Adenomyosis & Deep Endometriosis (DIE)
The Hidden Causes of Severe Pain.
Adenomyosis (endometrium growing INTO the uterine wall) and deep infiltrating endometriosis (DIE involving bowel, bladder, ureter, or nerves) are often missed by routine ultrasound. They are leading causes of severe chronic pelvic pain — and demand specialist evaluation.
Specialised Diagnostic Approach
Routine ultrasound misses adenomyosis and DIE in most cases. We use focused transvaginal ultrasound techniques and pelvic MRI to map disease extent BEFORE planning any treatment.
Key Points
- IDEA consensus-based transvaginal ultrasound for DIE detection
- Pelvic MRI for adenomyosis classification and deep endometriosis mapping
- Conservative options first: GnRH analogues, progestin IUDs, dienogest
- Surgical options when conservative fails: adenomyomectomy, DIE excision
- Fertility-preserving approach where family-completion is not yet decided
- Multidisciplinary team (colorectal, urology) for bowel/bladder DIE
Dr. Priyadatt Patel
Senior Gynecologist · IVF Specialist · Advanced Laparoscopic Surgeon · Endometriosis Expert
“Adenomyosis and deep endometriosis are not zebras — they are common, just commonly missed. The first step is being looked for properly. Most patients have already had 3-5 ultrasounds where it was not specifically sought.”