Transperineal, translabial, and transrectal sonography should be considered alternative approaches for imaging the female pelvis and are particularly useful for evaluation of the postmenopausal uterus, the cervix, and the lower urinary tract.

It is important to be cognizant of the expected changes in order to avoid misinterpreting physiologic changes as pathologic. The appearance of the normal endometrium and ovary varies significantly throughout the menstrual cycle in women of reproductive age. The examination should not be performed on any patient who does not or cannot willingly consent to the procedure, as well as on most virginal patients and those who experience marked discomfort with probe insertion. Not all patients are appropriate candidates for transvaginal examination. Therefore, TVS is considered the optimal sonographic technique with the highest diagnostic yield and should be incorporated into the sonographic examination of the female pelvis unless there are reasons that the transvaginal approach should be avoided. The transvaginal approach allows the probe to be placed closer to the “target organs,” providing higher resolution imaging, but has a limited field of view.īecause of the ability to use higher frequency probes, TVS usually provides the best anatomic detail.

TAS provides a wider field of view and better visualization of superficial structures and large pelvic masses but has limited resolution. Transabdominal sonography (TAS) and transvaginal sonography (TVS) are often complementary, providing different diagnostic information.

Pelvic sonogram