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To examine the lower abdomen and pelvis for abnormalities, a doctor may recommend a pelvic ultrasound. Often requested to observe the reproductive and urinary systems in more detail, this noninvasive imaging procedure uses soundwaves to take pictures and looped video of the body’s internal organs.

What Is a Pelvic Ultrasound?

Also known as ultrasound scanning or sonography, this procedure uses sonar technology to identify any abnormalities. First, a water-based gel is applied to the area being examined, so the soundwaves can travel through the skin. A small hand-held transducer transmits high-frequency, inaudible soundwaves.

Once the soundwaves hit an object, they bounce back and send data to a computer for analysis. From here, generated images get displayed on a monitor. Ultrasound technology can capture detail down to the cellular level and allows for imaging in real time.

The technology can assess the quality of the organ or tissue being examined and, as a result, can identify if something is solid or fluid-filled.

Another option, Doppler ultrasound may be requested. Often used to observe the speed and direction of blood circulation, Doppler ultrasounds can detect changes in pitch as the soundwaves return. As information is gathered, colored pictures and graphs illustrate blood flow through that area of the body.

In general, pelvic ultrasounds do not involve needles or injections and the procedure is relatively cost effective compared to other imaging methods. Particularly, the information gathered offers more detail of soft tissue than X-ray imaging, making it ideal for:

  • Identifying urinary and reproductive system disorders in their early stages, reducing the need for exploratory surgery
  • Monitoring pregnant women and their unborn babies
  • Guiding more invasive procedures like biopsies

Who Should Have This Procedure?

Pelvic ultrasound may be requested for female patients to observe the uterus, cervix, ovaries, fallopian tubes or bladder, as well as a developing embryo or fetus if she’s pregnant. Two and three-dimensional imaging helps identify the source or presence of:

  • Pelvic pain
  • Abnormal vaginal bleeding
  •  Menstrual issues
  • Ovarian cysts
  • Uterine fibroids
  • Ovarian and uterine cancers
  • Uterine abnormalities and scars
  • Endometrial polyps
  • Fibroids
  • Abnormal uterine bleeding

A doctor may also request a transvaginal ultrasound to examine the endometrium, the ovaries and muscles inside the uterus. Sonohysterography, or 3D ultrasound imaging, may further be used to examine the outside shape of the uterus and other irregularities.

For males, this procedure is used to observe the bladder, seminal vesicles and prostate. A transrectal ultrasound may be requested to examine the prostate gland in more detail.

For both sexes, doctors may request this procedure to:

  • Identify the presence or source of kidney stones, bladder tumors and urinary disorders.
  • Evaluate pelvic masses and pain, ambiguous genitalia and early or delayed puberty in children.
  • Guide a needle to extract cells during a biopsy.

Additionally, a Doppler ultrasound of the pelvis may be requested to identify blood clots, narrowing blood vessels, tumors and congenital vascular malformations, as well as reduced, increased or absent blood flow.


Ultrasounds require minimal preparation. Some patients may be asked to drink water ahead of time to fill their bladder. Jewelry and other metal objects should be left at home.

The patient lies on a table that may be angled or moved during the procedure. Although you’ll start on your back, you may be asked to turn to the side to capture images at certain angles. Each type of pelvic ultrasound – transabdominal, transvaginal and transrectal – unfolds differently.


  • A sonographer applies the gel to your abdomen and will move the transducer back and forth over the area.
  • Once the procedure is done, the gel is wiped off and any residue will dry.


  • This procedure, requested to identify the source of pelvic pain, requires the patient to first empty her bladder. Then, a transducer is covered, lubricated and inserted two to three inches into the vagina.
  • Although most patients remain on their backs, you may need to put your feet in stirrups.


  • A protective cover is placed over the transducer before it’s inserted into the rectum. The procedure feels similar to a rectal exam performed by your doctor.
  • If a biopsy is also being performed, this will add time to the procedure.
  • For this type of pelvic ultrasound, a patient lies on his side, facing away from the radiologist, with his knees or hips flexed slightly.

Following all pelvic procedures, patients may resume their normal day-to-day activities. In the meantime, the radiologist reviews the images and discusses the results with your doctor. You may be asked to come in for a follow-up visit or undergo additional imaging.
Has your doctor recommended a pelvic ultrasound? Contact us to make an appointment today!