Pelvic Ultrasound (complete)

What it is

Sound does not travel through gas, and the pelvis is surrounded by bowel, so scanning it from the outside depends on finding a window. A full bladder is that window: fluid conducts sound well, and a distended bladder displaces the bowel and lets the beam reach the organs behind it. Through it the sonographer measures the uterus, assesses the thickness of its lining, looks at both ovaries, and checks the bladder itself — or, in a male patient, the bladder and prostate. Complete means that defined set is imaged and documented rather than one structure. A transvaginal study, where a slim probe is placed internally to get much closer to the uterus and ovaries, is a distinct examination with its own code, and the two are frequently done back to back in one appointment.

Why it is done

• To investigate pelvic pain, pressure, or a mass felt on examination
• To look for fibroids, ovarian cysts, or other growths
• To evaluate abnormal or heavy menstrual bleeding, or bleeding after menopause, by assessing the lining of the uterus
• To assess the ovaries in the workup of infertility, or to monitor treatment
• To confirm an early pregnancy and its location
• In men, to assess the bladder and prostate, or to measure urine left after voiding

What to expect

Patients are usually told to drink several glasses of water an hour or so beforehand and not to urinate until the scan is finished, which is the uncomfortable part of an otherwise painless test. Gel is spread on the lower abdomen and the sonographer presses the probe across it, which can be unpleasant against a full bladder. If a transvaginal study follows, the bladder is emptied first and a covered probe is inserted a short distance — broadly comparable to a gynecologic examination. The whole appointment generally runs 30 to 45 minutes. A radiologist reads the images and sends a report.

Questions worth asking

• Will a transvaginal ultrasound be done at the same visit? It is a separate code and a second charge, and it is worth knowing before arriving, not after.
• Is this being coded as a pregnancy-related ultrasound or a non-obstetric one? The codes and the coverage rules differ.
• Is it being performed in a gynecology office or in a hospital radiology department, and is a facility fee added in the hospital setting?
• If follow-up scans are planned to watch a cyst or a fibroid, what is the price of each repeat, and how many are expected?