed, the ultrasound specialist collects the patient’s medical history, studies the medical history, this will allow him to draw up an accurate picture of the examination.
Ultrasound results
During the examination, the doctor reads information from the monitor screen and records it in the examination protocol, which is transmitted to the attending physician. The examination results reflect the most important indicators about the condition of the pelvic organs, in particular the uterus and ovaries. The parameters and results are not constant and depend on the patient’s age, the phase of the menstrual cycle, the number of pregnancies and births. Therefore, only a qualified doctor can correctly interpret the diagnostic results.
An ultrasound examination should be done not only at the first ailments in a woman’s genital area, but also for preventive purposes; this will provide accurate information about the structure of the internal genital organs and surrounding tissues. Also identify even minor deviations, which may be the first sign of gynecological diseases.
In modern medicine, ultrasound of the uterus and appendages is a frequently used method for examining patients, allowing a quick, painless and accurate diagnosis.
Today there are three options for examining female organs:
- transabdominal – examination with an external sensor through the anterior abdominal wall.
- transvaginal - examination by inserting a special vaginal sensor into the vagina.
- transrectal - examination through the rectum using an internal rectal probe.
For each examination option, there are indications and contraindications, which are determined by the doctor. Do not forget that one method does not exclude the other. In classical ultrasound diagnostics, an examination is first performed through the abdomen to obtain a general picture, followed by a transvaginal or transrectal procedure for a more detailed examination of the uterus and appendages.
How to prepare for diagnosis? Preparation for different types of examination differs. Let's take a closer look at them.
- The transabdominal method requires a full bladder. The filling must be physiological. To do this, it is enough not to urinate for 2 hours before the test. During the day before the procedure, it is advisable not to consume foods that cause increased gas formation in the intestines (potatoes, legumes, dairy products, fatty meat, etc.). The presence of gas in the intestinal loops can complicate its implementation and reduce the information content.
- The transvaginal method does not require special preparation. Before ultrasound of the appendages, you must urinate and not eat foods that increase gas formation in the intestines.
- The transrectal method is used quite rarely; it has very limited indications (impossibility of passage through the vagina, virginity). To prepare for it, you need to do an enema to cleanse the intestines and urinate before the procedure.
Optimal timing
When is it better and her appendages? Most often, the examination is carried out in the first phase on days 5–10 of the menstrual cycle.
Do not forget that we begin to count the menstrual cycle from the first day of menstruation (the day when the first bloody discharge from the genital tract appeared, even if it is spotting). But there are also exceptions. For example, with endometriosis, ultrasound is performed in the second phase of the menstrual cycle, starting from the 16th day.
If you decide to go for the procedure on your own, but you do not have a referral from a gynecologist, feel free to go on the 5th–10th day of your menstrual cycle. And the ultrasound doctor will advise you whether a repeat examination is needed on another day of the menstrual cycle, depending on the results obtained.
Indications for use
The indications for scanning the female pelvic organs are quite extensive.
- Lack of menstruation, suspicion of pregnancy.
- Determination of gestational age and determination of fetal pathology in the early stages.
- Pain in the lower abdomen, suspicion of inflammation of the pelvic organs in a woman.
- Menstrual irregularities – absence of menstruation, prolonged, heavy, painful, irregular menstruation.
- Suspicion of developmental anomalies of the uterus, ovaries, and tubes.
- Dysfunction of neighboring organs - disorders of urination, defecation.
- Suspicions of tumors of the pelvic organs in women.
- Complications after childbirth and abortion.
And don’t forget that even if nothing bothers you, you must do an ultrasound once a year. This is necessary to identify the early stages of gynecological diseases that have not yet manifested themselves, and to begin their treatment early.
Signs of the main detectable pathologies of the pelvic organs
When examining the female pelvic organs, pathology of the endometrium, uterus, and ovaries is most often detected. The fact of pregnancy and its duration are also established.
This is what ovarian cysts look like through transvaginal access
Endometrial pathology
Hyperplasia is excessive growth of the endometrium. With this disease, its thickness does not correspond to the phase of the menstrual cycle. Main ultrasound indicators of endometrial hyperplasia:
- in the first phase – more than 8 mm,
- in the second phase – more than 15 mm.
Endometrial polyp is the presence of a formation in the uterine cavity with clear contours. For an accurate diagnosis, it may be necessary to inject a contrast agent into the reproductive organ.
Endometrial hypoplasia is the thinning of the endometrium, the discrepancy between its thickness and the phase of the menstrual cycle. It is most often detected in the second phase of the cycle and is accompanied by thinning of the endometrium of less than 8 mm. This can lead to infertility and miscarriage and requires immediate treatment.
Endometrial cancer is a malignant neoplasm. It is characterized by thickening, heterogeneity, inclusions in the thickness with unclear contours, and increased blood flow.
Pathology of the uterus
Myoma is a benign disease characterized by the appearance of nodes - rounded formations in the thickness of the uterine muscles of different sizes that have a capsule. Modern equipment allows you to see nodes from 2 mm in diameter.
Adenomyosis is the appearance of foci of growth of the endometrium (uterine mucosa) in the thickness of the muscle. According to the study, diffuse heterogeneity of the myometrium is most often determined with the appearance of small foci of varying degrees of echogenicity.
Ovarian pathology
Inflammation of the ovaries (adnexitis, oophoritis) - most often manifested by an increase in their volume of more than 9.1 cubic centimeters, blurred contour due to edema, pain during the procedure, and the appearance of fluid in the retrouterine space. But all ultrasound symptoms are nonspecific and require additional research, which we will talk about later.
Ovarian cysts are round liquid formations on the ovaries of varying sizes. Cysts can be physiological (do not require treatment) or pathological. The contents can be different - liquid, blood, pus, fat, hair.
Polycystic ovaries (PCO) - the presence of more than 12 follicles with a diameter of less than 10 mm, located in the ovary in the form of “pearl beads”. Attention! The process is always two-way. The presence of at least one follicle with a diameter of more than 10 mm excludes PCOS.
Will an ultrasound show inflammation of the appendages?
There are no specific ultrasound signs of inflammation of the appendages. But if there are symptoms (pain in the lower abdomen, fever, purulent or bloody discharge from the genital tract), an examination is necessary.
Most often, an increase in the volume of the ovaries of more than 9.1 cubic centimeters is detected, blurring of the contour of the ovaries due to edema, pain during the procedure, and the appearance of fluid in the retrouterine space. On the basis of which an ultrasound diagnostic doctor can give an opinion about the inflammatory process in the ovaries.
Further diagnosis of inflammatory diseases of the appendages (other and related methods)
To make a correct diagnosis, additional examination is necessary. To do this, you need to contact a gynecologist.
The gynecologist will collect the entire history of the disease - question and clarify complaints (localization of pain, duration, strength of painful sensations, spotting, etc.), determine the presence of allergies for the purpose of further prescribing treatment, clarify family heredity, chronic diseases. That is, he will collect a gynecological history. All this will help to make a diagnosis.
Next, a mandatory gynecological examination is carried out on a chair: the vagina and cervix in the mirror and bimanual. This makes it possible to identify pain in the area of the appendages, an increase in the size of the appendages, their pastiness, and the presence of space-occupying formations. Also, with the bimanual method, you can determine the pain of the arches, their smoothness and pain when moving the cervix. All this will help in correctly determining inflammation.
The next mandatory stage is laboratory research. It includes:
- general blood analysis;
- microscopic analysis of smears for flora;
- bacterial culture from the vagina with determination of sensitivity to antibiotics;
- PCR for infections (chlamydia, ureplasma, mycoplasma);
- Femoflor17.
The latter is a very informative and modern research method - it is the study of vaginal discharge for 17 indicators (lactobacteria, obligate pathogenic bacteria, opportunistic bacteria, anaerobes, ureaplasma, mycoplasma, fungi)
In rare cases, if it is impossible to make a diagnosis or there is no effect from the treatment, diagnostic laparoscopy is indicated.
All these studies help to make a correct diagnosis, prescribe adequate and complete treatment, recover quickly and not become chronic.
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