Dr Steven R. Goldstein MD USING TRANSVAGINAL ULTRASOUNDS TO DIAGNOSE ENDOMETRIOSIS
Endometriosis is a painful condition which occurs in women. It is a very unusual gynecologic disease, whereby the glands that normally lie inside the uterine cavity and are the ones that are shed with a normal period, somehow come to lie outside the uterine cavity almost always in other places in the pelvis. Thus, when bleeding from a period occurs, these glands will have a tiny amount of bleeding internally. This can cause some scarring (adhesions) as well as inflammatory changes that are a wellknown source of pelvic pain and sometimes infertility. Usually, the pain is worse with the menses, although it can often occur between periods as well. Implants of endometriosis can occur anywhere; however, the more common areas of involvement include the bladder wall, ureter, and anterior abdominal wall in patients who have had abdominal surgery such as a prior C section or laparoscopy. Endometriosis of the bladder wall appears as a fusiform solid thickening of the wall itself. A non-functioning kidney may be the result of chronic ureteral obstruction that is silent and present as a result of endometrial implants impinge on the ureter. In patients who have had prior abdominal surgery, endometriosis may present as a hard, solid mass in the anterior abdominal wall in the region of the scar.