click on the items in the table to see images:

SIS picture showing endometrial polyp	SIS picture showing uterine cavity fibroid
Picture of early small ovarian cancer	Picture of dermoid ovarian cyst
Picture of ectopic tubal pregnancy	Picture of endometriosis inside ovary
Picture of uterine (endometrial) cancer	Picture of Hydrosalpinx.Blocked Fallopian Tube, Infertile

Gynaecological scans are useful to provide medical information when the woman has abdominal pain or bloating, irregular menstrual bleeding, heavy or painful periods, post-menopausal bleeding, break through menstrual bleeding, infertility, painful intercourse, suspected tubal (ectopic) pregnancy, women with known breast cancer taking Tamoxifen tablet or women with a family history of ovarian cancer. A pelvic scan is also useful when a family doctor or gynaecologist suspects on clinical examination that the woman may have a lump or mass in the pelvis.

Pelvic ultrasound scan can accurately identify small ovarian cyst, endometriosis, early small ovarian cancer/tumours, uterine polyps, uterine pre-cancer, hydrosalpinx (blockage of fallopian tube), and uterine tumour such as fibroids. The early detection of such conditions is more commonly detected by ultrasound and it is less common for such conditions to be detected initially by surgical operations such as laparoscopy.

Women with a contraceptive device (IUCD) placed inside the uterus commonly use pelvic ultrasound to detect a shift in position of the IUCD away from the inside of the uterus and thus help in avoiding an unplanned pregnancy.

Women who have never been sexually active (virgins) are required to attend for a pelvic scan by filling up the urinary bladder by drinking 4 large glasses of water (at least one litre water) starting one and a half hours prior to the scan appointment. Do not empty the urinary bladder for at least one and a half hours.

Women who are not virgins may attend with a comfortable urinary bladder as most women prefer to have a vaginal ultrasound scan performed. This is performed by placing a small plastic transducer (a probe) inside the vagina much like using a tampon or having a Pap smear taken. There is no pain or X- Rays. The examination is generally brief in duration. Trans vaginal scan (TVS) generally provides more detailed and more accurate medical information about pelvic conditions. TVS may be performed during menstrual bleeding. In a small number of situations, both an abdominal and vaginal ultrasound scan is performed at the same visit to provide extra information.

Saline Infusion Sonohysterography (SIS) is a form of vaginal ultrasound scan which is a highly accurate method of looking at abnormal tissue inside the uterine cavity (and is as accurate as diagnostic hysteroscopy which is usually performed by doctors in a hospital with some form of anaesthetic administered). SIS is generally painless, done without anaesthesia at COGUS using both 2D and 3D ultrasound scanning with the patient awake and is of brief duration.

The information gained by SIS allows the patient to avoid hospitalisation and unnecessary Dilatation and uterine curettage (D & C) or hysteroscopy in some situations, and is generally helpful in planning surgery of uterine polyps or hysteroscopic resection of intra-uterine cavity fibroids.