COULD IT BE ENDOMETRIOSIS?

What is Endometriosis?

Dr Steven R. Goldstein is a NYC Gyn and specialist for Endometriosis in NYC. Endometriosis is an all-too-common gynecologic condition where the glands that lie inside the uterine cavity can come to lie outside the uterus in the pelvis. When the endometrial glands bleed (that is a period) these glands located outside the uterus bleed as well. This can cause some scar tissue. If there is a collection of this blood within the ovary, it is referred to as an endometrioma (or sometimes called a “chocolate cyst”).

Endometriosis can also take the form of small deep implants of endometrial tissue in many different places in the body, including the wall of the bladder, the anterior abdominal wall, the bowel wall and the uterosacral ligaments, as well as other pelvic sites. Rarely endometriosis can occur in sites such as the lung, potentially causing hemoptysis.

What are the symptoms of Endometriosis?

The exact cause of endometriosis is unknown and there are multiple theories. Endometriosis does not always show symptoms. There appears to be a higher incidence of endometriosis in women who are diagnosed with infertility and pelvic pain. Symptoms of Endometriosis include pelvic pain, painful periods, heavy bleeding during periods, or bleeding between periods.

Painless Diagnosis of Endometriosis by NYC Gyn Increasingly, transvaginal ultrasound can make a very strong presumptive diagnosis of endometriosis without any surgical laparoscopy which, until recently, was the gold standard for making a definitive diagnosis. An endometrioma of the ovary has a classic appearance and, when present, can confirm the absolute diagnosis of endometriosis.

However, there are times where there is no obvious endometrioma, but the presence of scar tissue can result in structures becoming adherent to each other and be a source of pain. Such abnormal mobility can be judged by transvaginal ultrasound but only if it is done dynamically. Unfortunately, this is not generally practiced here in the United States where a technician instead takes dozens of still twodimensional images which are later read by the radiologist.

What is a dynamic Transvaginal Ultrasound for Endometriosis?

Dr. Goldstein, an Endometriosis Specialist NYC, as well as most European doctors, performs his own ultrasound, and movement of structures at the time of the exam can often give a strong clue to adhesions associated with endometriosis, as well as eliciting pain with the probe and the abdominal examining hand which can also be indicative of a high likelihood of endometriosis.

Dr. Goldstein, a leading NYC Gyn has helped to author a paper entitled, “An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis.”

What can you do about Endometriosis in NYC? If you suffer from pelvic pain and think there is a suspicion of any endometriosis, a dynamic ultrasound performed by an expert sonologist like Dr. Goldstein can be extremely helpful in making the diagnosis without surgery, and then beginning medical intervention for treatment. Schedule an appointment with Dr. Steven R. Goldstein, a top NYC Gyn for an evaluation.