Endometriosis / Pelvic Pain Clinic
What will happen in clinic?
Consultation
After being greeted in clinic you will be given a questionnaire which records your symptoms. You will be then seen by the consultant, registrar or nurse practitioner.
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Examination
A gynaecological examination by your doctor is very important. Your GP or gynaecologist would have a feel of your tummy, and then examine the vagina with a speculum. This is the instrument used to take a Pap smear. A vaginal examination is then performed which may reveal an area of tenderness. The doctor may also feel some nodularity in the vagina which would indicate scar tissue behind the vagina or on the bowel.
Often the gynaecological examination is perfectly normal. This does not exclude endometriosis, as a woman may still have mild or moderate disease which has not caused significant scar tissue to be able to be felt on vaginal examination.
Ultrasound
The only abnormality an ultrasound would pick up is a cyst of endometriosis in the ovaries. This is called a ‘chocolate cyst’ because it is filled with old blood that looks like melted chocolate. When we see chocolate cysts in the ovaries, it usually means advanced endometriosis. In general these cysts develop once endometriosis has grown in a lot of areas of the tummy already.
Laparoscopy
Laparoscopy is the only way we can make a definite diagnosis of endometriosis. This is also called ‘keyhole surgery’ which is done under general anaesthetic in hospital. Very small cuts (half a centimeter) are made in the tummy and a laparoscope (this is like a telescope) is inserted through the belly button. The laparoscope is connected to a camera and television, so the surgeon can visualize all the gynaecological organs.