Prioritising Patient Care in Pelvic Ultrasounds: A Conversation With Sonographer Kristelle Sos

We spoke with Kristelle Sos, a Sonographer at IN Radiology (across the road from INMC), about her approach to pelvic ultrasounds and the importance of patient comfort and control. Kristelle is a dedicated Sonographer who believes in providing exceptional patient care with compassion and understanding. Her interest in patient autonomy means she keeps up to date with the latest and best methods. She brings a wealth of knowledge and a genuine passion for the role medical imaging can play in creating positive, empowering healthcare experiences, particularly in the area of pelvic health.

Hi Kristelle. What should someone expect during a pelvic ultrasound? 

In my practice I always aim to make the patient feel as comfortable as possible. As a standard pelvic assessment, it includes two parts: a part where you scan on top of their tummy and another part is a transvaginal scan that requires a probe. I always give the patient the option whether they want to have both parts completed or not. Most doctors prefer to have both of these scans done if possible, as it gives a more complete picture of what the issue is. 

I see a wide variety of patients, some may have histories of trauma or vaginismus (involuntary tensing of the vagina), so we make this an informed decision - they are in control at all times during the  scan. They can insert the probe themselves, and at any time if they are not comfortable, they can stop. In some cases a follow up scan may be necessary, so I aim to make every examination as comfortable as possible.

You speak a bit about the option of self-probing. Can you speak more about this and what it involves?

Yes, I have always advocated for giving patients the option to self-probe, which means they insert the probe themselves. Usually people understand their own bodies best, and doing it this way helps the person feel more comfortable and in control. I think it’s quite an important part of the process. I’ve had a lot of people come in who say they have never been offered the choice to self-probe before, which is saying something, as I feel it should be standard care, especially in cases of trauma. 

How do you guide a patient through this self-probing process?

I start by explaining the process of how to  insert the probe and what they may experience. Nearly all patients find it a lot more comfortable and non invasive to self-insert giving them control over the situation. They know their bodies best. Naturally people come in here and they can be nervous. I always talk the patient through it - it’s like putting a tampon in. If anyone finds it too difficult I can help or provide extra assistance if needed.

Why is it often difficult for women to get a proper diagnosis for pelvic health conditions? And what are some common health issues not picked up in a pelvic ultrasound? 

Women's health is complex and at times things can be missed or disguise themselves as something else like polyps, dermoids or adhesions, and may not get picked up. Also things like early endometriosis or adenomyosis can be difficult to pick up on a scan. Often people who have endometriosis can find an internal scan more painful than those who don’t. We only do the scans to the limits of what the person is comfortable with and this may limit the ultrasound. 

Do you think pelvic health conditions are becoming easier to diagnose with newer imaging techniques?

We are pretty lucky with the ultrasound technology we have in most of the areas around Melbourne, as they all need to meet certain accreditation standards. So in metropolitan areas, the machines should all be fairly good. In rural areas the technology can be a bit older. We have a fantastic machine here at IN Radiology, you can see everything really well. Patients will often comment how much clearer our images are compared to other scans they have had - ‘you can see everything!’ 

What improvements would you like to see in the field of pelvic ultrasound in the coming years?

The self-insertion, I would love to see this become standard protocol in all practices. I would love everyone to be given that option. It’s really up to the sonographer to be up to date on the technology and the latest research. Although ongoing general professional development is mandatory for sonographers like myself, there’s no formal requirement to continually refine scanning techniques. That’s why it’s so important for sonographers to take initiative in staying up to date and actively applying improvements in their day-to-day practice.

I also think it’s so important to remove as many barriers as possible when you are having health checks. For example, if someone doesn’t want a stranger to insert a probe into them for an ultrasound, giving them the option to do it themselves removes that barrier, and results in them being more comfortable, and getting a better health outlook.

How do you stay up to date with the latest in sonography?

There are always conferences on, often focusing on different specialties in sonography. There is one coming up in Melbourne, and another one in New Zealand so I’ll be attending both. There are also conferences online. It’s still up to the sonographer to put it into practice whether they use what they have learnt or not. I am actually wanting to do a research topic on self probe. I think it’s very relevant in today’s age. 

Thanks Kristelle for sharing all of your insights with us. What’s the best way to request an appointment?

Yes - they need to see their doctor first and we need to have a clinical indication of why we are doing the scan. The referral has no expiry date.

To book an ultrasound with Kristelle, head to the IN Radiology website and fill out the booking form today.