Because endometriosis mainly occurs behind the uterus, a vaginal ultrasound will allow much better imaging of the pelvic organs. A narrow, gel covered ultrasound probe is gently introduced into the vagina. You will be asked to empty your bladder before the scan for your comfort as well as to optimise our views. The ultrasound usually takes approximately 30 minutes. The results are often discussed with you and will be sent to your referring doctor.
If your doctor refers you specifically to look for endometriosis and you feel uncomfortable about having a vaginal ultrasound, please advise our receptionist and she will discuss it with the doctor. In such circumstances an MRI can be performed as an alternative method to detect DIE.
Because endometriosis can infiltrate the bowel, the doctor or sonographer who does the ultrasound will carefully look at the bowel during the transvaginal ultrasound. When the rectum is empty, the views of the bowel are generally better as bowel content can cause shadows on ultrasound. A mild bowel preparation prior to the ultrasound may optimise the views when you have had a past history of severe endometriosis or when you have significant bowel pain during your periods. This consists of a mild laxative the night before the ultrasound and an enema within an hour before the ultrasound as outlined below.
Bowel Preparation for Endometriosis
The bowel preparation is always mild and usually well tolerated and is outlined below. The medication is over-the-counter medication. It is cheap and does not require a script. Make sure the chemist gives you the fleet enema rather than the oral fleet.
The night before the scan:
- take Dulcolax, one tablet of 5 mg or Ducolax SP 10 drops.
Approx an hour before the scan:
- Fleet enema
Fleet Enema
A fleet enema is a bottle with 133 ml of liquid in it. It has a nozzle that is pre-covered with gel. Apply it while lying on your side, inserting the nozzle into your anus and squirting the full content of the bottle into the rectum. An urge to go to the toilet will follow the application. Try to wait 3 – 5 minutes before going to the toilet. After this, your rectum should be completely empty, optimising ultrasound images.