Freedom of information requests

Transvaginal ultrasounds

Questions

1. For what symptoms would a transvaginal ultrasound be indicated?

2. Are there any groups of people a transvaginal ultrasound would not be carried out on? If so, why would they not be indicated?

3. Does trust policy indicate that it is allowed to carry out transvaginal ultrasounds on those who have never been sexually active before? If it is not allowed, what is the reasoning behind no sexual contact being a contraindication for these scans?

4. If transvaginal ultrasounds are not allowed in your trust for the 'sexually inactive', what is the justification for this going against the British Medical Ultrasound Society’s guidelines, which state: “The concept of virginity plays no part in the clinical decision making for a TVUS” and “if a patient has not had penetrative sex, they are still entitled to be offered, and to accept, a TVUS [transvaginal ultrasound] in the same way that cervical screening is offered to all eligible patients"?
(https://www.bmus.org/static/uploads/resources/Transvaginal_Ultrasound_Guidance_Final_With_Front_Cover_MesUP8a.pdf)

5. What does the Trust define as ‘sexual activity’?

6. Which members of staff in your trust perform transvaginal ultrasounds?

7. Have all of those staff members received diversity and inclusion training regarding their patient-facing roles? If so, please detail the nature of the course or programme and number of hours completed.

 

 

Response

1. A TVUS may be indicated for the assessment and diagnosis of gynaecological disorders/pathology, it also has wide usage in obstetrics and fertility care.

2. Absolute Contraindications:
Patients aged under 16 years of age.
Premature rupture of membranes in pregnancy.
Bleeding associated with known placenta praevia.
Vaginal obstruction
Although not absolute contra indicators, conditions including age-related atrophy, vaginismus, vaginitis and recent surgery may make TVUS particularly uncomfortable for the patient and may increase their risk of infection.
Patients who are survivors of sexual abuse or have suffered from Female genital mutilation are treated with the utmost sensitivity and offered the same detailed counselling as other patients if a TVUS is recommended for management of their current condition. Religious beliefs are also respected and a person’s sexual orientation or gender identity does not preclude them from being offered, and accepting, a TVUS.

3. Trust policy at present does not recommend TVUS in patients who are virgo intact due to the discomfort/pain they could experience during the scan and a small risk of infection.

4. We are hoping to update our TVUS protocols imminently to match the BMUS recommendations and offer TVUS to all patients 16 years old and over.

Every person assigned female at birth aged 16 years or older will be eligible to be offered TVUS. Eligibility is also extended to transgender men, transgender women and people who identify as asexual, intersex or non-binary. In some very specific circumstances minors may be offered TVUS. There is no upper age limit for TVUS. The age, sexual status, sexuality, religious or personal beliefs of the person or the ultrasound practitioner should not be barriers to offering TVUS.

In patients who are virgo intacta and the hymen is believed to be intact, and the patient accepts TVUS, they will be counselled accordingly in advance and given the power to end the examination at any point.

5. No formal definition could be found despite referring to:

UHB Safeguarding team, "Working together to Safeguard Children". A guide to inter-agency working to safeguard & promote the welfare of children. July 2018 and the GOV.UK safeguarding policies.

6. Sonographers
Midwives
Clinical Nurse Specialists in Obstetrics & Gynaecology
Consultant Radiologists
Consultants in Obstetrics & Gynaecology
Trainees

7. Inclusion & Diversity Training is part of all clinical employees’ online mandatory training.

This only has to be completed once (usually at time of induction).

It is the employee’s responsibility to ensure they are up to date with all mandatory training which is checked at annual appraisals.