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Pelvic Ultrasound and Water Hysterosonography

Pelvic ultrasound is a diagnostic test using sound waves to produce images of the uterus, ovaries, bladder and other pelvic structures. Ultrasound does not use ionizing radiation or intravenous dye.

The most common indications for pelvic ultrasound are:

  • Pelvic pain
  • Abnormal bleeding
  • Suspected ovarian cyst or mass
  • Uterine enlargement
  • Evaluation of fibroids and the uterine lining
  • Pelvic distension and bloating
  • Unexplained abdominal pain
  • IUD localization

How is pelvic ultrasound performed?

The first part of the pelvic ultrasound is performed with a full bladder. Having a full bladder is important because it displaces the bowel loops out of the pelvis and provides a wide field of view of the uterus, ovaries and bladder. Ultrasound gel is put on the lower abdomen and an ultrasound transducer is use to evaluate the pelvic structures.

A transvaginal ultrasound may be performed when indicated after the bladder is emptied. This exam produces highly detailed images of the uterus, ovaries and adjacent pelvic tissues.

Water hysterosonography

Water hysterosonography is a specialized examination designed to evaluate the uterus for abnormal bleeding, suspected endometrial polyps or submucosal fibroids.

Indications for water hysterosonography:

  • Abnormal bleeding - pre or post menopausal
  • Suspected submucosal fibroids (fibroids within or approximating the uterine cavity)
  • Suspect endometrial (uterine lining) polyps or hyperplasia.
  • Uterine anomalies (duplicated or bicornuate uterus)
  • Infertility

How is water hysterosonography performed?

A pelvic examination with a speculum is performed to identify the cervical canal. A small catheter or tube is positioned in the cervical canal and uterine cavity and sterile saline water is injected into the uterus. Transvaginal ultrasound is performed to evaluate the uterine cavity for fibroids or thickened or abnormal endometrium (uterine lining).

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