As a reference center in pelvic pain and endometriosis, the Hospital Clínic de Barcelona has specialized in the diagnosis of endometriosis. The disease, which causes pain during menstruation and can cause infertility, affects the ovaries. But sometimes other pelvic structures as well. At FIVclínic we have the specialist Cristina Ros, an expert in imaging using gynecological ultrasound. She explains how the diagnosis of this disease has improved.
What is endometriosis?
Endometriosis is a benign disease where the tissue inside the uterus, which is the endometrium, comes out of the cavity. Despite being tissue, this ectopic endometrium reacts the same as the hormones produced by the ovary during the menstrual cycle. The disease, which causes pain during menstruation and can cause infertility, mainly affects the ovaries. However, it can also affect other pelvic structures such as the urinary bladder, vagina, retruterine and retrocervical space, or the large intestine (rectum and sigma).
Is transvaginal ultrasound a useful technique in the study of endometriosis?
“Years ago, when I finished my residency, the diagnosis of this disease was made through laparoscopic surgery,” explains Dr. Ros. Instead, trained radiologists worked in specialized centers who could identify her by magnetic resonance imaging. Ultrasound also allows you to visualize the effects of this disease.
What do these endometriosis screening ultrasounds include?
“Endometriosis screening ultrasounds (diagnosis) include a thorough evaluation of the uterus and ovaries with high-resolution ultrasound scans and three-dimensional probes, as well as that of other pelvic organs such as the urinary bladder, rectum, and uterine and vagina ligaments” , details Dr. Ros. Sometimes, we ask to do a simple intestinal preparation with enemas and diet in order to better visualize the walls of the intestine.
When is this endometriosis screening ultrasound recommended?
This expanded and detailed assessment of the pelvis is indicated in women with severe menstrual pain, pain in intercourse (dyspareunia), or pelvic pain. But it is also useful for a physical examination suspected of endometriosis, or for endometriosis cysts (endometriomas or “chocolate” cysts) on a conventional ultrasound, associated with foci of deep endometriosis in more than half of the cases.
Endometriosis and infertility
Due to the association of this disease with sterility, performing endometriosis screening ultrasound in an assisted reproduction clinic is of special interest. “My activity applied to the world of reproduction is gratifying and especially motivating, as it helps to better manage the woman who wants a pregnancy,” explains Dr. Ros.
Dra. Cristina Ros. Gynecologist specializing in imaging techniques in assisted reproduction and medical consultant at FIVclínic.
