Ultrasound in endometriosis: when to do?
It should be noted that ultrasound is an indispensable method for the study of gynecologic pathology, including endometriosis, inflammation of the uterus and appendages, and after the treatment of this pathology. It is connected with the security and ease of examination with high diagnostic accuracy of ultrasound.
In addition, no training is required to that study (if applicable transvaginal access). If the genitals are planned to examine the transabdominal, the bladder needs to fill tight. For this patient sixty to ninety minutes before the scheduled procedure, you should drink about a liter of fluid (preferably still water).
It should be noted that with ultrasound it is possible to identify local and diffuse form of the disease. In this study it is recommended to perform on the fifth-seventh day of the cycle (in this case it is possible to obtain more objective data).
Echographic symptoms of diffuse endometriosis:
- the uterus undergoes changes (as a rule, there is an increase, sometimes up to 5-8 weeks of pregnancy);
- the shape of the body is spherical;
- the contours are smooth and clear;
- myometrium may be normal or heterogeneous structure (then visualized areas of hyperechoic inclusions);
- the wall of the uterus is asymmetrical;
- An ultrasound using a transvaginal transducer can show the presence of diffuse extended convoluted vessels in the uterine wall;
- the endometrium is thickened due to glandular hyperplasia (varies by day of the cycle);
- the ovaries are not changed (no signs of inflammation);
- the bladder is either not changed, but more often deformed due to the pressure of the enlarged uterus.
Along with this, during and after treatment, it is necessary to hold the control ultrasound (to what day of cycle is best to do should be addressed with your doctor).
Hormonal drug buserelin has high efficiency in the treatment of endometriosis of the uterus. I should say that this drug, being a synthetic analogue of gonadotropin-releasing hormone, suppresses the production of androgenov, on what is based its therapeutic action.
Echographic manifestations in diffuse endometriosis in adolescents
In this age period the most characteristic feature of endometriosis on ultrasound is a globular form of the uterus. The size of the body is not changed or increased slightly. Myometrium can be also changed. Ecoprotect walls of the uterus may be non-uniform (or diffuse) increased. Inflammation of the ovaries are seen.
The main thing is that if this time is not to special (hormonal) treatment, the consequences can be irreversible. Very often, the endometriosis threatens to infertility. Therefore, to clarify the diagnosis is often done laparoscopy genitals.
Along with this, in menopause, the uterus decreases in size, but its globular form is maintained. While endometriosis usually undergo the opposite development.
It should be said that the endometriosis should be differentiated from inflammation, fibroids of the uterus, as during these processes the size of the body as well as in pathology of the endometrium, increased.
Ultrasound for local endometriosis
Pathological changes in local endometriosis can manifest itself in the following way:
- visualization of the myometrium hyperechoic rounded inclusions, up to four;
- uterus in size, usually not enlarged;
- the endometrium is not changed (depends on the day of the cycle).
Sometimes the symptoms of endometrial pathology may not be visible with ultrasound, so a negative ultrasound result does not guarantee the complete absence of the disease. In this case, it is recommended to conduct a laparoscopy to exclude or confirm the diagnosis.
The fact that it is very important to choose the day cycle, when is the best time to do ultrasound scan of the genitals, especially for evaluating control of endometriosis after treatment.
I should say that if after treatment of endometriosis there is a positive trend, which is to relieve pain symptom and signs of inflammation, then only enough medical treatment. As a control, it is recommended laparoscopy.
So, if drug therapy buserelina symptoms of endometriosis disappeared, and only progressed, there are growing signs of inflammation of the appendages, it is necessary to do surgery. Preoperative laparoscopy is recommended to clarify the prevalence of pathological process and assessment of the state of the endometrium.
As shown, after treatment with buserelin possibility of recurrence of endometriosis. So for the best result you should combine the use of this hormonal drug with surgery, as well as to laparoscopy for early detection of relapse of the disease. After the operation buserelin suppresses the remaining small foci of endometriosis, which allows to prevent relapses of the disease.
Summing up, it should say that endometriosis is a grave disease, which can lead to infertility. For more accurate results of sonography need to determine in advance what day of cycle to conduct a survey. It is possible to detect the signs of endometriosis, tumors or inflammation of the genitals. Be sure to conduct a follow-up examination after treatment (medical, surgical or a combination of these methods), and laparoscopy of the genital to clarify the diagnosis.