An adnexal ultrasound is a pelvic scan that images the uterine adnexa—the ovaries, fallopian tubes and nearby pelvic tissues—to identify cysts, masses, ectopic pregnancy, infection or pelvic fluid. It may be performed transabdominally or transvaginally (the latter gives higher resolution). Doppler assessment of blood flow can help distinguish benign from suspicious lesions and guide further management.

A normal non‑pregnant uterus is about 5–8 cm long, 3–5 cm wide and 2–3 cm thick (commonly cited ~7.5 × 5 × 2.5 cm), with a volume roughly 30–80 mL. Ovaries (adnexa) in premenopausal women are about 3 × 2 × 1.5 cm with volumes around 6–14 mL; postmenopausal ovaries are smaller, often ≤2.5 cm and <5–8 mL.

We scan the adnexa to evaluate ovaries, fallopian tubes and surrounding tissues for causes of pelvic symptoms and reproductive problems. Imaging detects ovarian cysts and masses, ectopic pregnancy, adnexal torsion, pelvic inflammatory disease, endometriosis and malignancy; assesses blood flow and structural changes; and guides fertility evaluation, treatment planning and follow-up after surgery or therapy.

The uterus is the pear-shaped muscular organ in the pelvis that houses and supports pregnancy, sheds the lining during menstruation, and contracts during childbirth. The adnexa are the structures adjacent to the uterus—mainly the ovaries, fallopian tubes, and supporting ligaments and tissues—responsible for egg production, transport and hormonal function. Clinically, adnexal problems (cysts, ectopic pregnancy) differ from uterine conditions (fibroids, endometritis).

Adnexa refers to the structures beside the uterus: the ovaries, fallopian tubes and supporting ligaments and tissues. Normal adnexa on exam or imaging show ovaries of appropriate size and shape for age with smooth contours and no suspicious cysts or masses, non‑dilated tubes, absence of abnormal pelvic fluid, and no signs of inflammation or localized tenderness.

The adnexa (ovaries and fallopian tubes) are not always removed with a hysterectomy. A total hysterectomy removes the uterus and cervix; removing ovaries/tubes requires a salpingo-oophorectomy. Surgeons may remove one or both adnexa for cancer risk reduction, disease, or menopausal considerations. The choice depends on age, diagnosis, and patient preference, discussed before surgery.