Ultrasound for assessment of deep endometriosis with bowel preparation
Endometriosis is a common gynaecological condition defined as presence of endometrial like tissue outside the uterus which impairs quality of life. In more severe disease, there may be ovarian cysts and deep infiltration of the pelvic organs. Deep endometriosis may involve the bowel, most commonly rectosigmoid colon. Using transvaginal and transabdominal ultrasound with bowel preparation allows good views of this area to make a more extensive assessment of the pelvis. This may influence surgical decision making to allow time for complex surgery and sometimes the presence of a bowel surgeon to work with your gynaecologist.
You will need ‘Picoprep’ and a ‘Fleet’ ready-to-use enema 133ml. This is available at chemists or can be obtained from Women’s Ultrasound when you arrive 1 hour prior to your appointment.
The Picoprep sachet is included with this information.
Instructions:
- Take one sachet of PICOPREP at 5pm on the day prior to your ultrasound. Mix the contents of the sachet into a glass of hot water, stir until dissolved, leave to cool. This should be followed by at least 1 glass of water.
- Have a light evening meal such as soup and toast the night prior, then on the morning of your ultrasound, a light breakfast such as tea and toast. Then, fluids only until your ultrasound.
- Use a FLEET ENEMA 1 hour prior to your appointment. This will produce a quick result that empties the rectosigmoid colon. The enema will work in approximately 5 minutes. This can be done at home or in the rooms where a nurse will be available to assist you if required.
Bowel preparation empties the lower bowel so that clear images can be obtained. Views of the bowel are often hindered by the presence of gas and faecal material which can obscure both bowel and other pelvic structures.
The ultrasound will be done both transabdominally and transvaginally assessing the whole pelvis with detailed views of uterus, ovaries, rectosigmoid, bladder and surrounding structures. You will be able to see the images and discuss the findings at the time of your scan.