Is an internal pelvic ultrasound as accurate as one with a full bladder.

It can be: Depending on what on is looking for, patient size, technologist skill, and how well the bladder is distended. The transvaginal exam is done with a probe that better sees the ovaries and inside of the uterus, so problems there are usually best examined that way.

Typically better: Internal, otherwise known as transvaginal, ultrasound is usually more accurate since the tranducer is closer to the uterus and ovaries.