Transvaginal Ultrasound: Info, Appearance & Get a Scan

A transvaginal ultrasound scan (TVS), also known as an endovaginal or pelvic ultrasound scan, is a quick and safe internal procedure. It provides important information about your menstrual or reproductive health and can help to identify abnormalities, pelvic pain or problems with fertility. It may sound daunting, but most people find it more comfortable than a smear test.

This article explains how a technician or sonographer will carry out your scan, what it can show, and how your doctor will use the results to help diagnose and treat you. Knowing how it works and what to expect can help you decide if it’s the right scan for you.

What is a transvaginal ultrasound, and how does it work?

A transvaginal ultrasound scan uses high-frequency sound waves to create an image of the inside of your body, specifically within the pelvis area.

It does this with a transvaginal ultrasound wand or probe (also known as a transducer) that contains soundwave transmitters and receivers. These soundwaves bounce off tissues and organs inside you and send ‘echoes’ of those bounces back to the receivers to create a moving image, which your technician can see on a monitor during the scan.

TVS shows a more detailed view of your internal organs than a regular ultrasound scan, allowing the technician to look closely at organs, such as your ovaries or womb, and spot any issues, changes or abnormalities.

Transvaginal means ’through the vagina’, so your technician will insert the wand into your vagina. They will ask you to remove your underwear and lie down on your back or your side for the procedure, and they’ll give you a sheet to cover yourself so you’re more comfortable. They may ask you to raise your knees or let them fall to each side to make insertion easier and more comfortable.

The transvaginal ultrasound probe or wand is slender and small, just a little larger than a tampon. It will be covered with a disposable protective ‘sheath’ a little like a condom (if you’re allergic to latex, let them know), and your technician will also use a lubricating gel to make insertion easier, which may feel cold.

Why You Might Need a Transvaginal Ultrasound Scan

If you have any of the following symptoms, speak to your doctor who may recommend a transvaginal ultrasound scan of the pelvic area:

Abnormal vaginal bleeding
Abnormal vaginal discharge
Slight vaginal discharge that’s blood stained or has a pungent smell
Pelvic pain
Recurrent urine infections
Pain, burning or stinging when urinating
Sudden or more frequent urges to urinate
Changes to your bowel habits
An intrauterine device (IUD) that has previously been fitted but cannot be located
Fertility problems (problems getting pregnant)
Recurrent miscarriages

Transvaginal ultrasound scans of the pelvic organs are used to diagnose conditions such as fibroids, polyps and endometriosis that can cause abnormal uterine bleeding, painful menstrual bleeding and infertility.

These types of internal scans are also used to diagnose and rule out specific conditions such as non-cancerous benign gynecologic lesions (lumps in the pelvic region that aren’t cancerous) and a pelvic structures infection (an infection of the body structures and other soft tissue found in the pelvic cavity).

They can also be used to give a fertility prognosis to help you decide on potential future assisted fertility treatment.

A transvaginal ultrasound is usually needed when a transabdominal scan (when an ultrasound probe is moved over the skin on the outside of the abdomen) has produced unclear results or insufficient information.

An external abdominal ultrasound is usually used to determine pregnancies. But if you’re pregnant and you or your doctors are concerned about the health of your baby, they may use an internal transvaginal ultrasound to help diagnose birth defects and potentially some types of unborn baby cancers. Internal scans can also diagnose a condition called placenta previa, where the placenta attaches itself low down in the uterus, close to the cervix during pregnancy.

What can a transvaginal ultrasound detect?

Your doctor will suggest a TVS if they need to look more closely at organs inside your pelvis, including your:

ovaries
fallopian tubes
uterus (womb)
cervix
bladder
vagina

The scan can help detect abnormalities or changes in the womb and pelvis and diagnose conditions including:

Ectopic pregnancy - where a foetus has implanted outside the womb
Abnormalities in the womb and ovaries - such as cysts, tumours, fibroids or polyps
Pelvic inflammatory disease - an infection of the womb, fallopian tubes or ovaries
Miscarriage (pregnancy loss)
Polycystic ovary syndrome - a condition that causes irregular periods
Endometriosis - where tissue grows in the ovaries and fallopian tubes
Confirming early pregnancy or monitoring during early pregnancy

Your doctor may also use a TVS to help them plan a surgical procedure.

How to prepare for a transvaginal ultrasound

Wear something that allows you to feel comfortable and relaxed, so loose-fitting clothing is ideal. You’ll need to remove everything below the waist, including your underwear, so we recommend wearing a separate top and bottoms, rather than a dress or jumpsuit, so that your top half can stay covered.. You don’t need to groom, wax or shave before the scan.

If you’re wondering whether a transvaginal ultrasound requires a full bladder, the answer is usually no, but you’ll receive preparation instructions from your selected scanning centre before your scan. You may actually need an empty bladder, as it helps the scan capture clearer images of your organs. The pressure from the wand may also feel uncomfortable with a full bladder in some cases.

Bring a trusted friend or family member for support if you're anxious. They can put you at ease during the scan and help you remember answers from the technician if you’re distracted.

Equipment Used

An ultrasound machine sits on a small medical trolley next to a bed, and sends high frequency sound waves through an ultrasound probe, or transducer. Computers attached to the ultrasound machine pick up the echoes sent back through the transducer in the form of electrical signals, and turn them into real time, moving images, ready for interpretation by a radiologist.

A special, clear conductive gel is also used to lubricate the transducer to make the procedure more comfortable. This gel also helps transmit the sound waves and receive the echoes and electrical signals. It will feel cold and wet when applied, but is easily wiped away with tissue after your scan and won’t stain your clothing.

Benefits

Transvaginal ultrasound scans are quick, effective and safe for most people, including those who are pregnant. Unlike x-rays and CT scans, they don’t require the use of ionising radiation and as such don’t carry the small risks associated with radiation exposure.

Risks

Ultrasound scans carry no risks and have no known side effects. If you’re experiencing considerable pain in your pelvic area however, you may find a transvaginal ultrasound uncomfortable.

Since a latex sheath or condom is used to cover the probe, if you have a latex allergy, let your ultrasound technician know so they can use a latex-free alternative.

The Procedure Explained: What to Expect

A transvaginal ultrasound is carried out by an ultrasound technician known as a sonographer, usually in the radiology department of a hospital or specialist clinic.

At your appointment, you’ll be asked some questions about your symptoms and overall health before being asked to sign a consent form.
You’ll then be asked to undress from the waist down and lay on your back on a bed, with a cover over your lower half and your knees bent upwards.
Your ultrasound technician will place a latex sheath over the transducer, cover it with conductive gel and place it into your vagina. They’ll hold it in place with one hand, slowly moving it around when necessary, and use the other hand to control the ultrasound machine and take images. The procedure will take 15 to 30 minutes. It’s a safe procedure and shouldn’t hurt, but you may feel some mild discomfort.

During your appointment, you may also have a physical exam whereby your sonographer feels around your lower abdomen for any signs of tenderness or pain. They may also perform a pelvic exam and feel around the inside of your vagina with a gloved finger. This helps them get an idea of what might be causing your discomfort, abnormal bleeding and other symptoms.

What Happens After a Transvaginal Ultrasound?

Once your ultrasound technician is happy they have enough high quality ultrasound imaging results, the scan will be complete. You’ll then be able to wipe away the conductor gel with tissue and get dressed. You’ll be able to return home and to your normal duties the same day.

You may be informed of any early abnormal findings on the day, but generally, it’s best to wait until your follow up appointment to discuss a normal or abnormal result with your consultant.

What Does a Transvaginal Ultrasound Cost?

In the UK, a full sonography transvaginal assessment, that includes a transvaginal ultrasound, costs between £175 and £250.

Transvaginal ultrasound results

After your scan, a radiologist will examine and interpret your images and write a report of their findings. This report will be sent to you via email and a clinician from Scan.com will call you to discuss your results and any next steps needed.

Depending on what your scan is looking for, you might get an idea of your results immediately. For example, your sonographer might be able to let you know that they haven’t found anything abnormal or worrying during the scan. But you should not feel alarmed if they do not make any indication - it is best to wait until your clinician contacts you with the results of the completed report.

If you have a normal transvaginal ultrasound result, that means that the sonographer was unable to find any abnormalities during the scan, and your pelvic structure is normal.

If you have an abnormal transvaginal ultrasound, it could mean that your sonographer found changes or abnormalities during the scan, such as cysts or fibroids, signs of infection, or other problems.

It’s best to talk to your clinician directly about the results of your TVS when they call. They can explain the results, answer any questions, and recommend the next steps in your treatment.

Transvaginal ultrasound images - what do they look like?

Your womb will appear as a thick, grey line surrounded by a thinner, brighter endometrial lining. The walls of the womb will be grainy and grey.

The ovaries will have an oval or rounded shape.

Any abnormalities, like fibroids, polyps, cysts or tumours will show up as bright white patches against the darker grey tissues or as unusual fluid pockets behind organs.

How can I find a private transvaginal ultrasound near me?

You can book a private ultrasound scan near you today with Scan.com. We can help you fast-track your diagnosis with no GP referrals required and expert clinical consultations within days. Choose from over 150 centres nationwide with flexible appointment times and get fast online results, including a digital imaging report. It’s easier than ever to skip the waiting lists and get your health back on track.

FAQs

Is a transvaginal ultrasound painful?

While a transvaginal ultrasound may feel a bit uncomfortable, it shouldn’t be painful.

You might feel a little pressure as the transducer goes into the vagina, similar to what you feel during a smear test. You can ask to insert the wand yourself if you would find that easier.

You may feel a little discomfort as the wand moves around inside, but again, this shouldn’t be painful. Let the sonographer know if you experience pain or if something doesn't feel right.

You can still have a transvaginal ultrasound if you have not had penetrative sex, if you are transgender, or if you are intersex. The sonographer should reassure you that this is the case and ask for your consent before the procedure. However, it is your right to refuse a transvaginal scan if you would prefer not to have one, and you can ask to stop the procedure at any time.

Can I have a transvaginal ultrasound while on my period?

Yes, you can have a transvaginal scan if you’re having your period.

Just be sure to take your tampon out if you’re wearing one, and bring a fresh tampon or pad with you.

How long does a transvaginal ultrasound take?

The procedure usually takes around 15 to 30 minutes.

What Does a Transvaginal Ultrasound Show?

Transvaginal ultrasound scans are used to create detailed images of a woman’s uterus, ovaries, fallopian tubes, cervix and vagina. They also show any abnormalities that may be causing symptoms such as pain in the pelvic area and abnormal bleeding.

Is a Transvaginal Ultrasound Safe?

Yes, a transvaginal diagnostic ultrasound of the female pelvis is considered a safe procedure, suitable for most patients.

Can a Transvaginal Ultrasound Cause Miscarriage?

No, a transvaginal ultrasound cannot cause a miscarriage and is considered a safe procedure for pregnant women.

Can a Transvaginal Ultrasound Detect Cervical Cancer?

A transvaginal ultrasound can detect changes in the cervix that may indicate that cancerous cells are present; they’re not usually used to diagnose cervical cancer.

References:

Having a transvaginal ultrasound. (2019). https://www.sth.nhs.uk/clientfiles/File/Tranvaginal%20Ultrasound.pdf

Pahuja, M. (2017). Transvaginal Ultrasound.https://www.insideradiology.com.au/transvaginal-ultrasound/

Transvaginal Ultrasound Examinations – Guidance for Practitioners. (2022). https://www.bmus.org/static/uploads/resources/Transvaginal_Ultrasound_Guidance_Final_With_Front_Cover_MesUP8a.pdf

Transvaginal ultrasound scan. (2022) https://www.cancerresearchuk.org/about-cancer/womb-cancer/getting-diagnosed/tests-diagnose/transvaginal-ultrasound-scan

Transvaginal Ultrasound. (2022). https://my.clevelandclinic.org/health/diagnostics/4993-transvaginal-ultrasound

Ultrasound scan. (2021). https://www.nhs.uk/conditions/ultrasound-scan/

What Is a Transvaginal Ultrasound? (2017). https://www.healthline.com/health/transvaginal-ultrasound