Disease in the uterine wall
Endometrial glands and stroma within the myometrium. Causes heavy menstrual bleeding, dysmenorrhoea, dyspareunia, and infertility. Diagnosis by ultrasound (MUSA criteria) or MRI. Often coexists with endometriosis.
Beyond surface lesions
Disease penetrating more than 5mm beneath peritoneal surface. Common sites: uterosacral ligaments, recto-vaginal septum, bowel, bladder, ureters. Requires specialised mapping (#Enzian system) and often multidisciplinary surgical input.
Individualised and multidisciplinary
Medical management often first-line. Surgery for symptomatic patients not responsive to medical therapy. For DIE: requires meticulous specialised surgery sometimes with colorectal or urology input. For adenomyosis: uterine-sparing options vs hysterectomy depending on fertility goals.
Adenomyosis vs deep endometriosis
| Adenomyosis | Deep endometriosis | |
|---|---|---|
| Site | Uterine muscle wall | Outside uterus, infiltrating |
| Main symptom | Heavy bleeding | Pain, dyschezia, dyspareunia |
| Imaging | TVS / MRI (MUSA) | TVS / MRI (IDEA) |
| Surgery | Limited; often hysterectomy | Excision when indicated |
Aligned with current international evidence, not habit.
Frequently asked
Dr Patel leads endometriosis diagnosis and surgery at Balaji Horizon with an evidence-based, ovarian-sparing philosophy aligned to ESHRE and ESGE — integrating pain, fertility and long-term disease control into a single plan, rather than treating the disease in isolation.
Imaging-led diagnosis, medical-first management, and precise surgery only when it is the right step — planned around your pain and fertility goals.
Adenomyosis — when endometriosis’s “cousin” is the problem
In adenomyosis, endometrial-type tissue grows within the muscular wall of the uterus itself, causing heavy, painful periods and often a bulky, tender uterus. It frequently coexists with endometriosis but is a distinct condition needing its own approach.
Getting the diagnosis right
Adenomyosis is diagnosed on specialist ultrasound or MRI rather than at laparoscopy (it is inside the uterine wall, not on the surface). Distinguishing it from fibroids and endometriosis matters because the treatments differ — which is why accurate imaging is central.
Treatment matched to your goals
For symptom control without surgery, hormonal options including the Mirena intrauterine system are often effective. Where fertility is the priority, management is individualised, since adenomyosis can affect implantation and pregnancy. Hysterectomy is definitive but reserved for women who have completed childbearing and exhausted other options.
Our philosophy
We aim to control symptoms and protect fertility with the least intervention that works, escalating only when clearly justified — not treating the scan, but the woman and her goals.
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
