Transvaginal ultrasound: preparation, as do

Ultrasound examination is considered to be one of the most informative and safe methods of studying the internal organs of a person. This comparatively inexpensive method of diagnosis has gained special popularity in connection with the pathologies of the pelvic organs, especially since it can be carried out in various ways, with the aim of getting closer to the organ under investigation. For example, when it comes to women, transvaginal ultrasound is the most informative for studying the internal genitalia of the weaker sex. After all, when you study through the vagina, there is the least amount of obstruction between the sensor and the female organs.

Types of ultrasound: their relevance and safety

Ultrasound diagnosis in recent years is becoming increasingly popular in the work of general practitioners and highly specialized specialists. And this is not surprising, because research with ultrasound, which is generally safe for the human body, helps not only assess the condition of internal organs, if the diagnosis is difficult for doctors, but also to determine the main directions of therapeutic effects and evaluate the effectiveness of treatment.

Examination with ultrasound is considered a safer procedure than a popular X-ray study. Therefore, if there is no need for such a deep penetration of the rays, as in the examination of the bone system, doctors prefer to assign ultrasound.

To carry out ultrasonic diagnostics it is accepted in three ways:

• through the abdominal cavity (transabdominal or abdominal ultrasound) is the most popular and habitual for us method of diagnosis, prescribed equally for women and men due to diseases of various organs, including the brain),
• through the vagina (transvaginal or vaginal ultrasound) is a study assigned only to women to examine organs that are located deep in the body in the distance from the abdominal wall,
• through the rectum (transrectal ultrasound) is the rarest kind of study that can be performed on patients of both sexes, but it is associated with some discomfort and requires careful preparation.

The first type of ultrasound, which has gained popularity among pregnant women and patients with kidney or liver pathologies, seems much safer in terms of what does not require the introduction of the device into the body. Carrying out the procedure of investigation does not cause absolutely no discomfort, especially when it is not required to carry it with a filled bladder, and the harm from ultrasonic rays is minimal.

In transvaginal and transrectal examination, the sensor of the device is inserted into the interior of the body through an appropriate opening, and this fact itself causes caution. Is transvaginal (or transrectal) ultrasound dangerous? What is the probability of internal damage during the procedure? Will not it hurt during the study?

Such questions are quite understandable and logical, although worry about the procedure of transvaginal ultrasound is not particularly worth it. In fact, despite the apparent danger of damage to the internal organs with a careful and professional examination, the risk of any damage is minimal. In addition, the study is not blind, the doctor on the monitor controls the movement of the sensor and controls it so that it does not harm the patient and at the same time get maximum information about the organ of interest.

Probably, the reader will have a question, but why do we need ultrasound types that require penetration into the body if we had previously been treated with usual safe transabdominal ultrasound? The need for transvaginal ultrasound was not accidental. The emergence of this type of diagnosis is associated with an increase in the number of various female diseases and the hidden location of the internal sex organs of the weaker sex, access to which through the vagina gives more accurate information about their size and condition of the mucosa.

Another reason for the prevalence of transvaginal and transrectal ultrasound is the increased percentage of people who are overweight. A thick fat layer on the abdomen can somewhat distort the results of transabdominal ultrasound, especially when it comes to deep-lying organs.

In such situations, when examining women, a doctor rarely questions what kind of research is better: abdominal or transvaginal ultrasound? It is clear that the choice will be for that procedure, which will give more complete and accurate results. So, for example, the same widespread erosion of small sizes can be detected only with the help of transvaginal ultrasound.

Transabdominal ultrasound is carried out mainly if the hospital does not have equipment for specialized studies through the vagina or rectum, and also in those cases when the study through the vagina is impossible.

Indications for the procedure

Transvaginal ultrasound is a procedure that can be prescribed to a woman both for therapeutic and diagnostic purposes and for preventive purposes. The point is that ultrasound diagnostics can detect pathological changes in internal organs at the earliest stages, when other methods of research are not very effective.

For preventive purposes, this procedure is recommended for adult women at least once every 2 years. And after a woman turns 40 years old (and at a mature age the risk of cancer and gynecological pathologies increases significantly), doctors recommend to be examined by ultrasound every year.

As for therapeutic and diagnostic measures, transvaginal ultrasound is most often prescribed for pathologies of the genitourinary system, inflammatory and dysplastic gynecological diseases, suspicion of oncology in the pelvic organs, diagnosis of pregnancy in the first 10-12 weeks. Transvaginal ultrasound may also be prescribed in urgent situations, for example, if it is impossible to establish a source of bleeding from female genital organs.

Let's consider, in what situations the  transvaginal ultrasound of the pelvic organs  gives the maximum benefit:

• when there is pain in the lower abdomen for an unknown reason,
• with complaints of pain during intercourse,
• if the menstrual cycle is disturbed (a woman may complain of a delay in menstruation, their absence for a long time, bleeding in periods between menstruation, too much or, conversely, a short duration of menstrual bleeding)
• when there are suspicious discharges from the female genitalia (bloody veins, smear, purulent discharge with odor, etc.)
• at suspicion on development of an inflammation in internal genitals,
• with suspected benign and malignant neoplasms in the uterus and ovaries, among which the most frequent are myoma, endometriosis and uterine dysplasia, cyst and ovarian cancer, etc.,
• if there is a suspicion of female infertility, if a woman can not become a mother for six months or more, despite regular sex life (determining the shape and features of the ovaries, patency of the fallopian tubes with contrast agents),
• at suspicion on an ectopic pregnancy,
• with bleeding from the genital tract of unknown etiology (helps determine the cause of hemorrhage),
• with suspicion of varicose veins of the pelvis (pathology affects the work of the reproductive organs of a woman, as a violation of blood circulation in the uterus and ovaries provokes malfunctions of the menstrual cycle, regular pain in the lower abdomen and even problems with conception of the child)
• if you suspect a pathology of the urinary system (for example, in cases of violations of the act of urination: pain, delay or incontinence, the appearance of mucus in the urine), in this case, appoint a  transvaginal ultrasound of the bladder.

Transvaginal ultrasound of the intestine  is less often due to violations of defecation. More information in this regard is provided by transrectal examination using ultrasound. But if it is difficult, for example, due to intestinal obstruction or in the presence of tumors (polyps, hemorrhoids), which can be damaged by a tube of an ultrasound device inserted into the rectum, transvaginal examination comes to the rescue. In this case, it is more effective than the abdominal because the large intestine is located near the thin walls of the vagina. An examination of the intestine through the abdominal wall can not give as accurate results as a study from the side of the vagina.

Using transvaginal ultrasound, a procedure for in vitro fertilization (IVF) is also monitored. After all, after the fertilization of the fertilized egg in the female body, all the processes proceed secretly from the human eye and it is possible to trace them safely only through ultrasound.

Transvaginal ultrasound in gynecology

Transvaginal ultrasound is prescribed both for clarification of the alleged diagnosis, and for informational purposes to determine the boundaries, size and condition of specific organs. For example, with its help you can get information about the structure and health of the main reproductive organ of a woman - the uterus. Using vaginal ultrasound, you can measure the length of the cervix, the size and shape of the uterus, the thickness of the mucous layer (endometrium), which constantly changes depending on the phase of the menstrual cycle.

The smallest thickness of the endometrium (of the order of 1 mm) is noted on the 1st and 2nd day of the menstrual cycle. On the 3rd and 4th day it increases to 3-4 mm. Research these days is not very informative. From 5 to 7 days, the thickness of the uterine mucosa can reach 6 mm, and before menstruation - 10-20 mm. In this case, the endometrium should have a uniform structure without any kind of condensation and bulges, which can speak of inflammatory (endometritis) or tumor processes.

Endometritis (inflammation of the uterus) on the screen is seen in the form of an increase in the cavity of the organ, a decrease in the thickness of the mucous membrane with a pronounced heterogeneity of its composition, the accumulation of gas inside the uterus. The comparative characteristic of the wall thickness of the endometrium is performed depending on the phase of the menstrual cycle, otherwise the results will be inaccurate.

Measuring the length of the cervix is important if there is a risk of miscarriage. Normally, the length of the cervix is about 3.5-4 cm.

The diameter of the cervical canal of the cervix is in the range of 2 to 3 mm. In the cervical channel there is a uniform mucous secret. The change in the size of the cervix and the heterogeneity of the mucosal secretions may also indicate inflammatory or malignant processes, or the pathological proliferation of the endometrium of the uterus (endometriosis).

With uterine myoma, the organ is enlarged, its contours are changed, and the neoplasm (nodule) is determined in the muscular layer. The echogenicity of the myoma is different: from the near contour, the sound waves are reflected, and the far contour can not even be seen depending on what lies inside it (these can be cystic formations or seals formed from calcium compounds). Endometriosis reveals vesicular formation, both in the fallopian tubes, and in different parts of the uterus.

Polyposis of the uterus (as well as the intestines) is characterized by volumetric formations inside the organ caused by a viral infection, which, depending on the size and location, may influence its contours somewhat. But in most cases they are defined as rounded comparatively small formations inside the uterus, they are clearly visible in contrasting.

Cancer tumors when viewed with an ultrasound sensor have some similarities with polyps, but inflammatory edema is seen on the tissues near them. Confirm or disprove the diagnosis with biopsy. In this case, a piece of tissue for examination for malignancy is taken right during the diagnostic procedure, the vest at the end of the device has a special channel with a needle to take a biopsy.

According to the results of ultrasound, a cancer tumor of the cervix is defined as a highly echogenous neoplasm with uneven contours. Doctors also note narrowing of the uterine pharynx and an increase in regional lymph nodes. By the exact location of the tumor, it is also possible to determine the depth of penetration of the cancer tumor into the uterine tissue and nearby organs.

Suspicion of uterine cancer occurs when the following symptoms occur: spotting outside menstruation, abdominal pain, blood during copulation, copious watery discharge, swelling of the lower extremities in the absence of pathologies of the heart and kidneys, difficulty in urinating.

The possibilities of carrying out a vaginal ultrasound examination during pregnancy are somewhat limited. Transvaginal ultrasound is performed only in the early stages of pregnancy, until the procedure can not cause uterine contractions and pregnancy disruption. Increased tone of the uterus sonologist (a doctor who conducts ultrasound diagnostics) sees as a local increase in the thickness of the wall of the reproductive organ. But such a study allows you to diagnose pregnancy with great accuracy in the first weeks after conception and track the development of the child in a very responsible first trimester of pregnancy.

The determination of the size of the uterus body plays a role in the diagnosis of pregnancy for a period of 3 weeks or more. Normally, the uterus measures 4.5-6.7 cm (length) by 4.6-6.4 cm (width) and about 3-4 cm in diameter, and if transvaginal ultrasonography reveals deviations from the generally accepted indices, this is an occasion for reflection.

Small size of the uterus creates problems with the bearing of the fetus, and the increased size can speak about the onset of pregnancy. A more thorough examination in the latter case helps to confirm or disprove other possible but less pleasant diagnoses, such as uterine myoma or malignant neoplasms in it.

Starting at week 5, transvaginal ultrasound can be used to determine the heartbeat of a child, which is an important indicator of fetal development.

A large role  transvaginal ultrasound of the uterus and appendages  plays in the diagnosis of infertility. With its help, it is possible to evaluate both the features of the functioning of the ovaries, and the possibility of access to the uterus through the uterine tubes.

The size of the ovaries is in the range (3-4) x (2-3) x (1.5-2.2) cm (length, width, thickness). In the middle of the menstrual cycle, the ovaries should contain several small follicles (egg embryos) up to 6 mm in size and one large to 2 cm. The presence of larger follicles can speak of a follicular cyst.

Large in comparison with the normal size of the ovaries indicate an inflammatory process in them or the presence of neoplasms in the organ.

As for the fallopian tubes, ideally they are hardly visible. To see this organ is possible only through contrasting. If the fallopian tubes can be seen without the use of contrast agents, this indicates an inflammatory process. What is always associated with the increase in the size of organs. Transvaginal ultrasound reveals the presence of liquid secretions in the fallopian tubes (this can be inflammatory exudate, pus, blood).

Another cause of the "growth" of the fallopian tubes can be an ectopic pregnancy, which is associated with obstruction of the organ due to the presence of adhesions, inflammatory process or birth defects (bend, small diameter of some sections of the tube, etc.). Such a study is carried out using contrast agents.

An important factor in the diagnosis of infertility is the location of the uterus. Normally, it should be slightly tilted forward. If such a slope is, but in the other direction (congenital defect), the probability of normal pregnancy is reduced, but there is a risk of developing an ectopic.

With the help of transvaginal ultrasound, fluid accumulation in the lower abdominal cavity can be detected, which is associated with the inflammatory processes of the internal organs (excreta discharge into the pelvic cavity) or rupture of cystic formations filled with liquid secretion.

Within 2-3 days after ovulation (from 13 to 15 days), a small amount of fluid can be detected in the cavity behind the uterus, which is considered quite normal. In other periods, the appearance of fluid near the uterus indicates the infectious processes in the organ.

Transvaginal ultrasound of ovaries is  prescribed for inflammatory pathologies of the organ in which future eggs are ripening, and with severe pains in the lower abdomen (if they are not associated with menstruation). The same study will be relevant for suspected cyst or ovarian cancer. In these cases, the doctor who carries out the procedure of ultrasound, notes the increase in the size of the ovary, edema of the tissues, deformation of the body contours (with neoplasms), the presence of fluid inside the neoplasms (in the case of the ovarian cyst).

Ultrasound vaginal diagnostics can reveal pathological changes in the uterus associated with malignant neoplasms in the organ associated with pregnancy. For example, both during and after the resolution of pregnancy in the embryonic part of the placenta (chorion) in the uterus, a tumor consisting of epithelial cells can form. This new formation is called chorinoepithelioma. Less often the tumor is found out not in the body of the uterus, but on its neck or on the ovaries. It is able to destroy blood vessels, quickly gives metastases to various vital organs.

Echogram in this shows the increase in the uterus (its neck or ovary), because the tumor grows rapidly, the tone of the muscles of the organ decreases, they become soft with a non-uniform consistency. The form of the organ changes, on it appear tubercles, not peculiar to a healthy state.

Another dangerous pathology of early pregnancy is considered to be a cirrhosis. Pathology is characterized by a pathological growth of the villi of the chorion, with the formation of vesicles at their ends, the penetration of the tumor into the deep layers of the myometrium, the destruction of the uterine tissues. At the same time, fetal death is noted at an early stage of development, both with complete and partial bubble drift. But the uterus still continues to grow, though not the organ itself, but the malignant tumor that struck it.

Transvaginal ultrasound reveals uneven uterine tissue (dense mass with interspersed unusually soft areas), presence of small-cysts, large cysts on the ovaries. The size of the uterus does not correspond to the period of pregnancy, while the fetus in it can no longer be detected.

It is very important to detect the tumor as early as possible, when there were suspicions of intrauterine fetal death. After all, miscarriage in this case does not mean the disappearance of the tumor, and the woman is in serious danger.

[1], [2], [3], [4], [5], [6], [7], [8]

Preparation

Transvaginal ultrasound is a very informative method for diagnosing various pathologies of pelvic organs in women, which allows to detect deviations from the norm even at the initial stage of the disease. The procedure itself is not difficult for the doctor or the patient. It is quick and in most cases painless.

Another advantage of this type of diagnostic studies is the lack of special preparation for the procedure. For example, the study of the bladder and other organs of the small pelvis by the abdominal means involves the preliminary use of a large amount of fluid. Diagnosis is carried out with the maximum full bladder (according to the principle of echolocation in navigation), which is not very convenient. During the procedure a person experiences certain inconveniences due to an irresistible desire to empty the bladder when the sensor moves along it and when pressing on the stomach.

With a transvaginal method of examining the pelvic organs, filling the bladder is not required, because the sensor is directly in contact with the organs under investigation, and ultrasonic waves travel through the air and are reflected from the internal organs, creating a picture on the screen. The patient may even be asked before the procedure to go to the toilet, so that the bladder is empty.

Another condition for the quality of transvaginal ultrasound is the absence of gases in the intestine, which distort information about the size of the organs. If a woman suffers from increased gas formation, which often happens in gastrointestinal pathologies, on the eve of the procedure (a couple of days before her) it is not recommended to eat foods that can cause flatulence (raw vegetables and fruits, baked goods, sour-milk products). With an excess of gases in the intestines will help cope with some medicines, such as "Activated Carbon", "Smecta", "Espumizan", etc.

As for the filling of the intestine, it is desirable to empty it in advance in a natural way without the use of enemas.

Drink on the eve of the study is recommended only to pregnant women who have ultrasound carried out with partial filling of the bladder. To do this, it is enough to drink a couple of glasses of water an hour before the procedure.

In urgent conditions, preparation for the procedure is not carried out, even if this negatively affects the accuracy of the studies, which will subsequently have to be repeated when the patient's condition is stabilized.

What should I take with me on the procedure of transvaginal ultrasound? Nothing but shoe covers and diapers or towels, which will need to be sent under the couch.

What is the best time for a transvaginal examination? If you just need to examine the internal genitalia in a woman, the procedure is recommended for doctors to spend on the 5.6 or 7 day of the menstrual cycle (immediately after the end of menstruation for 2-3 days), when the thickness of the endometrium is average, and secretion is minimal and does not affect it on the results of research. In principle, it is permissible to conduct routine diagnostics up to the 10th day of the cycle.

Somewhere on the 12-14th day, ovulation occurs, after which the woman actively prepares for conception, which, naturally, leads to various physiological changes in the gynecological area.

By the way, with suspicion of endometriosis of the uterus, the study is just recommended to be carried out during this period, i.e. In the second half of the menstrual cycle. Studying the patency of the fallopian tubes, doctors also prefer to spend on the 24-28 day of the cycle (actually before the monthly).

If a woman enters the hospital with a bleeding, the examination is performed irrespective of the phase of the menstrual cycle urgently.

When asked whether transvaginal ultrasound can be performed with a monthly test, the answer will be yes. Moreover, such a study may even prove useful, since it helps to identify cystic formations in the ovaries. But, despite the fact that the monthly is not a contraindication to the procedure of transvaginal ultrasound, doctors prefer to assign a different time for diagnosis, when menstrual discharge is absent. Still, the blood in the uterus and the fallopian tubes can be a pathological symptom.

When planning pregnancy and treating inflammatory pathologies of the pelvic organs, the examination can be scheduled several times during one menstrual cycle. This makes it possible to trace the process of formation and growth of follicles (diagnostics can be prescribed at intervals of 3-4 days, for example, on days 5, 9, 12, 15). In inflammatory diseases, such a serial examination helps evaluate the effectiveness of the course of treatment.

[9], [10]

Technique of the transvaginal ultrasound

Diagnostic measures for ultrasound examination of pelvic organs using the transvaginal method are conducted in 2 stages. At the first stage, the patient is explained the essence of the research and the method of its conduct, after which they offer to take off all the clothes below the belt, send the diaper and lie back on the couch (it is allowed to use a gynecological chair for the procedure). Legs need to be moved apart and bent at the knees, pushing the feet closer to the buttocks.

Apparatus for transvaginal ultrasound, which is a sensor connected to a computer monitor, is inserted directly into the vagina to a small depth (up to the cervix). All that is located further is considered by means of reflected ultrasonic waves.

The transvaginal transducer, the same transducer, is not a disposable instrument. It is used for research by many women, but can not be effectively disinfected. To protect the woman and the device itself, a new condom is worn on the sensor before use.

A small amount of a special gel is applied to the condom, which facilitates the gliding of the device inside the vagina and ensures a better passage of ultrasonic waves.

What is a transducer? This is a plastic rod, the length of which is 12 cm, and the diameter does not exceed 3 cm. The outer edge of the rod is provided with a needle channel, through which a biopsy is performed in case of suspected oncology.

Inside the vagina, the sensor can move in different directions depending on which organ is the target of the study. Since the transducer is not deep, the patients do not feel pain, except for cases of severe inflammation or painful neoplasms. If a woman experiences discomfort during the procedure, you should definitely notify the doctor who carries out ultrasound.

The duration of the vaginal examination with ultrasound in different situations can vary from 5 to 20 minutes, so that in most cases the patients do not even have time to get scared.

Using transvaginal ultrasound, the body and cervix, ovaries, follicles in the ovaries are more accurately estimated, the location and structure of the organs, the exit points of the fallopian tubes and their filling, the quantitative ratio of mature follicles and those in the embryonic stage, the presence of free fluid in small pelvis. Abdominal examination gives in this case more diffuse results, which does not allow to capture the disease in the very bud. But it is with this goal that preventive diagnostics of gynecological diseases is carried out.

Contraindications to the procedure

Transvaginal ultrasound can be called a procedure, which practically does not require special training. And all because it is as simple and safe as possible. Perhaps, for this reason, this type of diagnostic examination of internal organs has almost no contraindications.

And yet, despite the fact that the transducer is introduced at a shallow depth, the hymen will be an additional obstacle and may be damaged during the procedure. Virgin transvaginal ultrasound is not carried out. Alternatively, a transrectal examination or even an abdominal diagnosis can be prescribed if no specification of the size and structure of the organs is required.

At 2 and 3 degrees of obesity, transvaginal ultrasound can also be replaced by diagnostics through the rectum depending on whether the organ is being examined.

In pregnancy, transvaginal ultrasound is usually prescribed up to 14 weeks. This is a safe study for both the future mother and the fetus in her womb. Still, sound waves, in contrast to X-rays, are not capable of causing gene mutations and lead to various malformations of the child.

In the second and third trimester of pregnancy, this examination is not applied in order not to cause premature birth in the patient due to manipulations near the uterus, which can stimulate its reduction, and not because of the negative influence of ultrasound. An abdominal or abdominal ultrasound of pregnant women without consequences can be carried out until the birth.

One more thing. If a woman has an allergy to latex, this must be told to the doctor even before the procedure, so that then do not have to treat various manifestations of allergic reactions.

[11], [12], [13], [14], [15], [16]

Complications after the procedure

Transvaginal ultrasound is not in vain considered a relatively safe procedure, because complications after it are possible only in rare cases, if contraindications are not taken into account. For example, with an allergy to latex, a woman can subsequently feel an itch in the vagina, which will require the use of antipruritic and antihistamines.

During the study, the patient is asked to relax. Thus, the doctor gets free access to internal organs through the vagina and can freely move the device inside the patient's body. However, it is not all women who relax, which causes microdamages of the mucous female genital organs from the outside and inside. The blood after transvaginal ultrasound is most often for this reason.

This symptom is more typical of pregnant women. If the future mother after the procedure of transvaginal ultrasound notes on the lingerie of pink or brown discharge, without expressed pain and discomfort, she has nothing to worry about. This is a common situation for pregnant women prone to exaggerate the danger. You should consult a doctor only if such discharges continue for a long time, become more abundant and are accompanied by pains in the lower abdomen, blood stains appear on the underwear, the back begins to hurt, etc.

As for the pains, they should not ideally be after the procedure. Minor discomfort in the abdomen in pregnant women can be associated with an increase in the tone of the uterus, which should come back to normal in a short time. If this does not happen, there are pulling pains in the lower abdomen and in the lower back, indicating the beginning of fights, there are spotting and other unfavorable symptoms you need to urgently call for an ambulance and go to the hospital to stop labor.

In principle, the situation described after transvaginal ultrasound is the exception, indicating that the study was conducted for a period longer than 12-14 weeks or there are other abnormalities during pregnancy that are not related to the procedure. Theoretically, this situation can also speak of the incompetence of the doctor who carried out the diagnosis, which is unlikely in this situation.

Pain after transvaginal ultrasound most often occur against the background of existing inflammatory pathologies. In this case, a woman may experience discomfort during and after the procedure. Still, the movement of the sensor can disturb the diseased organ, which will subsequently result in pain or pulsation in the lower abdomen.

Against the background of increased pressure and excitement about the procedure, in some women, not only the stomach, but also the head begins to ache. In this case, it is necessary to stabilize the pressure both before the procedure and the end of the manipulations, if necessary.

Dyspnea after transvaginal ultrasound in women who do not plan to become a mother, happens very rarely and is associated again with microscopic damage to the mucosa or taking a biopsy on a site richly endowed with blood vessels. By the way, often after such intervention, an earlier onset of menstruation is noted. There is nothing terrible in this, but it still costs to consult a doctor, if only in order to differentiate menstrual discharge from bleeding (especially if the blood is accompanied by pain, which was not previously observed).

Alertness should cause a woman (pregnant or not) the fact, if on the background of pains and brown (red, pink) discharge, she also has a temperature increase. This says, most likely, about the infection. But it's not so much about sexually transmitted infections, as about the usual staphylococcus, streptococcus, Escherichia coli and other representatives of opportunistic microflora. More serious infections should be protected by a condom. But in any case, you need to see a doctor.

By the way, it is very important to ensure that the doctor before the examination necessarily put a new condom on the sensor, and not just wipe it with a disinfectant solution. This is considered a violation of the established norms for carrying out transvaginal ultrasound. In addition to the conditionally pathogenic microflora, the sensor can retain more serious infections, for example, HIV or hepatitis viruses, especially if there was no preliminary preparation for the study in previous patients, and transvaginal ultrasound without a condom exposes women to the risk of contracting dangerous, intractable pathologies. This is the opinion of specialists in the field of epidemiology, and not ordinary patients who spread panic.

Ideally, before carrying out the vaginal examination, a smear should be taken on the microflora so that the doctor knows what it is dealing with. This can help in the future and in clarifying the diagnosis, which is put on the results of transvaginal ultrasound, printed on a special form.

[17], [18], [19], [20], [21], [22], [23], [24], [25]

Care after the procedure

Many women after seeing a gynecologist on an armchair or carrying a transvaginal ultrasound, fearing infection, rush to conduct serious hygiene procedures called douching. The effectiveness of such procedures in these situations is not proven. Moreover, in some cases, douching can even do harm, especially since it is not carried out under sterile conditions.

The inner genitalia of a woman is trebled in such a way that they are able to clean themselves from infection and dirt. This is promoted by the useful microflora of the vagina, which is roughly washed away by douching, thus allowing pathogenic microorganisms and pathogenic fungi to develop, which were in an inactive state. In the end, it may turn out that the reason for the infection of the female genital organs was not the procedure of transvaginal ultrasound itself, but the preventive measures that the patient performed without a doctor's appointment.

What hygienic and medical procedures to conduct after ultrasound diagnosis and diagnosis should be appointed by the attending physician. The same goes for taking medications.

[26], [27]

Reviews

The opinions of patients who have undergone the procedure of transvaginal ultrasound converge in the fact that this study with gynecological diseases is more informative than the usual abdominal diagnosis. It is the vaginal examination that allows you to see the pathology from the inside and assess the degree of organ damage, which means that the diagnosis will be more accurate.

It is clear that much depends on the professionalism of the doctor and his skills in working with special equipment. It is only an unskilled doctor who can make mistakes in conditions of complete visibility and absence of time restrictions. True, an incorrectly assigned time of research may play some role. It is not for nothing that certain phases of the menstrual cycle are planned, when it is necessary to conduct research specifically for each pathology.

Advantages of the procedure women consider it painless. Of course, some discomfort can still be present, but here even an important role is played by the psychological factor, rather than objective sensations.

Those who have already experienced the procedure of abdominal ultrasound for a full bladder can appreciate the lack of suffering a small need for transvaginal examination. Yes, and a slippery cold gel on the body of few people can attract, and with vaginal ultrasound there is no need to apply it.

As for the safety of ultrasound diagnostics using a vaginal sensor, then opinions differ. Most of all, this study worries pregnant women who are afraid of the threat of miscarriage. However, practice shows that in the early stages of transvaginal ultrasound is not dangerous, if it is carried out very carefully, qualified.

As for the threat of infection through the vaginal sensor, when using disposable condoms it is completely excluded. It's another matter if doctors do not meet the requirements for the procedure and save on the means of protection, relying on disinfection with antiseptics. At this point, anxiety among women is not in vain, the risk of seizing a dangerous infection with a condom refusal always remains.

In principle, feedback about the ostutsviya condom on the sensor and the appearance after the procedure of suspicious symptoms (pulling pain in the lower abdomen, vaginal itching) and secretions is not so much. It is important to be careful, because it is always possible to refuse examination because of the lack of necessary materials (in this case a condom), to go to another clinic where the care of the patients will be on top.

Concerning the cost of the procedure, it can be said that most patients consider it inexpensive and quite affordable. Moreover, the results, which gives transvaginal ultrasound, can immediately begin effective treatment, without doubting the diagnosis. And if you consider that someone such a diagnosis can please even more pleasant news about the long-awaited pregnancy at the earliest time, then its value doubles.