1. What is the pelvic ultrasound and when should it be done?
  2. Doppler flowmetry: when is it done?

What is the pelvic ultrasound and when should it be done?

The pelvic ultrasound is a non-invasive diagnostic imaging exam. It is based on the emission of ultrasounds through which images of organs such as bladder or female genitalia are obtained. The pelvic ultrasound or the normal gynaecological ultrasound exam allows the study of the internal female genitalia including uterus, tubes and ovaries. It gives information on the health of these organs, obtaining more information on the gynaecological system to explore malignant and benign pathological conditions.

An ultrasound probe is placed on the lower abdomen issuing an ultrasonic beam that meets the internal anatomic structures, goes through them and is reflected in different ways according to their nature and density resulting in an image on the screen that can be photographed or video recorded to obtain a documentation.

It is a risk-free exam and is not painful, its execution is simple and allows to obtain an immediate result. The pelvic ultrasound is recommended to check on problems such as menstrual irregularities, benign or malign pathologies of the uterus, of the tubes and of the ovaries like ovarian cysts; in addition, to perform a pelvic ultrasound, the bladder must be full in order to provide the right contrast for the images and bring intestinal loops back. However, a transvaginal ultrasound, which does not require full bladder and gives much more clear and detailed information is preferable.

Doppler flowmetry: when is it done?

Flowmetry is a particular ultrasound technique that is also known as Doppler scan. The use of Doppler allows diagnosing different pathologies including ovarian ones, as it analyses the vascularization of gynaecological masses. Tumours present a different vascularization according to their nature. This analysis allows the differentiation of benign and malign pathologies. In addition, Doppler is also useful for the analysis of uterine pathologies and for fertility study.

It is executed with full bladder with a particular Doppler known as “power or energy Doppler” that also allows the visualization of those very slow flows in very small vessels. The exam begins with an abdominal probe to have a complete vision of pelvic vascularization. Usually, at a second stage, the bladder is emptied and transvaginal observation begins. An internal probe, which allows a better visualization of the ovarian and uterine vessels, is used. This exam is highly dependant from the experience and knowledge of the operator; therefore an expert operator is preferable.

In particular, flowmetry is recommended in case of abdominal or pelvic pain, menstrual irregularities, ovarian cysts or fibroids, suspicious uterine malformations, endocavitary pathologies (i.e. polyps), or for prevention in case of no symptoms in women of childbearing potential or in menopause.

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