Endometriosis is one of the most common causes of chronic pelvic pain in women. It can also cause fertility problems and lead to pregnancy complications. In some women it can also affect the bowel and kidneys. It is a benign condition, but in rare cases endometriotic cysts can become cancerous.

How is endometriosis diagnosed?

Until recently the only way to diagnose endometriosis was at surgery. That caused long delays in reaching the diagnosis and many women had suffered pelvic pain for years before being offered effective treatment. In the last ten years, our consultant team have been at the forefront of the research into non-surgical diagnosis of endometriosis by ultrasound.

We showed that ultrasound is an accurate method to detect moderate or severe pelvic endometriosis comparable to surgery and magnetic resonance imaging (MRI). We are not only able to detect it, but we can also assess the extent of the disease and the spread to other organs such as bowel and urinary tract.

How is endometriosis treated?

Treatment can be surgical or medical. Some women with endometriosis do not experience pelvic pain or fertility issues and in such cases no treatment is needed. Ultrasound diagnosis prior to surgery is very important for planning the operation and making sure that women are referred to surgeons who are experienced and skilled in carrying out complex key-hole surgery. Ultrasound findings can be compared to women’s symptoms which help to plan surgery in more effective ways and reduce the risk of complications.

The ability to diagnose endometriosis non-invasively in outpatient clinics gives women the opportunity to consider medical treatment as an alternative to surgery. Using ultrasound, we are also able to monitor progression of the disease, response to medical treatment and to assess the success and completeness of surgical treatment.

How does endometriosis affect pregnancy?

Endometriosis can make it harder for some women to fall pregnant. Endometriotic cysts often change in their appearance due to the effect of pregnancy hormones on their lining. These changes can sometimes appear alarming as they could mimic cancerous cysts. Our team have been studying behaviour of endometriotic cysts in pregnancy for a while and we are often asked to help to reassure women with unusual looking cysts that there is nothing to worry about.

Recent research has shown that women with severe endometriosis may be at increased risk of various pregnancy complications such as bleeding and early delivery. All pregnant women who attend for ultrasound scans in our Centre are checked for the presence of deep endometriosis. When it is found, this information is passed to women’s obstetricians which then helps to ensure that they are provided with safe antenatal care.