Women’s Imaging is currently the only practice in Tasmania that is recognised by SAFE (Sonographic Association for Endometriosis). It affects one in ten women and is often a cause for infertility.
What is Endometriosis?
Endometriosis is defined as the presence of normal tissue of the lining of the uterus (endometrium) in an abnormal place, usually the female pelvis. The most common sites in the pelvis are on and below the ovaries, and deep in the pelvis behind the uterus, called the Pouch of Douglas. Here the endometriosis grows on the ligaments behind the uterus and on the vagina and rectum. It also may grow on the bladder and appendix. It can even sometimes be found in the upper abdomen or in the abdominal wall in scars from a laparoscopy or caesarean section.
Women’s Imaging is recognised as a specialist practice in Endometriosis scanning. Our sonographers have specific endometriosis expertise with the ability to diagnose deep infiltrating endometriosis with transvaginal ultrasound with a high degree of accuracy. Ultrasound will not detect superficial lesions so in case of a normal ultrasound a laparoscopy is still indicated when there are significant symptoms.
Risks
Both methods of scanning whether across the tummy or through the vagina require some probe pressure and may be uncomfortable. It is rarely painful.
Occasionally there will be bleeding after a vaginal scan which should stop in 24 hours. If it does not stop, please see your local doctor.
Endometriosis scanning has some limitations and so we may not be able to see everything we want to see. These limitations are commonly related to displacing the overlying bowel.
Benefits
An endometriosis scan can give us a lot of information about your ovaries and uterus
It can help determine why you might be experiencing such things as pelvic pain and pelvic bleeding.
If your doctor has recommended that you have some mild bowel preparation before the scan then this can greatly increase our chances of identifying endometriosis in your pelvis.
What happens on the day?
The timing of the scan is not critical but if the problem you are experiencing is heavy bleeding, then having the scan just after your period has finished is optimal.
When you arrive for your scan you will be asked to fill out a form about your gynaecological history to date.
The sonographer will then take you through to the scanning room.
You will be asked to lie on the table and expose your tummy. A towel will be tucked into your pants to limit spread of the gel onto your clothes.
Clear gel is applied to your tummy and the sonographer moves the probe over your tummy recording images. The sonographer may place their hands on your tummy to gently move the pelvic organs into better imaging positions.
The bladder and the kidneys will be examined briefly for changes such as obstruction which may be due to diseases in the pelvis.
After we have scanned across your tummy, a vaginal scan is then performed (with your consent). A vaginal scan is generally required to enhance the detail of the uterus and the ovaries and to assess sites of pelvic pain. It gives us a much better picture of your uterus and ovaries. You will be able to see for yourself on our plasma screen monitors!
After emptying your bladder and wearing a gown you will lie on the bed and a special probe is positioned in your vagina. This has a sterile disposable cover. During this examination the vaginal probe is moved with varying pressure at different angles to obtain images of the uterus and ovaries.
After the scan, the sonographer will leave the room to review the images and to discuss them with the Radiologist or Gynaecologist. Sometimes for clarification more images are required.
What is an Ultrasound scan?
An ultrasound scan uses high-frequency sound waves to create images of the inside of the body. Sound waves are used instead of radiation which makes them safe.
Why have an Endometriosis Scan at Women’s Imaging?
Women’s Imaging is currently the only practice in Tasmania that is accredited by the Sonographic Association for Endometriosis to carry out these scans. Our sonographers are trained to the highest standards. All of our endometriosis scans are checked by our in-house radiologist or gynaecologist. If there is any significant clinical concern about your scan we will come and discuss this with you on the day.
How long will it take?
An endometriosis scan takes approximately 45 minutes to an hour.
How should I prepare for the scan?
Sometimes endometriosis can infiltrate the bowel and the sonographer who does the ultrasound will want to look carefully at the bowel during the transvaginal ultrasound. When the rectum is empty, views of the bowel are generally better as bowel content can cause shadows on ultrasound. For this reason, some doctors prefer you to do a mild bowel preparation prior to the ultrasound. This is generally done when you have had a past history of severe endometriosis or when you have significant bowel pain during your periods. This consists of taking a mild laxative the night before the ultrasound. Please contact our reception staff if you have been advised by your doctor to have bowel preparation before your ultrasound.
If you don’t have a proven history of significant endometriosis or no significant bowel symptoms, it is probably not necessary to take bowel preparation.
On the day of your scan, you should arrive for your scan with a filled bladder. We recommend that you drink 2 glasses of water a half hour before your scan time.
Remember to bring your referral form with you.
After arriving with a full bladder, the sonographer will ask you to lie on the bed and expose your tummy and a towel will be tucked into your pants. Gel will be placed on your tummy, which enables the ultrasound probe to move freely over the area. Images will be recorded.
You will then be asked to go and empty your bladder and change into a gown. The sonographer will then proceed with a transvaginal ultrasound. A special probe is used which will have a sterile cover and will be placed in your vagina. It will be moved in different directions to obtain diagnostic images and help formulate an answer for your pain.
Can I bring a friend along with me for my scan?
We are happy for you to bring a friend along with you. However due to the nature of the vaginal scan you may want privacy at that time.
We ask that women who have young children make arrangements to have them taken care of whilst you have your scan. Our sonographers need to concentrate on what they are doing and a crying child can be very distracting for them. We thank you for your understanding.
When will I get my results of my scan?
The full report of the scan will be with your doctor within 48 hours. If there is anything of major clinical concern that we uncover from your scan, we will come and speak to you on the day. There are lots of normal benign things that we see all the time. We do not ordinarily discuss these normal findings with patients.
Things you should know
- Please ensure you pick up your bowel preparation medication from the practice.
- You will need to take your bowel preparation the night before your scan.
- Please drink 2 glasses of water a half hour before your scan.
- You feedback throughout the scan is very valuable to us as you can often tell us where you are experiencing discomfort.