The Endometriosis Scan

WHAT IS ENDOMETRIOSIS?

The tissue that normally lines the inside of the uterus is called the endometrium. In some women, this tissue grows outside the uterus. When this happens a woman has a condition called endometriosis. This condition affects up to 20% of women of childbearing age.

The most common areas for this abnormal growth of endometriosis are the ovaries and floor of the pelvis just behind the neck of the uterus. It can also grow on the bowels, bladder, rectum, liver or anywhere else in the abdomen. Endometriosis tissue tends to respond to the hormones of the menstrual cycle and bleeds each month in the same way the lining of the uterus responds to hormones.  But since the tissue is not in the uterus, the blood has no way to leave the body. It therefore collects in the body forming cysts, adhesions, endometriosis lumps and scarring.

WHAT ARE THE SYMPTOMS?

Endometriosis may cause no symptoms in some women. However, when symptoms occur, they may include:

• Abnormal or heavy menstrual bleeding
• Pelvic pain before and after the menstrual period
• Very painful menstrual cramps
• Painful sexual intercourse
• Painful bowel movements with diarrhoea, constipation
• Passing blood in your stool especially during periods
• Painful urination or feeling the need to urinate often during menstrual periods
• Trouble falling pregnant.

USING ULTRASOUND TO DIAGNOSE ENDOMETRIOSIS

In the last decade, transvaginal ultrasound has become the preferred method for diagnosing different forms of endometriosis before surgery¹.  The advantages of ultrasound over other methods are that it is cheaper and easily available². It is also an interactive test and does not expose you to radiation². Diagnosing endometriosis before surgery is also important because you and your health care provider can consider all the options available to you for managing this condition.

At JUNIC Specialist Imaging Center, we can help you check if you have endometriosis using transvaginal ultrasound. The technique we use for this scan was described by Menakaya and Condous et al². Before you get the scan, we will advise you on the important things you need to do to prepare for the scan.

It is important you know that

• It is an interactive scan
• It checks for the different forms of endometriosis (i. e scarring, adhesions, ovarian cysts, endometriosis lumps)
• It may take up to 30mins
• The bladder needs to be empty for the scan
• The bowel needs to be empty for the scan
• In some cases, additional ultrasound gel may be used to improve what we are seeing.

WHAT HAPPENS AFTER THE SCAN?

After the scan, we will tell you whether you have the mild or the more severe type of endometriosis³. With this information, you and your health care provider can tailor your management accordingly.

REFERENCES

1          Menakaya UA, Reid S, Infante F, Condous G: The ‘Sliding sign’ in conjunction with sonovaginography: Is this the optimal approach for the Diagnosis of Pouch of Douglas Obliteration and Posterior Compartment deep infiltrating endometriosis? AJUM August 2013: 16 (3); 118 -123.

2          Menakaya UA, Reed S, Infante F, Condous G: The systematic evaluation of women with suspected endometriosis using a five-domain ultrasound based approach. J Ultrasound Med 2015; 34:937–947

3          Menakaya UA, Reid S, Infante F, Lu C, Condous G (2014): Ultrasound based staging system as a preoperative triage tool for laparoscopic treatment of endometriosis. UOG Sept 2014: 44 (S1); Pg. 347