Deep Endometriosis scans

This is a detailed scan to map out visible deep endometriosis in the pelvis.

Endometriosis and Deep Endometriosis Ultrasound Services

Endometriosis is a common gynaecological problem. It is present when endometriotic glands, similar to the endometrium (uterine lining), are found growing in other parts of the body. It most frequently affects the pelvis. Wherever the endometriosis grows, it responds to the instructions given by the ovarian hormones, oestrogen and progesterone, which are found in the bloodstream.

During menstrual periods the endometriosis sheds and bleeds, along with the uterine lining. However, without a natural drainage outlet (as the vagina is to the uterus) the tiny amounts of blood and shedding tissue gradually accumulate, frequently causing painful periods and, over time, scarring or blood collections known as endometriomas.

What is Endometriosis

Endometriosis is commonly seen as very small, superficial deposits on the surfaces of the pelvic walls and organs. These deposits are very difficult to identify with ultrasound, even when widespread.
Endometriomas are blood-filled cysts that most often develop within the ovaries. They are usually easily recognised by ultrasound, though they sometimes have similar features to other cysts.
Deep Endometriosis is said to be present when the endometriotic glands grow deeper into the organs or pelvic walls on which they began to grow. It often affects the bowel wall, uterine support ligaments, vaginal skin and bladder. As the glands grow deeper, inflammation and the natural healing response to this causes local thickening of the organ or pelvic wall. These thickened areas may be identified with ultrasound. Deep Endometriosis is frequently more difficult to remove at surgery, with increased risk to the organs which are affected. For this reason, it is helpful to know if you have this condition before undertaking surgery. The inflammation caused by pelvic endometriosis sometimes causes the surface of one organ to stick to a neighbouring organ or body wall. This may occur with both superficial and deep endometriosis. Such tethering may be detected with transvaginal (internal) ultrasound, which allows the health professional to press gently against the pelvic organs and see them move.

Endometriosis is associated with painful and heavy periods, pelvic pain at other times in the month, pain with intercourse and painful bowel motions. It is also seen more frequently when there is difficulty falling pregnant. However, not everyone with these symptoms has endometriosis and sometimes endometriosis causes very few or no symptoms.

When to Consider a Deep Endometriosis Scan

At this practice, we consider the possibility of endometriosis whenever we perform a pelvic ultrasound for someone with symptoms which may be due to the condition. However, your doctor may ask us to perform a detailed Deep Endometriosis scan if

You are considering surgery to look for or remove endometriosis

You have had a prior scan showing or suggesting the presence of endometriosis

You have symptoms which suggest the possibility of severe endometriosis

Preparing for Your Deep Endometriosis Scan

A detailed scan for Deep Endometriosis (DE) may take a little longer than a typical pelvic ultrasound, depending on how severe your disease is. If pelvic pain is the main reason you have been sent for a detailed DE scan, you may like to consider taking some pain relief before you come. (Whatever you prefer to use for pain relief during your periods would be good.)

We also ask you to use some mild laxatives before the scan, to reduce the solid and gas content in the rectum and lower colon. This helps us get better views of the walls of the colon.

Bowel Preparation Guidelines

2 tablets of Dulcolax taken the evening before the scan is effective for most people. This will usually result in loose bowel motions in the morning (sometimes during the night). If there is little response by the morning, using a Microlax enema as well can help to bring about a bowel motion. Both of these can be bought at your local chemist for little cost.

Special Considerations for Bowel Prep

If you suffer from constipation, you may need additional measures to respond to the Dulcolax and Microlax. Plenty of fluids with a low fibre intake the day before can help.

If you suffer from Irritable Bowel with frequent diarrhoea, or have a very regular bowel motion each morning, you may not need to use laxatives. We leave this choice to you.

Sometimes, even with use of laxatives, there is still gas or solids in the bowel which may limit the views. It is very uncommon for this to result in a recommendation for another scan.

When to Schedule Your Scan

The ideal time to schedule a Deep Endometriosis scan is in the 2 weeks before your period is expected (if you are not on any hormones). If you are using hormones, the timing does not particularly matter. If you have painful periods, try to avoid scheduling the scan during your bleeding days, just to reduce your own discomfort (the bleeding does not cause a problem for the scan otherwise).

You will be advised of the findings of your scan at the time. A detailed report will be sent to your referring doctor, who will provide you with further options and management advice.

Schedule Your QDOS Ultrasound Now

Receive professional, compassionate care from our experienced team. Book an ultrasound appointment at a time that works best for you and take the next step in your pregnancy journey.