3D TVS in Pokhara — Transvaginal Ultrasound for Pelvic Health

What is a 3D TVS (transvaginal ultrasound)?

A TVS, or transvaginal ultrasound, is a pelvic scan in which a slim, covered probe is placed gently into the vagina to take close-up pictures of the uterus (womb), cervix, ovaries and the area around the fallopian tubes. If you are looking for a 3D TVS in Pokhara, Kaligandaki Diagnostic and Research Center (KDRC) at Shantipath, Amarsingh Chowk, performs transvaginal scans on a high-definition ultrasound system with 3D, 4D and volume scanning, and the scans are reported by consultant radiologists.

Like every ultrasound, a TVS uses high-frequency sound waves, not X-rays, so there is no ionising radiation. Cleveland Clinic describes the transvaginal scan as giving a more detailed view of the pelvic organs than other exams (Cleveland Clinic). The “3D” part means the machine can also collect a block (volume) of data and rebuild the uterus in planes that a standard two-dimensional scan cannot show directly. Many people also call it a TVS scan, internal scan, vaginal ultrasound or “bhitra bata garne USG”.

A TVS is a gynaecology and early-pregnancy test. Later pregnancy scans, such as growth checks and the anomaly scan, are usually done over the tummy. For an overview of all scan types, see our ultrasound in Pokhara page or the guide to types of ultrasound scan.

Why does an internal probe give clearer pelvic images?

An internal probe gives clearer pictures because it sits only a few centimetres from the uterus and ovaries, so it can use higher-frequency sound waves that show finer detail. Higher frequencies produce sharper images but do not travel far through the body. In a scan over the tummy (transabdominal), the sound has to pass through skin, fat, muscle and bowel before it reaches the pelvis, which blurs small structures.

During a TVS, the probe is inserted only about two to three inches, and its tip is smaller than the speculum used for a Pap test (RadiologyInfo). From this position the radiologist can see the lining of the womb (endometrium), small follicles in the ovaries, a very early pregnancy sac and small fibroids or polyps that may be hidden on an abdominal scan. It is especially helpful when a person has a larger body size, a tilted (retroverted) uterus, or a lot of bowel gas.

The trade-off is field of view. A TVS sees the pelvis in great detail but cannot show large masses that extend high into the abdomen. That is why the radiologist sometimes combines a quick abdominal scan with the transvaginal scan in the same visit.

What is a 3D TVS used for?

A 3D TVS is used to examine the uterus, endometrium and ovaries in detail when a woman has symptoms such as pelvic pain, irregular or heavy bleeding, fertility problems, or a known finding that needs closer measurement. Cleveland Clinic lists investigating pelvic pain or irregular bleeding, finding cysts, fibroids and polyps, checking for ectopic pregnancy or miscarriage, looking for causes of fertility problems and checking that an IUD is in the right place among its main uses (Cleveland Clinic).

The table below summarises the most common reasons doctors in Pokhara request a transvaginal scan and what the radiologist looks at.

A TVS does not replace a doctor’s examination. Your gynaecologist uses the scan findings together with your history, examination and blood tests to decide on treatment.

3D TVS for uterine anomalies, fibroids, IUCD position and the endometrium

3D TVS is most valuable when the shape of the uterus or the exact position of something inside it matters. RadiologyInfo explains that three-dimensional ultrasound permits evaluation of the uterus and ovaries in planes that cannot be imaged directly, and that in infertility evaluation it shows the outer contour of the uterus and uterine irregularities (RadiologyInfo).

Uterine anomalies: septate, bicornuate and arcuate uterus

Some women are born with a uterus that formed differently. In a septate uterus, a band of tissue (septum) divides the cavity while the outer surface of the womb is smooth. In a bicornuate uterus, the top of the womb itself is heart-shaped with an indentation on the outside. The treatment and implications for pregnancy can differ, so telling them apart matters. A standard 2D scan sees the cavity in slices, but the 3D “coronal” view shows the cavity and the outer contour of the uterus in one image, making the distinction much clearer. Women with recurrent miscarriage or difficulty conceiving are often referred for this view.

Fibroid mapping

Fibroids are common non-cancerous growths of the womb muscle. An ultrasound scan shows whether you have fibroids, how many there are, where they are and how large they are (NHS). Location matters as much as size: a fibroid that pushes into the cavity (submucosal) is more likely to cause heavy bleeding and fertility problems than one on the outside of the womb. 3D TVS helps map each fibroid in relation to the cavity, which helps your gynaecologist plan treatment or surgery.

IUCD (Copper-T) position

A TVS can confirm whether an intrauterine contraceptive device is sitting correctly in the cavity (Cleveland Clinic). If you cannot feel the threads, have new pain or bleeding, or are worried the device has moved, your doctor may request a scan. The 3D coronal view can show the whole device, including its arms, within the cavity.

The endometrium (lining of the womb)

The endometrium changes in thickness through the menstrual cycle, so its measurement is always interpreted with the day of your cycle, your age and any hormones you take. TVS shows the lining clearly, and 3D views help outline polyps or other changes in the cavity. When the cavity needs an even closer look, your doctor may suggest sonohysterography (saline infusion sonography), in which sterile saline gently expands the cavity so that polyps, fibroids or scarring show up more clearly (RadiologyInfo).

TVS in early pregnancy: viability, dating and ectopic concern

In the first weeks of pregnancy, a TVS can show the pregnancy sac, the embryo and its heartbeat earlier and more clearly than a scan over the tummy. Cleveland Clinic lists confirming the location of the pregnancy, dating it, measuring the heartbeat and spotting complications as early-pregnancy uses (Cleveland Clinic). The NHS notes that if doctors think you might be having a miscarriage, you may be offered an internal vaginal (trans-vaginal) ultrasound scan (NHS).

Typical early-pregnancy questions answered by a TVS include:

• Is the pregnancy inside the womb? Seeing a sac inside the uterus is the main way to rule out an ectopic pregnancy.
• Is the pregnancy developing (viability)? The radiologist looks for a yolk sac, embryo and heartbeat appropriate for the dates.
• How many weeks? Measuring the embryo gives an accurate due date.
• One baby or more? Twins can be identified early, along with how they share the placenta.

If a pregnancy is very early, it may be too small to see yet. In that case, a repeat scan after a short interval, often with blood hormone (beta-hCG) tests arranged by your doctor, gives a clear answer. This is normal and not in itself a sign that anything is wrong. For scans from 11 weeks onwards, including the dating and NT scan, see our fetal ultrasound page and the pregnancy ultrasound schedule in Nepal.

Ectopic pregnancy: why symptoms need urgent care

An ectopic pregnancy is one that grows outside the womb, most often in a fallopian tube. Around 1 in every 90 pregnancies is ectopic, and symptoms often appear between the 4th and 12th week of pregnancy (NHS). Symptoms include a missed period with tummy pain low down on one side, vaginal bleeding or brown watery discharge, pain in the tip of the shoulder and discomfort when passing urine or stool.

If you might be pregnant and have sharp, sudden, intense tummy pain, feel very dizzy or faint, feel sick or look very pale, go to the nearest emergency department immediately. These can be signs of a ruptured ectopic pregnancy, which needs urgent surgery.

A scan is part of diagnosis, but it is not a substitute for emergency care. If you have sudden severe pain, feel faint or look very pale, do not wait for a routine scan appointment — go to the nearest emergency department. KDRC also runs a 24/7 ambulance service in Pokhara.

Follicle tracking and fertility scans in Pokhara

Follicle tracking (follicular monitoring) is a series of transvaginal scans that measure how the egg-containing follicles in the ovaries grow during a cycle, so that your fertility doctor can time ovulation, intercourse, insemination (IUI) or a trigger injection. Because the follicles are small and the measurements must be precise, the internal approach is the standard method.

A typical tracking cycle, as planned by your fertility doctor, looks like the timeline below. The exact days vary from person to person and from cycle to cycle.

Other fertility-related TVS assessments include an antral follicle count (a measure of ovarian reserve, usually done early in the cycle), checking the endometrium before embryo transfer, and a 3D look at the uterine shape. RadiologyInfo notes that three-dimensional ultrasound, sonohysterography or HyCoSy (a test of whether the fallopian tubes are open) may be used for patients with infertility (RadiologyInfo). KDRC performs the imaging and reports the findings; your fertility specialist interprets them and decides the treatment plan. Bring your tracking chart to every visit so measurements can be compared.

PCOS, ovarian cysts and postmenopausal bleeding

TVS is the most common imaging test for ovarian problems and for bleeding after menopause, because it shows the ovaries and the endometrium in fine detail.

PCOS (polycystic ovary syndrome)

Polycystic ovary syndrome is a hormonal condition that can cause irregular periods, excess hair growth, acne and difficulty getting pregnant. The NHS lists blood tests for hormone levels and insulin resistance, plus an ultrasound scan of the ovaries, among the tests, and notes that the ultrasound is only done for people over 18 (NHS). On a TVS, the radiologist counts the small follicles and measures the volume of each ovary. A scan finding alone does not diagnose PCOS: your doctor combines it with your symptoms and blood results. In younger girls and in those who have not been sexually active, an abdominal scan is used instead.

Ovarian cysts

Ovarian cysts are fluid-filled sacs on the ovary. Most are simple “functional” cysts linked to the menstrual cycle that disappear on their own. TVS shows the size, wall and contents of a cyst, which helps the radiologist describe it as simple, haemorrhagic, a dermoid, an endometrioma or a cyst that needs further assessment. Your doctor may ask for a repeat scan after one or two cycles to check that a functional cyst has gone. Sudden severe one-sided pain with nausea can be a sign of ovarian torsion and needs emergency care.

Postmenopausal bleeding

Any vaginal bleeding after menopause should be checked by a doctor, even if it is only a small amount or has only happened once (NHS). The NHS advises that you should not wait more than 2 weeks to see a specialist, and lists a vaginal ultrasound scan among the first tests. On a TVS, the radiologist measures the thickness of the endometrium and looks for polyps or fluid. Most causes are not serious, but a thickened or irregular lining usually leads your gynaecologist to arrange further tests such as hysteroscopy or a biopsy.

This table shows how the TVS findings for these three conditions are usually followed up.

When blood flow in a cyst, fibroid or ovary needs assessment, the radiologist can add colour Doppler during the same scan.

How to prepare for a TVS scan

For a TVS you usually need an empty bladder, so you will be asked to pass urine just before the scan. RadiologyInfo explains that the transducer is inserted after you empty your bladder (RadiologyInfo). This is the opposite of an abdominal pelvic scan, where a full bladder is needed; if your doctor has asked for both, we will guide you on the order.

The right timing in your cycle depends on why the scan is being done.

Having your period does not always stop the scan; Cleveland Clinic advises removing a tampon beforehand (Cleveland Clinic). Call us if you are unsure whether to keep or change your appointment. Tell staff if you have a latex allergy so a latex-free probe cover can be used (NHS). For a general list of what to carry, read what to bring to an imaging appointment.

What happens during a 3D TVS at KDRC?

A TVS at KDRC is done in a private room, with your consent, and usually takes 15–30 minutes. Cleveland Clinic gives this range, depending on what is being checked and how easily the structures can be seen (Cleveland Clinic).

When 3D is needed, the radiologist holds the probe still for a few seconds while the machine sweeps through a volume of tissue. The 3D image is then rotated and sliced on screen. This adds only a little time to the examination.

Privacy, chaperones, comfort and hygiene

A TVS is an intimate examination, so it is only performed with your consent, in a private room, and you can ask to stop at any time. The NHS describes the patient as being in control of the scan and confirms that you can ask for another person to be in the room, either someone you know or a member of staff (NHS).

• Chaperone: you may request a female chaperone, or bring your mother, sister, husband or a friend into the room.
• Covering: you undress only from the waist down and a sheet covers you throughout.
• Self-insertion: you can ask to insert the probe yourself, much like a tampon (NHS).
• Explanation: the person scanning explains each step before doing it.

Does a TVS hurt?

A TVS may be uncomfortable but should not be painful. Cleveland Clinic says the probe is less than 1.5 inches in diameter and may feel like inserting a larger-than-normal tampon (Cleveland Clinic), and RadiologyInfo notes it is usually more comfortable than a manual gynaecological examination (RadiologyInfo). Relaxing your tummy and breathing slowly helps. If an area is tender, for example an inflamed ovary, tell the radiologist — that information is itself useful. Light spotting afterwards is uncommon and settles quickly.

Hygiene: probe covers and disinfection

The probe is always covered with a fresh, single-use protective sheath and lubricating gel for every patient (RadiologyInfo). After each examination the cover is discarded and the probe is cleaned and disinfected according to infection-control standards for internal ultrasound probes before it is used again. You are welcome to ask the staff to show you the new cover being opened.

When is a transabdominal scan used instead of TVS?

A transabdominal (over-the-tummy) scan is used instead of TVS when a person has never been sexually active, declines an internal examination, or is a child or adolescent. The approach is simple: a TVS is offered when it will give the clearest answer, but if it is not acceptable to you, an abdominal scan is done with a full bladder. You never have to have an internal scan to receive care at KDRC.

An abdominal scan shows the uterus and ovaries reasonably well when the bladder is full, but small details — a very early pregnancy, small polyps or follicles — may be less clear. The radiologist will note this in the report so that your doctor can decide whether anything further is needed. Transabdominal scanning is also preferred for large fibroids or masses that rise out of the pelvis, and in later pregnancy. Some women benefit from both approaches in one visit, and the radiologist will explain if this is suggested.

Is a transvaginal ultrasound safe?

Yes. A transvaginal ultrasound uses sound waves and no ionising radiation, so it can be repeated when needed, including in early pregnancy. Diagnostic ultrasound has been used for decades, and professional bodies advise that it be performed for a medical reason by trained staff, keeping the exposure as low as reasonably achievable (the ALARA principle). A TVS does not cause miscarriage and does not harm an early pregnancy. Read more in our guide is ultrasound safe?

TVS is not suitable for everyone in every situation. It is usually avoided in those who have never been sexually active, after some recent pelvic surgery, and when there is significant narrowing or pain of the vagina; in these cases an abdominal scan, or another test such as MRI, may be chosen. MRI is sometimes requested after a TVS to map complex uterine anomalies, deep endometriosis or large fibroids before surgery.

3D TVS results and reports

After your scan, the consultant radiologist reviews the images and prepares a written report for you and your doctor; for most ultrasound examinations at KDRC the report is ready the same day. The report usually lists the size and position of the uterus, endometrial thickness, each ovary’s size and appearance, and any fibroid, cyst, polyp, pregnancy or device seen, with measurements. 3D images can be included where they help your doctor.

The radiologist can explain the main findings, but treatment decisions are made by your gynaecologist or fertility doctor. Keep your reports together, especially for follicle tracking or repeat cyst scans, because comparison with earlier measurements is important. For help understanding the terms used, read how to read an ultrasound report. Referring hospitals can also arrange reporting through our teleradiology service.

How much does a 3D TVS cost in Pokhara?

The cost of a 3D TVS in Pokhara depends on what the examination includes, so KDRC quotes the price individually rather than listing a fixed rate. Factors that affect the price include whether 3D volume imaging is required, whether a transabdominal scan or colour Doppler is added in the same visit, and whether you need a series of follicle-tracking scans. For the current TVS scan price, call 061-553538 or 9856077433 (Viber).

Why choose KDRC for 3D TVS in Pokhara?

Women and referring doctors choose KDRC for a 3D TVS in Pokhara because it combines HD 3D ultrasound, consultant radiologist reporting and a respectful, private examination.

• HD ultrasound with 3D, 4D and volume scanning, plus colour Doppler for blood flow in fibroids, cysts and the ovaries.
• Consultant radiologists: Dr. Bishworaj Bastakoti and Dr. Nawaraj Paudel have been consultant radiologists at KDRC since its inception and are NMC-registered radiologists. Read more on our doctors page.
• Same-day reports for most ultrasound examinations, so you can see your gynaecologist sooner.
• Privacy and choice: consent at every step, the option of a female chaperone, and an abdominal scan if you prefer not to have an internal scan.
• One centre for pelvic and pregnancy imaging: TVS, fetal ultrasound, the anomaly scan and 4D/5D ultrasound, as well as biopsy when your doctor needs tissue diagnosis.

KDRC is located at Shantipath, Amarsingh Chowk, Pokhara-10, Kaski. If you searched “TVS scan near me” from Lakeside, Bagar, Prithvi Chowk, Lekhnath or anywhere in Pokhara, call 061-553538 or 9856077433, or book your 3D TVS appointment online. See our contact page for directions, or browse all KDRC services.