Answers and questions on ultrasound

Hello. The corpus luteum is formed after the rupture of the dominant follicle and the release of the egg from the ovary. This process is called ovulation. It occurs in the middle of the menstrual cycle. For example, with a 28-day cycle, ovulation can occur on the 14th day of the menstrual cycle, therefore the corpus luteum should be controlled on the 15-16th day. BUT ovulation may not occur every month and not necessarily clearly in the middle of the cycle, so folliculometry is the best option to do. Folliculometry is an ultrasound observation of ovarian activity. The ultrasound specialist monitors in which ovary the dominant follicle begins to form (the one where the future egg cell will mature), how it behaves during the first phase of the cycle, and then, in the second phase, fixes the fact of the presence or absence of the corpus luteum. With a standard 28-day menstrual cycle, the first ultrasound is usually prescribed on the 7-10th day. Then ultrasound is performed every 2-3 days or as agreed with the doctor until the fact of ovulation is established.

Follicular cysts occur due to the accumulation of fluid in the follicle as a result of hormonal disorders and are found mainly in childbearing age. Such cysts usually disappear within 1-2, less often 3 menstrual cycles.

If the fact of the presence of a "cyst" has already been established earlier, then it is better to conduct examination after menstruation (on the 3-5th day of the cycle).

Paraovarian cysts account for 8 to 16.4% of all ovarian masses and are diagnosed mainly between the ages of 20 and 40. Cysts can be either small (5-6 cm) or gigantic. The main and almost the only ultrasound sign of paraovarian cysts is visualization of a separately located ovary.

Endometrioid or “chocolate” cysts, named after the old blood they contain, are a form of external genital endometriosis. Endometrioid cysts not only do not disappear during dynamic observation, but can increase.

 A corpus luteum cyst occurs due to the accumulation of fluid in the place of a bursting follicle, sometimes it can contain blood. Such cysts occur between the ages of 16 and 45. To eliminate errors, a dynamic ultrasound is required in the 1st phase of the next menstrual cycle. With a corpus luteum cyst, observation is indicated for 1-3 menstrual cycles, since its reverse development is not excluded.

An ultrasound examination (ultrasonography) of pelvic organs allows obtaining an image of the tissues and organs located in the lower abdomen and pelvis. In gynecology, this examination is most often used to assess the condition and structure of the uterus, cervix, ovaries, uterine (fallopian tubes), peri-ocular space and bladder (if it is sufficiently filled).

Ultrasound examination in gynecology is carried out in the following ways:

• Transabdominal ultrasound of pelvic organs - examination of internal organs through the anterior abdominal wall. The procedure is performed with a full bladder and allows determining the size of the genitals, their structure and the presence of large pathological formations (tumors, cysts).
• Transvaginal ultrasound - examination using a special probe inserted directly into the vagina. The method allows examining in more detail the structure of organs, determine the size, shape and structural features of pathological formations.
• Combined - transabdominal scan with a full bladder and after emptying the bladder, switch to transvaginal examination. These two methods complement each other. 

Preparation for ultrasound of pelvic organs in women will differ depending on the method of examination.

Transabdominal ultrasound is done when the bladder is full. For examination to be the most informative, it is necessary to drink about 1 liter of liquid 1.5-2 hours before the examination.

For a transvaginal ultrasound, some preparation is also required. It is recommended to exclude foods that contribute to gas formation from the diet before the examination. The procedure is carried out with an empty bladder, therefore, it is necessary to urinate before the examination.

In your case, ultrasound will be useful and informative, because tests sometimes give a false negative or false positive result. An ultrasound specialist will assess the condition and structure of pelvic organs, then you need to contact a gynecologist, who, based on examination, ultrasound and additional tests (if required), will determine the exact reason for the delay and prescribe the necessary treatment.

Examination of abdominal organs requires a little preparation to ensure good visibility and to obtain reliable results.

Preliminary preparation includes the following:

• special diet for 3 days;
• before the examination, complete abstinence from food for 10-12 hours, for children - 8 hours (preparation is needed to prevent gas formation and collapsed gallbladder).

For three to four days, eliminate from your diet the food causing gas production: black bread, dairy products, nuts and mushrooms, fresh vegetables and fruits, legumes, sauerkraut, coffee, alcohol, carbonated drinks. Try to also limit your intake of fatty meat and sweets.

You can eat: lean poultry and fish, beef, baked apples without sugar, cereals, a small amount of eggs, hard cheese with a low percentage of fat.

On the doctor’s recommendation, drugs that improve digestion and reduce gas production can be added to the diet.

Such a diet for this type of ultrasound lasts until the evening before the examination (if the procedure is carried out in the morning). If your appointment is after 15:00, a light breakfast is allowed.