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WHEN WOULD I NEED A TRANSVAGINAL ULTRASOUND?

For symptoms of pelvic pain, abdominal pain, unusual vaginal bleeding, difficulty conceiving, or other menstrual problems such as heavy or irregular periods, it’s important to speak with your health care practitioner. Your doctor may order a variety of tests to investigate the cause for these types of symptoms, including medical imaging such as a pelvic ultrasound with transvaginal ultrasound.  

An ultrasound is a safe, versatile, and fast diagnostic imaging exam that uses high frequency sound waves transmitted through a transducer (probe) to produce images of your organs, tissues, and blood vessels.  

  • Pelvic ultrasounds assess your kidneys, reproductive organs, and the surrounding area. At the end of a transabdominal pelvic ultrasound a transvaginal ultrasound is routinely added to get more detailed pictures.  It does not indicate that any abnormalities were seen during the exam.  
  • A transvaginal ultrasound examines the internal pelvic cavity and the organs within it, including the cervix, uterus, and ovaries. This type of ultrasound can reveal abnormal structures and growths in your pelvic area, which may indicate a condition or disease. 

WHAT IS THE DIFFERENCE BETWEEN A PELVIC ULTRASOUND AND TRANSVAGINAL ULTRASOUND?

A pelvic ultrasound is performed with a full bladder. During the exam sonographer will apply warm, non-scented ultrasound gel to your skin on your lower abdominal area before using a transducer to visualize the organs and surrounding area in your pelvis. 

Whereas a transvaginal ultrasound (also known as an endovaginal ultrasound) uses a long, narrow transducer that looks like a wand is inserted into the vagina. This allows for a more detailed visual of the organs and the soft tissue inside the pelvic cavity. 

A transvaginal ultrasound takes between 6-15 minutes. If you are having your period, the ultrasound can still be done. Prior to the exam, you will be asked to empty your bladder and will be given privacy to remove your clothes from the waist down and cover yourself with a large sheet. The sonographer will explain the procedure in detail and answer any questions to make sure you understand and consent to the exam.  

For the exam the transducer is covered in a plastic sheath with lubricating gel that will be gently inserted into the vagina. Depending on your preference, you may be given the option to insert the transducer yourself, or the sonographer may do it for you. The sonographer will move the transducer around to capture photos. You may experience mild to moderate pressure while the sonographer takes the images, but the exam should not be painful. If you experience any pain or would like to discontinue the exam at any time, please let the sonographer know.  

WHEN IS A TRANSVAGINAL ULTRASOUND PERFORMED?

Your doctor may order this imaging to: 

  • Investigate pelvic pain or abnormal bleeding – If you are experiencing ongoing pelvic discomfort, irregular periods, or heavy bleeding, a transvaginal ultrasound can help identify the cause. It may detect uterine fibroids, ovarian cysts, or other structural changes. 
  • Evaluate early pregnancy – This imaging is often used in early pregnancy to confirm viability, assess gestational age, and rule out concerns such as ectopic pregnancy. 
  • Assess infertility – It may be part of an infertility workup to evaluate ovarian follicles, uterine lining, or detect anatomical abnormalities that could impact conception. 
  • Monitor known conditions – If you’ve previously been diagnosed with fibroids, ovarian cysts, or endometriosis, your physician may use periodic transvaginal ultrasounds to monitor changes. 
  • Check Postmenopausal bleeding – Any bleeding after menopause warrants investigation. A transvaginal ultrasound helps assess the thickness of the endometrial lining and check for abnormalities. 
  • Follow-up after abnormal tests – If a lab test, pelvic exam, or other imaging has shown something concerning, a transvaginal ultrasound may provide additional insight.
     

WHAT HAPPENS AFTER MY EXAM? 

The technologist will not be able to provide any details or give any results upon completion of the exam.  

Your images will be reviewed by a radiologist who will compile a medical report that is sent to your doctor within 24 hours, sooner for urgent requests.  

Your doctor will receive your medical report from the radiologist and discuss next steps with you, such as a treatment plan or the need for further diagnostic imaging or lab tests to ensure an accurate diagnosis. 

Mayfair Diagnostics has 14 locations  across Calgary which provide ultrasound services, as well as one in Cochrane and one in Regina. For more information about our services, please visit our services page. 

REFERENCES: 

Cleveland Clinic (2025) “Transvaginal Ultrasound.” my.clevelandclinic.org. Accessed June 4, 2025. 

John Hopkins Medicine (2025) “Pelvic Ultrasound.” www.hopkinsmedicine.org. Accessed June 4, 2025. 

Inside Radiology (2025) “Transvaginal Ultrasound.” www.insideradiology.com.au. Accessed June 4, 2025. 

RadiologyInfor.org For Patients (2025) “Pelvis Ultrasound.” www.radiologyinfo.org. Accessed June 4, 2025. 

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abdomen CT

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Computed tomography (CT) is an advanced imaging system that uses a combination of X-rays and computer technology to produce comprehensive images of your abdomen. CT scans give a much more detailed picture than regular X-rays and can identify many conditions that may escape detection on other imaging tests.

Your health care practitioners may order an abdomen CT scan to examine one of the following (or, for a more comprehensive exam, a combined abdomen/pelvis CT):

  • A cause of pain or swelling.

  • Lymph nodes or blood vessels.

  • The kidney or bladder.

  • The liver, pancreas, or spleen.

  • The small or large bowel.

HOW DO I PREPARE FOR MY EXAM?

WITHOUT CONTRAST: If contrast is not used, you will need to fast for two hours prior to your appointment.
ORAL CONTRAST: If oral contrast is prescribed, you will need to fast for four hours prior to your appointment and arrive two hours prior to your exam, unless otherwise specified at the time of booking.
IV CONTRAST: If oral contrast and/or IV contrast is prescribed, please arrive 15 minutes before your appointment to allow enough time to check-in with reception.
Bring photo identification and your provincial health card.
Please do not drink coffee, tea, or juice six hours prior to your exam.