Confusion 1: What is the difference between transabdominal ultrasound and vaginal ultrasound? Transabdominal ultrasound requires holding urine, which affects the time spent on the test, while vaginal ultrasound is relatively simple and uses the same equipment as abdominal ultrasound. Although this test is simple, it is not suitable for everyone. It is contraindicated for unmarried girls and is not suitable for heavy vaginal bleeding (heavy menstrual periods). Vaginal ultrasound can be done in the first two months of pregnancy and abdominal ultrasound after two months. Both methods have their “advantages and disadvantages”: transvaginal ultrasound uses a high-frequency probe and is more accurate due to its proximity to the uterus and ovaries and the high resolution of its images, making it particularly suitable for examining small lesions such as the endometrium and for detecting the size of developing follicles, while transabdominal ultrasound is suitable for a wider range of examinations. In the two pictures below, the top picture is a transvaginal ultrasound and the bottom picture is an abdominal ultrasound, where a full bladder can be seen. Confusion 2: What is the best level to hold urine? Generally speaking, it is best to hold urine until you feel the urge to urinate, not to the limit as many people “rumor”, because an overfilled bladder can compress the pelvic organs, causing them to shift and deform, and some subtle lesions are often covered up, such as small Uterine fibroids, ovarian cysts, etc. will not show up. The signs of pregnancy (fetal sac, germ) are also not visible due to the pressure and flattening. Therefore, holding too much urine can cause diagnostic difficulties and errors, as can holding too little urine. So what can be considered holding urine in the right amount? The sign of good filling is: when the subject is lying down, the lower abdomen is slightly elevated in a shallow arc and can sink when pressure is applied, and it is tolerable. If the abdominal bulge is very high and the belly is hard, and the slight pressure is unbearable, it is too much to hold urine and the filling is too much. Confusion 3: Why do I need to hold urine for abdominal ultrasound? The uterus and ovaries are deep inside the pelvic cavity and the small intestine tends to sag into the pelvic cavity. When doing abdominal ultrasound, the peristalsis of the intestines and their contents can interfere with the images of the uterus and ovaries, making them appear unclear. Therefore, it is necessary to drink a lot of water before the examination to fill the bladder and push the intestines upwards. If ultrasound is done without a full bladder, the gas in the bladder can overlap with the gas in the uterus, causing misdiagnosis and missed diagnoses. However, not all gynecological transabdominal ultrasound requires urine holding, such as the following cases: after 8 weeks of pregnancy, the uterus grows into the abdominal cavity, pushing the intestinal canal upward naturally, and there is amniotic fluid in the uterine cavity, so it is no longer necessary to hold urine to observe the fetus. There are also very large fibroids that can be seen without holding urine. Confusion 4: What can I drink to speed up holding my urine? Want to fill up your bladder faster because of the limited time available for the visit? Drinking plain water is too slow, but if you switch to caffeinated beverages such as coffee and tea, it will be faster because it has a diuretic effect on the body, making it easier to lose water, and you can also choose some juices, which also have a certain diuretic effect, such as strawberry juice, watermelon juice, apple juice, etc. Confusion 5: color ultrasound vs. black and white ultrasound The ordinary ultrasound is black and white, then the color ultrasound is color? In fact, color ultrasound is not color, it is only based on black and white ultrasound, plus color Doppler blood flow imaging, that is, in the ultrasound display can also show the red and blue colors, to indicate the different blood flow direction and flow rate. Compared with the single black and white ultrasound, color ultrasound has more functions and more ways to diagnose diseases, and the diagnosis of diseases is also more clear. Its image resolution is also better than that of ordinary black-and-white ultrasound, which is especially valuable for the diagnosis of some malignant masses. In gynecological examinations, doctors recommend the use of color ultrasound for ectopic pregnancy, but for general gynecological checkups, uterine fibroids or ultrasound screening before abortion, ordinary ultrasound is sufficient. Confusion 6: Is ultrasound safe? The key to the safety of B-ultrasound is the dose of ultrasound, which is the product of the intensity of ultrasound and exposure time. High-intensity and prolonged ultrasound can cause damage to the human body or fetus. Generally speaking, regular ultrasound equipment has strict control over the output power of ultrasound, and there are doctors who control the dose of ultrasound at all times, under such conditions, ultrasound is safe for gynecological examination. So far, normal ultrasound has not produced any significant adverse effects, and there have been no reports of fetal malformations caused by ultrasound examination. Confusion 7: Why are the ultrasound results different? Many people have experienced why the position of the uterus is different between two ultrasound examinations, one in the anterior position and the other in the posterior position, is the ultrasound inaccurate or does the uterus really move? In fact, the position of the uterus is divided into anterior, middle and posterior position, which varies from person to person and is not a pathology. Generally speaking, the anterior uterus has more chances of conceiving and the posterior uterus has less chances of conceiving. If the tissues around the uterus are not infected or adherent, the position of the uterus will be active. Some patients with ovarian cysts are eager to review the ultrasound after taking Chinese herbal medicine for a few days, comparing the size of the cysts with the ultrasound done before and after, and exclaiming, “The cysts have become smaller!” Or “The cyst has not decreased but increased in size!” In fact, cysts and pelvic effusion are actually three-dimensional things, three-dimensional, and the measurement plane obtained by the ultrasound doctor’s probe is two-dimensional, and the shape of these abnormal echoes is irregular, so there are errors in measurement, which are all within the permissible range.