The right ovary is clearly not located what it means. Ultrasound examination of the ovaries

It is often difficult to study the work of the ovaries using a conventional ultrasound examination, because the ovary is simply not visible. But this in no way means that it is not in the body of a woman.

In what situations is the ovary not visible on ultrasound?

Difficulties in examining the ovaries in a patient during ultrasound diagnostics may arise:

• After surgery on the tubes of the uterus or the ovaries themselves;
• With a large size of the uterus;
• With deformation of the uterus from myomatous nodes;
• With severe pathology of the uterine tubes;
• With a severe polyetiological disease of the uterus, for the occurrence of which there may be many reasons: age-related changes in the female body, work in a hazardous enterprise, changes in the immune system, or neuropsychic stimuli.

Do not be upset if, during the examination, the specialists did not see the ovary on ultrasound. You just have to use a different method. For convenience and information content, ultrasound diagnostics of the ovaries often resort to transvaginal examination (endovaginal sound examination or transvaginal ultrasound). A transvaginal ultrasound is performed through the vagina.

Prerequisites for the transvaginal research method

Your gynecologist may refer you for a transvaginal ultrasound if:

• Pain in the pelvic area;
• Infertility;
• Bleeding or irregular menstruation;
• Suspicion of an ectopic pregnancy;
• Neoplasms on the female internal genital organs, identified during a physical examination of the patient.

How to prepare for a transvaginal ultrasound?

No special preparation is required. The only condition is an empty bladder. Already in the office, the doctor will ask you to completely undress below the waist, take a horizontal position on the couch and relax the muscles of the lower body. The procedure is absolutely painless. You may feel some discomfort from the pressure of the sensor on the walls of the vagina.

How is an endovaginal sound examination performed?

For maximum diagnostic information, it is very important to correctly position the sensitive sensor. It is most convenient to examine the ovaries when the woman lies on the couch with her legs bent at the knees. To exclude trauma and infection of the vagina, a condom is put on the sensor. The condom is lubricated with a special gel before insertion, which minimizes friction.

Health hazards in transvaginal ultrasound diagnostics

Unlike x-rays, ultrasound examination is absolutely safe for a woman's health. This method has only positive characteristics. Today, in every medical center, diagnosticians resort to the help of ultrasound equipment. The speed and accuracy of the procedure help to diagnose unwanted deviations of women's health from the norm in time. The painlessness of the procedure helps to eliminate unnecessary excitement of the patient.

cimax-kino.ru

Yellow body on ultrasound after ovulation: what does it mean

The corpus luteum on ultrasound after ovulation is a natural process in the female body, which means the release of a mature egg and a high chance of conception. By the time of the onset of menstruation, the temporary gland self-destructs, the effect on the body of progesterone, which causes acne in many women, increases, breast tenderness during PMS decreases, and a new cycle begins.

The second name of the corpus luteum (VT) is the luteal gland.

What methods will help to find out about the presence of a corpus luteum

There are two ways to find out about the existence of a temporary gland:

1. Ultrasonography. The most reliable method that allows you to clearly see the picture of what is happening on the monitor, determine the size, the likelihood of conception, the effect of VT on the reproductive organs.
2. Test for the hormone progesterone. Relying on this method alone is not enough, because there are situations with hormonal failure.

If a woman is tracking ovulation in order to get pregnant, then the most common solution is to use both methods at the same time.

Corpus luteum after ovulation on ultrasound

On ultrasound, the gland looks like a round, soft sac located on one of the ovaries or on 2 at once. In the latter case, multiple pregnancy is likely with successful fertilization of the egg.

After ovulation has taken place, the gland appears almost immediately, gradually increasing in size. To assess the state of reproductive function, especially the ovaries, it is recommended to do an ultrasound three times per cycle:

• on day 7-10 of the cycle. At this time, the mucous membrane of the uterus is quite thin and allows you to see hidden pathologies, and the ovaries after the last menstruation are “refreshed”;
• on the 14-16th day of the cycle. The follicle is just starting to grow, so the study is prescribed to find out if there is ovulation, pathology, neoplasm development or not;
• on day 22-24 of the cycle. The preparation of the body for menstruation begins, so experts look at the changes in the ultrasound picture after ovulation: what happens to the follicle, has it turned into a cyst, has it disappeared, etc.

A three-time study will accurately show the picture of the functioning of the genital organs, and also indicate the specific day of ovulation, because the individuality of each organism knows no boundaries: the follicle can begin to develop much earlier than the 14th day of the cycle, and later than the 24th.

Table of sizes of the corpus luteum after ovulation based on the conclusion of the ultrasound:

If the size of the luteal gland at the end of the monthly cycle is from 12 to 15 mm, then this indicates the reverse development of VT. The value of 24-30 mm indicates the possible presence of a normal pregnancy. From 30 mm or more - the appearance of a VT cyst, in which case therapy is prescribed and pregnancy planning is postponed. But if it has already come, they are carefully monitored during the first trimester. There is no serious threat.

The constant presence of the luteal gland also speaks of cystic formation. The normal duration of the "life" of VT is 13-14 days, until the onset of menstruation.

What does the absence of the luteal gland mean?

If there is no corpus luteum in the ultrasound picture, the probable causes include:

1. Anovulatory cycle or late ovulation. If the gland is not visible, then ovulation will either not happen at all, or it will happen later.
2. Follicular cyst. The follicle did not mature, did not grow to its size, stopped developing, did not break, turning into a formation that often disappears on its own in the next cycle with a temporary failure (if follicular cysts appear systematically or are poorly absorbed, the reason lies in the woman's reproductive health).
3. Infertility and other diseases of the small pelvis. Follicles may not develop at all. In this case, a thorough examination, search for the root cause, and its elimination are necessary.

Every woman has anovulatory cycles during which the corpus luteum is absent - this is a normal and natural process. However, the occurrence of anovulatory cycles systematically is a serious reason to be examined.

oyaichnikah.ru

Ultrasound of the ovaries reveals cysts, infertility and cancer | Clinic Diana in St. Petersburg

Ultrasound is widely used to diagnose a huge number of pathologies in the human body. It is also indispensable when examining the reproductive system of a woman. Ultrasound of the ovaries is an affordable and absolutely harmless method for studying the shape, size, location and structure of the organ, as well as the follicular apparatus.

Indications for ovarian ultrasound

As an independent procedure, it is carried out quite rarely. As a rule, ultrasound of the ovaries is done in combination with an ultrasound examination of the pelvic organs. In some cases, the procedure is prescribed if it is necessary to assess the functional activity of the ovaries. This is mainly necessary when diagnosing the causes of female infertility.

In this case, an ovarian examination is done to measure the dominant follicle when a woman is unable to conceive for a long period. In this case, for a certain period, the doctor monitors the follicle and records the fact of the onset or absence of ovulation. This examination of the ovaries is called folliculometry.

Also indications for the appointment of ultrasound of the ovaries are:

• irregular menstrual cycle, lack of menstruation (unless it is during pregnancy);
• regular pulling or sharp pain in the lower abdomen;
• pain during intercourse;
• too little or heavy menstrual bleeding;
• unusually severe menstrual pain;
• disease of the mammary glands;
• suspicion of infertility;
• inflammation of the appendages;
• suspicion of pathology;
• preparation for pregnancy;
• preparation for IVF;
• preventive examination.

What pathologies are detected by ultrasound examination of the ovaries

Ultrasound of the ovaries is a fairly effective method in detecting pathologies, and with its help it is possible to detect some diseases even at the preclinical (before the onset of symptoms) stage, and those pathologies that cannot be detected using other research methods.

• An ovarian cyst (functional and pathological) is a benign neoplasm characterized by the formation of a fluid-filled protrusion on the ovary (or both at once). Pathology is dangerous by degeneration into a malignant tumor, provocation of infertility, peritonitis, or disruption of neighboring organs.
• Polycystic ovaries is a hormonal disease in which the ovaries increase in size and accumulate a lot of cysts. The disease provokes infertility, because it does not allow ovulation to occur, i.e. the release of eggs from the ovary.
• Salpingoophoritis is a joint infectious and inflammatory process in the ovaries and fallopian tubes. Independent inflammation of the ovary - oophoritis - is quite rare. The pathological process is caused by infection (streptococci, staphylococci, chlamydia, etc.). Most often it comes from the vagina and uterus along the ascending path.
• Torsion of the ovary is a serious pathological condition in which the nutrition of the ovary is disturbed. Requires immediate medical attention.
• Malignant tumors - cancer.

Sonography technique

There are three ways to examine the ovaries using ultrasound. The doctor makes the choice of a specific method taking into account the patient's history.

• Transabdominal - carried out using an external sensor through the abdominal wall. This method is the most comfortable, but the least informative, it can only detect a gross violation of the organ. It is usually used during a general gynecological examination, for virgins and women with malformations of the vagina.
• Transvaginal - is carried out using an intracavitary sensor (transducer), which is inserted into the vagina. The method is the most accurate and informative, since the sensor is in close proximity to the internal organs. May be accompanied by slight discomfort during the insertion of the probe. This type of ultrasound is contraindicated for virgins and with malformations of the vagina.
• Transrectal - carried out using an intracavitary probe (thinner than for TVU), which is inserted into the rectum. The method is absolutely painless, but very uncomfortable for a woman. It is carried out in some cases when TAU turned out to be insufficiently informative, and TVU cannot be performed for objective reasons (virginity, atresia (fusion), severe stenosis (narrowing) of the vaginal entrance, etc.).

The duration of the procedure is about 15 - 20 minutes.

How to prepare for the procedure

Each research method requires special training in order to obtain the most accurate and informative result.

Transabdominal ultrasound of the ovaries

This type of study requires careful preparation, including a slag-free diet and cleansing the intestines from gases. 2-3 days before the procedure, it is necessary to stop eating foods that cause flatulence (carbonated drinks, beans, fresh fruits and vegetables, yeast and dairy products, etc.). For a day, start taking absorbent drugs (smecta, espumizan, activated charcoal, etc.).

During the procedure, the bladder must be full, so a woman needs to drink 1 liter of liquid (non-carbonated and non-dairy) an hour before her and not urinate.

Transvaginal ultrasound of the ovary

Special preparation for such an ultrasound is not needed, since the only condition for its implementation is an empty bladder. Immediately before the procedure, a woman just needs to urinate. If there is a tendency to increased gas formation, in a day - two should start taking drugs that reduce flatulence (smecta, espumizan, activated charcoal, etc.).

Transrectal ultrasound

Preparation for such an ultrasound is similar to preparing for a transvaginal examination. Additionally, for 9-10 hours, it is necessary to cleanse the intestines from feces with a cleansing enema (1-1.5 l), microclysters, glycerin suppositories or laxatives.

The timing of the study depends on its purpose. If the ultrasound is planned, then it is carried out on the 5th - 6th day of the menstrual cycle and no later than a week after the end of menstruation. In severe situations, an ultrasound scan is performed on the day symptoms are detected. If it is required to evaluate the functioning of the ovaries, then the procedure is prescribed three times (on the 8-9th day, on the 14-15th day and on the 22nd-23rd day of the menstrual cycle).

How is the procedure carried out

transabdominal method. The patient lies back on the couch and exposes the abdomen. The doctor applies a special gel to the area of ​​the abdomen projected to the ovaries to improve contact with the sensor, and then scans the ovaries by moving the device over this area.

transvaginal method. The patient exposes a part of the body below the waist and lies on her back on the couch, bending her knees. The doctor gently inserts a cavity sensor into the vagina, on which he previously put on a condom to prevent the ingress of foreign microflora and lubricated it with a lubricant. The transducer is inserted shallowly, about 5-8 cm.

transrectal method. The patient exposes the lower part of the body and lies sideways on the couch, bending her knees. The doctor slowly and carefully inserts a sensor into the anus, on which a condom was previously put on and a lubricant was applied in order to minimize discomfort and discomfort for the woman.

During the examination, the doctor evaluates the structure of the ovaries, their condition, size, localization, confirms or refutes the presence of pathological changes and inclusions. Upon completion of the procedure, he gives the patient an ultrasound report, with which the woman should contact the treating specialist for treatment.

Deciphering ultrasound of the ovaries: norms

Normally, the ovaries are located on the sides of the uterus at a small distance from it, often asymmetrically. On the monitor, they are visualized as oval, rather outlined, hypoechoic formations, while the ovaries are not identical to each other, the difference in their sizes is minimal. Their normal surface is considered bumpy due to the follicles ripening in them. The more time has passed since the beginning of the cycle, the larger these tubercles.

Normally, cystic, tumor-like and other formations should be absent in the ovaries, and the organ itself should not be enlarged. The interpretation of the results contains an indication of the size of the ovaries and follicles.

Normative indicators of the size of the ovaries are presented in the table. Values ​​may vary depending on the age of the patient, the phase of the cycle, the number of pregnancies, etc.

After the onset of menopause, the ovaries in size and volume decrease by almost 2 times (up to 2 cm3 on average), their silhouette becomes uneven, wrinkled, and echogenicity increases.

Normally, the ovaries consist of a capsule and follicles of varying degrees of maturity, the number of which may differ on the left and right. In healthy women, the following indicators of follicles are visualized depending on the phase of the menstrual cycle:

Why the ovaries are not visible on ultrasound

In some cases, the doctor cannot recognize the ovary on ultrasound. This can happen for the following reasons:

• congenital absence of ovaries;
• removal during surgery;
• premature exhaustion of the organ;
• sharp swelling of the intestine;
• high density of the abdominal wall with pelvioperitonitis;
• severe adhesive disease of the small pelvis;
• dense fat layer or scars on the anterior abdominal wall.

In this case, a second study is usually carried out, in preparation for which an obligatory emphasis is placed on getting rid of flatulence with the help of medications.

Pathologies of the ovaries and their signs on ultrasound

Some diseases, such as luteal (yellow body cyst) and follicular cyst, are considered "normal" and do not need treatment, since they usually heal spontaneously as soon as the hormonal background changes. Other cysts and diseases are pathological and require mandatory treatment.

On ultrasound, the cyst looks like a formation of 2.5 cm with fluid inside, which has a different structure and degree of staining.

Any pathology detected on ultrasound of the ovaries must be confirmed by other research methods, only after that an accurate final diagnosis can be made.

Research Alternative

There are many alternative methods for examining the ovaries, among which the most commonly prescribed are:

• computer and magnetic resonance imaging;
• puncture of the Douglas space with subsequent cytological analysis of the washout;
• diagnostic laparoscopy (laparotomy) with express biopsy and smear-printing.

Ultrasound of the ovaries is the most versatile method of examination and stands out among the rest.

Its advantages are the following:

• non-invasive (without tissue injury) research method;
• painless;
• much cheaper and more accessible than other methods;
• absolutely harmless to the body - ionizing radiation is not used, therefore it can be carried out repeatedly;
• excellent visualization of soft tissues, unlike X-ray;
• ideal for monitoring intrauterine development of the fetus;
• shows the state of the body in "real time", thanks to which even an acute disease can be diagnosed without resorting to puncture of the posterior vaginal fornix and biopsy.

Where to do an ultrasound of the ovaries in St. Petersburg, the price of the examination

You can sign up for an expert pelvic ultrasound, which includes a complete examination of the ovaries at the DIANA clinic (St. Petersburg), on our website. The cost of a comprehensive examination will be only 1000 rubles. In this case, the study will be carried out using a new device with Doppler (manufacturer SAMSUNG MEDISON). Here you can take any tests. We work without days off and lunch!

medcentr-diana-spb.ru

2018 Women's Health Blog.

Pelvic examination in postmenopausal women

1. Uterus. In postmenopausal women, the uterus becomes much smaller and more homogeneous in echostructure: the endometrium is not traced.
2. Postmenopausal ovaries. The ovaries are small and often very difficult or impossible to visualize on ultrasound. If they do appear, they appear hyperechoic, without follicles, and often nearly isoechoic to the surrounding tissue.

Position of the uterus

The uterus can be rotated so that the body of the uterus is defined behind the cervix (retroversio condition). The body of the uterus can be tilted anteriorly (anteversio).

If the body of the uterus is tilted towards the cervix, it is in antejlexio. If the body of the uterus is tilted back from the cervix, this condition is called retroflexio.

In cases where the uterus is not visualized, it is necessary to find out if there was a history of hysterectomy. If there is a history of surgery, carefully look for the cervical stump, as supravaginal amputation is not a hysterectomy.

When normal pelvic echostructures are not clearly visualized, give the patient more fluid to fill the bladder.

The ovaries can occupy a different position, but are always behind the bladder and uterus. Most often they are found at the site of the appendages, on the side.

The ovary may be located in the retrouterine space or above the fundus of the uterus. In postmenopausal women, the ovaries are small and often not visualized.

If it is difficult to visualize the uterus and ovaries, move the uterus manually through the vagina and continue scanning in different planes to refine the anatomical details. A similar technique can be used in the presence of low-lying pelvic formations.

In the absence of imaging of the ovaries, the following technique may be used:

1. Place the patient in the lateral position and scan the opposite ovary through a full bladder.
2. Decrease the sensitivity level of the instrument. If the sensitivity is too high, the ovary may be poorly identified against the background of the surrounding parametrium and may not be visualized.

If the ovaries are still poorly visualized, this may be due to overfilling or underfilling of the bladder. Adequate filling is considered such that the bladder covers the bottom of the uterus, if the bladder is not filled enough. give the patient more water. Repeat the study after 30 minutes, try to visualize the ovaries.

If the bladder is full, it will push the ovaries down from the uterus or laterally onto the psoas. Ask the patient to partially empty the bladder (give her a special measuring vessel for filling). Then repeat the study.

Even if the bladder is adequately filled, the ovaries may be poorly visualized due to shielding by intestinal gases. This often happens if the ovaries are located higher than usual.

If necessary, scan the patient in an upright position or in a vertical oblique view. This will help dislodge the gas-filled loops of bowel so that the ovaries are more clearly visualized.

If the normal anatomy is still not clearly defined, gently inject 20 ml of body temperature water into the vagina and scan over the pubis. The fluid will surround the cervix and make it easier to identify the organs. This method is particularly useful in making a differential diagnosis between hysterectomy and supravaginal amputation in cases where clinical investigation is not possible.

If it is difficult to visualize the retrouterine masses, inject 200 ml of warm water into the rectum, then examine the area. Air microbubbles will be visualized as bright hyperechoic structures that clearly delineate the anterior rectal wall, which facilitates the recognition of formations in the intestinal lumen, such as fecal masses, which are the most common cause of diagnostic errors.

normal ovaries

When the ovaries are visualized, determine if there is any displacement of the surrounding structures. Determine the state of the internal structure of the ovaries and the presence or absence of acoustic pseudo-amplification. If anechoic structures are visualized in the thickness of the ovaries or along their periphery, it is possible that these are follicles. Decrease the sensitivity level when examining the ovaries, since normal ovaries are highly conductive and there is an increase in the deep sections. Take measurements for each ovary.

Examine the tissues around the ovary for cystic, solid, or fluid-containing masses. Look for fluid in the retrouterine space. Examine both ovaries.

The ovaries are normally never located in front of the uterus. In an atypical position, rotate the patient to look for adhesion fixation of the ovary and to determine if it is markedly enlarged.

The sensitivity of the instrument must be varied as different structures in the pelvis are examined in order to obtain an optimal image. The relationship of the pelvic organs can be better determined with a slow, steady scan over about 10 seconds.

Follicular apparatus of the ovary

Follicles are visualized as small cystic anechoic structures in the thickness of the ovary or along its periphery and are better visualized when a low sensitivity level of the device is set. Depending on the phase of the menstrual cycle, cystic structures can reach 2.5 cm in diameter. Simple cysts larger than 5 cm in diameter may be physiological and may change, become smaller or disappear).

If the presence of a cystic tumor formation is expected, dynamic observation is necessary - a study in the early and late phases of the menstrual cycle. Follicular cysts regress, while non-functional cysts do not change their size. If doubts remain, conduct a study next month.

A physiological cyst in the ovary can be up to 5 cm in diameter. Cysts of this size should be re-examined at the end of the menstrual cycle or during the next cycle.

Thanks to the organs of the small pelvis, the most important event in the life of every girl is carried out - the onset of pregnancy, which most of the female population dreams of. Therefore, after undergoing an ultrasound examination, some are shocked and puzzled by its results: what does “the ovary is not visualized” mean, what is it and is there any threat? The main task facing a woman in such a situation is not to lose heart. There are many reasons why the ovaries are not determined. They require more detailed consideration.

Anatomical location of the pelvic organs

Before considering the reasons why the ovaries can hide from view, it is necessary to understand the structure of the pelvic organs. It contains the following organs:

• the rectum, through which processed food comes out;
• bladder in contact with the walls of the vagina and uterus;
• the vagina, which is adjacent to the cervix and passes through the urogenital diaphragm;
• the uterus, which has a pear-shaped shape and consists of muscles; performs a reproductive function;
• two ovaries, which produce hormones and are responsible for the maturation of eggs;
• fallopian tubes that connect to the ovaries on both sides of the uterus.

Why the ovaries are not located on ultrasound

The specialist may say that the ovaries are not located. What does it mean? Why is this happening? In simple words, if an ovary is not visible on an ultrasound, this means that the monitor shows the absence of an organ, i.e. it is not defined. With its presence, on the ultrasound picture in the conclusion they write that they are determined. In frequent cases, the organs may not be located due to the incompetence of the gynecologist, who, due to his incompetence, simply could not see the organs on the monitor or adjust the sensors.

Normally, the contours of the ovaries in a healthy woman are uneven and clear. Fuzzy contours can indicate inflammation, cystic formations, the presence of a corpus luteum. Blurred - they talk about a disease such as salpingoophoritis - inflammation of the uterine appendages. With a fuzzy contour and a reduced size of the ovaries - the ultrasound picture indicates the likely onset of menopause.

Other cases of the left or right ovary not being determined include pathologies, endocrine disorders, and body characteristics.

Visualization also depends on the correctness of the ultrasound examination and the operation of the devices. During a transabdominal ultrasound, the patient must drink plenty of water to fill the bladder, as with a lack of fluid, the left ovary can hide behind the uterus. Before a transvaginal ultrasound, you should empty yourself, because the sensor is inserted into the vagina and its location becomes close to the organs, and the liquid during this study makes it difficult to see what is happening inside.

Is it possible to do ultrasound diagnostics during menstruation, read the article Ultrasound of the pelvic organs and menstruation

Intestinal disorders

The first most popular organic reason for not seeing the left or right ovary is a large accumulation of intestinal gases, flatulence, intestinal fullness after eating. As a rule, on the next study, the organ appears in the field of view.

Postponed surgical interventions

After gynecological operations, the organ is not located, because the stress transferred by the body can disrupt its work for a certain time, as a result of which a decrease in the organ can occur, up to the size of a pea.

Taking birth control pills

OK drugs are used to treat hormonal disorders and contraception. They dampen the hormones produced by the ovaries to prevent the maturation of eggs, thereby eliminating the possibility of ovulation for fertilization.

Since hormones are closely related to the processes in the small pelvis, internal organs can become invisible to the equipment due to the effect of hormonal pills on reproductive function. While taking contraceptives, ultrasound is less informative.

Anovulatory cycle

It happens that the ovary is not viewed by a specialist during the examination due to the lack of ovulation. There are two reasons for her absence:

• temporary hormonal failure, in which the usual state of the body returns in the next menstrual cycle.
• serious hormonal disorders or diseases of the small pelvis (for example, polycystic).

If more than two cycles in a row, ultrasound does not show a normal result, there is no ovulation, most likely it is necessary to examine the endocrine system.

Hormonal disorders

If the patient denied the reasons listed above, and the ovary was not visualized after the second examination, it is recommended to be tested for female sex hormones:

• Prolactin;
• Estradiol (estrogens);

Remember! Only an experienced specialist can accurately determine the reason why the ovaries are not visualized

Other reasons

The following circumstances can also cause an organ to be missing from the examination:

• adhesive process in the genitals or abdominal cavity;
• premenopause and menopause;
• congenital absence or abnormal development of the ovary;
• enlarged uterus;
• organic displacement of the organ due to the transferred pathology.

Instead of making disappointing diagnoses for yourself, it is recommended to find out whether the absence of an organ in the conclusion is the result of improper preparation for the examination, a doctor’s mistake, a short-term failure, or the presence of feces in the intestines. In most cases, girls shocked by the absence of an organ in the results of the examination and according to the doctor turn out to be ordinary intestinal gases, lack of ovulation, or interaction with an incompetent doctor.

oyaichnikah.ru

The ovaries are not visualized what does this mean? | WHO? WHAT? WHERE?

The ovaries are a paired organ of the female reproductive system responsible for childbearing and the health of the lady. It is possible to detect any deviations from the norm in their work during an ultrasound scan. But sometimes the doctor cannot examine the organs, referring to the fact that the ovaries are not visualized. What does this mean, how should one react to such a statement from a specialist, and should one start worrying about one's own health?

Why is an ovarian ultrasound performed?

The procedure is often prescribed for preventive purposes 1-2 times a year. This allows women to monitor their well-being and timely detect a variety of pathologies, preventing their development and degeneration into a chronic form. Most gynecological ailments can be cured at an early stage if periodically examined by a specialist.

At least ultrasound is prescribed to determine the effectiveness of the treatment of a particular ailment, to decide on the need for surgery and choose a method of treatment.

The location of organs in the pelvis, features of the examination

The ovaries are located between the bladder and uterus, but in some women they may be hidden under the uterine fundus. With the onset of menopause, the organs are greatly reduced in size, which makes them almost invisible during ultrasound. But this is the norm, and in some cases, the lack of visualization may mean an error in the research process.

To avoid errors, the procedure must be performed as follows

• the patient must come to the examination with a full bladder

• you need to take a side position on the couch

• the researcher starts by carefully adjusting the sensitivity of the device (if the parameter is set at high frequencies, there is a chance that the right ovary will not be seen.

The left ovary is often not visible due to poor filling of the bladder: the organ is hidden behind the fundus of the uterus, not visualized during the study. If this happens, you should drink more water and repeat the procedure after half an hour.

But in some cases, the amount of liquid you drink and the settings of the device do not really matter. The organ does not appear in the doctor's field of view. This can happen due to excessive fullness of the intestines with gases.

Other reasons

• undergone surgery in the pelvic area

• absence of ovaries from birth (rare but possible pathology)

• the climacteric age of the patient, when the organs are greatly reduced in size

• a full bowel (feces or air can hide the ovaries from the ultrasound machine)

• organs are displaced due to developmental pathology or previous diseases

• dangerous pathologies of the uterus when it changes in size

• doctor's mistakes made during the examination

kto-chto-gde.ru

Pelvic ultrasound in postmenopausal women

Pelvic examination in postmenopausal women

1. Uterus. In postmenopausal women, the uterus becomes much smaller and more homogeneous in echostructure: the endometrium is not traced.
2. Postmenopausal ovaries. The ovaries are small and often very difficult or impossible to visualize on ultrasound. If they do appear, they appear hyperechoic, without follicles, and often nearly isoechoic to the surrounding tissue.

Position of the uterus

The uterus can be rotated so that the body of the uterus is defined behind the cervix (retroversio condition). The body of the uterus can be tilted anteriorly (anteversio).

If the body of the uterus is tilted towards the cervix, it is in the antejlexio. If the body of the uterus is tilted back from the cervix, this condition is called retroflexio.

In cases where the uterus is not visualized, it is necessary to find out if there was a history of hysterectomy. If there is a history of surgery, carefully look for the cervical stump, as supravaginal amputation is not a hysterectomy.

When normal pelvic echostructures are not clearly visualized, give the patient more fluid to fill the bladder.

The ovaries can occupy a different position, but are always behind the bladder and uterus. Most often they are found at the site of the appendages, on the side.

The ovary may be located in the retrouterine space or above the fundus of the uterus. In postmenopausal women, the ovaries are small and often not visualized.

If it is difficult to visualize the uterus and ovaries, move the uterus manually through the vagina and continue scanning in different planes to refine the anatomical details. A similar technique can be used in the presence of low-lying pelvic formations.

In the absence of imaging of the ovaries, the following technique may be used:

1. Place the patient in the lateral position and scan the opposite ovary through a full bladder.
2. Decrease the sensitivity level of the instrument. If the sensitivity is too high, the ovary may be poorly identified against the background of the surrounding parametrium and may not be visualized.

If the ovaries are still poorly visualized, this may be due to overfilling or underfilling of the bladder. Adequate filling is considered such that the bladder covers the bottom of the uterus, if the bladder is not filled enough. give the patient more water. Repeat the study after 30 minutes, try to visualize the ovaries.

If the bladder is full, it will push the ovaries down from the uterus or laterally onto the psoas. Ask the patient to partially empty the bladder (give her a special measuring vessel for filling). Then repeat the study.

Even if the bladder is adequately filled, the ovaries may be poorly visualized due to shielding by intestinal gases. This often happens if the ovaries are located higher than usual.

If necessary, scan the patient in an upright position or in a vertical oblique view. This will help dislodge the gas-filled loops of bowel so that the ovaries are more clearly visualized.

If the normal anatomy is still not clearly defined, gently inject 20 ml of body temperature water into the vagina and scan over the pubis. The fluid will surround the cervix and make it easier to identify the organs. This method is particularly useful in making a differential diagnosis between hysterectomy and supravaginal amputation in cases where clinical investigation is not possible.

If it is difficult to visualize the retrouterine masses, inject 200 ml of warm water into the rectum, then examine the area. Air microbubbles will be visualized as bright hyperechoic structures that clearly delineate the anterior rectal wall, which facilitates the recognition of formations in the intestinal lumen, such as fecal masses, which are the most common cause of diagnostic errors.

normal ovaries

When the ovaries are visualized, determine if there is any displacement of the surrounding structures. Determine the state of the internal structure of the ovaries and the presence or absence of acoustic pseudo-amplification. If anechoic structures are visualized in the thickness of the ovaries or along their periphery, it is possible that these are follicles. Decrease the sensitivity level when examining the ovaries, since normal ovaries are highly conductive and there is an increase in the deep sections. Take measurements for each ovary.

Examine the tissues around the ovary for cystic, solid, or fluid-containing masses. Look for fluid in the retrouterine space. Examine both ovaries.

The ovaries are normally never located in front of the uterus. In an atypical position, rotate the patient to look for adhesion fixation of the ovary and to determine if it is markedly enlarged.

The sensitivity of the instrument must be varied as different structures in the pelvis are examined in order to obtain an optimal image. The relationship of the pelvic organs can be better determined with a slow, steady scan over about 10 seconds.

Follicular apparatus of the ovary

Follicles are visualized as small cystic anechoic structures in the thickness of the ovary or along its periphery and are better visualized when a low sensitivity level of the device is set. Depending on the phase of the menstrual cycle, cystic structures can reach 2.5 cm in diameter. Simple cysts larger than 5 cm in diameter may be physiological and may change, become smaller or disappear).

If the presence of a cystic tumor formation is expected, dynamic observation is necessary - a study in the early and late phases of the menstrual cycle. Follicular cysts regress, while non-functional cysts do not change their size. If doubts remain, conduct a study next month.

A physiological cyst in the ovary can be up to 5 cm in diameter. Cysts of this size should be re-examined at the end of the menstrual cycle or during the next cycle.

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The ovaries are the paired organ of the female reproductive system. The onset of pregnancy and the health of the woman as a whole depend on their normal functioning. Therefore, it is necessary to regularly undergo preventive examinations for ultrasound. If a woman has symptoms of a gynecological disease, then an ultrasound examination is necessary for diagnosis. To date, this is the most accessible and informative method of examination for diagnosis.

Why is an ovarian ultrasound prescribed?

For prevention, it is enough to undergo an ultrasound examination 1 or 2 times a year. This approach will help to avoid many serious female diseases. In addition, it will be possible to diagnose them at an early stage of development and prescribe treatment in time. As a rule, most diseases in gynecology are much easier to cure at the initial stage than in the acute stage.

If a woman has already visited a medical center for various symptoms and has already been treated, then the doctor prescribes an ultrasound scan for diagnosis. The following symptoms should be the reason for contacting a specialist and undergoing an examination:

Menstrual cycle of different duration or its absence;

Painful periods and long cycles;

Painful sensations in the suprapubic part of the abdomen and pulling pains;

Infertility;

The appearance of discharge with an admixture of blood in the intervals between menstruation.

Also, the doctor prescribes an ultrasound examination, if you need to determine the duration of pregnancy. In the treatment of infertility, ultrasound diagnostics shows how the corpus luteum in the ovary matures and whether it is there at all: it depends on whether pregnancy occurs.

Indications for ultrasound

Ultrasound allows you to accurately determine the gestational age and the number of embryos in the uterus, to control their development. In addition, the doctor can confirm or refute the development of the following diseases:

All types of pathology of the endometrium of the uterus;

Tumors and other neoplasms on the ovaries and near them;

salpingitis;

Inflammatory processes in the pelvic organs, including the ovaries;

Various pathologies of the cervix;

Since at the same time as the ovaries the doctor can examine other organs of the small pelvis, such a diagnosis is complex and helps to detect violations of the hormonal background and the functions of the genitourinary system.

Features of ultrasound of the ovaries

The examination can be carried out in several ways - transvaginally and transabdominally. This makes it possible to most fully visualize the organ. The first method is that the patient is injected with a special sensor into the vagina. No preparation is required, and the guide gel is applied directly to the scanner.

A transabdominal examination is a scan of the pelvic organs through the wall of the abdominal cavity. Before this, it is necessary to fill the bladder in order to better visualize the ovaries. However, it happens that an ovary is not detected on ultrasound. This could be for several reasons:

The ovary was removed by surgery;

This is a congenital pathology, and it happens that two organs are missing at once;

The ovaries are reduced in size due to malnutrition and are difficult to visualize;

There are myomatous nodes in the uterus and from this it is enlarged and closes the ovaries;

The patient has multiple adhesions in the organs, which is why they are enlarged and also close the ovary;

Intestinal distention can also interfere with the definition of the ovary on ultrasound.

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2018 Women's Health Blog.

Many women after an ultrasound want to know when the ovaries are not visualized, what does this mean? In order to answer this question, it is necessary to describe the procedure for ultrasound examination of the appendages.

These organs are located in patients behind the bladder and uterus. Ultrasound demonstrates their location on the side, next to the appendages. In some women, the ovaries are located above the uterine fundus. If a woman has menopause, then the organs decrease in size, and the ovary is not detected on ultrasound.

In some cases, difficulties during ultrasound of the pelvic organs arise through the fault of the doctor. In order to eliminate errors during diagnostics, it is necessary to carry it out according to all the rules.

Note: The procedure is carried out as follows. The patient should take a lateral position, after filling the bladder. The doctor diagnoses the organ, carefully adjusting the sensitivity of the device. If this parameter is adjusted too high, then the doctor will not see the right appendage on ultrasound. This is due to the fact that the parametrium surrounding this organ makes the readings of the device unreliable.

Why is the left ovary not visible? Sometimes this happens due to insufficient fullness of this organ. To do this, the patient needs to drink such an amount of liquid in which the bottom of the uterus will be blocked by the bladder. If a woman has not drunk enough water, she needs to fill her bladder completely. After half an hour, the study is repeated.

Even if the bladder is adequately filled, the ovaries may not be seen at diagnosis if the bowel loops are filled with gases.

Causes

The left ovary is not visualized what does this mean? Don't worry ahead of time. In some cases, gynecologists may refer you for a second ultrasound if they do not exclude the possibility of an error during the previous diagnosis.

There are a number of reasons why these organs are not visualized on ovarian ultrasound:

• Previous gynecological surgeries.
• Absence of ovaries since birth.
• Climax or depletion of the functions of these organs.
• Bloating and full bowels. For this reason, doctors recommend that you always come to surgery with an empty bowel.
• Diseases that lead to displacement of the organ.
• Pathological diseases of the uterus, as a result of which it increases in size.
• Mistakes made during an ultrasound examination by a gynecologist.

The ovaries are the paired organ of the female reproductive system. The onset of pregnancy and the health of the woman as a whole depend on their normal functioning. Therefore, it is necessary to regularly undergo preventive examinations for ultrasound. If a woman has symptoms of a gynecological disease, then an ultrasound examination is necessary for diagnosis. To date, this is the most accessible and informative method of examination for diagnosis.

Why is an ovarian ultrasound prescribed?

For prevention, it is enough to undergo an ultrasound examination 1 or 2 times a year. This approach will help to avoid many serious female diseases. In addition, it will be possible to diagnose them at an early stage of development and prescribe treatment in time. As a rule, most diseases in gynecology are much easier to cure at the initial stage than in the acute stage.

If the woman has already applied to medical Center about various symptoms and have already been treated, the doctor prescribes ultrasound for diagnostics. The following symptoms should be the reason for contacting a specialist and undergoing an examination:

Menstrual cycle of different duration or its absence;

Painful periods and long cycles;

Painful sensations in the suprapubic part of the abdomen and pulling pains;

Infertility;

The appearance of discharge with an admixture of blood in the intervals between menstruation.

Also, the doctor prescribes an ultrasound examination, if you need to determine the duration of pregnancy. During treatment infertility Ultrasound diagnostics shows how the corpus luteum in the ovary matures and whether it is there at all: it depends on whether pregnancy occurs.

Indications for ultrasound

Ultrasound allows you to accurately determine the gestational age and the number of embryos in the uterus, to control their development. In addition, the doctor can confirm or refute the development of the following diseases:

All types of pathology of the endometrium of the uterus;

Tumors and other neoplasms on the ovaries and near them;

salpingitis;

Inflammatory processes in the pelvic organs, including the ovaries;

Various pathologies of the cervix;

Since at the same time as the ovaries the doctor can examine other organs of the small pelvis, such a diagnosis is complex and helps to detect violations of the hormonal background and the functions of the genitourinary system.

Features of ultrasound of the ovaries

The examination can be carried out in several ways - transvaginally and transabdominally. This makes it possible to most fully visualize the organ. The first method is that the patient is injected with a special sensor into the vagina. No preparation is required, and the guide gel is applied directly to the scanner.

A transabdominal examination is a scan of the pelvic organs through the wall of the abdominal cavity. Before this, it is necessary to fill the bladder in order to better visualize the ovaries. However, it happens that ovary not detected on ultrasound. This could be for several reasons:

The ovary was removed by surgery;

This is a congenital pathology, and it happens that two organs are missing at once;

The ovaries are reduced in size due to malnutrition and are difficult to visualize;

There are myomatous nodes in the uterus and from this it is enlarged and closes the ovaries;