Pelvic Floor preparation

The following information is a general guide to preparing for Pelvic Floor, Pelvic Organ Prolapse and urinary incontinence assessment using ultrasound.

If your referral does not state this reasoning, please refer to the General Pelvic Ultrasound Preparation page. If you are unsure, please speak to our reception staff at time of booking.

If the preparation required for your appointment varies from the below, our reception staff will inform you and advise new instructions at the time of booking.

About this examination

A pelvic floor ultrasound is a simple and safe scan used to assess for pelvic organ prolapse (POP) and urinary incontinence by providing a detailed look at how well the pelvic floor muscles are working and whether any organs like the bladder, uterus, or bowel are shifting out of place (prolapsing).

Indications for this examination include:

  • Urinary incontinence

  • Pelvic organ prolapse

  • Posterior compartment prolapse (rectoceles)

  • Anal sphincter trauma

  • Pelvic floor trauma post delivery

  • Post – Surgical Complications or recurrence associated with mesh repair and TVT Slings

The nature of this examination requires a combination of scan approaches due to the necessity to assess the structure and function of the pelvic organs, as well as, the musculature of the pelvic floor. The initial portion of the ultrasound will require a transabdominal ultrasound, followed by transperioneal (translabial) and lastly a transvaginal ultrasound. Before commencing each step, you will be explained the examination and asked to consent to the proceeding examination. 

This scan can take up to 45-minutes, please allow adequate time for this. 

Preparing for your scan

You will need to have a comfortably full bladder prior to your scan.

To fill your bladder, we ask that you drink a minimum of 1L of water over the 12 hours leading up to your scan. If your scan is in the early morning, please drink the night before; if your scan is in the afternoon, please drink earlier in the day.

Please refrain from emptying your bladder within 30-minutes of your appointment time.

Scan techniques for pelvic floor assessment using ultrasound

Transabdominal

A transabdominal ultrasound is a non-invasive imaging test used to examine the female pelvic organs, including the uterus, ovaries, and bladder, from outside the body. During the procedure, a clear gel is applied to your lower abdomen, and a handheld device, called a transducer, is moved across the skin. The transducer sends out sound waves that create images of the internal organs on a screen.

Why do I need a T/A scan in PF U/S?

During a pelvic floor ultrasound, a transabdominal ultrasound is used to assess the pelvic organs, particularly the bladder for any anomalies or obstructions that may be contributing to symptoms.

A transperineal ultrasound is a non-invasive imaging test used to view the pelvic organs and pelvic floor muscles. It involves placing the ultrasound probe externally on the perineum—the area between the vagina and the anus and is sometimes called a translabial ultrasound in women.

Because the probe stays outside the body, it is generally well tolerated and does not require internal insertion, making it a comfortable option for many patients. The scan can capture both static images and real-time video, showing how the pelvic muscles and organs move during actions like coughing or squeezing.

As the patient, it is your right to consent or decline any ultrasound at any stage. Please speak to one of our friendly team for more information or to discuss any concerns you may have.

Why do I need a T/P scan in PF U/S?

A transperioneal ultrasound allows the transducer to sit alongside the pelvic floor musculature to dynamically assess their function in real time. Using a T/P transducer with advanced 3D and 4D ultrasound imaging, along with special software that allows for detailed, multi-angle reconstructed views provides a dynamic and comprehensive assessment of the muscles, nearby organs and their integral relationship. The images collected can be viewed in three dimensions and in thin slices, much like a CT or MRI scan. One of the major advantages of ultrasound over other imaging modalities, is the ability to watch how the pelvic floor muscles move in real time, giving a clear picture of how the muscles and organs work together during different actions like contracting or bearing down.

During the examination, you will be asked to do various breathing exercises and muscle straining to monitor how your urinary muscles are contracting in relation to different pressures in real time. You may be asked to do this several times, and to hold in a particular breathing pattern. Please speak to your sonographer if this may be difficult for you to achieve or maintain.

Transvaginal

Following the T/A ultrasound, you will be asked to go to the bathroom and empty your bladder before commencing an internatal ultrasound (transvaginal). A transvaginal ultrasound is considered the gold standard for imaging the female pelvic organs. Unlike an abdominal ultrasound, this procedure involves inserting a small, wand-like probe (called a transducer) into the vagina. The probe uses sound waves to create detailed images of the inside of your pelvis. It might feel a little uncomfortable, but it shouldn’t be painful.

As the patient, it is your right to consent or decline any ultrasound at any stage. Please speak to one of our friendly team for more information or to discuss any concerns you may have.

Why do I need a T/V scan in PF U/S?

During a pelvic floor ultrasound, a transvaginal ultrasound is necessary to accurately assess the structure of the uterus and ovaries for their relationship and any anomalies that may be contributing to symptoms.

Transperineal

If you require further instruction or have any questions regarding the above, please discuss with our admin team.