Pelvic ultrasound has been a “staple” in my practice for many years. I learn so much from them, and feel like I am doing what I am supposed to do: tell you that your pelvic organs are fine. There’s the pap smear and the speculum exam. That checks vulva, vagina and cervix. But what about the uterus and ovaries? Why is the “standard of care” to do a blind two handed pelvic exam then call it a day? A quick pelvic ultrasound is much more accurate, no more invasive, and contains no radiation.
An ultrasound can be done at the same time as a pap smear and only takes minutes. It is amazing what a trained eye can tell. Most exams are completely normal, most women leave reassured. Their random pelvic bloat and pain are just the complex symphony of “ovulating”, that miracle that can produce new life, or some other benign occurrence. Real time imaging is fun – most women have never seen their uterus or the eggs waiting in their ovaries. They leave knowing that they have been thoroughly “checked out”, some with a picture. I love it! Of course, if everything is “just fine” in your pelvis, this exam doesn’t have to be done and may not be paid for. It’s your choice.
I have done tens of thousands of these exams. I know the many variations of normal. I know what to leave alone. And I know how to push this envelope to its maximum. Something is lost when the ultrasound tech does the exam, provides only static snapshots to a radiologist, who then writes a report to your doctor. Did you even meet that radiologist? And they won’t show you the pictures or let you know the results until later.
Pushing the envelope to the maximum means real time imaging. It means understanding your history, your on the spot responses, and then using the experiential wisdom derived from similar problems I’ve seen in the past. Yes I know when to go further. Yes I can explain why and do so with your permission. And yes, sometimes I find an early cancer and help save a life. But most of the time I just celebrate your health with you after thoroughly checking you out.
Please watch these videos. The first, although a little sensationalized, is an accurate representation of a pelvic ultrasound.
The last shows an example or going further – a sonohysterogram. In this test sterile saline is flushed through the uterus and reveals a uterine polyp. This is a common finding, benign but annoying, which can block embryo implantation, cause you to spot midcycle, or cause heavy clotty periods. If found, it can easily be removed with no cuts and no scars on your body, just better periods.