Can the ovaries be seen without the internal ultrasound scan ?

Just asking as I am going back for another scan in December, but I am going in hospital on Monday to have a GA and hysteroscopy and it says a biopsy and polypectomy , so I assume they think its a polyp ? 

Would they scan the ovaries while under GA or would I still need the scan in December ?

Thanks 

Sometimes the ovaries can be seen transabdominally (across the top), sometimes a transvaginal (internal) is needed and sometimes neither method show the ovaries no matter what the sonographer does. 

It depends greatly on where you are in your menstrual life - young and not on certain contraceptions then your ovaries will usually be larger and easier to spot as they'll have juicy follicles on them. As you get older you don't have as many follicles and once you're postmenopausal then you shouldn't have any follicles growing and that makes them harder to see (not unusual not to see ovaries at all if they're normal and you're into menopause). However if you're into menopause and are growing follicles (when you shouldn't) then we'll call them cysts and it's really the cysts that makes them stand out. 

Other factors make it harder too - bowel often makes it very hard as that overlays the ovaries on ultrasound, sometimes the sonographer will need to apply pressure to move the bowel but sometimes that doesn't work. Great if you can empty your bowels before the scan but don't take laxatives to do so as that'll churn your bowels up and ironically make it even harder to see. Sometimes it's the position of your ovaries and uterus that makes it harder to spot things - if you've got a retroverted (tilted) uterus (womb) then it'll dip out of view on the transabdominal scan so a transvaginal scan will be needed. Sometimes it's an underfilled bladder as a full bladder usually pushes your uterus and ovaries into a good position and dramatically reduces the chances of an internal scan.

If the sonographer sees everything across the top then they'll not need a transvaginal scan. Often that's the case for a young person but often a transvaginal scan will be needed once you're into menopause. Again it depends on your clinical history too as to what the doctor actually wants to know about - if they're only interested in the endometrium (the lining of your womb) and that's been answered then the sonographer may not need to do the transvaginal scan to attempt to see the ovaries if the doctors aren't really worried about them (anything major is

more likely to be seen transabdominally anyway).

A hysteroscopy is a special camera (not ultrasound) that looks at the lining of your uterus (I would recommend taking some pain killers before hand). That's not really my area but I'm pretty sure it can't see anything other than the lining of your uterus (which would make sense if they're going to remove a polyp which will be in the cavity of your uterus i.e. the lining of your uterus). They may still want the scan in December to reassess the thickness of the endometrium but I doubt they'll be particularly concerned about the ovaries if that's the clinical history. Always remember though that nothing is compulsory and you can always say no - you don't have to give any reasons. And that's at any point too - even if they've started scanning. For most people a transvaginal ultrasound does not usually hurt but if you've not been sexually active for a long time or if you've suffered from dryness in your vagina then sometimes it can be but it's rare that it'll hurt. Occasionally if the sonographer applies pressure to move the bowel that can be tender, it won't damage the bowel but if its a hard bit of faecal matter (esp if you're a bit constipated) then it may be a bit tender - but tell the sonographer as they may be able to change their angle or look at something else in the hope that the bowel will move naturally. Sometimes the sonographer just has to admit defeat and that's when they'll record that the ovaries haven't been identified. Remember you can always tell them to stop - that goes across all medical professions, it's your body not theirs... And it's okay to ask what the consequences of a decision will be too - from a sonographers point of view, it might mean we can't see something but if the doctors aren't overly worried then the significance is reduced. The doctors are also able to request different types of scans such as an MRI if they are desperate to see the ovaries but ultrasound hasn't seen them. As the saying goes "there's more than one way to skin a cat" although I'm not sure who would want to skin a cat in the first place! 

Hope that helps and hope that makes sense too. 

You're welcome, glad the Ca125 were normal - benign things can raise them too such as endometriosis but glad yours are normal. I think everything should be latex free as I'm pretty sure most hospitals would be the same as mine. Even on medical notes we stopped putting elastic bands on them - they're all electronic now though. I would keep an eye on the discharge and let your GP know hopefully it'll nothing to worry about but let the doctor know.