Could endo be cause of positive FOB test?

[J1j4]

I was diagnosed with endo in my mid 20's and had a couple of laparoscopies confirming that it was fairly severe and in the Pouch of Douglas. I had some of it removed and symptoms improved when I had my children. Fast forward 20 years and I'm now perimenopausal with very heavy periods to the point I'm taking iron for anaemia. My GP has suggested the Mirena to get this under control so currently waiting for a date for this. He suggested I have an ultrasound and do a FOB test first to make sure there everything is OK before I go ahead with the Mirena. Th Ultrasound came back OK- showed thickening of endometrium (as expected) and a simple cyst but no concerns so good to go with the Mirena. However the FOB test came back positive. I'm now being referred for that for further investigation but fretting about what they may find. Just wondered if it's possible for the endo to be causing this as I'm aware that it can cause bowel issues?

[Lindle]

Firstly if the ultrasound was just a regular one done in gynaecology it will have only checked for basic abnormalities of the reproductive system and not for deep endo. If you had severe endo in the POD years ago that was only partially removed then you will still have it.

That needs an expert sonographer who would, as a minimum, check for what is called the sliding sign to see if the uterus and bowel move freely against each other as they should. Severe endo in the POD will almost almost mean they are stuck together. So it depends on how thorough the laps were and whether by an advanced excision surgical team which was probably unlikely to be the case 20 years ago. Lap surgery was only just getting off the ground then.

You would normally expect pain from deep rectovaginal endo but not always. So it could have been silently progressing over time and might now have infiltrated your bowel.

Whether or not the FOB would detect this I don't know as it's not routinely done for endo but I guess it might. What you now need is an expert scan to look for deep rectovaginal endo.

[J1j4 in reply to Lindle]

Thank you. I think the ultrasound I had recently was a basic one. I was only in there 5 minutes. I think it was just a case of ticking the box for the go-ahead for the Mirena.Although it was 20 years since my laparoscopy, I do recall the gynaecologist saying everything was well stuck down. I had unbearable pain back then and was diagnosed as stage 4. Luckily, I have no/minimal pain now but could well have been progressing silently over time.