Endometriosis Ultrasound: Diagnosis, Procedure & Preparation – Thomson Medical

What is an endometriosis ultrasound?

An endometriosis ultrasound is a medical imaging scan that helps your doctor check for signs of endometriosis. Endometriosis is a medical condition where tissue similar to the lining of the uterus grows outside the uterus.

During this ultrasound, doctors can examine areas where endometriosis commonly develops, such as:

• Ovaries

• Bladder

• Intestines

• Fallopian tubes

Endometriosis causes inflammation, resulting in symptoms such as:

• Intense menstrual cramps

• Pain during urination

• Discomfort during bowel movements

• Potential fertility challenges

Most endometriosis ultrasounds are transvaginal, where a probe is inserted into the vagina for clearer images.

Can an ultrasound detect endometriosis?

Ultrasounds can detect some endometriosis, but their effectiveness depends on endometrial tissue size and position.

What can an ultrasound show?

• Endometriomas

  • These ovarian cysts, also known as "chocolate cysts", contain old blood and are typically easier to detect on an ultrasound.

• Deeply infiltrating endometriosis (DIE)

  • This severe form of endometriosis extends more than 5 mm deep into organs like the bowel or bladder.

What does ultrasonography fail to detect?

• Superficial endometriosis

  • These are tiny lesions on organ surfaces, often smaller than 5 mm, which are the most common type but too small for ultrasound detection.

• Adhesions

  • Ultrasounds cannot identify adhesions, which are bands of scar tissue that may form between pelvic organs.

Limitations

Although ultrasounds provide valuable clues about potential endometriosis, they cannot definitively confirm a diagnosis. This is because they cannot detect superficial lesions or adhesions, which are often present in endometriosis patients.

The only way to be certain is through a surgical procedure called laparoscopy, where tissue is examined. However, ultrasound remains a useful tool for identifying possible endometriosis and helping healthcare providers determine the next diagnostic steps or treatment options.

Why would I need an endometriosis ultrasound?

Your healthcare provider might recommend an endometriosis ultrasound for several important reasons:

Diagnostic clarification

An endometriosis ultrasound helps doctors distinguish endometriosis from other conditions with similar symptoms. By providing detailed images of your reproductive organs and surrounding tissues, it allows healthcare professionals to:

• Identify potential endometrial-like tissue growths

• Rule out other potential causes of your symptoms

• Gather preliminary evidence about your condition

Treatment monitoring

The ultrasound plays a key role in tracking the effectiveness of your treatment. It can:

• Monitor endometriomas

• Assess how these tissues respond to hormonal treatments

• Provide visual evidence of changes over time

Surgical preparation

If surgical intervention becomes necessary, the ultrasound serves as a critical planning tool. It helps your healthcare provider:

• Precisely locate areas of endometriosis

• Determine if the condition is near sensitive areas like the intestines or bladder

• Determine which specialists, such as urologists or colorectal surgeons, might be required for your procedure.

By offering detailed insights into your condition, an endometriosis ultrasound helps your healthcare team develop the most effective diagnostic and treatment strategy tailored to your specific needs.

If you're experiencing pelvic pain, heavy periods, or fertility concerns, talking to a healthcare provider is a great first step. Request an appointment with Thomson Medical for a comprehensive evaluation. Our specialists will assess your symptoms and may recommend an endometriosis ultrasound to accurately diagnose your condition and develop a personalised treatment plan tailored to your needs.

How do I prepare for an endometrial ultrasound?

Your healthcare provider will guide you on how to prepare, depending on the type of ultrasound being performed.

Bladder preparation

• For a transabdominal ultrasound, you may need to arrive with a full bladder. This typically involves drinking a sufficient amount of water beforehand.

• For a transvaginal ultrasound, you may be asked to empty your bladder beforehand.

Important information to share

Inform your healthcare provider about:

• Your current menstrual cycle stage

• All medications you are currently taking

• Any recent medical history relevant to your reproductive health

Be sure to follow your provider’s instructions and review any pre-procedure guidelines carefully to ensure you're fully prepared for your ultrasound.

What happens during an endometriosis ultrasound?

If you are having a transvaginal ultrasound, you will need to remove your undergarments (or anything below your waist) and lie on your back with your feet in stirrups.

This type of ultrasound provides a detailed view of the pelvic organs most commonly affected by endometriosis, such as the ovaries, bladder, and bowel. The entire ultrasound typically takes 30 minutes to an hour.

Here’s what to expect during the procedure:

• A trained ultrasound technician will insert a lubricated, wand-like device (called a transducer) into your vagina.   

• The transducer emits sound waves that create images of the structures inside your pelvic area.

• The technician will gently move the device to capture images from different angles.

• The images will appear on a screen, which the technician—and sometimes you—can see in real time.

Once the ultrasound is complete, your healthcare provider will analyse the images to determine possible findings.

What do the results of an endometriosis ultrasound mean?

The results from an endometriosis ultrasound can vary, and your healthcare provider will help interpret these findings. Here’s what you might expect:

Normal results

Your normal ultrasound may show no signs of endometriosis, indicating:

• Healthy ovaries without cysts or masses

• A normal uterine shape and size

• No evidence of adhesions or scarring

Abnormal results

The ultrasound may reveal signs of endometriosis, such as:

• Presence of endometriomas

• Enlarged ovaries with cysts or masses.

• Potential signs of adhesions or scarring around the pelvic organs.

Next steps

Depending on your results, your provider may:

• Recommend additional tests, such as an MRI (magnetic resonance imaging) or laparoscopy, to confirm the diagnosis.

• Suggest treatment options to manage symptoms and improve fertility.

FAQ

How does endometriosis show on ultrasound?

On ultrasound, endometriosis may appear as a mass, nodule, or thickened area within the ovaries known as an endometrioma. It may appear as masses or scarring in the bowel wall, bladder wall, or other pelvic structures where endometriosis has infiltrated deeply.

What are three signs of endometriosis?

Three classical signs of endometriosis are:

• Painful periods

• Pelvic pain

• Infertility

Can endometriosis go away?

Endometriosis may naturally go away, especially after menopause, due to a drop in oestrogen levels. However, many individuals still experience symptoms and may require ongoing treatment to manage pain and other issues.

What happens if endometriosis is left untreated?

Endometriosis can lead to long-term, severe pain, especially during your period. It may affect the quality of life and sleep. Many people with endometriosis may also have difficulty getting pregnant. 

Who is at the highest risk for endometriosis?

Endometriosis mostly affects premenopausal groups aged between 20 and 40. Those at risk of developing endometriosis are:

• Family history

  • Having a mother or sister with endometriosis.

• Short menstrual cycles

  • Menstrual periods occurring less than 27 days apart.

• Long and heavy periods

  • Bleeding lasting more than 8 days.

Are there any risks associated with an endometriosis ultrasound?

Ultrasound examinations are a safe, non-invasive way to diagnose endometriosis. They use harmless sound waves, not radiation. However, a transvaginal scan may cause slight discomfort, especially for those with pelvic pain.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations based on your medical conditions, request an appointment with Thomson Medical.