TVS (Trans Vaginal USG)
Transvaginal ultrasonography (TVS) is an internal pelvic imaging technique used to examine the female reproductive organs, including the uterus, cervix, fallopian tubes, and ovaries. By inserting a specially designed, slender transducer directly into the vagina, clinicians can position the probe closer to the pelvic structures, bypassing abdominal fat and bowel gas to capture exceptionally detailed, high-resolution images.
TVS consists of several core diagnostic evaluations:
- Uterine and Endometrial Assessment: It measures the endometrial lining, which changes throughout the menstrual cycle. It is the primary tool for identifying structural abnormalities like uterine fibroids, endometrial polyps, or adenomyosis.
- Ovarian and Follicular Mapping: TVS tracks follicular development in the ovaries during the menstrual cycle, making it crucial for fertility treatments and diagnosing Polycystic Ovary Syndrome (PCOS), which features a distinct "string of pearls" appearance.
- Adnexa and Cervical Evaluation: It evaluates the fallopian tubes and surrounding adnexal spaces for anomalies like ectopic pregnancies or hydrosalpinx. It also evaluates the cervical canal for conditions like Nabothian cysts or cervical shortening during pregnancy.
- Advanced Imaging Modalities: Spectral and Color Doppler TVS maps blood flow to ovaries and uterine masses to evaluate for ovarian torsion or malignancy. Advanced 3D/4D TVS reconstructions provide a comprehensive view of the uterine cavity to detect congenital anomalies like a septate or bicornuate uterus.
- Fluid Detection: It easily visualizes free fluid collections in the Pouch of Douglas (posterior cul-de-sac), which can indicate internal bleeding, ruptured cysts, or pelvic inflammatory disease.
Ultimately, TVS serves as an invaluable diagnostic tool for evaluating abnormal uterine bleeding, pelvic pain, early pregnancy complications, and unexplained infertility.
