Ключевые выводы
- A pelvic ultrasound is a safe, painless imaging exam that uses sound waves to produce real-time images of the uterus, ovaries, fallopian tubes, cervix, and bladder without any radiation exposure
- There are two main types: transabdominal ultrasound (performed over the lower abdomen with a full bladder) and transvaginal ultrasound (using a slim internal probe for higher-resolution images of the reproductive organs)
- Common reasons women need a pelvic ultrasound include abnormal bleeding, pelvic pain, ovarian cyst evaluation, fibroid assessment, fertility investigation, and early pregnancy confirmation
- Preparation depends on the type of scan: a transabdominal ultrasound requires drinking 1 to 1.5 liters of water one hour before the appointment to fill the bladder, while a transvaginal ultrasound requires an empty bladder
- DCDC in Dubai Healthcare City offers both transabdominal and transvaginal pelvic ultrasound with same-day results reported by experienced consultant radiologists
A pelvic ultrasound is one of the most commonly performed diagnostic imaging examinations for women. It uses high-frequency sound waves to create detailed, real-time images of the pelvic organs, including the uterus, ovaries, fallopian tubes, cervix, and bladder. Unlike X-rays or CT scans, pelvic ultrasound involves no ionizing radiation, making it one of the safest imaging modalities available. Whether your doctor has ordered a pelvic scan to investigate abnormal bleeding, evaluate pelvic pain, monitor ovarian cysts, assess fibroids, or check on an early pregnancy, understanding what the examination involves can help you feel informed and prepared.
This guide covers everything women need to know about pelvic ultrasound: the two main types (transabdominal and transvaginal), when a pelvic ultrasound is recommended, how to prepare for the exam, what the scan can detect, how to understand your results, and the cost of a pelvic ultrasound in Dubai at Doctors Clinic Diagnostic Center (DCDC) in Dubai Healthcare City.
What Is a Pelvic Ultrasound?
A pelvic ultrasound is a non-invasive imaging examination that uses a device called a transducer to send high-frequency sound waves into the body. These sound waves bounce off internal organs and tissues, and the returning echoes are converted by a computer into real-time images displayed on a monitor. The technique allows the sonographer and radiologist to visualize the size, shape, position, and internal structure of the pelvic organs without any incision, injection, or radiation exposure.
Pelvic ultrasound is the first-line imaging investigation for the majority of gynecological conditions. The American College of Obstetricians and Gynecologists (ACOG) recommends pelvic ultrasound as the initial imaging modality for evaluating abnormal uterine bleeding, adnexal masses, pelvic pain, and infertility. The examination is widely available, relatively inexpensive compared to MRI or CT, completely painless for most women, and provides immediate diagnostic information that guides clinical decision-making.
There are two primary approaches to performing a pelvic ultrasound in women: transabdominal ultrasound, in which the transducer is placed on the surface of the lower abdomen, and transvaginal ultrasound, in which a slim, specially designed probe is gently inserted into the vaginal canal. In many cases, both approaches are used during the same appointment to provide complementary information. Transabdominal scanning gives a broader overview of the pelvic anatomy, while transvaginal scanning offers superior close-up resolution of the uterus, endometrium, ovaries, and surrounding structures.
"Pelvic ultrasound remains the cornerstone of gynecological imaging because it is safe, highly informative, and can be performed quickly at the point of care," says Dr. Osama Elzamzami, Head of Radiology at DCDC. "For most women presenting with pelvic symptoms, ultrasound provides all the diagnostic information needed to guide the next step in their care."
Transabdominal vs Transvaginal Ultrasound
Understanding the difference between transabdominal and transvaginal ultrasound helps women know what to expect and why their doctor may recommend one approach over the other, or both. Each technique has distinct strengths, and the choice depends on the clinical question, the patient's anatomy, and the level of detail required.
Transabdominal Pelvic Ultrasound
In a transabdominal pelvic ultrasound, the sonographer applies a water-based gel to the lower abdomen and moves a curved transducer over the skin surface. The gel eliminates air between the transducer and the skin, allowing the sound waves to travel efficiently into the body. The examination requires a full bladder, which serves as an acoustic window: the fluid-filled bladder pushes bowel loops out of the pelvis and transmits ultrasound waves more effectively, providing a clearer view of the uterus and ovaries behind it.
Transabdominal ultrasound provides a wide field of view that is particularly useful for assessing large pelvic masses, bulky fibroids, or organs that extend above the pelvic brim. It is also the preferred approach for women who have never been sexually active, adolescents, and any patient who prefers not to have an internal examination. The trade-off is that image resolution is lower than transvaginal scanning because the sound waves must travel a greater distance through the abdominal wall.
Transvaginal Pelvic Ultrasound
A transvaginal ultrasound uses a slim, cylindrical transducer (approximately 2 to 3 centimeters in diameter) that is covered with a disposable latex-free sheath and a small amount of lubricating gel. The probe is gently inserted into the vaginal canal, placing it in close proximity to the uterus, ovaries, and fallopian tubes. Because the transducer is closer to the organs of interest, transvaginal ultrasound produces significantly higher-resolution images than transabdominal scanning.
Transvaginal ultrasound is the gold standard for evaluating the endometrial lining (thickness, pattern, and focal abnormalities), detecting small ovarian cysts, identifying early intrauterine pregnancies (as early as 5 weeks gestation), diagnosing ectopic pregnancy, and characterizing adnexal masses. It does not require a full bladder; in fact, the bladder should be empty for optimal image quality. Most women describe the procedure as mildly uncomfortable but not painful, and it typically takes 10 to 20 minutes to complete.
"We often perform both transabdominal and transvaginal ultrasound in the same session," says Dr. Osama Elzamzami, Head of Radiology at DCDC. "The transabdominal scan gives us the big picture, and the transvaginal scan gives us the fine detail. Together, they provide a comprehensive assessment that maximizes diagnostic accuracy."
| Feature | Transabdominal Ultrasound | Transvaginal Ultrasound |
|---|---|---|
| Probe placement | On the surface of the lower abdomen | Gently inserted into the vaginal canal |
| Bladder requirement | Full bladder required | Empty bladder required |
| Image resolution | Good overview but lower resolution | Superior close-up resolution |
| Best for | Large masses, fibroids, broad pelvic overview | Endometrial assessment, small cysts, early pregnancy, ectopic pregnancy |
| Patient comfort | No internal examination; pressure from full bladder | Mild internal pressure; no full bladder discomfort |
| Duration | 10-15 minutes | 10-20 minutes |
| Suitable for virgins | Yes | No (transabdominal used instead) |
| Radiation exposure | None | None |
Comparison of transabdominal and transvaginal pelvic ultrasound approaches. Your radiologist will recommend the most appropriate technique based on your clinical needs.
When Do Women Need a Pelvic Ultrasound?
A pelvic ultrasound is recommended whenever a healthcare provider needs to visualize the female reproductive organs or bladder to investigate symptoms, monitor known conditions, or guide treatment decisions. The following are the most common clinical indications for a pelvic ultrasound in women:
Abnormal Uterine Bleeding
Abnormal uterine bleeding is the single most common reason women are referred for a pelvic ultrasound. This includes heavy menstrual periods (menorrhagia), bleeding between periods (metrorrhagia), irregular cycles, and postmenopausal bleeding. Ultrasound can identify structural causes such as uterine fibroids, endometrial polyps, endometrial thickening (hyperplasia), and adenomyosis. The Royal College of Obstetricians and Gynaecologists recommends transvaginal ultrasound as the first investigation for all women presenting with postmenopausal bleeding, because measuring the endometrial thickness can help rule out endometrial cancer.
Pelvic Pain
Acute or chronic pelvic pain is another frequent indication. Ultrasound helps identify ovarian cysts (simple, complex, or hemorrhagic), ovarian torsion, ruptured cysts, pelvic inflammatory disease, tubo-ovarian abscess, endometriomas (chocolate cysts associated with endometriosis), and ectopic pregnancy. In emergency settings, a pelvic ultrasound can be performed rapidly to guide urgent clinical decisions.
Ovarian Cyst Monitoring
Many ovarian cysts are discovered incidentally or during routine examinations. Most simple cysts in premenopausal women are functional (follicular or corpus luteum cysts) and resolve spontaneously within one to three menstrual cycles. Pelvic ultrasound is used to monitor these cysts at follow-up intervals, typically 6 to 12 weeks after the initial scan, to confirm resolution. Complex cysts, persistent cysts, or cysts with worrisome features (thick septations, solid components, internal blood flow) require closer follow-up or further investigation.
Uterine Fibroids
Uterine fibroids (leiomyomas) are benign muscular tumors of the uterus that affect up to 70 percent of women by age 50. Pelvic ultrasound is the primary imaging tool for diagnosing fibroids, determining their number, size, and location (submucosal, intramural, or subserosal), and monitoring growth over time. This information is essential for gynecologists to decide whether a fibroid requires medical treatment, surgical intervention (myomectomy or hysterectomy), or observation alone.
Fertility Assessment
For women undergoing fertility evaluation, pelvic ultrasound plays a central role. It is used to perform an antral follicle count (AFC), which is a key marker of ovarian reserve. Ultrasound also monitors follicular development during ovulation induction cycles, confirms ovulation, assesses the endometrial lining thickness and pattern before embryo transfer in IVF, and identifies structural abnormalities such as uterine septum, polyps, or hydrosalpinx that may impair fertility.
Early Pregnancy
Pelvic ultrasound, particularly transvaginal ultrasound, is used in early pregnancy to confirm an intrauterine pregnancy, determine gestational age, detect the fetal heartbeat, identify multiple pregnancies (twins or more), and rule out ectopic pregnancy and molar pregnancy. The earliest a pregnancy can be visualized on transvaginal ultrasound is typically around 5 weeks gestation, when the gestational sac becomes visible.
Intrauterine Device (IUD) Check
Ultrasound is routinely used to confirm the correct position of an intrauterine device after insertion, or to investigate suspected displacement or migration. The scan verifies that the IUD is properly seated within the uterine cavity and has not perforated the uterine wall or migrated into the cervical canal.
Book a Pelvic Ultrasound at DCDC
At Doctors Clinic Diagnostic Center in Dubai Healthcare City, our radiology team provides expert pelvic ultrasound services with both transabdominal and transvaginal techniques. Get accurate results reported by experienced consultant radiologists, with same-day availability.
How to Prepare for a Pelvic Ultrasound
Proper preparation for a pelvic ultrasound depends entirely on which type of scan has been requested. Correct preparation ensures the best possible image quality and avoids the need to repeat the examination. Here is what you need to do for each type:
Preparation for Transabdominal Pelvic Ultrasound
- Drink water: Drink approximately 1 to 1.5 liters (4 to 6 glasses) of water starting one hour before your appointment. Do not empty your bladder after drinking. A full bladder is essential because it acts as an acoustic window, allowing the ultrasound waves to pass through and produce clear images of the uterus and ovaries.
- Timing matters: Start drinking water approximately 60 minutes before your scheduled scan time. If your bladder fills too early, you may experience significant discomfort. If you drink too late, the bladder may not be adequately full by the time of the scan.
- Wear comfortable clothing: Wear a two-piece outfit so you can easily expose the lower abdomen without fully undressing. You will be asked to lower your waistband to your hip bones.
- No fasting required: You can eat normally before a pelvic ultrasound. There is no need to fast unless you have also been scheduled for an abdominal ultrasound on the same day, in which case fasting instructions will be provided separately.
Preparation for Transvaginal Pelvic Ultrasound
- Empty your bladder: Unlike the transabdominal approach, a transvaginal ultrasound requires an empty bladder. A full bladder can push the uterus and ovaries away from the probe, reducing image quality. You will be asked to use the restroom immediately before the scan.
- No special preparation: There is no need to douche, use any special cleansing products, or refrain from using tampons before the examination. Simply come with an empty bladder.
- Menstruation is not a barrier: A transvaginal ultrasound can be performed during menstruation if clinically necessary. However, for non-urgent scans, some women prefer to schedule the appointment outside of their menstrual period for comfort.
- Inform the team: Let the reception staff or sonographer know if you have a latex allergy, as the transducer cover can be changed to a non-latex alternative.
If Both Scans Are Performed Together
When both transabdominal and transvaginal ultrasound are performed in the same session, the transabdominal scan is done first with a full bladder, followed by the transvaginal scan after you have emptied your bladder. This sequence is the most efficient way to obtain both sets of images in a single visit.
"One of the most common reasons we need to repeat a pelvic ultrasound is inadequate bladder preparation," says Dr. Osama Elzamzami, Head of Radiology at DCDC. "Taking the time to drink enough water and arriving with a comfortably full bladder makes a significant difference in the quality of the images we can produce."
What Does a Pelvic Ultrasound Show?
A pelvic ultrasound provides detailed information about the structure, size, and condition of the female pelvic organs. The radiologist evaluates multiple parameters during the examination, and the findings are documented in a comprehensive report sent to the referring physician. Here is what a pelvic ultrasound can show:
- Uterus: Size, shape, position (anteverted or retroverted), myometrial texture, and the presence of fibroids (with their number, size, and location classified as submucosal, intramural, or subserosal)
- Endometrium: Endometrial thickness, pattern (trilaminar in the proliferative phase, echogenic in the secretory phase), and focal abnormalities such as polyps, hyperplasia, or suspicious thickening
- Ovaries: Size, volume, follicle count, presence of cysts (simple, hemorrhagic, dermoid, endometrioma), solid masses, and blood flow patterns assessed by Doppler ultrasound
- Fallopian tubes: Normal fallopian tubes are not typically visible on ultrasound. However, dilated tubes (hydrosalpinx or pyosalpinx) and tubal ectopic pregnancies can be detected
- Cervix: Cervical length, cervical canal, and the presence of Nabothian cysts or cervical masses
- Bladder: Bladder wall thickness, residual urine volume after voiding, and the presence of bladder masses or stones
- Free fluid: The presence and quantity of free fluid in the cul-de-sac (pouch of Douglas), which may indicate a ruptured cyst, ovulation, ectopic pregnancy, or pelvic inflammatory disease
- Pelvic masses: Any abnormal mass in the pelvis, with assessment of its origin, size, internal characteristics (solid, cystic, mixed), and blood flow on Doppler imaging
Patient Story: Pelvic Ultrasound Identifies a Hidden Fibroid
A 38-year-old woman in Dubai had been experiencing progressively heavier menstrual periods for over a year. Her gynecologist performed a clinical examination and noted that the uterus felt slightly enlarged, but the cause was not clear from the physical exam alone. She was referred to DCDC for a pelvic ultrasound.
The transabdominal scan confirmed that the uterus was enlarged, but it was the transvaginal ultrasound that revealed the critical finding: a 4-centimeter submucosal fibroid protruding into the uterine cavity. Submucosal fibroids, even when relatively small, are the type most likely to cause heavy bleeding because they distort the endometrial lining. The ultrasound also showed that the endometrial thickness was normal and both ovaries were healthy, ruling out other potential causes of her symptoms.
Armed with the precise ultrasound measurements and the detailed radiology report from DCDC, her gynecologist was able to recommend a targeted treatment plan: a hysteroscopic myomectomy to remove the fibroid through the cervix, avoiding the need for a larger abdominal surgery. The patient underwent the procedure successfully and reported a return to normal menstrual flow within two cycles.
Understanding Your Pelvic Ultrasound Results
After your pelvic ultrasound, the radiologist reviews all the captured images, measures the relevant structures, and prepares a written report that is sent to your referring doctor. Understanding what the key findings in this report mean can help you have a more productive conversation with your healthcare provider.
Normal Findings
A normal pelvic ultrasound report typically describes a uterus of normal size (approximately 7 to 8 cm in length in reproductive-age women) with a smooth myometrial texture, an endometrial thickness appropriate for the phase of the menstrual cycle (4 to 8 mm in the proliferative phase, up to 14 mm in the secretory phase), two ovaries of normal size (approximately 3 to 5 cm in longest diameter) with a normal number of small follicles, no free fluid or a small physiological amount in the cul-de-sac, and a normal bladder. A normal report is reassuring and typically means no further imaging is needed.
Common Abnormal Findings
- Uterine fibroids: Described by their number, size (in centimeters), and location. Small asymptomatic fibroids may require only monitoring. Fibroids causing heavy bleeding or pelvic pressure may warrant treatment.
- Ovarian cysts: Simple cysts with thin walls and clear fluid are almost always benign and often resolve without treatment. Complex cysts with thick walls, septations, or solid components require further evaluation and possible follow-up imaging.
- Endometrial thickening: An endometrial thickness greater than 4 to 5 mm in a postmenopausal woman, or a significantly thickened endometrium in a premenopausal woman with abnormal bleeding, may prompt further investigation such as an endometrial biopsy.
- Endometrial polyps: These appear as focal thickenings or small masses within the endometrial cavity, often best seen on transvaginal ultrasound. They are a common cause of abnormal bleeding and can usually be removed hysteroscopically.
- Adenomyosis: Characterized by a diffusely enlarged, globular uterus with a heterogeneous myometrial texture. Adenomyosis is a condition in which endometrial tissue grows into the muscular wall of the uterus and causes heavy, painful periods.
- Free fluid: A small amount of free fluid in the pelvis after ovulation is normal. Larger volumes of free fluid may indicate a ruptured cyst, ectopic pregnancy, or infection and require clinical correlation.
When Further Imaging Is Recommended
In some cases, the pelvic ultrasound report may recommend additional imaging. An MRI may be suggested for complex fibroids before surgical planning, for indeterminate ovarian masses, or when endometriosis involving deep tissues is suspected. A saline infusion sonography (SIS) may be recommended to better evaluate endometrial polyps or submucosal fibroids. A follow-up ultrasound may be advised at a specific interval to monitor a cyst or other finding. Your referring doctor will discuss these recommendations with you and explain the next steps in your care.
"The ultrasound report is a critical communication tool between the radiologist and the referring doctor," says Dr. Osama Elzamzami, Head of Radiology at DCDC. "At DCDC, we structure our reports to give your doctor clear, actionable information, including precise measurements, a differential diagnosis, and specific follow-up recommendations when needed."
Pelvic Ultrasound Cost in Dubai
The cost of a pelvic ultrasound in Dubai varies depending on the type of scan performed, the facility, and whether the examination is covered by insurance. Here is a general guide to pelvic ultrasound pricing in Dubai:
- Transabdominal pelvic ultrasound: AED 300 to AED 800 at most diagnostic imaging centers in Dubai
- Transvaginal ultrasound: AED 400 to AED 1,000, reflecting the higher diagnostic detail and expertise required
- Combined transabdominal and transvaginal ultrasound: AED 500 to AED 1,200, often the most cost-effective option when both approaches are clinically indicated
At DCDC in Dubai Healthcare City, pelvic ultrasound pricing includes the scan, the radiologist's interpretation, and a detailed written report. Most major insurance plans accepted in the UAE cover pelvic ultrasound when it is medically indicated and accompanied by a physician referral. The reception team at DCDC can verify your insurance coverage and provide a cost estimate before your appointment.
Several factors influence the total cost of a pelvic ultrasound: the type of scan (transabdominal only, transvaginal only, or combined), whether Doppler assessment is included, the experience and qualifications of the reporting radiologist, and the location and accreditation of the facility. It is worth noting that the lowest price does not always represent the best value. The accuracy of the examination depends heavily on the skill of the sonographer performing the scan and the expertise of the radiologist interpreting the images.
For a broader overview of ultrasound pricing across different body areas, see our detailed guide on ultrasound cost in Dubai.
Get Expert Pelvic Ultrasound at DCDC
DCDC in Dubai Healthcare City offers comprehensive pelvic ultrasound services for women, including transabdominal, transvaginal, and Doppler assessments. Our experienced consultant radiologists provide same-day results with detailed reports tailored to your clinical needs.
Or call us directly to schedule your pelvic ultrasound.
Часто задаваемые вопросы
Final Thoughts
A pelvic ultrasound is a safe, radiation-free, and highly informative examination that plays a central role in diagnosing and managing a wide range of gynecological conditions. Whether you are being evaluated for abnormal bleeding, pelvic pain, ovarian cysts, fibroids, fertility concerns, or early pregnancy, pelvic ultrasound provides the real-time imaging your doctor needs to make informed decisions about your care. Understanding the difference between transabdominal and transvaginal approaches, preparing correctly for the examination, and knowing what the results mean puts you in a stronger position as an active participant in your own healthcare.
At Doctors Clinic Diagnostic Center in Dubai Healthcare City, women benefit from expert pelvic ultrasound services performed by experienced sonographers and interpreted by consultant radiologists who specialize in women's imaging. With same-day results, a comfortable and private scanning environment, and a commitment to clear, actionable reporting, DCDC ensures that every patient receives the diagnostic clarity she needs. To learn more about how ultrasound works, visit our guide on what is an ultrasound scan, or read about how to prepare for an ultrasound for additional preparation tips.
Источники и ссылки
Эта статья проверена нашей медицинской командой и ссылается на следующие источники:
- American College of Obstetricians and Gynecologists (ACOG) - Practice Bulletin: Evaluation of the Uterus in Patients With Abnormal Uterine Bleeding
- Royal College of Obstetricians and Gynaecologists - Management of Postmenopausal Bleeding
- RadiologyInfo.org - Ultrasound: Pelvis
- American Institute of Ultrasound in Medicine (AIUM) - Practice Parameter for the Performance of Ultrasound of the Female Pelvis
Медицинский контент на этом сайте проверяется врачами, лицензированными DHA. См. нашу редакционную политику для получения дополнительной информации.
Автор
Dr. Osama Elzamzami
Diagnostic Radiology
MD, FRCR
Dr. Osama Elzamzami is Head of Radiology at DCDC Dubai Healthcare City, specializing in diagnostic imaging including ultrasound, CT, MRI, and interventional radiology.