Patient Information: Gynaecological Ultrasound and Saline Infusion Sonography

Preparation 

Vaginal ultrasound almost always allows clearer views of the pelvic organs. Most gynaecological ultrasounds are therefore performed transvaginally. There is no preparation for this ultrasound. A narrow, gel covered probe is gently introduced into the vagina. Most patients experience no pain or only very mild discomfort. You will be asked to empty your bladder before the scan for your comfort as well as to optimise our views.
The examination takes approximately 10-20 minutes. 

If you feel uncomfortable about having a vaginal ultrasound or if you have never had sexual intercourse, in which case a vaginal scan is not advisable, the doctor will perform a transabdominal scan only. This means that we put gel on your tummy and look at the uterus and the ovaries through the tummy wall. A full bladder will make the images obtained from the abdominal scan as clear as possible. Usually the fuller the bladder, the better the views. Please advise our staff when booking your appointment that you want a transabdominal scan only.

When should the ultrasound be done? 

If the ultrasound is done to determine the cause of abnormal bleeding, our preference is to perform the scan shortly after the period has finished. The lining of the uterus is then thin and pathology can more easily be seen. Just before a period, the lining of the uterus is thick and appears quite bright on ultrasound. Some causes of abnormal bleeding, such as small polyps can then be missed and a reassessment just after the period may be necessary. 

If the ultrasound is done for another reason such as pain, absence or irregular periods, possible fibroids, subfertility or suspected pelvic mass or ovarian cyst, it can be organised at any time during the menstrual cycle, even when you are bleeding. It is not necessary to change your appointment if this happens, unless you feel uncomfortable having a vaginal scan then.

Are additional tests sometimes needed? 

Sometimes it becomes obvious during the ultrasound examination that a Saline Infusion Sonography or SIS would give important additional information. SIS is basically an ultrasound performed after a little saline (salt water) has been injected into the uterine cavity via a fine plastic catheter that is passed through the cervix. The discomfort is similar to that of a PAP smear. The saline dilates the uterine cavity slightly and outlines the lining of the uterus well, making it easier to detect certain pathology like polyps. 

An SIS is rarely necessary, but if it would be beneficial, we will discuss the test in detail with you. This will allow you to make an informed decision as to whether you want to have the test or not. 

Results

Because at Women’s Scan Room the doctor personally performs the ultrasound examination, the results can be discussed with you during and after the examination. Don't hesitate to ask questions. Abnormal results requiring more urgent attention will promptly be discussed with your referring gynaecologist. Some doctors receive the report electronically in which your doctor will have the result the same day. Otherwise a written copy of the result is sent in the mail and should reach your doctor 2 days after your ultrasound. Please advise us if you see your doctor earlier than that so we can fax the results.