Endometriosis is a common gynecological condition that affects millions of women worldwide. Early diagnosis and proper management of endometriosis are important for the quality of life of women who experience it. One of the most important tools in the diagnosis of endometriosis is transvaginal ultrasound.

What is Endometriosis?

Endometriosis is a condition in which tissue similar to the endometrium (the tissue that lines the inside of the uterus) grows outside the uterus. This tissue can be found in the ovaries, fallopian tubes, the surface of the uterus, the peritoneum (the membrane that covers the internal organs of the abdomen), and other areas of the body.

During the menstrual cycle, the endometrial tissue responds to hormonal changes, swells, breaks down and bleeds. When this tissue is outside the uterus, bleeding cannot be expelled from the body, causing inflammation, pain, and scarring and adhesions.

Frequency of Endometriosis

Endometriosis affects about 10% of women of reproductive age. Although it can occur at any age, it is usually diagnosed in women aged 25-35. The exact cause of endometriosis is not known, but possible risk factors include heredity, immune disorders, environmental toxins, and other factors.

Symptoms of Endometriosis

Endometriosis can cause a range of symptoms, which may include:

• Intense pain during menstruation (dysmenorrhoea).
• Pain during intercourse (dysparenia).

• Pain during urination (dysuria) or defecation (dyschezia)especially during menstruation.
• Abnormalities in bleeding (heavy period, especially when combined with adenomyosis).
• Infertilitydifficulty achieving pregnancy.
• Fatiguediarrhea, constipation, bloating and nausea.

The Significance of Transvaginal Ultrasound in the Diagnosis of Endometriosis

Transvaginal ultrasound is a non-invasive diagnostic test that is widely used to detect endometriosis. During the examination, a thin ultrasound probe is inserted into the vagina to visualize the woman’s reproductive organs, as well as the rest of the pelvic organs.

Advantages of Transvaginal Ultrasound

• Accuracy: Provides detailed imaging of the ovaries, uterus and adjacent tissues.
• Detection of Endometriomas: Can detect cysts (endometriomas) in the ovaries.
• Non-invasive: It is painless and does not require anesthesia or surgical incision.
• Direct Process: The test usually takes only 10-20 minutes and can be performed in the gynecologist’s office.
• Low cost: much lower cost than other diagnostic methods (magnetic resonance or computed tomography).

Transvaginal Ultrasound Procedure

The woman lies on a gynecological chair and a thin transducer, covered with gel and a special protector, is carefully inserted into the vagina. The probe sends out sound waves that bounce off the reproductive organs and create images on a screen. These images allow the doctor to see the internal structures and detect any abnormalities.

What Does Transvaginal Ultrasound Show?

Through the transvaginal ultrasound, the doctor can see:

• Endometriomas: Blood-filled cysts in the ovaries, characteristic of endometriosis (chocolate cysts).
• Adhesions and Scars: Scar tissue and adhesions that have formed due to endometriosis.
• Changes in the Structure of the Uterus: Abnormalities in the shape or position of the uterus due to the disease.

How Does It Help With Diagnosis?

Transvaginal ultrasound is particularly useful in diagnosing endometriosis because it can reveal endometriomas and other structural abnormalities associated with the condition. An accurate diagnosis allows the doctor to suggest appropriate treatment and help the woman manage her symptoms. The transvaginal ultrasound has the possibility of monitoring the disease over time as well as its response to treatment.

Other Diagnostic Methods

In addition to transvaginal ultrasound, other diagnostic methods include magnetic resonance imaging (MRI) and laparoscopy. Laparoscopy is the most reliable method of diagnosis, as it allows the doctor to directly see the endometrial tissue and take samples for biopsy or cauterize it.

Treatment of Endometriosis

Treatment of endometriosis may include:

• Medication: Pain relievers, hormonal treatments to regulate the menstrual cycle and reduce the growth of endometrial tissue.
• Surgery: Laparoscopic surgery to remove endometrial foci and adhesions.
• Support and Management: Counseling and physical therapy to improve quality of life and manage chronic pain.

Medication

Medication may include:

• Analgesics: To relieve pain.
• Hormonal Treatments: Birth control pills, progesterone and other hormone treatments to reduce the growth of endometrial tissue and regulate the menstrual cycle.

Surgery

Laparoscopy, or open surgery-laparotomy, is the most common surgical method for the diagnosis and treatment of endometriosis and is usually the last stage of treating the disease.