Trano Vaginal Scan (TVS)

Key Points About Transvaginal Ultrasound (TVS):

1. What is Transvaginal Ultrasound (TVS)?

• Transvaginal ultrasound is a diagnostic imaging procedure that uses high-frequency sound waves to create detailed images of the organs and structures in the pelvic area. These sound waves are emitted by a probe that is inserted into the vagina.
• The primary purpose of a TVS is to provide a clearer, more detailed view of the reproductive organs, which may not be fully visible or assessable with an abdominal ultrasound, especially in women who are overweight or those with gas in the intestines.

2. How is a Transvaginal Scan Performed?

• Procedure: The woman lies on her back with her legs in stirrups, similar to a gynecological exam.
• The ultrasound probe (transducer) is covered with a thin latex or non-latex cover and a lubricating gel is applied to facilitate easier insertion. The probe is gently inserted into the vagina, allowing it to be close to the pelvic organs.
• Once in place, the ultrasound technician (sonographer) will move the probe to capture different angles of the uterus, ovaries, fallopian tubes, and surrounding structures.
• The images are then displayed in real-time on a screen, allowing the doctor to observe the structures and identify any abnormalities.

3. Indications for Transvaginal Ultrasound (TVS):

Transvaginal ultrasound is used for a variety of clinical purposes, including:

• Pelvic Pain or Discomfort: To identify possible causes of chronic pelvic pain, such as ovarian cysts, fibroids, or endometriosis.
• Abnormal Bleeding: For evaluation of abnormal vaginal bleeding or spotting between periods, or post-menopausal bleeding.
• Infertility Evaluation: To assess the ovaries (e.g., for polycystic ovary syndrome, or PCOS), check for structural abnormalities in the uterus, or evaluate the thickness of the endometrial lining.
• Monitoring of Pregnancy: It can be used in early pregnancy to confirm the presence of a gestational sac, heartbeat, or to evaluate for ectopic pregnancy (when the embryo implants outside the uterus, typically in the fallopian tube).
• Ovarian Cysts or Tumors: TVS provides better visualization of the ovaries compared to abdominal ultrasound, allowing for the detection of cysts, fibroids, or other growths.
• Endometrial Abnormalities: To evaluate the endometrium (lining of the uterus) for abnormalities like thickening, which can indicate conditions such as endometrial cancer or polyps.
• Assessment of Fibroids (Myomas): To identify the size, location, and number of uterine fibroids, which can cause symptoms like heavy bleeding or infertility.
• Postmenopausal Evaluation: To assess the endometrial lining in postmenopausal women who have abnormal bleeding or signs of endometrial hyperplasia.
• Follow-up on Previous Abnormalities: If a previous ultrasound (abdominal or transabdominal) has detected an abnormality, TVS may be used for further evaluation or monitoring.

4. Advantages of Transvaginal Ultrasound (TVS):

• Higher Resolution Images: Because the probe is inserted closer to the pelvic organs, TVS provides higher-quality images and more detailed visualization of structures like the uterus, ovaries, and fallopian tubes than abdominal ultrasound.
• Better for Early Pregnancy: It can detect very early pregnancies (as early as 4 to 5 weeks) and is more accurate than abdominal ultrasound in identifying ectopic pregnancies.
• Clearer Evaluation of Small Structures: TVS is especially useful for assessing small organs, such as the ovaries, and detecting ovarian cysts, fibroids, and tumors that may not be visible on a traditional abdominal scan.
• Non-invasive and Safe: TVS is a non-invasive, safe procedure that does not require radiation and is considered suitable for pregnant women and those undergoing infertility treatments.
• Accurate Assessment of Endometrial Health: The scan can evaluate the thickness of the endometrial lining, which is important in diagnosing endometrial cancer, hyperplasia, and other uterine abnormalities.

5. Limitations of Transvaginal Ultrasound (TVS):

• Discomfort: While generally well-tolerated, the procedure can be uncomfortable for some women, especially if the transducer is inserted too deeply. The discomfort usually subsides quickly after the test is completed.
• Not Suitable for Everyone: TVS may not be suitable for women who have vaginal infections, vaginal bleeding, or certain types of pelvic conditions that could make the procedure uncomfortable or unsafe.
• Limited for Obese Women: While it provides clearer images than an abdominal scan, obesity or excess abdominal fat can make it more difficult to perform the scan effectively in some women.
• Requires Skill: The procedure requires a skilled technician to get accurate results, and the quality of images depends on the experience of the operator.

6. What Can a Transvaginal Scan Detect?

• Pregnancy: Confirming an intrauterine pregnancy, detecting the heartbeat, and ruling out ectopic pregnancy (when the fertilized egg implants outside the uterus, typically in a fallopian tube).
• Ovarian Cysts: Detection of follicular cysts, corpus luteum cysts, or endometriomas (chocolate cysts) that may cause pain or affect fertility.
• Fibroids (Leiomyomas): These non-cancerous growths in the uterus can be detected and assessed for size, location, and number.
• Endometrial Abnormalities: Detection of abnormal thickening or masses in the uterine lining, which may indicate conditions like endometrial hyperplasia or endometrial cancer.
• Pelvic Infections: Such as pelvic inflammatory disease (PID), which affects the uterus, fallopian tubes, and ovaries.
• Congenital Anomalies: Abnormalities of the uterus, such as septate uterus, bicornuate uterus, or other structural malformations that may cause fertility problems or recurrent miscarriages.
• Ectopic Pregnancy: Early detection of an ectopic pregnancy (pregnancy implanted outside the uterus) to prevent life-threatening complications.
• Fertility Issues: Evaluation of the ovaries for polycystic ovarian syndrome (PCOS), ovarian reserve, and other causes of infertility.

7. Risks of Transvaginal Ultrasound (TVS):

• Minimal Risks: TVS is a non-invasive procedure and is generally considered very safe. There are no known risks related to the ultrasound waves used in the scan.
• Discomfort or Minor Irritation: Some women may experience mild discomfort or vaginal irritation during or after the procedure, but this typically resolves quickly.
• Infection Risk: If there is an infection or active vaginal bleeding, the doctor may choose to delay the procedure to avoid complications.

8. What to Expect During the Procedure:

• Preparation: No special preparation is usually required for a transvaginal ultrasound, although it is important to empty the bladder beforehand, as a full bladder may interfere with the scan.
• During the Scan: The procedure itself typically lasts about 15 to 20 minutes. It is generally painless, but you may experience some discomfort when the probe is inserted. Let your doctor or technician know if you feel any pain or significant discomfort during the procedure.
• After the Scan: You can resume normal activities immediately after the scan. There is usually no downtime or recovery time needed.

In Summary:

Transvaginal ultrasound (TVS) is a valuable diagnostic tool used to assess a woman’s reproductive organs. By providing clear and detailed images of the uterus, ovaries, and surrounding structures, it helps in diagnosing conditions such as pregnancy complications, ovarian cysts, fibroids, endometrial abnormalities, and pelvic infections. It is particularly useful for evaluating early pregnancies, fertility problems, and structural abnormalities of the reproductive system. TVS is a safe and non-invasive procedure, though it may cause mild discomfort for some women. It is an essential tool in both routine gynecological exams and in the management of high-risk pregnancies or fertility issues.