Pelvis

Pelvic USS is indicated for the following conditions and is a requirement of primary care management prior to referral.

Transvaginal USS preferable unless otherwise stated

• Intermenstrual bleeding
• Dysmenorrhoea
• Heavy menstrual bleeding with specific criteria (available here)
• Recurrent miscarriage
• Chronic pelvic pain
• Suspected endometriosis
• Raised CA125 (urgent USS request -> then manage as per guidelines here
• Primary amenorrhoea (transabdominal)
• Secondary amenorrhoea
• Suspected ovarian cyst (then refer according to pre-menopausal or post-menopausal guidelines)
• Failed IUS/IUD removal
• Suspected perforation of uterus by IUD/IUS – abdomen and pelvis XR is indicated if not visible on USS
• Suspected fibroid uterus

Pelvic masses which are not obviously fibroids should be referred via the 2ww pathway

PCOS - USS is not necessary to diagnose PCOS. The ultrasonographers at RCHT do not accept referrals from GPs to look for cysts alone. Current guidance is available here

Infertility – Pelvic USS is not required for referral. Current guidance is available here