STD from a transvaginal ultrasound?

[MagnoliaMe]

I have had two transvaginal ultrasounds in the past six months for ovarian cysts. I didn't think about this the first time, but my second one was yesterday, down the hall from my gynecologist's office, which is in a women's center in a hospital.

I tried not to look at what the provider was doing because I was anxious, but I did not see or hear her put a cover or condom over the probe and it felt like cold plastic, like maybe it did not have a cover on it. There were at least two or three other women in the waiting room who went in before me within a half hour's time.

Last night, I felt soreness or irritation in my vaginal area/labia and started thinking about it and became completely grossed out and horrified at the thought that the provider might not have covered the probe. Just the mere idea of a probe that has been used on so many other patients without a cover being used on me was awful, even if it was disinfected.

Then, I thought what if they cut corners on disinfection given how many women seemed to be going in and out. (I have read the instructions for thorough disinfection online, and it talks bout washing it with soap, taking it apart, soaking it in a solution and air drying it. Am I really supposed to believe they do that to every probe with all those women going in and out?

I am so thoroughly grossed out and terrified/worried that I might have picked up an STD, especially HSV or HPV or who knows what kind of bacteria or virus.

My question: is it possible that I could have gotten an STD from this probe? Should I get tested for STDs, especially herpes? (If I did get it from the probe, I want a negative test now so I can prove it was from the probe if I were to get a positive test in a few months.) Should I ask about their disinfection procedures and if they use covers? How would I know if they're telling the truth? And, finally, is it bad practice to not use covers?

Thanks so much.

[Edward W Hook, MD]

Welcome to the Forum.  I am not a gynecologist and do not do vaginal ultrasounds so I am not in a personal position to answer your questions.  I do know however that there appears to be an awful lot of controversy as to the risk of infection with vaginal ultrasounds, particularly as it involves HPV.  It is also my impression that while most ultrasonographers use covers (usually condoms) for transvaginal ultrasounds and apply the lubricating get to the outside of the transducer that goes into the vaginal, these procedures also vary from site to site.

Having acknowledged that there is a potential problem here, I however can also tell you that infections resulting from contamination due to transfer infections during transvaginal ultrasonography are not recognized as a major medical problem and had there been many such infections we would have heard more about it.

My advice is to talk with your doctor about your concerns, and given all the variability, rather than assuming anything, I would go to the source and ask about the issue and their procedures.

I hope this comment is some help to you.  EWH  

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A related discussion, transvaginal scan -hiv risks was started.

[Edward W Hook, MD]

Thanks for the follow-up. I'm pleased both the hear of the procedures your doctors are doing and your confort with their assurrances.  I think your increasing level of comfort is appropriate.  Take care. EWH

[MagnoliaMe]

Hi Dr. Hook,

I wanted to let you know I called today and spoke with my doctor's nurse. She told me that they use a cover that's like a condom that they put on the probe for each new patient. She said they also use sanitizing wipes on the probe. It's not ideal as I'd rather have heard they do the full soaking/sanitizing process plus use a cover but I definitely feel much, much better and I think I probably just didn't notice the tech putting the cover on because I was nervous and wasn't really watching what she was doing. I also have quite a bit of medical anxiety.

Thanks again!

[Edward W Hook, MD]

Sorry I didn't have a better answer.  My guess is that a cover was most likely used but again, there appears to be variability in what is done form place to place. Please let us know what you find if you have the chance.  EWH

[MagnoliaMe]

Thanks so much, Dr. Hook. I appreciate the honest answer, though not exactly what I was hoping to hear. I tried to call my doctor, but the office is closed for the holiday weekend until Tuesday. I am supposed to go in and pick up a CD of the ultrasound next week, so I am going to talk to my doctor or someone who works in the ultrasonography area to get more clarification on their procedures. Maybe they will tell me they use covers and thoroughly disinfect the probes,though I'm not sure I will believe them unless they tell me they have like 10 probes because there were just too many women going in and out of there.

I just wished I had looked to see if she used a cover. I have done some reading on studies about this and am very surprised and upset that this could be an issue without patients being informed about it. I can't believe every single place doesn't both do the full disinfection *and* use a cover. Anyway, thanks so much for your answer.