Women’s Health · Your Scan

Transabdominal or Transvaginal — Which Pelvic Scan?

Two routes to the same organs, with a real difference in image quality. Here is what each involves, when it matters, and why the choice is always yours.

Private ultrasound examination room with a couch, blanket and modern scanner

A pelvic ultrasound looks at the womb, its lining and both ovaries. It can be done through the abdominal wall, or with a slim probe placed in the vagina. The organs are the same either way — what differs is how close the probe gets, and therefore how much detail is visible.

Side by Side

How the two compare

Transabdominal Transvaginal
How it is done Gel and a probe over the lower abdomen A slim probe, about the width of a tampon, placed a short way into the vagina
Preparation Full bladder needed Empty bladder — more comfortable
Detail of womb lining Limited Clear — the main reason it is preferred
Ovaries Often harder to see well Usually seen clearly
Small findings Polyps and small cysts can be missed Much better detected
Overview of large structures Better — large fibroids can extend beyond the probe’s reach internally Limited field of view
Comfort No internal examination; full bladder can be uncomfortable Not usually painful, though some find the idea daunting

For large fibroids or a bulky womb, the two are often done together — the internal scan for detail, the abdominal one for the overall picture.

Your Choice

You decide, and you can change your mind

Transvaginal is the standard approach for most pelvic questions because the detail is genuinely better — particularly for the womb lining, where an abdominal view often cannot answer the question at all. We will explain why we are suggesting it for your specific situation.

But it is always your decision. You can decline, choose the abdominal approach, stop at any point, or ask for a chaperone — and none of that requires a reason or an apology. If you choose the abdominal route we will scan thoroughly that way and, where something could not be assessed properly, the report will say so plainly rather than implying a normal result.

A transvaginal scan is not done if you have never been sexually active, unless you specifically ask and it is appropriate. It can be performed during a period if needed — tell us and we will handle it discreetly. Our patient information on having a transvaginal scan for the first time walks through it step by step.

At IUS London

How the appointment runs

  1. 1
    PreparationArrive with a comfortably full bladder. If we go on to a transvaginal scan you empty it first — so coming prepared keeps both options open. 30 minutes.
  2. 2
    We start abdominallyGel over the lower abdomen for the overview, and we talk through what we can and cannot see from there.
  3. 3
    Then discussIf a transvaginal scan would answer your question better, we explain why and ask. You are free to say no.
  4. 4
    Privacy and controlYou undress privately, you are covered throughout, you position the probe yourself if you prefer, and the scan stops the moment you ask.
  5. 5
    ResultsExplained on screen as we scan, with the written report usually with you within two hours — stating which approach was used and any limitation that created.
FAQs

Your questions answered

Does a transvaginal scan hurt?
Most people find it uncomfortable at most rather than painful. The probe is slim — roughly the width of a tampon — and goes in a short way. Tell us if anything hurts and we will adjust or stop.
Can I refuse and still have a useful scan?
Yes. We will scan thoroughly abdominally, and the report will state clearly what could not be assessed that way. You never need to justify declining.
Do I need a full bladder?
For the abdominal scan, yes — it lifts the bowel out of the way. For the transvaginal scan the bladder should be empty. Arriving full keeps both options available.
Can I have it during my period?
Yes, if needed — it does not prevent the scan and is handled discreetly. For heavy bleeding questions, though, the lining reads best in the days just after a period, so timing may be worth planning.
Can I have someone with me?
Yes. You can bring someone, and a chaperone is available on request — just ask when you book or on the day.
Is it safe in early pregnancy?
Yes. Transvaginal scanning is routine in early pregnancy and is the standard way to assess it in the first weeks.
Related

Where to go from here

PrepareYour First Transvaginal Scan

What happens, step by step, and what you control.

Read more →SymptomsPelvic Pain — When to Scan

What the pattern of pain suggests and when it is urgent.

Read the guide →SymptomsHeavy Periods — Causes

What counts as heavy, and what a scan can find.

Read the guide →

Your scan, your pace

Womb, lining and both ovaries assessed by the approach you are comfortable with — explained on screen as we scan, with the written report usually within two hours, stating exactly what was and was not seen.

From £159
Pelvic scan

Pelvic scan

5a Lucerne Mews
Kensington, London W8 4ED
3 mins from Notting Hill Gate

This article is general information about pelvic ultrasound, not individual medical advice. You may decline any part of an examination at any time. For persistent pelvic symptoms, see your GP whatever a scan shows — NHS guidance on ultrasound scans explains the general procedure.

Written and clinically reviewed by the HCPC-registered sonographers who perform this scan at IUS London — a CQC-registered diagnostic ultrasound clinic (Provider ID 1-2775844974). Your own findings are explained to you at the scan and set out in your report.

Author: Yianni Kiromitis, Senior Sonographer, HCPC RA38415 — over 20 years’ experience in NHS and private ultrasound
Medically reviewed: 9 August 2026