Ultrasound below the cervix

Transvaginal (TV) ultrasound is a very common investigation principally focusing on the uterus and ovaries. It is easy to overlook the structures that can be seen below and adjacent to the cervix which include the urethra, bladder, vagina and perineal structures. On occasion there may be specific requests to view pathology associated with the perineum or vagina.

Pathology in this region can include Bartholin’s, Skene’s and Gartner duct cysts. Urethral pathology can include diverticula, the effects of prolapse and iatrogenic findings such as silicone injections and tension-free vaginal tape (TVT). Incidental soft tissue masses such as lipomas may also be seen. Malignant lesions include vulval and vaginal carcinoma and cervical carcinoma extending inferiorly. Dynamic scanning can demonstrate the degree of prolapse with cystoceles, rectoceles and enteroceles.

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