Procedures
Ultrasound of the female lower abdomen
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Summary
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Synonyms: Sonography, sonography of the lower abdomen, US ovaries, US uterus

Ultrasound examination of the female lower abdomen is a conventional procedure carried out as an initial investigation of unexplained pain in this region. The bladder, uterus and ovaries are examined. The procedure provides a rapid overview and is often the first choice for investigation or planning of further procedures.

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Technique
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What it is

Ultrasound examination of the female lower abdomen is a classic ultrasound procedure. It does not involve the use of X-rays. The procedure is performed directly on the patient by a radiologist

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How it works
The patient lies on her back on an examination table.
The ultrasound machine stands next to the examination table. It consists of a monitor, a computer and a transducer, which is connected to the machine by a cable. While the radiologist moves the ultrasound transducer over the lower abdomen, the organ being examined is displayed on the monitor.
For a more accurate assessment, it may be necessary to insert a special rod-shaped transducer into the vagina. In many countries this examination, referred to as an endovaginal ultrasound, is carried out by a gynaecologist.

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Purpose
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An ultrasound of the female lower abdomen allows for a wide range of disorders of the bladder, the uterus and the ovaries to be simply and quickly investigated and diagnosed. If the results are inconclusive, further investigations may be necessary, such as CT or MRI scans.

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Target Patient Group

Ultrasound examination of the female lower abdomen is carried out for various gynaecological, surgical and urological problems. Examples are:
  • Unexplained pain in the lower abdomen
  • Incontinence
  • Monitoring of known changes (e.g. uterine fibroids, cysts)
  • Exclusion of gynaecological causes in suspected appendicitis
  • Ruling out fluid in the abdominal cavity
  • Suspected tumours
  • Monitoring an existing pregnancy
  • Infertility

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Procedure
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Persons
You will be looked after by an experienced team, consisting of a medical radiology technician (MRT) and a radiologist.
The procedure itself will be carried out by the radiologist.
During the procedure, the radiologist observes and assesses all the organs and takes several pictures, so-called standard sections, of the upper abdominal organs being examined. After the procedure, all the pictures are re-assessed and compared with preliminary findings if necessary. A written report of the results is then drawn up. This is either given to you or sent on to the doctor who referred you. 

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Preparation
1.    You should not have anything to eat for about 4-6 hours before the procedure. You can drink as much water as you like. It is best to avoid food that produces flatulence for a few days before the examination, since gas in the bowel can reduce the quality of the images.
2.    A full bladder is essential for a successful investigation of the lower abdomen.
3.    You should take your usual daily medication with some liquid in the morning.
4.    If you are a diabetic, please ask your doctor how you should take your medication on the day of the examination. If you feel that your blood sugar is low, please tell the technical assistant immediately.

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Precautions
No precautions are necessary.

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Duration
The whole procedure takes about 15 minutes.

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Process
The examination is carried out with the lower abdomen undressed.
A gel will then be applied to the skin of your lower abdomen to ensure a better interface between the surface and the ultrasound transducer. This improves conduction of the sound waves. From the ultrasound transducer, the sound waves fan outwards and are then reflected back by the lower abdominal organs and their surroundings. These reflections or echoes are then received by the transducer. The computer evaluates the information and generates several images per second that are displayed on the monitor. Different cross-sectional images are produced, depending on how the radiologist moves the transducer over the organs. It is not always possible to assess the ovaries, because they are often hidden by adjacent parts of the intestine. However, indirect signs such as fluid in the abdominal cavity can still provide indications that are useful for planning further investigations. A full bladder is important for a diagnostically conclusive examination, since many parts of the organs can only be assessed like this.
After the examination, you will be given a towel to wipe off the remaining ultrasound gel. 

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After procedure
You will usually be able to go straight home after the procedure.

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Consideration
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Risks
Ultrasound is an extremely safe procedure. In rare cases, the pressure of the transducer may feel a little uncomfortable. The ultrasound waves are not harmful to the body. Pregnant patients and children can also be examined without safety concerns. No X-rays are used, so there is no exposure to radiation.

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Alternatives
Procedures such as computed tomography and magnetic resonance imaging can be used to further investigate findings that are inconclusive. These techniques make it possible to identify and assess even the smallest changes.

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FAQ

Do I have to be an in-patient in the hospital to have an ultrasound of the lower abdomen?
No, the procedure can be carried out if you are an out-patient. You can go straight home afterwards unless there are other medical reasons why you should not do so.

Which patients should not have an ultrasound?

For assessment of known malignant changes in the lower abdomen, the CT and MRI provide significantly better results.


What do I need to I bring with me?
Nothing.


How much radiation will I be exposed to?
Ultrasound is a mechanical sound wave with a very high frequency, and has no damaging effects on the body. No X-rays are used, so there is no exposure to radiation.

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Citations
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1   Team General Hospital Vienna
 
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