Diagnosed by ultrasound

[BluePanda7]

Is this usual? I have been diagnosed with endometriosis, adenomyosis, an endometrioma and pelvic congestion from an internal ultrasound . The consultant has said they don't need to do a laparoscopy to confirm... To me this seems highly unusual as all my friends have had to have a laparoscopy to be diagnosed. Has anyone been diagnosed by ultrasound alone?

[Lindle]

The diagnostic procedure does start with scans. An endometrioma is endo of the ovary so have you had endo found elsewhere? Do you have the report?

[BluePanda7 in reply to Lindle]

Thanks for replying Lindle. I ust had a letter from the gynaecologist which listed all the conditions but nothing else and no treatment plan yet. I'm hoping I can see them asap as I'm struggling with the constant pelvic pain...

[Lindle in reply to BluePanda7]

If you have had endo diagnosed on ultrasound somewhere apart from the endometrioma then it will be quite severe as mild endo doesn't show on scans. You will need referring to a specialist endo centre so be sure you are.

[Avourneen]

This means your doctor is competant and up to date with the latest medical practices.With an MRI if you have a competant sonographer it is actually more accurate at diagnosing endo and especially adenomysioisis than with a lap. Laparoscopys often miss adenomysiois in particular. Having a scan first also really helps the surgeon know which areas to focus on and shows areas they could miss. Then when you have a lap it is more likely to be successful. Every time youu have an operation on your abdomen it creates scarring and adhesions internally even a diagnostic lap. Once you have had a few operations surgons will start saying you are too scared inside to offer you another operation so only doing a lap after a scanhelps reduce the causing of scarring and adhesions too. Years ago it was normal to do a lap first and without a scan but that was when scans were less accurate. I think you are lucky you have a surgeon who is being really careful and preparing to operate more carefully than most. Really good surgeons for endo are unusual so perhaps that's why your friends are suprised, maybe they had their ops done a long time ago? sounds like your doc is doing things the right way.

[BluePanda7 in reply to Avourneen]

Thank you Avoureeen for your detailed and helpful answer. My friends were diagnosed at least 10 years ago so that would make sense. I am worried about further scarring as I have already had 2 c-sections so it's definitely worth bearing that in mind.

[Kittye]

Yes, it's normal. I was diagnosed after a scan. Then I had a second scan 6 months later, which showed growth of my 2 endometriomas. Then they did an MRI which gave a much more detailed picture. I opted not to have any surgery - 'Expectant Management'.

[Sammyjam in reply to Kittye]

I have an endometrioma! Picked up on scan and mri in March still haven’t seen a specialist! I thought surgery was protocol for endometriomas! Is it not ! I have little knowledge.

[Kittye in reply to Sammyjam]

Yes, if it's over a certain size, they recommend that it's removed. When they did the MRI, they realised the endometriomas were actually 2 salapinx (blood-blocked ovaries). These would also normally be operated on, but as I don't want children, I decided to leave them and see how it goes. I also have various cysts (but probably not endometriomas), various adhesions here and there and an indrawn rectum caused by endo adhesions. Stage 4 basically. The MRIs can give a lot of information without having to do a laparoscopy. I also had an endoscopy for possible bowel endo, but that was negative.

[BluePanda7 in reply to Kittye]

An MRI definitely sounds preferable to a laparoscopy-thank you Kittye.

I'm glad your bowel is clear from adhesions. What does "Expectant management" involve?

[Kittye in reply to BluePanda7]

Expectant management means 'Wait and see. If things get worse, consider surgery. But if it's manageable, don't intervene'. I take a progesterone-only pill without any breaks and pain meds if I have flare-ups. So far, I'm doing fine.

[BluePanda7 in reply to Kittye]

I'm glad it's working for you. I'm on the progesterone pill too but I have now been bleeding for the last 102 days so I don't think it suits me!

[Kittye in reply to BluePanda7]

No, that doesn't sound good. You need something else. Will you see a gynaecologist soon? They need to advise.

[BluePanda7 in reply to Kittye]

I hope so! I've been waiting since September and am on the first available appointment list...

[EternalSunshine87]

I've not had a lap. I've been diagnosed with stage 4 endo and adeno. I had an ultrasound and an MRI.

[BluePanda7 in reply to EternalSunshine87]

Thank you Eternal Sunshine. That's reassuring

[Silks32 in reply to EternalSunshine87]

This is the same with me, diagnosed with stage 4 via ultrasound and MRI. It was quite recent though- within the last 4 months.

[EternalSunshine87 in reply to Silks32]

It's such a blur. I think mine must have been at least 4 years now.

[bluebug]

My adenomyosis was diagnosed on an ultrasound.

Apart from imagining the only way to diagnose adenomyosis is by pathology after an hysterectomy.

[redlillies]

Its not an “official” diagnosis because laparoscopy is the gold standard, but sometimes they can see enough to make a reasonable diagnosis. For me, my ovaries are conjoined and they suspect this is due to deep pelvic endometriosis. It’s really obvious to see on ultrasound and MRI.