US of the Postprocedure Uterus: Long-term Findings with Correlative Imaging

Interpretation of pelvic US requires knowledge of clinical symptoms, menstrual status, and any hormonal supplementation. The additional history of prior percutaneous or surgical procedures and any implanted devices is also essential, although not always available when the study is performed or interpreted. While many of these procedures may occasionally result in an acute complication requiring imaging, long-term imaging of these women-months and years later-is frequent. In most patients, it is sufficient to appreciate the resulting "normal" changes in the appearance of the uterus, so that one does not interpret them as abnormal. In a smaller group of patients, symptomatic situations may develop, requiring knowledge of the prior intervention and its specific potential complications. The authors address both the expected normal sonographic appearances of the uterus after these interventions in addition to potential long-term complications. The uterine interventions discussed include cesarean delivery, intrauterine device placement, endometrial ablation, uterine artery embolization for fibroids, uterine dilation and curettage, and several miscellaneous procedures. Transabdominal and transvaginal imaging with coronal reformations and sonohysterography are complemented by CT, MRI, and hysterosalpingography. Although it is performed for a variety of unrelated reasons, the US appearance of these uterine interventions and their long-term complications is useful to view as a complete reference collection for radiologists who may not be familiar with them. ^©RSNA, 2026 Supplemental material is available for this article. See the invited commentary by Patel and Young in this issue.