Individualized approach from the diagnosis to treatment
In our philosophy “WOMAN FIRST”, we believe that your worries, your questions, your symptoms and your quality of life come first. Our approach starts with listening carefully and empathically to your medical history; we record your symptoms and expectations in details, and we proceed with specific questions which will bring us to a diagnosis. Gynaecological examination and ultrasound are essential components of our specialised service to investigate your symptoms and potential pathologies correlated.
Especially in endometriosis, it is fundamental to know about your pain symptoms, your medications and your previous surgery. It is important to know if symptoms are worsening or synchronising around the time of your period. These symptoms can include heavy or painful periods, painful sex, painful bowel movements, diarrhoea, painful urination and chronic pelvic pain. We take all the time needed to build up a trust relationship with you and understand your concerns and agree with you on the best treatment option.
We offer an abdominal and pelvic examination to assess genital organs and any abnormality such as pain or bleeding.
In case of suspicious endometriosis, we look for abdominal masses and specific pelvic signs, such as reduced organ mobility and enlargement, tender nodularity in the posterior vaginal fornix, and visible vaginal endometriotic lesions.
Ultrasound is the first-line imaging technique to assess pelvic organs. Evidence demonstrates that its accuracy for pelvic endometriosis is more than 80% if performed by a specialist. We have published several research articles on endometriosis and the diagnostic role of ultrasound.
Within our service, we perform an advanced ultrasound scan which can detect endometriosis and other rarer presentations of endometriosis and adenomyosis. These conditions would usually be missed on a standard scan. In expert hands, ultrasound may give a dynamic picture since organs can be pushed against each other to find out where adhesions are. MRI may also be used to diagnose deep infiltrating endometriosis if it is suspected.
In the other hand, superficial endometriosis is not reliably confirmed or refuted on any form of scan currently and the only way to diagnose it is to undergo a diagnostic laparoscopy (keyhole surgery) under general anaesthetic and to see it directly and treat it by excision at the same time.
Endometriosis is a disease that still requires much more research and knowledge. It is crucial for us to work with you, and find the management strategy that works best in your case.
Read more on our articles:
Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment 2011. A prospective study which has demonstrated the value of transvaginal ultrasound in assessing deep infiltrating endometriosis
Question mark form of the uterus: a simple sonographic sign associated with the presence of adenomyosis 2015. A prospective study which has introduced a new sonographic sign to improve the diagnosis of adenomyosis (pdf)