Transvaginal ultrasound will most likely NOT show endometriosis, especially the type that would cause rectal bleeding. The ONLY type of endometriosis visible on ultrasound is an endometrioma, an ovarian cyst whose walls are made from endometrial tissue.
The transvaginal ultrasound uses a wand about the size of 2 fingers in width and as long as it needs to be (they don't insert the full length). They may also take some images from the outside of your abdomen while your bladder is full, then have you empty your bladder before they continue the exam. The wand wasn't covered by a condom any of the times I've had it, it was covered by a sterile plastic sleeve. If you ask, they will allow you to insert it yourself (if you are in pain, that makes a big difference!). They will likely look at your uterus and ovaries for size, thickness, number of follicles, and any abnormalities (cysts, uterine fibroids, etc).
Endometriosis is a very common GYN condition, and is incredibly underdiagnosed. The ONLY way to make a definitive diagnosis of endometriosis is to perform a laproscopy - a procedure where the surgeon makes a small incision in your abdomen and inserts a camera to visualize the inside of the pelvic cavity. Here's what I wrote recently on another VP entry: "Endo is FAMOUS for getting missed on any/ALL medical imaging tests. The implants are often small enough that they are below the resolution size of the imaging equipment and/or could be considered normal variations in shape for that area of anatomy. Many, MANY female patients have been opened up by a surgeon who told them "I really don't think endo is the source of your pain." only to find out that they have severe adhesions from the disease. Endometriosis, by definition, it the growth of slightly abnormal uterine tissue OUTSIDE of the uterine cavity. Therefore, it doesn't ever "start in the uterus." Also, the uterus and bowel being "grossly normal" on an exam doesn't exclude the possibility of endo - sometimes the structures look like that just because that's how they "settled" on that imaging session, and other times they are only in that configuration because they are held together by endometriosis adhesions."
Lots and lots of OBGYNs wouldn't know endometriosis if it bit them in the face. Others might recognize it, but would suggest you go back on the birth control merry go round. There is a strong argument that time wasted trying hormonal methods which do NOT cure endometriosis allows the disease to become more severe. The best treatment is early, complete excision via laproscopy. A Reproductive Endocrinologist is more likely to be versed in endometriosis and it's surgical excision. I HIGHLY suggest calling some who are covered by your insurance and asking them how many patients they treat for endo, and how many they perform surgery on.
Always ask for copies of your test results. If you don't understand them and/or the medical provider is a jerk, post them on here and someone will help you know what questions to ask the medical provider!
Heavy bleeding and chronic pain are NOT par for the course if you are female! Don't take "we don't know, take this birth control pill instead" for an answer!
There's lots of good content over at http://cjlevett.proboards.com/index.cgi if you'd like to do some more reading on endometriosis. :-)
Above all (this comment is so long!) (((HUGS!!!)))
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Date: 2011-06-19 03:29 am (UTC)The transvaginal ultrasound uses a wand about the size of 2 fingers in width and as long as it needs to be (they don't insert the full length). They may also take some images from the outside of your abdomen while your bladder is full, then have you empty your bladder before they continue the exam. The wand wasn't covered by a condom any of the times I've had it, it was covered by a sterile plastic sleeve. If you ask, they will allow you to insert it yourself (if you are in pain, that makes a big difference!). They will likely look at your uterus and ovaries for size, thickness, number of follicles, and any abnormalities (cysts, uterine fibroids, etc).
Endometriosis is a very common GYN condition, and is incredibly underdiagnosed. The ONLY way to make a definitive diagnosis of endometriosis is to perform a laproscopy - a procedure where the surgeon makes a small incision in your abdomen and inserts a camera to visualize the inside of the pelvic cavity. Here's what I wrote recently on another VP entry: "Endo is FAMOUS for getting missed on any/ALL medical imaging tests. The implants are often small enough that they are below the resolution size of the imaging equipment and/or could be considered normal variations in shape for that area of anatomy.
Many, MANY female patients have been opened up by a surgeon who told them "I really don't think endo is the source of your pain." only to find out that they have severe adhesions from the disease. Endometriosis, by definition, it the growth of slightly abnormal uterine tissue OUTSIDE of the uterine cavity. Therefore, it doesn't ever "start in the uterus."
Also, the uterus and bowel being "grossly normal" on an exam doesn't exclude the possibility of endo - sometimes the structures look like that just because that's how they "settled" on that imaging session, and other times they are only in that configuration because they are held together by endometriosis adhesions."
Lots and lots of OBGYNs wouldn't know endometriosis if it bit them in the face. Others might recognize it, but would suggest you go back on the birth control merry go round. There is a strong argument that time wasted trying hormonal methods which do NOT cure endometriosis allows the disease to become more severe. The best treatment is early, complete excision via laproscopy. A Reproductive Endocrinologist is more likely to be versed in endometriosis and it's surgical excision. I HIGHLY suggest calling some who are covered by your insurance and asking them how many patients they treat for endo, and how many they perform surgery on.
Always ask for copies of your test results. If you don't understand them and/or the medical provider is a jerk, post them on here and someone will help you know what questions to ask the medical provider!
Heavy bleeding and chronic pain are NOT par for the course if you are female! Don't take "we don't know, take this birth control pill instead" for an answer!
There's lots of good content over at http://cjlevett.proboards.com/index.cgi if you'd like to do some more reading on endometriosis. :-)
Above all (this comment is so long!) (((HUGS!!!)))