Transvaginal Ultrasound: 7 Things You Should Know Before Going for a TVS Scan

A transvaginal ultrasound scan, commonly known as a TVS scan, is a commonly used diagnostic test to examine the uterus, ovaries, cervix, and other pelvic structures. It may be recommended for women experiencing pelvic pain, abnormal menstrual bleeding, irregular periods, fertility problems, or complications during early pregnancy.

Unlike an abdominal ultrasound, in which the probe is moved over the abdomen, a transvaginal ultrasound involves gently inserting a specialised ultrasound probe into the vagina. This allows the sonographer to obtain clearer, more detailed images of the pelvic organs.

Although the procedure is generally safe, knowing what to expect can help women feel more comfortable and prepared.

Dr Lavanya Kiran, Director and Lead Consultant, Obstetrics and Gynaecology, KIMS Hospitals, Electronic City, Bengaluru, shares seven things patients should know before undergoing a transvaginal ultrasound scan.

1. You Usually Do Not Need a Full Bladder

One of the main differences between an abdominal ultrasound and a transvaginal scan is bladder preparation.

According to a report published in the Journal of Ultrasound in Medicine, an abdominal pelvic ultrasound often requires a full bladder to improve the visibility of the pelvic organs. However, for a TVS scan, the bladder should generally be empty.

An empty bladder can make the procedure more comfortable and help the specialist obtain clearer images of the uterus and ovaries. Patients may therefore be asked to use the toilet immediately before the scan.

If both abdominal and transvaginal scans are planned, follow the instructions provided by the healthcare team, as the preparation may differ for each examination.

2. Wear Comfortable Clothing

Choosing comfortable clothing can make the appointment easier. Patients may be asked to remove their lower garments and change into a hospital gown before the examination.

• Loose-fitting clothes that are easy to remove or adjust are a practical choice.
• It is also important to remember that a TVS scan is a medical examination. The healthcare professional should explain the procedure, respect the patient's privacy, and obtain consent before proceeding.

Patients can ask questions or discuss any concerns before the examination begins.

3. The Procedure Usually Takes 15–30 Minutes

A transvaginal ultrasound generally takes around 15–30 minutes, although the duration can vary depending on why the scan has been recommended and how much information the specialist needs.

During the procedure, the patient usually lies on an examination couch with their knees bent. A narrow ultrasound probe, covered with a protective sheath and lubricating gel, is gently inserted into the vagina.

The probe uses sound waves to produce images of the pelvic organs on a screen. The sonographer may move it gently to view different structures.

The scan does not use ionising radiation, unlike X-rays or CT scans.

Also Read: Before Ultrasound, How Did Doctors Know a Baby Was Developing Normally?

4. Mild Discomfort Is Possible, but Severe Pain Should Not Be Ignored

Some women may experience mild pressure or discomfort when the probe is inserted or moved. However, the examination should not cause severe pain.

The sonographer should insert the probe gently and explain what is happening during the procedure. Patients should immediately inform the specialist if they experience pain, significant discomfort, or feel unable to continue.

Women who have vaginal tenderness, pelvic pain, or anxiety about internal examinations can discuss these concerns beforehand. The healthcare professional may be able to make adjustments to improve comfort.

Patients can also ask to pause or stop the examination at any time.

5. Inform the Doctor if You Are Pregnant or Experiencing Bleeding

Patients should tell the doctor or sonographer if they are pregnant, suspect they may be pregnant, or are experiencing vaginal bleeding.

A TVS scan is commonly used during early pregnancy to assess the pregnancy's location and development. It can help identify certain complications, depending on the stage of pregnancy and the findings.

Vaginal bleeding or menstruation does not automatically prevent a transvaginal ultrasound from being performed when it is medically necessary. However, the reason for the scan and the patient's symptoms should be discussed with the healthcare team.

Do not postpone an important scan without consulting your doctor.

6. Follow Any Specific Instructions Given by Your Doctor

Although a TVS scan usually requires little preparation, individual circumstances may affect how and when it is performed.

For example, the doctor may recommend the scan at a particular point in the menstrual cycle when assessing certain fertility concerns or ovarian conditions. The timing may also depend on the symptoms being investigated.

Tell your doctor about any medicines you take and follow the instructions provided regarding preparation and appointment timing. Do not stop prescribed medication unless your healthcare professional advises you to do so.

Also Read: CT Scan VS MRI: Which Is Better For Diagnosis?

7. Ask What the Scan Is Looking For

Understanding the purpose of the scan can help patients make sense of their results.

A TVS may be used to investigate pelvic pain, abnormal bleeding, fibroids, ovarian cysts, endometriosis-related concerns and certain causes of infertility. It can also help assess early pregnancy.

However, the scan does not diagnose every gynaecological condition on its own. The findings must be interpreted alongside symptoms, medical history, previous reports and, when necessary, other investigations.

Dr Kiran emphasises the importance of understanding what the doctor is assessing and how the findings will guide further care.

Final Word

Knowing why the transvaginal scan has been advised, following preparation instructions and discussing concerns with the healthcare team can make the experience more comfortable and help patients understand the next steps in their care.