International Ultrasound Services offers private ultrasound scans in a convenient central London location. This private scan service is offered to patients who: Require quick diagnosis and treatment of their symptoms Are anxious and the NHS waiting increases their anxiety Require a private baby scan not offered by the NHS. Avoid overcrowded Emergency departments that most often than not are not able to offer an ultrasound scan. Disease Diagnosis during the novel Covid-19 era It is now even more important to not ignore any symptoms of a potential disease. Pain, discomfort or 'strange feelings' are your body's way to say that something is wrong. During the current coronavirus pandemic, the NHS has cancelled most routine investigations including ultrasound scans. The reasons for this are: Medical resources should be spared and prioritized. Avoid unnecessary exposure of medical personnel to (potentially) infected patients and vice versa. The risk of infection is particularly high during ultrasound investigation due to the proximity of the sonographer and the patient The number of visits should be reduced to the essential minimum Importance of Early Diagnosis It is a grave time for the NHS throughout the UK but mainly in overpopulated London. While every effort is directed towards the COVID-19, lives will undoubtedly be lost due to delay in the diagnosis of disease. The chances of survival can significantly increase when a disease is caught in the early stages. People will underlying known or unknown disease have higher mortality than healthy people who caught the coronavirus. Cancer Diagnosis According to Science Blog diagnosis of cancer has been heavily impacted. Fewer people booking GP appointments resulting in an up to 25%t drop-in urgent and 2-week referrals. This very concerning as it means that more than 2000 cases of cancer are not diagnosed every week. This will, in turn, create a massive backlog for when NHS re-opens. At our London Ultrasound Clinic, we offer same-day private scans to diagnose any potential disease and any signs of cancer. Pregnancy Ultrasound scans Pregnancy ultrasound scans are still offered by the NHS although guidelines by ISUOG recommend the dating scan should be performed at 13+6 weeks gestation. The anomaly scan should be performed at 23 weeks and the growth scan should not be performed (as always has been in the UK) unless there are clinical indications. If you need a private baby scan you can rest assured knowing that we are here to offer you the help and support you need in a comfortable setting with a personalised approach. Heart Disease The novel coronavirus not only causes viral pneumonia but also has major implications for the cardiovascular system. What is coronavirus? The coronavirus is a flu-like virus that can affect the lungs and airways. People with underlying conditions have a higher risk of complications. What is an Ultrasound scan? Ultrasound is probably the easiest and faster medical examination to diagnose bodily disease. It is a non-evasive medical test using high-frequency soundwaves to obtain images of the inside of your body. Ultrasound is mainly used to diagnose issues with: The upper abdomen including the liver The urinary tract Issues with the female anatomy such as the uterus and the ovaries Problems with the thyroid gland Testicular problems in men Musculoskeletal Issues Investigate superficial lumps In conclusion, it is now more important than ever to make sure that these niggles you feeling are nothing significant to concern and that you have no underlying causes that can impact your fight with coronavirus. As the NHS has diverted resources in fighting the COVID-19 it is anticipated that future mortality rates of diseases unrelated to coronavirus will increase due to collateral damage caused by delayed diagnosis. It is time to take responsibility for your own health and your loved ones and book a private ultrasound in London today. Don't wait for tr NHS to reopen as this can take a long time.
Medical Sonographer A sonographer is a healthcare professional who specialises in the use of ultrasound imaging devices to produce diagnostic images, scans, videos or three-dimensional volumes of anatomy and diagnostic data, frequently a radiographer, but may be any healthcare professional with the appropriate training. Most people associate medical sonography with ultrasound scans during pregnancy, as sonogram pictures are the most common way to view a foetus. There are many things that sonography, also called ultrasound technology, is used for in the medical field. Sonograms are used for looking inside the body painlessly, and as such can be used to track blood in the circulatory system, view tendons and ligaments, ensure the proper functioning of digestive organs, and much more. At International Ultrasound Services our two sonographers and founders provide a wide range of private ultrasound direct to our community in London., including early pregnancy scans as well as Wellman and well-woman scans. Job Description A medical sonographer uses a sonography machine which bounces sound waves off of structures within the body to get a picture of what's going on inside. Ultrasound examinations require that the medical sonographer have up-close contact with patients, and that the sonographer know how to interpret the results. Education and Training Medical sonographers have a lot of different choices for how they want to go about their training. They can study an undergraduate course or obtain postgraduate qualifications after they have finished a relevant undergraduate course such as radiography or midwifery. Ultrasound Scans A sonographer is required to operate and maintain complex ultrasound equipment in order to perform sonographic procedures. Operating sonography equipment and producing high-quality images takes a significant amount of training and practice. The ultrasound process involves applying a gel to the skin in the area that needs to be examined which helps with the transmission of sound waves. Then the sonographer places an acoustic transducer on the patient’s skin. The transducer produces high-frequency sound waves that are transmitted into the body. These sound waves bounce around the parts inside the patient’s body and then come back to the transducer which detects these wave echos and how they bounce around inside the body. Structures in the body will reflect these sound waves differently. Mapping these waves together produces an image of the body’s internal structures. The sonographer’s goal is to move and manipulate the transducer over the body in order to obtain the best view of the situation inside the patient. These acoustic signals are then converted into electronic signals to create a digital image of internal organs, blood vessels and other structures. These images can be viewed on a monitor and can be recorded on video for use by other medical professionals, such as doctors, surgeons and radiologists. The sonographer will issue a medical report that will be used by the clinicians to identify the best way of treatment associated with the patient's symptoms and ultrasonic findings. A sonographer spends more time with their patients than many other health care professionals. The ultrasound process is very “hands-on”, and many technicians appreciate the amount of patient contact they get to be involved with. While some sonographers specialize in a certain area, others perform on a variety of patients and conditions. Many sonographers work in tracking fetal health and development. Other specialities include abdominal, adult and pediatric heart and vascular procedures. A cardiac sonographer (also known as an echocardiographer) works on researching the heart and supporting vein system.
What is the Thyroid? The thyroid gland is the biggest gland in the neck. It is situated in the anterior (front) neck below the skin and muscle layers. The thyroid gland takes the shape of a butterfly with the two wings being represented by the left and right thyroid lobes which wrap around the trachea. The sole function of the thyroid is to make thyroid hormone. This hormone has an effect on nearly all tissues of the body where it increases cellular activity. The thyroid produces hormones that help your body to function properly. The thyroid gland absorbs iodine from the diet, which is found in fish, seafood and dairy products. It also produces two hormones; thyroxine (T4) and triiodothyronine (T3) which help keep the body functioning normally. Ultrasounds is the first imaging modality being used to identify any thyroid abnormalities. The thyroid scan is one of our most popular investigations amongst the private ultrasounds we offer in our clinic in London. Common Thyroid Problems The thyroid gland is prone to several very distinct problems, some of which are extremely common. These problems can be broken down into  those concerning the production of a hormone (too much, or too little),  those due to increased growth of the thyroid causing compression of important neck structures or simply appearing as a mass in the neck,  the formation of nodules or lumps within the thyroid which are worrisome for the presence of thyroid cancer, and  those which are cancerous. The information in this article is arranged to give you more detailed and complex information as you read further. — Goiters ~ A thyroid goitre is a dramatic enlargement of the thyroid gland. Goitres are often removed because of cosmetic reasons or, more commonly because they compress other vital structures of the neck including the trachea and the oesophagus making breathing and swallowing difficult. Sometimes goitres will actually grow into the chest where they can cause trouble as well. Several nice x-rays will help explain all types of thyroid goitre problems. — Thyroid Cancer ~ Thyroid cancer is a fairly common malignancy, however, the vast majority have excellent long term survival. — Solitary Thyroid Nodules ~ There are several characteristics of solitary nodules of the thyroid which make them suspicious for malignancy. Although as many as 50% of the population will have a nodule somewhere in their thyroid, the overwhelming majority of these are benign. Occasionally, thyroid nodules can take on characteristics of malignancy and require either a needle biopsy or surgical excision. — Hyperthyroidism ~ Hyperthyroidism means too much thyroid hormone. Current methods used for treating a hyperthyroid patient are radioactive iodine, anti-thyroid drugs, or surgery. Each method has advantages and disadvantages and is selected for individual patients. Many times the situation will suggest that all three methods are appropriate, while other circumstances will dictate a single best therapeutic option. Surgery is the least common treatment selected for hyperthyroidism. The different causes of hyperthyroidism are covered in detail. — Hypothyroidism ~ Hypothyroidism means too little thyroid hormone and is a common problem. In fact, hypothyroidism is often present for a number of years before it is recognized and treated. There are several common causes, each of which are covered in detail. Hypothyroidism can even be associated with pregnancy. Treatment for all types of hypothyroidism is usually straightforward. — Thyroiditis ~ Thyroiditis is an inflammatory process ongoing within the thyroid gland. Thyroiditis can present with a number of symptoms such as fever and pain, but it can also present as subtle findings of hypo or hyperthyroidism. There are a number of causes, some more common than others. Each is covered on this site. Thyroid Cancer In the UK, approximately 3000 people are diagnosed with thyroid cancer each year according to Cancer Research. It is a fairly rare type of cancer that develops slowly and is usually more common in middle-aged and older people. However, there is one type, known as papillary thyroid cancer, which often affects younger people. Overall, more women get thyroid cancer than men. It rarely affects children. The four main types of thyroid cancer are: Papillary Thyroid Cancer - Papillary cancer develops in the follicular cells and grows slowly. It is usually found in one lobe; only 10% to 20% of papillary cancers appear in both lobes. Follicular Thyroid Cancer - Follicular cancer also develops in the follicular cells and grows slowly, yet is less common. When detected early, it can be treated successfully. Papillary and follicular cancers makeup 80% to 90% of thyroid cancers, and are grouped under the term differentiated thyroid cancer. When detected early, especially in people below the age of 45-50 years, it can be treated successfully. Medullary Thyroid Cancer - Medullary cancer develops in the C cells. It can be controlled if it is found and treated before it spreads to other parts of the body. Medullary cancer accounts for 5% to 10% of thyroid cancers. Anaplastic Thyroid Cancer - This is a very rare and aggressive form of thyroid cancer that takes its origin from differentiated thyroid cancer or other benign tumours of the gland, and in its giant cell variety is often rapidly fatal. The outlook for most types of thyroid cancer is usually very good, and many people are completely cured of the disease, even if it has spread beyond the thyroid. As we well know, there are many kinds of cancer; unfortunately, they all come about because of the out-of-control growth of abnormal cells. Healthy Cells vs. Cancer Cells Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need the energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally. The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet. Signs and Symptoms of Thyroid Cancer The most common symptom of thyroid cancer is a lump or nodule, that can be felt in the thyroid gland or neck. Other symptoms are rare. Pain is seldom an early warning sign of thyroid cancer. You may have a tight or full feeling in the neck, difficulty breathing or swallowing, hoarseness or swollen lymph nodes. Thyroid Ultrasound The thyroid ultrasound scan will identify any lumps on the thyroid and will also check the overall appearance of the thyroid for evidence of thyroiditis. International ultrasound services offer ultrasound scanning services in a central London location. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
The thyroid ultrasound scan is one of the most common private ultrasound scans in London. It is very common to identify thyroid nodules during a thyroid ultrasound in our private ultrasound clinic. Some of these nodules have benign appearances but some others have been proven by FNA to be malignant. You should, therefore, be aware of the thyroid cancer signs and seek medical advice when necessary. Thyroid Cancer Symptoms, Signs What are the symptoms of thyroid cancer? Lump in the neck (or lump in throat): painless, enlarged nodule; But not always, sometimes there is pain. Thyroid cancer involves the adjacent tissues (e.g. throat), causing a difficulty swallowing, hoarseness. One or multiple firms or hard, fixed thyroid nodules. Swollen lymph nodes in the neck. Thyroid cancer symptoms are often not accompanied by high thyroid symptoms and low thyroid symptoms. Early symptoms of thyroid cancer At the beginning of the disease, thyroid cancer symptoms almost do not emerge. Therefore, the patients do not notice it. Only with an increase in the size of the thyroid cancer, the patient will feel discomfort and have thyroid cancer symptoms. Most of the thyroid cancers do not lead to changes in thyroid function, so the patients have "thyroid cancer symptoms" but no high thyroid (hyperthyroidism symptoms), as well as no low thyroid (hypothyroidism symptoms). Advanced thyroid cancer symptoms In the early stage, the thyroid cancer symptoms often can not be perceived by victims. However, with further growth of the tumour, the thyroid cancer increases in size and therefore causes thyroid cancer symptoms: Sufferers palpate a lump in the thyroid, that is larger with time and characterized by one or multiple firm, hard and fixed thyroid nodules. The large thyroid cancer has the ability to invade and squeeze the adjacent organs and tissues. For this reason, the patients may experience some "thyroid cancer symptoms", such as difficulty in breathing and swallowing by pressure on the trachea or throat. ①When the growing thyroid cancer involves nerves, other "thyroid cancer symptoms" may occur. If the so-called "recurrent laryngeal nerve" affected, the voice may sound hoarse due to a paralysis of the vocal folds. The hoarseness is very common and can occur in the throat cancer, oesophagal cancer, other benign or malignant tumours of the neck. Thyroid cancer symptoms may also occur due to an invasion to the so-called "cervical sympathetic plexus". If the thyroid cancer involves the nerves in the neck, it will develop a "Horner's syndrome": It is characterized that the pupil is constricted, the eyeball is sunk back into the orbit (eye socket) and the upper eyelid droops on the affected side. Horner's syndrome can also be caused by "Pancoast tumour", that is lung cancer in the apex of the lung. If the "cervical plexus nerves" of the neck are affected, the patients may feel pain in ear, shoulder or the back part of the skull.The above three types of thyroid cancer symptoms are all caused by thyroid cancer, that invades and compresses the nerves of the neck. In end-stage, the above thyroid cancer symptoms get worse, and the weight loss looks very prominent. Thyroid cancer metastasis Can thyroid cancer spread? There are large differences in the degree of malignancy among the different types of thyroid cancer. In some cases, the thyroid cancer spread to lymph nodes starts in the stage 1 thyroid cancer; Some thyroid cancers begin with stage 2; Some thyroid cancer does not spread via the lymphatic circulation, until stage 3 or 4. Lymph node metastasis to the neck is not always proportional to the prognosis for recovery. For lymph node metastasis, the thyroid cancer symptoms are manifested with some rough and swollen lymph nodes in the neck, poorly moved in the neck's tissue. Does thyroid cancer spread to distant organs? Thyroid cancer cells can spread to the lungs, liver, bone, brain, and that patients thus lose the chance of surgery, but not always. Thyroid function In general, thyroid cancer does not affect the thyroid function, and therefore, thyroid cancer symptoms do not include abnormal thyroid function. One of the exceptions is that the follicular thyroid cancer (20% of thyroid cancer) will cause high thyroid symptoms: such as tremor, loss of weight, sweating, heat intolerance, heart palpitations, restlessness, irritability. The other is low thyroid, which can be caused due to the normal thyroid tissue and cells damage by thyroid cancer. Therefore, thyroid hormone production is not enough. The low thyroid symptoms: inactivity, cold intolerance, muscle pain, increased need to sleep, constipation, dizziness, tingling sensations in hands, hair loss, and rougher voice. Weight gain? It seems unlikely because the end-stage thyroid cancer symptoms are cachexia and emaciation. When to seek medical advice for thyroid cancer? If you have the above-mentioned symptoms, you'd better make an appointment with your doctor. Lump in the neck, enlarged thyroid, thyroid nodules is all the words used to describe the diseases associated with the thyroid. They are very common, and the vast majority of lump and nodules are benign, due to goitre, hyperthyroidism, as well as thyroiditis and thyroid adenoma. Less than 5 per cent are thyroid cancer. In recent years, there are about 50,000 people a year who are diagnosed with thyroid cancer in the United States. Thyroid cancer typically presents as a thyroid lump or one or more thyroid nodules. Compared with benign, they all look almost the same. How to clarify the causes and diagnose thyroid cancer, is the doctor's responsibility and expertise. It is recommended if you have an enlarged thyroid, thyroid nodules or lump in the front of your neck/throat, you should see your GP and request an ultrasound scan in London asap. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
One of the most dangerous medical conditions existing in the world today is that of vascular disease. While it can take many forms, they all associated with high cholesterol and high blood pressure. Unfortunately, the majority of patients with some form of this disease do not seek treatment until their symptoms force them to, very often when they become life-threatening. Perhaps a little more education is in order so that people become more aware of the dangers of leaving these conditions to go untreated. The Dangers of High Cholesterol When a person’s cholesterol is not in check through medical treatment, there is a risk that cholesterol and fat deposits can find their way into the bloodstream and adhere to the walls of arteries and veins. Over time, these deposits build-up, causing the diameter of the artery or vein to decrease, restricting the flow of blood through them. Blood is needed for healing and when it cannot effectively reach an area that needs it, there is a chance that problems can develop that will lead to even more complications like losing a limb or worse. Restricted movement of blood through veins and arteries also causes the heart to work harder to get the blood throughout the body. This results in spikes of high blood pressure weakened arteries and veins and even damage to the heart itself, over time. Out of control conditions that are easily treated can have a domino effect on the body, causing more harm than help, so no matter how minor a condition may be thought of as being, it should be taken as seriously as possible, including high cholesterol. The Most Dangerous Forms of Vascular Disease The most common form of vascular disease that affects a lot of patients today is that of Peripheral Artery Disease or PAD. Peripheral means that it will affect the limbs of the body, primarily, most often the legs rather than the arms. It begins with feeling a sluggishness or fatigue in those limbs while moving about like they are weighted down. This is the first sign that blood is not flowing as it should throughout those areas. Patients will also experience occasional numbness or tingling in the region, not often enough to be considered chronic but often enough to be noticeable. The condition occurs when the flow of blood through the arteries to the heart becomes so bad that the lack of oxygen resident in the blood begins to damage the heart itself. Blood flows from the heart to the lungs, where oxygen is released into the bloodstream. If the arteries that serve that route have become blocked due to plaque buildup, the less oxygen-rich blood is released to flow back into the heart, causing the heart itself to become damaged. Symptoms of this condition can include progressive shortness of breath, chest pain and fainting following exertion. Over time, the restricted blood flow will cause ulcers or sores to develop in the skin, and infection of those ulcers can grow quickly, due to a lack of healing blood flow to the area. This can lead to a loss of a limb due to gangrene, further restricting the patient’s ability to move around on their own. While serious, this is not the most dangerous form of this disease; that title is reserved for Pulmonary Vascular Disease. Other types of vascular diseases include Post-Thrombotic Syndrome, Vasculitis, Aortic Dissection, Carotid Artery Disease, Buerger’s Disease, Varicose VeinsFibromuscular Dysplasia, Critical Limb Ischemia (CLI), Renovascular Hypertension (RAS), Lymphedema, Stroke, Chronic Venous Insufficiency (CVI), Pulmonary Embolism, Mesenteric Artery Disease, Thoracic Aortic Aneurysm and, Thrombophilia all of which can be fatal. Diagnosis of Vascular Disease The occurrence of vascular disease increases with age and the prevalence varies considerably. Diagnosis is of the utmost importance as people with this disease have four to five times more incidence of stroke or heart attack. It is, therefore, a good habit to go for checkups every now and then just to be on the safe side and also eat healthy foods which are low on or better yet free of calories. Vascular ultrasound can detect early signs of vascular disease. International Ultrasound Services offers private ultrasound to check the health of your veins and arteries. This will give a quick diagnosis and will allow you to act on any findings. In our private ultrasound clinic we offer: Carotid ultrasound scans to evaluate the health of your carotid arteries for any signs of atheroma. DVT ultrasound scans to check for any signs of deep vein thrombosis. Effective Treatments Treatments for the vascular disease can include blood thinners to alleviate some of the pressure involved in getting blood to circulate, medications to control cholesterol and high blood pressure, and finally, surgery to remove any clots or blockage to a specific area. All of these conditions can eventually become life-threatening, so treatment must be acquired as soon as possible. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
Testicular Cancer Testicular ultrasound is one of our most common private ultrasound tests for men to exclude testicular cancer which is a disease in which malignant (cancer) cells form in the tissues of one or both testicles. The Testicles The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles. The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored. Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumours are seminomas and nonseminomas. These 2 types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation. A testicular tumour that contains both seminoma and nonseminoma cells is treated as a nonseminoma. Testicular cancer is the most common cancer in men 30 to 34 years old. There are 2400 testicular cases every year which is almost 6 every day. Risk Factors of Testicular cancer Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for testicular cancer include: Having had an undescended testicle. Having had abnormal development of the testicles. Having a personal or family history of testicular cancer. Being white. Signs of testicular cancer. Signs of testicular cancer include swelling or discomfort in the scrotum. These and other symptoms may be caused by testicular cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: A painless lump or swelling in either testicle. A change in how the testicle feels. A dull ache in the lower abdomen or the groin. A sudden build-up of fluid in the scrotum. Pain or discomfort in a testicle or in the scrotum. Diagnostic Tests Tests that examine the testicles and blood are used to detect and diagnose testicular cancer. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient’s health habits and past illnesses and treatments will also be taken. Testicular Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. International Ultrasound Services provides testicular ultrasound scans and other private ultrasound tests helping to obtain a quick diagnosis and speed up any treatment. You can also combine your private scan with other ultrasound scans for men to evaluate your overall health. Serum tumour marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumour cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumour markers. The following 3 tumour markers are used to detect testicular cancer: Alpha-fetoprotein (AFP). Beta-human chorionic gonadotropin (Î²-hCG). Lactate dehydrogenase (LDH). Tumour marker levels are measured before radical inguinal orchiectomy and biopsy, to help diagnose testicular cancer. Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.) If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan treatment. Prognosis The prognosis (chance of recovery) and treatment options depend on the following: Stage of cancer (whether it is in or near the testicle or has spread to other places in the body, and blood levels of AFP, Î²-hCG, and LDH). Type of cancer. Size of the tumour. Number and size of retroperitoneal lymph nodes. Testicular cancer is often curable. Treatment for testicular cancer can cause infertility. Certain treatments for testicular cancer can cause infertility that may be permanent. Patients who may wish to have children should consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use. Stages of Testicular Cancer After testicular cancer has been diagnosed, tests are done to find out if cancer cells have spread within the testicles or to other parts of the body. The process used to find out if cancer has spread within the testicles or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:•Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.•CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.•Lymphangiography: A procedure used to x-ray the lymph system. A dye is injected into the lymph vessels in the feet. The dye travels upward through the lymph nodes and lymph vessels, and x-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes.•Abdominal lymph node dissection: A procedure to examine lymph nodes in the abdomen. Lymph nodes are removed and a pathologist checks them for cancer cells. For patients with nonseminoma, removing the lymph nodes may help stop the spread of disease. Cancer cells in the lymph nodes of seminoma patients can be treated with radiation therapy.•Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.)•Serum tumour marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumour cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumour markers. The following 3 tumour markers are used in staging testicular cancer:◦Alpha-fetoprotein (AFP)◦Beta-human chorionic gonadotropin (Î²-hCG).◦Lactate dehydrogenase (LDH). Tumour marker levels are measured again, after radical inguinal orchiectomy and biopsy, in order to determine the stage of cancer. This helps to show if all of the cancer has been removed or if more treatment is needed. Tumour marker levels are also measured during follow-up as a way of checking if cancer has come back. There are three ways that cancer spreads in the body. The three ways that cancer spreads in the body are:•Through tissue. Cancer invades the surrounding normal tissue.•Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.•Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body. When cancer cells break away from the primary (original) tumour and travel through the lymph or blood to other places in the body, another (secondary) tumour may form. This process is called metastasis. The secondary (metastatic) tumour is the same type of cancer as the primary tumour. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. The following stages are used for testicular cancer: Stage 0 (Carcinoma in Situ) In stage 0, abnormal cells are found in the tiny tubules where the sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumour marker levels are normal. Stage 0 is also called carcinoma in situ. Stage I In stage I, cancer has formed. Stage I is divided into stage IA, stage IB, and stage IS and is determined after a radical inguinal orchiectomy is done.•In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle. All tumour marker levels are normal.•In stage IB, cancer:◦is in the testicle and the epididymis and has spread to the blood or lymph vessels in the testicle; or◦has spread to the outer layer of the membrane surrounding the testicle, or◦is in the spermatic cord or the scrotum and maybe in the blood or lymph vessels of the testicle. All tumour marker levels are normal. •In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum and either:◦all tumour marker levels are slightly above normal; or◦one or more tumour marker levels are moderately above normal or high. Stage II Stage II is divided into stage IIA, stage IIB, and stage IIC and is determined after a radical inguinal orchiectomy is done.•In stage IIA, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦has spread to up to 5 lymph nodes in the abdomen, none larger than 2 centimetres. All tumour marker levels are normal or slightly above normal. •In stage IIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and either:◦has spread to up to 5 lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimetres, but none are larger than 5 centimetres; or◦has spread to more than 5 lymph nodes; the lymph nodes are not larger than 5 centimetres. All tumour markers levels are normal or slightly above normal. •In stage IIC, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦has spread to a lymph node in the abdomen that is larger than 5 centimetres. All tumour marker levels are normal or slightly above normal. Stage III Stage III is divided into stage IIIA, stage IIIB, and stage IIIC and is determined after a radical inguinal orchiectomy is done.•In stage IIIA, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more lymph nodes in the abdomen; and◦has spread to distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to slightly above normal. •In stage IIIB, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more nearby or distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to high. •In stage IIIC, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more nearby or distant lymph nodes or to the lungs or anywhere else in the body. The level of one or more tumour markers may range from normal to very high. Testicular Cancer Prognosis For nonseminoma, all of the following must be true:•The tumour is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and•The tumour has not spread to organs other than the lungs; and•The levels of all the tumour markers are slightly above normal. For seminoma, all of the following must be true:•The tumour has not spread to organs other than the lungs; and•The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (Î²-hCG) and lactate dehydrogenase (LDH) may be at any level. Intermediate Prognosis For nonseminoma, all of the following must be true:•The tumour is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and•The tumour has not spread to organs other than the lungs; and•The level of any one of the tumour markers is more than slightly above normal. For seminoma, all of the following must be true:•The tumour has spread to organs other than the lungs; and•The level of AFP is normal. Î²-hCG and LDH may be at any level. Poor Prognosis For nonseminoma, at least one of the following must be true:•The tumour is in the centre of the chest between the lungs; or•The tumour has spread to organs other than the lungs; or•The level of any one of the tumour markers is high. There is no poor prognosis grouping for seminoma testicular tumours. Testicular Cancer Questions and Answers •Nearly all testicular cancers are one of two general types: seminoma or nonseminoma. Other types are rare (see Question 1).•This disease occurs most often in men between the ages of 20 and 39. It accounts for only 1 per cent of all cancers in men (see Question 1).•Risk factors include having an undescended testicle, previous testicular cancer, and a family history of testicular cancer (see Question 2).•Symptoms include a lump, swelling, or enlargement in the testicle; pain or discomfort in a testicle or in the scrotum; and/or an ache in the lower abdomen, back, or groin (see Question 3).•Diagnosis generally involves blood tests, ultrasound, and biopsy (see Question 4).•Treatment can often cure testicular cancer (see Question 5), but regular follow-up exams are extremely important (see Question 6). 1. What is testicular cancer? Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles. The testicles (also called testes or gonads) are a pair of male sex glands. They produce and store sperm and are the main source of testosterone (male hormones) in men. These hormones control the development of the reproductive organs and other male physical characteristics. The testicles are located under the penis in a sac-like pouch called the scrotum. Based on the characteristics of the cells in the tumour, testicular cancers are classified as seminomas or nonseminomas. Other types of cancer that arise in the testicles are rare and are not described here. Seminomas may be one of three types: classic, anaplastic, or spermatocytic. Types of nonseminomas include choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors. Testicular tumours may contain both seminoma and nonseminoma cells. Testicular cancer accounts for only 1 per cent of all cancers in men in the United States. About 8,000 men are diagnosed with testicular cancer, and about 390 men die of this disease each year (1). Testicular cancer occurs most often in men between the ages of 20 and 39, and is the most common form of cancer in men between the ages of 15 and 34. It is most common in white men, especially those of Scandinavian descent. The testicular cancer rate has more than doubled among white men in the past 40 years but has only recently begun to increase among black men. The reason for the racial differences in incidence is not known. 1. What are the risk factors for testicular cancer?•Undescended testicle (cryptorchidism): Normally, the testicles descend from inside the abdomen into the scrotum before birth. The risk of testicular cancer is increased in males with a testicle that does not move down into the scrotum. This risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.•Congenital abnormalities: Men born with abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may be at increased risk.•History of testicular cancer: Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.•Family history of testicular cancer: The risk for testicular cancer is greater in men whose brother or father has had the disease. The exact causes of testicular cancer are not known. However, studies have shown that several factors increase a man’s chance of developing this disease. 1. How is testicular cancer detected? What are the symptoms of testicular cancer?•a painless lump or swelling in a testicle•pain or discomfort in a testicle or in the scrotum•any enlargement of a testicle or change in the way it feels•a feeling of heaviness in the scrotum•a dull ache in the lower abdomen, back, or groin•a sudden collection of fluid in the scrotum Most testicular cancers are found by men themselves. Also, doctors generally examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor. Men should see a doctor if they notice any of the following symptoms: These symptoms can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause of any of these symptoms. 1. How is testicular cancer diagnosed? •Blood tests that measure the levels of tumour markers. Tumour markers are substances often found in higher-than-normal amounts when cancer is present. Tumour markers such as alpha-fetoprotein (AFP), Beta-human chorionic gonadotropin (ÃŸHCG), and lactate dehydrogenase (LDH) may suggest the presence of a testicular tumour, even if it is too small to be detected by physical exams or imaging tests.•Ultrasound, a test in which high-frequency sound waves are bounced off internal organs and tissues. Their echoes produce a picture called a sonogram. Ultrasound of the scrotum can show the presence and size of a mass in the testicle. It is also helpful in ruling out other conditions, such as swelling due to infection or a collection of fluid unrelated to cancer.•Biopsy (microscopic examination of testicular tissue by a pathologist) to determine whether cancer is present. In nearly all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin. This procedure is called radical inguinal orchiectomy. In rare cases (for example, when a man has only one testicle), the surgeon performs an inguinal biopsy, removing a sample of tissue from the testicle through an incision in the groin and proceeding with orchiectomy only if the pathologist finds cancer cells. (The surgeon does not cut through the scrotum to remove tissue. If the problem is cancer, this procedure could cause the disease to spread.) To help find the cause of symptoms, the doctor evaluates a man’s general health. The doctor also performs a physical exam and may order laboratory and diagnostic tests. These tests include: If testicular cancer is found, more tests are needed to find out if cancer has spread from the testicle to other parts of the body. Determining the stage (extent) of the disease helps the doctor to plan appropriate treatment. 1. How is testicular cancer treated? What are the side effects of treatment?•Surgery to remove the testicle through an incision in the groin is called a radical inguinal orchiectomy. Men may be concerned that losing a testicle will affect their ability to have sexual intercourse or make them sterile (unable to produce children). However, a man with one healthy testicle can still have a normal erection and produce sperm. Therefore, an operation to remove one testicle does not make a man impotent (unable to have an erection) and seldom interferes with fertility (the ability to produce children). For cosmetic purposes, men can have a prosthesis (an artificial testicle) placed in the scrotum at the time of their orchiectomy or at any time afterwards. Some of the lymph nodes located deep in the abdomen may also be removed (lymph node dissection). This type of surgery does not usually change a man’s ability to have an erection or an orgasm, but it can cause problems with fertility if it interferes with ejaculation. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
The urinary tract ultrasound or US Urinary tract is the primary imaging modality in the investigation of the urinary tact symptoms in men and women. Below we discuss the most common urinary tract symptoms that patients seek medical advice. Common Urologic Conditions in Both Men and Women Incontinence Total Incontinence Total incontinence is defined as a constant or intermittent loss of urine without normal urination. Stress Incontinence Stress incontinence is defined as an involuntary loss of urine not caused by bladder contraction and is associated with activities such as coughing, sneezing, laughing, lifting, or exercise. Stress incontinence usually occurs in females and may be associated with multiple vaginal deliveries. Urge Incontinence Urge incontinence is the involuntary loss of urine associated with an overwhelming desire or need to urinate. Overflow Incontinence Overflow incontinence results from urine loss as a result of a failure of the bladder to empty rather than an inability to properly store urine. The hallmark of overflow incontinence is a high urine volume after urination. Enuresis Enuresis refers to involuntary wetting in children. It is generally a problem at night but also occurs during the daytime. Urinary Tract Infections (UTIs) Upper urinary tract infections involve the kidneys. An infection of the kidney associated with fever chills, and flank pain is known as acute pyelonephritis. Acute pyelonephritis usually represents a serious infection and requires treatment with intravenous antibiotics and subsequent long-term oral antibiotic therapy. Lower urinary tract infections may involve the bladder (known as cystitis) or the urethra (known as urethritis). Symptoms typically include frequency, urgency, nighttime urination (nocturia), and painful urination (dysuria). Females have a higher incidence of cystitis, which increases throughout their lifetime. Treatment is usually with oral antibiotic therapy. Kidney Stones The patient with a kidney stone typically complains of pain in the flank, back, or side along with blood in the urine. Patients generally toss about and cannot find a comfortable condition. Sometimes there may be associated with nausea and vomiting. If there is associated infection (i.e., high fever, chills), immediate intervention is usually necessary. Approximately 12 to 24 million Americans will develop a kidney stone during their lifetime. Kidney stones are more common in men and occur frequently in people in their thirties or forties. Care of the patient with a kidney stone is based on: Size and location of the stone and likelihood of its spontaneous passage Any complicating medical problems (i.e., diabetes) Complications related to the stone (i.e., obstruction or infection) The large majority of stones pass spontaneously, and the patient requires only pain medication. However, stones that do not pass spontaneously or cause persistent symptoms are treated using lasers, ultrasound, or shock waves. Cancers Related to the Urinary Tract Bladder Cancer Bladder cancer is the second most common urologic cancer with close to 50,000 new cases and 12,000 deaths reported each year. It is 3 times more common in men than women, and it is 4 times more common in Caucasians than African-Americans. Although no cause of bladder cancer is known, it is felt that environmental exposure to carcinogens plays a major role. Cigarette smoking is a major risk factor for bladder cancer. When diagnosed early, most bladder cancers can be treated and effectively cured. Kidney Cancer Renal cell carcinoma is the most common solid renal tumour and occurs in 90% of cases. It primarily occurs in adults, and males are twice as likely to be affected. Thirty thousand new diagnoses are made each year in the United States, and 12,000 deaths from it are recorded. Presenting symptoms such as pain, blood in the urine (hematuria), and flank mass occur only rarely today and generally indicate advanced disease. Greater than 50% of tumours present as asymptomatic, incidental findings on radiographic imaging studies such as ultrasound or CT scans. Surgery is the most effective treatment for primary renal cell carcinoma as most tumours do not respond well to radiation therapy or chemotherapy. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
What is a Private Scan? A private scan is a medical imaging examination undertaken by a private healthcare provider where the cost of the examination is undertaken solely by the patient or through a private health insurance provider. There is a large number of private diagnostic imaging providers that offer various scans including private ultrasound, CT and MRI scans. What is a Scan? A medical scan is a medical imaging investigation employed to diagnose any internal abnormality of the human body that can explain any health symptoms someone might be experiencing. Different types of scans There are various kinds of diagnostic scans but the most common are: Ultrasound Scan The ultrasound scan, mostly associated with pregnancy ultrasounds, is using sound waves to obtain internal images of your organs. Uses no radiation and it is not known to be harmful to adults and most important to unborn babies. You can find more information about ultrasound scans. CT Scan Unlike the ultrasound scan, the CT scan uses radiation to obtain images of the internal organs and can be used in cases where ultrasound offer suboptimal imaging information. Due to radiation risk, CT scans are limited to patients where the diagnosis outweighs the radiation risks from the scan. MRI Scan The MRI scanner uses magnetic fields to obtain the required diagnostic information. Can I pay for a scan? Yes, you can pay to have a private scan but CT and MRI investigations will require a doctor's request. The majority of the ultrasound scan clinics do not require a doctors referral. How much an ultrasound Scan cost? Ultrasound scan prices vary quite significantly throughout the UK and mostly in London. The average price is however roughly between £100 and £200. Private hospitals will charge significantly more than a private ultrasound clinic run by NHS sonographers. This can sometimes be more than 3 times. You also need to be aware of any hidden costs. A few ultrasound clinics offer significantly discounted examinations, raising concerns not only about the quality of the service but also the diagnostic accuracy of the results. Why should I have a private ultrasound scan? The main reason patients choose to have a private ultrasound scan in London instead of one provided for free by the NHS is that the waiting times can be very long. Most NHS providers aim to offer an ultrasound examination within 6 weeks. It is unfortunately very common these days to hear stories of patients waiting for more than 6 weeks. This wait can have a significant impact on the patients' health management. Another reason the patient chose to go private is convenience. Although the NHS is slowly changing, most imaging departments operate between 9 to 5 which is not always suitable for our fast-paced and busy lifestyles. How to choose a private ultrasound clinic? There are so many ultrasound clinics in London offering scans and mainly private ultrasounds that makes it very difficult to choose the best. What should you look for when you choosing an ultrasound clinic? Care Quality Commission registration Independent reviews to find out what users think about the service they received. If the sonographers or radiologists are experienced and knowledgable. How long they have been offering ultrasound services? Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
What is a Tracking Cycle? We use a ‘Tracking Cycle or Assessment cycle’ to check that the orderly process of egg maturation through follicles’ size development, hormonal changes, and endometrial (the lining of the uterus) thickness build-up is occurring. This cycle is used to assess whether there is an ovulation cause for the couples infertility, assess the ovarian reserve and diagnose luteal phase insufficiency (low progesterone levels in the second half of the cycle). The follicle tracking scan is the most accurate method to time ovulation and aid couple achieving pregnancy naturally. Why tracking cycle? Follicle-stimulating hormone (FSH) and luteinising hormone (LH) are released from the pituitary gland (found at the base of the brain) under control of higher brain centres and feedback from ovarian hormones. These hormones stimulate the immature eggs in the ovary to undergo growth and maturation (follicles). This process releases estrogens and progesterone from the maturing follicles, which then stimulates the endometrium (lining of the uterus) so that it is ready to accept a fertilized egg (embryo), to undergo implantation, and hence achieve a pregnancy. As the egg matures a cyst called a follicle develops on the ovary, which produces estrogens. This follicle, which can be seen and measured on an ultrasound picture of the ovaries, may grow to about 2cm in diameter just before ovulation. The estrogens’ effects on the body are usually obvious, particularly by the amount and consistency of mucus discharged from the vagina. Ovulation is triggered by a surge of Luteinising Hormone (LH) from the pituitary gland. LH also stimulates the ovary to begin producing the hormone progesterone. Progesterone causes a slight increase in body temperature and prepares the endometrium for implantation of the fertilized egg. What is involved in the tracking cycle? Tracking cycle is a combination of ultrasounds scans and blood tests carried out at certain days of the menstrual cycle. Day 2 blood tests for FSH, LH, Prolactin, Oestradiol and progesterone Day 5 Ultrasounds scan to assess the ovarian reserve according to the Antral Follicular Count (AFC) Ultrasounds scan and blood test every 2-3 days from day 9 till ovulation. Blood tests to measure progesterone 7 days after ovulation (day 21) with or without ultrasounds scan to check the corpus luteum. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
Pelvic Infections or Pelvic Inflammatory Disease (PID), is a term used for infection of Pelvic organs i.e the Uterus, Fallopian tubes & Ovaries in a woman. These are commonly transmitted sexually but may, sometimes, be attributed to other causes. According to WHO, about 448 million new cases of Sexually Transmitted Infections (STI) are diagnosed annually and it is among the top 5 disease categories for which an individual seeks medical care. Signs and Symptoms – Many women having PID may not have any obvious symptoms, but usually an episode of PID or Pelvic infections may present with the following symptoms: Lower abdominal pain Pain during intercourse Bleeding after intercourse Irregular/ abnormal periods or spotting in between two periods. Excessive or foul-smelling vaginal discharge Vaginal or Perineal itching Frequent or painful/burning urination Occasionally, in advanced cases, there may be fever, vomiting, severe pain or even fainting episodes. Pelvic ultrasound is the first line of investigation for suspected pelvic inflammatory disease. You can find more about the investigation at our pelvic ultrasound page. Complications – Pelvic infections and PID can be a cause of significant morbidity and may have long-lasting outcomes including: It is the leading cause of infertility, about 1 in 8 women having a history of PID can have difficulty in getting pregnant. It may lead to chronic pelvic pain in about 25% of women. They may have pain related to menstrual cycles or may have persistent lower abdominal pain. PID leads to the formation of adhesions i.e scar tissue in or around fallopian tubes which significantly increases the chances of Ectopic pregnancy ( pregnancy implanted outside the cavity of the uterus that can lead to serious life-threatening complications) In the long-term, recurrent pelvic infection, especially with HPV, can be a precursor of cervical cancer. Causes and Risk factors – PID is generally considered to be a polymicrobial infection, i.e it is caused by multiple micro-organisms. These generally include bacterial pathogens like Chlamydia and Neisseria along with a number of other pathogens like Gardnerella, Mycoplasma, Trichomonas, Herpes Simplex Virus-2 and various anaerobic bacteria that may be transmitted by sexual contact and are found in the vagina. Hence, it comes as no surprise that PID results primarily from unprotected sexual intercourse in most cases. However, there may be other causes for the development of the infection and the following factors may increase the risk of a woman suffering from PID: Unprotected sexual activity i.e intercourse without using a condom. Having multiple sexual partners or having intercourse with a person who has multiple sexual partners. The onset of sexual activity before the age of 25 years. A history of the prior sexually transmitted disease which has been incompletely treated in the woman or the sexual partner. A history of sexual abuse Any history of Gynaecological interventional procedure for eg. Endometrial biopsy, IUCD insertion, Hysteroscopy etc. Vaginal douching has been paradoxically associated with the development of a vaginal infection as it alters the normal vaginal balance of useful versus harmful bacteria. However, some studies have failed to demonstrate a clear association between the two. Apart from these, certain genetic factors have been studied which are found to predispose to pelvic infection. Any decrease in generalized body immunity may also cause a flare-up of an underlying infection for eg – in prolonged illness, HIV infection or any immune-compromised state such as pregnancy. Pelvic Infection Treatment and Prevention – PID or Pelvic Infection treatment is usually by an antibiotic course along with other medications lasting for about 2 weeks. Depending upon your symptoms, this may be either an oral medication or sometimes, in severe cases, a woman may need to be hospitalised for injectable medications or surgical intervention as required. It is important for the sexual partner to be treated simultaneously to prevent re-infection. However, PID and sexually transmitted infections are better prevented than treated. Hence, anyone who is at risk of pelvic infections should take the following precautions: Practice safe sex i.e always use a condom at the time of intercourse ( unless of course, you are actually trying for pregnancy) Avoid indulging in indiscriminate sexual activity with multiple partners or with a partner who is in a sexual relationship with multiple persons. Avoid indulging in sexual activity at a very young age. Consult a doctor at the first sign of infection & take proper treatment. Practice good perineal hygiene and avoid vaginal douching. It helps to wipe from the front backwards after passing urine/stools rather than wiping from back to front. Consume a variety of fruits, probiotics and a healthy, well-balanced diet to boost your immunity.
What are fibroids Fibroids are benign (Non-cancerous) growths that develop from the muscle tissue of the uterus. Although their cause is unknown, they are known to be hormone-dependent tumours & estrogen stimulates their growth. They may be present inside the cavity of the uterus, within its wall, on its outer surface or attached to it by a stem-like structure. Who is most likely to have fibroids? They are more common in women aged between 30-40 yrs but may actually occur at any age. Commonly associated with familial predisposition & early onset of periods, these tumours are found more frequently in African- American women & Caucasians. How does a woman suspect she may have fibroids? Most of the fibroids may not cause any symptoms at all and diagnose on a routine pelvic ultrasound scan during a gynaecological check-up. When symptomatic, the Fibroids may cause the following symptoms : Changes in menstruation- Longer, more frequent or heavy menstrual periods. Painful periods or vaginal bleeding at times other than menstruation. Pain- Often dull, heavy & aching pain in the lower back or abdomen Pressure symptoms- Difficulty in urination or frequent urination; constipation/ rectal pain or difficult bowel movements A large lump in the abdomen Infertility or miscarriages and commonly diagnosed during early pregnancy scans and follicular tracking scans How are fibroids diagnosed? The fibroids may present with the above symptoms or be detected on routine pelvic ultrasound examination. Once clinically suspected, the diagnosis may be confirmed by: Ultrasonography- Uses sound waves to create a picture of uterus & other pelvic organs Hysteroscopy- Uses a camera mounted on slender long device to see the inside of the uterus Hysterosalpingography- Special X-ray test used to detect changes in the shape & size of Uterine cavity and fallopian tubes. Laparoscopy- Uses a camera on a slender long device to see the inside of the abdominal cavity MRI- Uses magnetic waves to produce exact images of body tissues Do all fibroids need to be treated? No, fibroids that do not cause symptoms, are small or occur in a woman nearing menopause often may not require treatment. However, certain signs & symptoms may signal the need for treatment: Heavy or painful periods Bleeding in-between periods A rapid increase in size Infertility Pressure symptoms, Difficulty in urination or defaecation Pelvic pain or lump abdomen Can medications be used to treat fibroids? Medications can be used to decrease the heavy bleeding or pelvic pain caused due to fibroids, but they do not prevent the growth of the fibroids nor do they make the fibroids disappear. Some medications that can be used are the painkillers eg. Paracetamol & Brufen, Oral contraceptive pills, Progesterone pills or IUCD & Gn RH agonists. What surgeries may be used to treat fibroids? Myomectomy is the surgical removal of fibroids while leaving the uterus intact. It may be done by laparoscopy/ hysteroscopy or by giving a cut on the abdomen in a conventional manner. Hysterectomy is the surgical removal of the uterus with the fibroids. The ovaries may or may not be removed. This also may be done by Laparoscopy or abdominally or vaginally. Hysterectomy is done when other treatments have failed or the fibroids are too large & childbearing function of the uterus has been completed. Other treatments modalities include Uterine artery embolisation or HIFU (High intensity focused Ultrasound ). Pelvic ultrasound Scan The pelvic ultrasound scan is the first line of investigation when fibroids or other gynaecological problems are suspected. Your doctor will probably refer you to your local hospital to have a transvaginal ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the transabdominal and transvaginal scans we offer at the exam page information.
The private abdominal scan is one of our most popular examinations. Upper abdominal pains that can be caused by calculi within the gallbladder are very common. Cholelithiasis is the medical term for Gallstone disease. Cholelithiasis is one of the most common and costly of all digestive system diseases. This post outlines some of the associated risk factors and the more common causes of gallstone formation with some additional details about their classification. According to the NHS, gallstones are thought to be caused by an imbalance in the chemical makeup of the bile within the gallbladder. These chemical imbalances cause tiny crystals to form within the bile that can gradually increase in size from tiny grains of sand to the size of a pebble over a period of time. Risk Factors The risk factors identified by Wang and Afdhal (2016) for gallstones in the gallbladder (cholelithiasis) include:- diet, age, gender, oestrogen therapy, obesity, fasting, diabetes, family history, rapid weight loss, some medications including those that reduce cholesterol or Lipids or an antibiotic called Cerfriaxone, disease of the ilium or it’s resection and spinal cord injuries. Stockley (2001) states that gallstones are not exclusive to fair, fat, flatulent, fertile over 40 years old females as was previously thought but are also found in young and old alike and have even been detected on fetal ultrasound scanning in the womb. According to Nathanson (2014) it has been estimated from autopsy studies that 12% of men and 24% of women of all ages have gallstone disease present and that 10-30% of them become symptomatic. There are over 40,000 operations to remove the gallbladder and its gallstones (cholecystectomy) performed annually in the UK. Stockley (2001) states that gallstones are formed in several ways: Cholesterol stones which are hard are formed due to an increase in the concentration of cholesterol in the blood (hypercholesterolaemia). An increase in bilirubin in the blood (hyperbilirubinaemia) found in patients with haemolytic anaemia which form irregularly shaped soft, small brown pigment gallstones. Biliary stasis caused by a faulty, malformed, non-emptying gallbladder or obstructed cystic duct leading to stagnant bile. This creates high concentrations of cholesterol and bile pigments following excessive water absorption. This leads to the formation of mixed cholesterol and bile pigment stones, the most common type of gallstone. Gallstone Classification There are different methods used for gallstone classification, namely their chemical composition location Wang and Afdhal (2016) classify gallstones into 3 types based on their chemical composition and macroscopic appearance: cholesterol, pigment and rare stones. 75% of gallstones in the Western world are cholesterol stones consisting mainly of cholesterol monohydrate crystals and precipitates of amorphous calcium bilirubinate. These stones are further sub-classified as either pure cholesterol or mixed stones that contain at least 50% of cholesterol by weight. The remainder of gallstones are classified as pigmented stones that contain mostly calcium hydrogen bilirubinate and they can be further sub-classified into two groups: black pigment (20%) and brown pigment stones (4.5%). Rare gallstones account for 0.5% and include calcium carbonate stones and fatty acid-calcium stones. Wang and Afdhal (2016) classify gallstones by their location as Intrahepatic stones which are predominantly brown pigment stones Gallbladder stones which are mainly cholesterol stones with a small group of black pigment stones. Bile duct stones (choledocholithiasis) which are composed mostly of mixed cholesterol stones. Gallstone Diagnosis The abdominal ultrasound scan is the first line of investigation in the diagnosis of gallstones. This ultrasound scan is performed on a fasted patient. The reason for fasting is that the gallbladder is like a balloon. When we eat something fatty, the gallbladder will excrete the bile into the gut to break down the fat and therefore the gallbladder collapses and it is not possible therefore to see if there are any stones within the lumen. International Ultrasound Services offers private ultrasound scans to evaluate your gallbladder for any signs of gallstones, thickening of the gallbladder wall and the existence of any pericholecystic fluid. We will also check your liver, your pancreas, your kidneys and the spleen at the same time. You can book an ultrasound scan in London by visiting our ultrasound scan appointments booking page. You can find more information about the upper abdominal scan here. References: NHS Choices (2016) Gallstones causes. Available at: http://www.nhs.uk/Conditions/gallstones/Pages/causes.aspx [Accessed 17/10/2016] Wang, D., Afdhal, N. (2016). Gallstone Disease In: Feldman, M., Friedman, L., Brandt,L.(eds) Sleisanger and Fordtran’s Gastrointestinal and Liver Disease Pathophysiology / Diagnosis / Management. Volume 1. 10th Edition. Philadelphia, Saunders Elsevier. pp -1100 - 1108 Stockley, M (2001) Abdominal Ultrasound. 1st edition. Greenwich Medical Media Nathanson, L. (2014) Gallstones, In: Garden, O., Parks, R. (eds.) Hepatobilary and Pancreatic Surgery. A Companion to Specialist Surgical Practice. 5th edition. Edinburgh. Saunders Elsevier. p 174. Bibiliograph: http://www.webmd.com/digestive-disorders/gallstones#1What Are Gallstones? [Accessed 17/10/2016] http://www.livescience.com/34726-gallstones-symptoms-treatment.html. [Accessed 18/10/2016] Mayo Clinic (2013) Gallstones causes. Available at: http://www.mayoclinic.org/diseases-conditions/gallstones/basics/causes/con-20020461. [Accessed 18/10/2016]
Welcome to our new private scan blog. Our private scan clinic in Notting Hill Gate offers a wide range of private scans for men and women as well as pregnancy private scans. We are conveniently located a few minutes walk from Notting Hill Gate tube station and we offer a range of out of hour private scan appointments, including emergency/on-call private scans to suit your lifestyle. You can find the whole range of our private scans and costs here. Who interprets the results of the private scan and how do I get them? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your private scan and provide you with a written report that you can take it your doctor. Our sonographers will also discuss the results with you during and after your ultrasound scan examination. It is very common that sometimes when you leave you to remember of a question that you forgot to ask, so please don't hesitate to contact us either via phone or e-mail and we will do our best to answer your question. What are the benefits and risks of the ultrasound scan examination? Benefits Ultrasound scanning is noninvasive. An ultrasound scan exam may be occasionally, temporarily uncomfortable, but it should not be painful. Ultrasound is widely available, easy-to-use and less expensive than other imaging modalities. Ultrasound imaging is extremely safe and does not use any ionizing radiation. Ultrasound scanning gives a clear picture of soft tissues such as liver that do not show up well on x-rays. Risks There are no known harmful effects on humans related to ultrasound scan examinations. What are the limitations of Ultrasound Scan Imaging? Ultrasound waves do not travel well in bowel or gas so you can not fully evaluate abdominal organs such as stomach and bowel or organs obscured by the bowel. It can also be hard to fully visualise the internal anatomy of large patients as the sound has further to travel and therefore the returning echoes are weaker. Why choose us for your private scan? We are conveniently located in the heart of London, just a few minutes’ walks from Notting Hill Gate station, in a cobbled cul-de-sac off Kensington Mall in the Royal Borough of Kensington and Chelsea. We offer same day and emergency after hours and weekend appointments in a clean and caring environment, to suit your needs. Unlike some of our competitors, we provide you with a private scan report at the same day to fast track any potential treatment. We have years of experience in medical ultrasound scanning. Experience gained working for flagship NHS trusts alongside leaders in the field of diagnostic medical imaging including general ultrasound, urology, musculoskeletal, gynaecology, pelvis, testicular and vascular scan examinations. You can, therefore be assured that your health is in good hands. Our range of private scan examinations includes the abdomen, pelvis, kidneys, bladder, prostate, ovary, testicle, scrotal, knee, shoulder, groin, ankle, wrist to name a few. We are also experts in pregnancy ultrasound and we regularly rotate through our hospital EPU that mainly deals with recurrent miscarriage. Our full range of private scans can be viewed via the site menu. Our competitively priced private scan services and personalised service is second to none and this is the reason our clients recommend us to friends and family. About Ultrasound Scans Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear can't hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike Ct and MRI, ultrasound does not use radiation and therefore is pregnancy friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints. Looking for a private scan in London? IUS London specialises in diagnostic private ultrasound scans to provide you with quick diagnosis and the much-needed reassurance about your health, within a convenient location. The cost of a private ultrasound scan shouldn’t be prohibited when it comes to someone’s wellbeing. This is why our prices are competitive and affordable with no compromise to the level of care. The price you see is the price you pay with no hidden extras. We have hundreds of happy clients including GP’s, consultants, radiologists and midwives to name a few. Some of our clients choose us when large, well-established ultrasound scanning companies failed them in diagnostic accuracy and especially aftercare. We offer ultrasound scan appointments via our online booking system or on the phone. We do not charge a deposit or a cancellation fee as we care more about our clients and we respect their decision to decide what is best for them without concern about the ultrasound scan deposit they already paid.
The ultrasound scan or ultrasonography as otherwise known is a painless diagnostic imaging technique utilising sound waves to produce internal images of the body. It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. A sound frequency that the human ear can’t hear. These are the frequencies used by the navy sonar and by animal echolocation such as dolphins and bats. The ultrasound waves are produced by the transducer or the probe as most commonly known. As these sound waves travel through the body bounce back because of differences in the tissues. The bounced back sound waves are called echoes. These echoes are picked up by the probe and a powerful computer analyses them and creates the 2d ultrasound image on the scanner screen. What is it used for? There are various kinds of sonograms that can be performed and each looks at different organs of the body to confirm or exclude possible pathology. In our ultrasound practice it is commonly used to diagnose problems in the abdomen and pelvis, testes and ovaries, in the veins of the legs, the joints and tendons of the body, major blood vessels and to examine lumps and bumps. Unlike CT and MRI, ultrasound does not use radiation and therefore is pregnancy-friendly. Ultrasound, therefore, is being used in all stages of pregnancy starting from as early as 5 weeks gestation. It is also live and is ideal for musculoskeletal exams to evaluate moving joints. Specialist Ultrasound Techniques In some situations, a clearer picture can be obtained when an ultrasound probe is inside the body. Specially shaped and designed probes can be placed inside the vagina (transvaginal) or the rectum (transrectal). If you need to have this type of the scan you will be informed beforehand and the radiologist or sonographer will explain what they are doing all the time. What does it involve? Ultrasound is carried out by a Consultant Radiologist or specialist trained Radiographer called Ultrasonographer or Sonographer, skilled in the technique and interpretation. You will usually lie on a couch in a darkened room and the doctor will place a handheld probe the size of a small camera, on the skin over the area to be examined. Warm lubricating jelly is used so that the probe can be moved easily and to allow good contact with the skin. Gentle pressure is applied and you may be asked to turn or move to obtain optimum pictures. Often you will be able to watch the monitor where the picture is constantly updated during the scan. What are the benefits and risks of sonography? Benefits Ultrasound scans are noninvasive. An ultrasound scan exam may be occasionally, temporarily uncomfortable, but it should not be painful. Ultrasound is widely available, easy-to-use and less expensive than other imaging modalities. Ultrasound scans are extremely safe and do not use any ionizing radiation. Ultrasound scanning gives a clear picture of soft tissues such as liver that does not show up well on x-rays. Risks There are no known harmful effects on adults or babies related to an ultrasound scan. Unlike some other scans, such as CT, ultrasound scans don't involve exposure to radiation. What are the limitations of Ultrasound Imaging? Sound waves do not travel well in bowel or gas so abdominal organs such as stomach and bowel or organs obscured by bowel cannot be fully evaluated with ultrasound. It can also be hard to fully visualise the internal anatomy of large patients as the sound waves have further to travel and therefore the returning echoes are weaker. Are there any special preparations needed for a scan? This will depend on the kind of imaging test you are having. You should have received information about preparation with your appointment confirmation. It is therefore very important to read your confirmation letter/e-mail carefully. Certain types of ultrasound scan may need you to follow specific instructions to improve the image quality of the scan. Examples include: Drink plenty of water and do not empty your bladder until after your scan – this may be necessary before an antenatal scan or gynaecological pelvic scan. Avoid eating for 8 hours before your scan, but drink plenty of clear fluids and do not empty your bladder until after the scan – this may be necessary before an abdominal scan checking your liver and gallbladder. External Ultrasound scan An external ultrasound scan is used to examine the liver, kidneys and other organs in your abdomen. It can also be used to assess your muscles and joints and many other organs through your skin. A lubricating gel is put on your skin and a small handheld probe is moved over your skin to assess the underlying structures. You should not feel anything other than the sensor and gel on your skin. Internal or Transvaginal Ultrasound scan An internal ultrasound allows our ultrasonographer to look through the vagina. During the procedure, you will be asked to lie on your back and a small probe will be gently passed into the vagina and the images are transmitted to a monitor. Internal examinations are ideal for looking at your ovaries and womb and may cause some discomfort, but should not be painful. Who will I see? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your ultrasound scan exam and provide you with a written ultrasound scan report that you can take it your doctor. Our sonographers will also discuss the ultrasound scan results with you during and after your scan. How long does a scan usually take? The actual examination takes 10 to 15mins depending on the scan you having. Please allow some extra time for your ultrasound report. How much does an ultrasound scan cost? The price of a private ultrasound scan in London shouldn’t be prohibited when it comes to someone’s wellbeing. This is why our ultrasound scan prices are competitive and affordable with no compromise to the level of care. The price you see for the ultrasound scan is the price you pay with no hidden extras and no booking fees Where can I get a scan? In the UK your doctor can refer you for a scan to your nearest NHS hospital. The waiting time in most hospitals is around 6 weeks. You can, therefore, opt to have a private ultrasound with prices starting from as little as £99. Ultrasound Ultrasound scanning is the use of high-frequency sound waves to produce images of organs, tissues, or blood flow within a patient for diagnostic purposes. Due to the use of sound waves instead of radiation, ultrasound procedures are believed to be completely safe. Ultrasound procedures The most common ultrasound procedures are: Pelvic scans: This scan can be performed both transabdominal and transvaginally. Transabdominal scans require a full bladder. You will need to consume a litre of water 30 to 60 minutes prior to your scan taking place. The ultrasound probe is pushed against the lower abdominal wall to look down into the pelvis. A transvaginal (TV) Scan is performed with an empty bladder, using a thin probe inserted into the vagina. This allows detailed information to be obtained by having the probe closer to the pelvic organs. Abdominal scans: Performed transabdominal, these scans usually involve fasting for four hours before the examination to allow for improved imaging of the liver and gall bladder. Renal scans: Performed transabdominal with a full bladder, this requires the patient to drink a litre of water 30 to 60 minutes prior to the scan taking place. This scan then helps to assess the kidneys and bladder. Doppler Venous/arterial scans: Doppler imaging analyses the flow of blood within vessels. Musculoskeletal scans: These are carried out by a musculoskeletal specialist Preparing for an Ultrasound scan Certain types of ultrasound scan may need you to follow specific instructions to improve the image quality of the scan. Examples include: Drink plenty of water and do not empty your bladder until after your scan – this may be necessary before an antenatal scan or gynaecological pelvic scan. Avoid eating for 8 hours before your scan, but drink plenty of clear fluids and do not empty your bladder until after the scan – this may be necessary before an abdominal scan checking your liver and gallbladder. External Ultrasound scan An external ultrasound scan is used to examine the liver, kidneys and other organs in your abdomen. It can also be used to assess your muscles and joints and many other organs through your skin. A lubricating gel is put on your skin and a small handheld probe is moved over your skin to assess the underlying structures. You should not feel anything other than the sensor and gel on your skin. Internal or Transvaginal Ultrasound scan An internal ultrasound allows our ultrasonographer to look through the vagina. During the procedure, you will be asked to lie on your back and a small probe will be gently passed into the vagina and the images are transmitted to a monitor. Internal examinations are ideal for looking at your ovaries and womb and may cause some discomfort, but should not be painful. Private Ultrasound If you are looking for reassurance early in your pregnancy (not 4D ultrasound) or a general medical private ultrasound in London to visualise the internal organs and body structures to get quick answers about your health, you can rest assured that our sonographers have the skills and the knowledge to provide you with the instant answers you need. Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare. Reviewed: 09/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)
Ultrasound Ultrasound scanning is the use of high-frequency sound waves to produce images of organs, tissues, or blood flow within a patient for diagnostic purposes. Due to the use of sound waves instead of radiation, ultrasound procedures are believed to be completely safe. Ultrasound procedures The most common ultrasound procedures are: Pelvic scans: This scan can be performed both transabdominal and transvaginally. Transabdominal scans require a full bladder. You will need to consume a litre of water 30 to 60 minutes prior to your scan taking place. The ultrasound probe is pushed against the lower abdominal wall to look down into the pelvis. A transvaginal (TV) Scan is performed with an empty bladder, using a thin probe inserted into the vagina. This allows detailed information to be obtained by having the probe closer to the pelvic organs. Abdominal scans: Performed transabdominal, these scans usually involve fasting for four hours before the examination to allow for improved imaging of the liver and gall bladder. Renal scans: Performed transabdominal with a full bladder, this requires the patient to drink a litre of water 30 to 60 minutes prior to the scan taking place. This scan then helps to assess the kidneys and bladder. Doppler Venous/arterial scans: Doppler imaging analyses the flow of blood within vessels. Musculoskeletal scans: These are carried out by a musculoskeletal specialist Preparing for an Ultrasound scan Certain types of ultrasound scan may need you to follow specific instructions to improve the image quality of the scan. Examples include: Drink plenty of water and do not empty your bladder until after your scan – this may be necessary before an antenatal scan or gynaecological pelvic scan. Avoid eating for 8 hours before your scan, but drink plenty of clear fluids and do not empty your bladder until after the scan – this may be necessary before an abdominal scan checking your liver and gallbladder. External Ultrasound scan An external ultrasound scan is used to examine the liver, kidneys and other organs in your abdomen. It can also be used to assess your muscles and joints and many other organs through your skin. A lubricating gel is put on your skin and a small handheld probe is moved over your skin to assess the underlying structures. You should not feel anything other than the sensor and gel on your skin. Internal or Transvaginal Ultrasound scan An internal ultrasound allows our ultrasonographer to look through the vagina. During the procedure, you will be asked to lie on your back and a small probe will be gently passed into the vagina and the images are transmitted to a monitor. Internal examinations are ideal for looking at your ovaries and womb and may cause some discomfort, but should not be painful. Private Ultrasound If you are looking for reassurance early in your pregnancy (not 4D ultrasound) or a general medical private ultrasound in London to visualise the internal organs and body structures to get quick answers about your health, you can rest assured that our sonographers have the skills and the knowledge to provide you with the instant answers you need.