An endometriosis ultrasound can help your healthcare provider spot tissue and cysts that may be signs of endometriosis. It’s a simple and safe imaging procedure that may be ordered if you’re experiencing symptoms associated with endometriosis.
An endometriosis ultrasound is an imaging procedure that helps your provider determine if you have endometriosis. With endometriosis, pieces of tissue that line your uterus (endometrium) can appear in places outside your uterus, like your ovaries, bladder, and intestines. This out-of-place endometrial tissue can become inflamed, grow into cysts called endometriomas, and cause unpleasant symptoms, like painful menstrual cramps.
An ultrasound doesn’t provide all the information needed to diagnose endometriosis. But it can offer clues that your provider can use to decide next steps when it comes to making a diagnosis. An ultrasound can provide information that your provider uses to suggest treatments, too.
Ultrasounds can show large clumps of tissue that are likely signs of endometriosis. Ultrasounds are also very good at identifying endometriosis of the ovaries. But ultrasounds can’t show tiny pieces of tissue that may also be signs of endometriosis. Not all tissue is the same with endometriosis. Ultrasounds can show some, but not all, types of tissue.
An ultrasound can show:
An ultrasound can’t show:
The tricky part is that even if the ultrasound shows tissue that doesn’t belong, there’s no way to be 100% sure it’s endometrial tissue. The only way to know for sure is to remove the tissue and test it. This requires surgery, a procedure called a laparoscopy. But an ultrasound can let your provider know that you likely have endometriosis, without surgery, and allows them to plan your surgery more effectively.
Your provider may recommend an ultrasound in order to:
Your provider will order the ultrasound, and an ultrasound technician (sonographer) will perform the procedure. An experienced ultrasound technician can make all the difference when it comes to correctly identifying endometrial tissue on an ultrasound. The technician will share the results with a radiologist, who will write a report that communicates findings with your provider.
An endometriosis ultrasound allows your provider to see inside your pelvic cavity, where your reproductive organs are. Your provider may order a transrectal ultrasound, which can show endometrial tissue on the back of your bladder. Usually, your provider will order a transvaginal ultrasound, which offers a close-up view of your organs most affected by endometriosis, like your ovaries, bladder, and intestines. For a transvaginal ultrasound:
A transvaginal ultrasound lasts anywhere from 30 minutes to an hour.
Your healthcare provider will give you the instructions you need to prepare for your ultrasound. Your provider may ask that you come to the procedure with an empty bladder or a full one. You may be asked to empty your bowels to prepare for your ultrasound. Follow your provider’s directions, and review any pre-procedure checklists carefully so that you’re all set once it’s time for your ultrasound.
Ultrasounds are safe. One of the benefits of having an ultrasound is that there’s no radiation involved during the procedure. The sound waves used to record what the structures inside your body look like are completely harmless.
Your healthcare provider can help you understand your results and, most important, what these results mean for your care. Depending on your results, your provider may suggest further procedures, like magnetic resonance imaging (MRI) or a laparoscopy, to better identify a mass that showed up during your ultrasound. Your provider may recommend that you begin treatment for endometriosis symptoms. Your provider is your best resource for determining next steps.
You’ll likely hear from your provider a few days after your ultrasound. Allow time for your provider to receive and thoroughly review the radiologist’s report.
If your endometrial tissue is tiny and appears on the surface of your organs instead of inside them, the ultrasound won’t detect it. Your results could come back normal even though you have endometriosis.
How accurate your ultrasound is depends in part on how skilled your ultrasound technician is and where the endometrial tissue is located in your body. Skilled technicians can usually tell if tissue that appears on an ultrasound is endometriosis. Transvaginal ultrasounds are especially good at showing more advanced endometriosis, which involves endometriomas (endometriosis of the ovaries).
Ultrasounds and MRIs can both find masses that are likely signs of endometriosis. Each has its pros and cons. For example, while they both allow your provider to see inside your pelvic cavity, they show different views of your internal organs and different levels of detail. Your provider is your best resource for deciding which imaging procedure is best for your diagnosis.
A note from Cleveland Clinic
An endometrial ultrasound can get you one step closer to experiencing relief from your endometriosis symptoms. Ultrasounds are safe, quick and effective when it comes to revealing signs of endometriosis. They can help your provider decide that endometriosis is the likely cause of your pain and discomfort, without you having to go through surgery.
Last reviewed by a Cleveland Clinic medical professional on 09/20/2021.
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