Transvaginal Ultrasound

Author: Dr Monica Pahuja*

What is a transvaginal ultrasound?

A transvaginal ultrasound examination involves an ultrasound undertaken through the use of an intravaginal probe. It allows detailed assessment of the uterus (including endometrium), cervix, fallopian tubes and ovaries. It is of particular value when a transabdominal pelvic scan is suboptimal due to an undistended bladder, excess pelvic bowel gas or in obese patients.

What are the generally accepted indications for a transvaginal ultrasound?

There are many reasons for which transvaginal ultrasound might be a useful examination:


  • pelvic pain or intermenstrual vaginal bleeding;
  • post-menopausal bleeding;
  • assessment of endometrium;
  • presence of polyps or fibroids;
  • ovarian cysts or tumours;
  • screening for ovarian cancer.


  • assessment for suspected polycystic ovaries;
  • assessment of ovarian stimulation during in vitro fertilisation procedures.


  • assessment of early pregnancy (dating);
  • first trimester bleeding: possible miscarriage;
  • suspected ectopic pregnancy.

What are the prerequisites for having a transvaginal ultrasound done?

If you are referring a patient for a transvaginal ultrasound examination, it is valuable to include: a concise, relevant clinical history, including pregnancy status, date of last menstrual period and relevant recent pathology or imaging results. Ensure that the patient attends the ultrasound department with all prior imaging studies for comparison.

What are the absolute contraindications for a transvaginal ultrasound?

  • Paediatric age group.
  • Premature rupture of the membranes.
  • Bleeding associated with known placenta praevia.
  • Patient refusal to sign consent despite informed discussion with the sonographer.

What are the relative contraindications for a transvaginal ultrasound?

  • Virginal status.
  • Vaginitis: this might cause increased patient discomfort.

What are the adverse effects of a transvaginal ultrasound?

Assuming that examinations are carried out at accredited sites using trained sonographers, then there are no adverse effects of a transvaginal ultrasound.

Are there alternative imaging tests, interventions or surgical procedures to a transvaginal ultrasound?

In the appropriate clinical settings, CT and/or MRI can be used in assessing the local extent of gynaecological pathology.

Further information about transvaginal ultrasound:

Please advise the radiologist of the date of the last period and if there is a history of gynaecological surgery, as well as the nature of this surgery.

Useful websites about transvaginal ultrasound:

Australian Society for Ultrasound in Medicine Website:

*The author has no conflict of interest with this topic.

Page last modified on 31/8/2017.

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