MRI before or after lap?

Hi ladies,

I've been reading through all of your posts for what seems like years now. I hear myself in each and every one of you! Since the birth of my last child 19 months ago I have been dealing with extreme fatigue, lower abdominal/pelvic pain that's worse on the ride side, bloating, frequent urination, heavy periods with large clots and pain during sex to the point that I am afraid to now have sex at all. I keep getting the run around between my obgyn and pcp. So far I've had 2 ultra sounds, numerous paps and a ct and everything has come back normal. My doctors look at me like I have 10 heads. I am not imaging all of these symptoms!!!! And to boot, they seem worse month to month. I've requested a laprascopy last month and my Dr sent me for the 2nd ultrasound. Tomorrow I meet with him again to get the results, however my pcp already stated it was normal.

After months of research I realize that the s/s of endometriosis and adenoyosis are very similar. I'm wondering if I should request an MRI first to see if it's adenoyosis or should I just request the lap procedure and have the MRI after. At this point I have lost all faith in my drs. I feel like they will tell me it's nothing even if they find something just to prove that they're right and I'm crazy.

What are your thoughts? Do the lap first or the MRI first?

13 Replies

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  • Is the consultant you are seeing from a specialist bsge centre? It might be worth having a look st the below link:

    bsge.org.uk/centre/

    I would personally ask for the MRI before, as if you have the possibility of it being two things, they could have a look at both during the procedure...

  • A MRI is a great thing to have before the lap, as they can pin point any large nodule and any deep endo, and look for adenomyosis too,

    If you are not under a bsge centre I would ask for a referral to one,

    If you are with a general gyne make sure they only deal with what they are qualified to do,

    Have a look at lindles post on nsh contract and treatment pathway ,

    The docs wouldn't say nothing is wrong they find something, but generally gyne often miss endo in certain circumstances so do e aware of this,

    Good luck and keep us informed xxx

  • Hi ,

    I like your comment about hearing others on here. I too would try an MRI first if you are already struggling with pain and fatigue a procedure may well flare that. Please keep in mind that endometriosis can be microscopic and seems it can be missed by general surgeons even in ladies with bad cases. I have diagnosed endo and my gynae did not need an MRI to diagnose me with probable andeyno. She has said an MRI may be of little use as it can be the smallest patches causing pain. Your MRI may well come back normal.

    Have you considered or been offered hormonal options? Are they treating your pain so you can live? Why is it you that has to request a laproscopy. If your doctors are not listening now if might be a good time to re assess before looking back on procedures that have caused truama to the body and take time out of your life. It sounds like you should have been offered medical support based on symptoms. It's sad that people almost have to become self advocates and approach the medical means available with a strategy in place. I would look at moving on in your medical professionals if your not feeling heard at this point. It is 2016 and that is sad to hear about still having to fight to have endo diagnoised.

    Good luck

  • Hi ,

    I like your comment about hearing others on here. I too would try an MRI first if you are already struggling with pain and fatigue a procedure may well flare that. Please keep in mind that endometriosis can be microscopic and seems it can be missed by general surgeons even in ladies with bad cases. I have diagnosed endo and my gynae did not need an MRI to diagnose me with probable andeyno. She has said an MRI may be of little use as it can be the smallest patches causing pain.

    Have you considered or been offered hormonal options? Are they treating your pain so you can live? If your doctors are not listening now if might be a good time to re assess before looking back on procedures that have caused truama to the body and take time out of your life. It sounds like you should have been offered medical support based on symptoms. It's sad that people almost have to become self advocates and approach the medical means available with a strategy in place. Good luck

  • Have the MRI first this will give you the answers xx

  • Hi

    I'm sorry to hear your pain is getting worse month to month. I honestly feel your pain and its soul destroying to be fobbed off over and over again. It starts to make you doubt if your just making it all up.

    But I would ask for an MRI, as I was told this is the only scan that can see endo. I had a diagnostic lap first but they found it so severe that, it I had to have an MRI to find out the extent. The ladies are right though it depends how bad the endo is, it may not show up on the scan.

    Xxx

  • Thank you for replying. That is what I will do!!!

  • From reading posts on here, I was led to believe endo can not be seen on MRI - am I wrong? Only a lap can show up the endo? Or is this more from a diagnosis point of view? I have my BSGE appt this week for my possible endo.

    Best wishes ladies

    x

  • From what I've read adenoyosis can be detected by mri, and depending on the severity so can endo.

    My thinking is that if they are going to go in surgically I want them to have an idea of what/where to look and if I do have it I'd like to be treated right there and then instead of getting another run around.

  • Best wishes to you as well!

  • I covered this on my new facebook group the other day when asked if CT can detect endo. I'll post the reply here:

    'CT uses x-rays and is not specific enough to be used for diagnosis of endo. Endometriomas may appear as cystic masses, but their appearance is nonspecific and this imaging technique should not be relied on for diagnosis. Complications of endometriosis, including bowel obstruction and hydronephrosis, may be seen on CT scans and also endo on the lungs may show especially if timed to menstruation. But MRI is far superior as it distinguishes between different types of tissue and so can identify deep nodules of endo not visible at a lap. However, MRI has its limitations and, for example, will rarely pick up on peritoneal lesions as they are shallow. Likewise even though the diagnostic lap is considered the gold standard this has limitations too as it will only visualise endo within the peritoneal cavity and deep endo is usually hidden beneath adhesions or outside the peritoneum in the rectovaginal septum. Ideally if deep disease is suspected a lap will be complimented with MRI/US to map the disease in the pelvis in order to carefully plan surgery. This is useful:

    radiopaedia.org/articles/en...'

  • Thank you all for you comments. You made me feel so much better about this appt today. I haven't been referred to a specialist, however I have been referred to a bladder specialist, kidney specialist, hematologist...everyone wants to pass me along, when I'm telling them what I think it is if they would just listen to me. I've been to 3 different obgyns and have also changed primary doctors twice because of this. I thought about giving up and just excepting that this is my new normal, but why?????

    I will keep you all updated! Thank you again, you are all so wonderful!!!!

  • Don't be scared to go back to your GP armed with paperwork on where you want to be referred to

    Good luck

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