Menstrual cup, ultrasound imaging

A menstrual cup is a reusable device that is inserted into the vagina to collect menstrual blood. It is usually made of silicone, rubber, or plastic. Ultrasound imaging can detect the cup on transabdominal and transvaginal ultrasound scan. 

The ultrasound and color Doppler findings of a menstrual cup are:

- The menstrual cup appears as a hypoechoic to isoechoic structure in the vaginal canal, with a bright echogenic rim at the edge of the cup.

- The menstrual cup may cause acoustic shadowing behind it, obscuring the view of the cervix and the uterus.

- The menstrual cup does not interfere with the assessment of the ovaries and the adnexa, which can be seen by transvaginal ultrasound.

- The menstrual cup does not affect the blood flow in the pelvic vessels, which can be visualized by color Doppler.

- The menstrual cup may cause artifacts in the color Doppler image, such as aliasing or flash artifact, due to the movement of the cup or the blood inside it.

Images on sonography of menstrual cup:

I hope this information is helpful to you. 😊

Important points to differentiate the other conditions from menstrual cup on ultrasound:

- **Vaginal foreign body: A vaginal foreign body may have a variable shape, size, and echogenicity, depending on the type of object. It may also cause inflammation, infection, or perforation of the vaginal wall, which can be seen as thickening, hyperemia, or fluid collection. A menstrual cup, on the other hand, has a uniform shape, size, and echogenicity, and does not usually cause any complications.

- **Endometrial polyp: An endometrial polyp is located in the uterine cavity, not the vaginal canal. It can be distinguished from the menstrual cup by its position, shape, and vascularity. An endometrial polyp may have a pedunculated, sessile, or polypoid shape, and may show internal blood flow on color Doppler . A menstrual cup is round, hollow, and avascular, and does not extend into the uterine cavity.

- **Uterine arteriovenous malformation (AVM): A uterine AVM is also located in the myometrium, not the vaginal canal. It can be differentiated from the menstrual cup by its appearance, location, and hemodynamics. A uterine AVM may have a complex, heterogeneous, or cystic appearance, and may be diffuse or focal in the myometrium. It may also show high-velocity, pulsatile, or chaotic blood flow on color Doppler. A menstrual cup is simple, homogeneous, and anechoic, and is confined to the vaginal canal. It does not affect the blood flow in the pelvic vessels .

Sonography of uterine pathology