Though they were first used in the late 50s, by the 70s, they had become commonplace in monitoring pregnancies. Since then, the technology has improved significantly and today, it is also commonly used to diagnose various medical conditions, as well as track the development of babies and the health of their mothers. In this guide, we will demystify ultrasound examinations and discuss the procedure for those going for a pelvis ultrasound in Sydney.

How Ultrasound Works

Ultrasound is an imaging technology that works similarly to how bats and dolphins use echolocation to hunt and navigate. They produce high-frequency sound waves that bounce off their prey and surroundings, enabling them to use sound waves to ‘see’. Ultrasound machines also use high-frequency waves, creating images of a patient’s internal organs, bones, and tissue.

During the pelvic ultrasound examination, a hand-held device called a transvaginal transducer will be inserted into the vagina. This transducer emits soundwaves which enter the body and bounce off the internal structures. The transducer captures the soundwaves that bounce back, and the ultrasound machine converts the echoing soundwaves into real-time images. Using these images, a doctor may be able to form a diagnosis.

About Pelvic Ultrasound

In medical settings, a pelvic ultrasound is a non-invasive diagnostic procedure. It uses ultrasound technology to generate images of the abdomen.

During the ultrasound examination, the images on the screen allow the doctor to observe the bladder and the reproductive and sexual organs, such as the uterus, cervix, fallopian tubes, and ovaries.

What Pelvic Ultrasound Detects

This imaging technique can uncover critical information about a woman’s reproductive health. It may detect abnormalities such as fibroids and cysts, identify the cause of pelvic pain, track the health and development of an early pregnancy, and assist in the diagnosis of infertility. This procedure typically lasts between 15 to 30 minutes and is painless.

Transvaginal Ultrasounds During Pregnancy

Doctors may perform such an ultrasound if the pregnancy is high-risk, if there is reason to believe it is an ectopic pregnancy, and to evaluate the location of the pregnancy. If there is a vaginal bleeding during early pregnancy, an ultrasound can assess the pregnancy viability. An early pregnancy transvaginal ultrasound also determines the gestational age of the pregnancy helping to work out the due date of the baby. Some women may experience slight discomfort during the procedure, but it is usually not painful.

Why a Doctor Would Recommend a Pelvic Ultrasound

There are a variety of reasons a doctor may recommend an ultrasound. If a patient presents with various symptoms, ultrasound is typically the first diagnostic tool they will use after performing a pelvic examination.

Ultrasounds are the gold standard when it comes to monitoring the development of an embryo during pregnancy, as they are safe and non-invasive for the mother and the baby.

Doctors can also use ultrasound to detect intrauterine devices (IUDs), and assess for pelvic inflammatory disease, endometriosis, fibroids, or ovarian cysts.

Symptoms which may warrant a pelvic ultrasound:

  • Heavy menstrual bleeding
  • Extremely painful periods
  • Chronic pelvic pain
  • Painful intercourse
  • Spotting vaginally between periods
  • Unexplained vaginal bleeding
  • Abnormal bloating
  • Infertility or reduced fertility
  • Post menopausal bleeding

Organs Visible in a Transvaginal Pelvic Ultrasound

As technology has advanced, ultrasound has come to provide doctors with detailed imagery of various organs in a woman’s pelvis. With the help of an ultrasound, doctors can examine the pelvic organs for any abnormalities, assess their size, shape, and structure, and monitor their functioning.

Organs visible during the examination:

  • Uterus
  • Fallopian tubes
  • Ovaries
  • The cervix
  • The bladder

Pelvic Ultrasound Preparation

If you’re expected to attend a pelvic ultrasound, there are a few things to know about prepping. Typically you do NOT have to drink water before the ultrasound. You will be asked to urinate before the ultrasound. A full bladder is not necessary when having a transvaginal ultrasound scan.

Observing Scar Tissue

While ultrasound produces images of the organs and their structures, it may struggle to visualise scar tissue. Minor scar tissue results from surgeries like C-sections or hysterectomies may not be clearly seen using ultrasound. Ultrasound is more adept at detecting excessive scar tissue, such as that found in severe cases of endometriosis (especially when recto-uterine adhesions are noted). However, if the scarring is minimal, the doctor will have to scan the area slowly and meticulously to detect it.

Endometriosis Visibility on an Ultrasound

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. This tissue can sometimes be detected with an ultrasound, although that depends on the severity of the condition. The endometrial-like tissue can result in scar tissue and adhesions; the more extensive these masses are, the more likely they will be visible.

Endometrioma Detection

Transvaginal ultrasound is particularly effective in detecting endometriomas (cysts related to endometriosis) and deep endometriosis as well as adenomyosis; but may not detect superficial endometriosis. Transvaginal ultrasound in experienced hands is a very powerful tool in the non-invasive diagnosis of endometriosis.

Detecting Pelvic Inflammatory Disease

Pelvic inflammatory disease, or PID, is an infection of the female reproductive organs. The infection can spread to one or more of these organs, from the ovaries to the fallopian tubes or uterus. While some women may not experience symptoms initially, if it is left untreated, it may cause abscesses and swollen Fallopian tubes to develop. These abscesses and swollen Fallopian tubes can be visible in an ultrasound; in instances where they are not, additional tests may be required to diagnose PID.

Recognising Pelvic Congestion Syndrome

Pelvic congestion syndrome (PCS) is another painful gynaecological condition that many women suffer from. It is caused by varicose veins in the pelvic area or lower abdomen. It is often visible in a transvaginal ultrasound where enlarged twisted veins are visible in the pelvic cavity. If these veins lose function, blood may build up inside them. As a result, the pelvic veins may change shape or become enlarged, similar tovaricose veins.

Identifying Fibroids

Fibroids, also known as leiomyomas, are growths of the uterus, are rarely cancerous and appear as round, well-defined masses within the uterine wall. These masses are

typically visible on a pelvic ultrasound, although this accuracy may be influenced by various factors such as the size and location of the fibroid, the skill and experience of the sonographer, and the quality of the ultrasound machine. For complex cases, additional imaging tests like an MRI may be necessary for a more accurate diagnosis.

The Procedure is Safe

Because ultrasound is non-invasive and does not expose patients to radiation, it is considered a very safe procedure. Unlike other imaging methods, such as X-rays, CT scans, and MRIs, which rely on radiation, ultrasound uses sound waves. These soundwaves are even safe for mothers and their developing fetuses.

One Minor Ultrasound Risk

The only potential risk an ultrasound may pose is an allergic reaction to the water-based gel applied to the abdomen or some discomfort during a transvaginal ultrasound. If you are expected to attend a pelvic ultrasound, any questions you may have can be directed to your healthcare provider before the procedure.

The Cost of a Pelvic Ultrasound in Sydney

The cost of an ultrasound in Sydney can vary significantly based on the facility, whether or not the patient has healthcare coverage, and what type of ultrasound is being performed. On average, if you’re paying out-of-pocket without insurance, you can expect to pay anywhere from $285 AUD to $450 AUD. OMNI offers very competitive rates, which start at an out-of-pocket cost of 194.95 AUD (compared to $294.65 at other sites). The out-of-pocket costs for an early pregnancy ultrasound begin at 195 AUD.

Ask For a Quote

For an accurate quote, the best solution is to ask your doctor exactly what kind of ultrasound is required, as there is a large variety depending on the patient’s needs. Following this, it is advisable to ensure your Medicare will cover the procedure and whether there are any additional requirements to provide coverage. For those who are not covered by Medicare, the cost of a pelvic ultrasound starts from $285 AUD.

A pelvic ultrasound is an invaluable tool in assessing women’s reproductive health. It is effective in detecting a variety of conditions, and it is the first diagnostic imaging tool doctors suggest as it is safe and non-invasive. In some cases, other diagnostic procedures may be required to get a definitive diagnosis of certain conditions. If you’re scheduled to have a pelvic ultrasound in Sydney, follow your healthcare provider’s instructions to prepare adequately. An informed patient is always her own best advocate.

OMNI Ultrasound & Gynaecological Care

Condous performs Advanced Endosurgery procedures for women needing intervention for pelvic masses, adnexal pathology, severe endometriosis or hysterectomy. He also runs ‘Hands on’ Live Sheep Laparoscopic Workshops for gynaecologists at Camden Veterinarian School.
Having completed an undergraduate degree with the University of Adelaide, he left Australia in 1993 and moved to London where he completed his training in Obstetrics and Gynaecology. From 2001 to 2003 Condous worked as a Senior Research Fellow at St George’s Hospital, London. At St George’s he set up the Acute Gynaecology Unit, the first in the United Kingdom. It was also during this time that he developed an interest in Early Pregnancy and especially the management of pregnancies of unknown location (PULs). Condous has developed many mathematical models for the prediction of outcome of PULs which have been featured in numerous peer review journals. In 2005, he returned to Australia where he completed his Laparoscopic Fellowship at the Centre for Advanced Reproductive Endosurgery, Royal North Shore, Sydney.

Condous was appointed as a Consultant Gynaecologist and Senior Lecturer at Nepean Hospital in 2006 and soon was made Associate Professor. In 2010, he was made Departmental Head of Obstetrics and Gynaecology at Nepean Hospital. He obtained the MRCOG in 1999 and was made FRANZCOG in 2005. In 2009, he was awarded his Doctorate in Medicine (MD), University of London, for his thesis entitled: “The management of pregnancies of unknown location and the development of new mathematical models to predict outcome”.

Condous has edited three books including the “Handbook of Early Pregnancy Care”, published over 100 papers in international journals and is internationally renowned for his work in Early Pregnancy. He is the Associate Editor for Gynaecologic Obstetric Investigation, which is a European based journal, as well as the Australasian Journal of Ultrasound in Medicine (AJUM). He is on the organising committee and is an invited speaker at the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) Scientific meeting in Sydney 2013. His current research interests relate to the management of ectopic pregnancy, 1st trimester growth, PULs and miscarriage and the use of transvaginal ultrasound (in particular sonovaginography, to predict posterior compartment deep infiltrating rectovaginal endometriosis).Condous is also actively involved with post-graduate education including the annual running of the Early Pregnancy and Gynaecological Ultrasound Interactive Courses for Sonologists, Radiologists, Sonographers and Gynaecologists in Australia.