Endometriosis Diagnosis & Treatment Auckland
Dr Guy Fisher is a specialist gynaecologist and advanced laparoscopic surgeon in Auckland with a focused practice in the diagnosis and treatment of endometriosis — including complex, recurrent, and Stage IV disease. As the only gynaecologist in New Zealand to hold both the AGES Advanced Endoscopic Surgery Training Program (AATP) and the Diploma of Diagnostic Ultrasound (DDU), Dr Fisher combines advanced endometriosis ultrasound with fellowship-trained laparoscopic surgery — providing accurate diagnosis, clear explanation, and carefully planned treatment, all from a single clinician.
Endometriosis affects approximately 1 in 10 women of reproductive age, yet it is often difficult to diagnose. Many women experience symptoms for years before receiving clear answers — particularly when previous ultrasound scans have been reported as normal. Standard pelvic ultrasound is not designed to detect endometriosis. Specialist endometriosis ultrasound is, and in most cases it can confirm the diagnosis without the need for surgery.
Endometriosis symptoms
Endometriosis can present in different ways. Common symptoms include:
Bowel or bladder pain
Fatigue
Symptoms do not always reflect the severity of disease, which is why specialist assessment is important.
How endometriosis is diagnosed
Standard imaging often does not detect endometriosis.
Advanced pelvic ultrasound can identify features such as deep endometriosis, reduced organ mobility, and characteristic changes in pelvic structures. This allows many cases to be diagnosed and mapped before surgery.
A clear diagnosis helps guide treatment decisions and avoids unnecessary delays or repeated investigations.
Endometriosis & fertility
Endometriosis can affect fertility in several ways, including inflammation, distortion of pelvic anatomy, and effects on egg quality and implantation.
Dr Guy Fisher provides integrated care for patients with endometriosis who are trying to conceive, combining surgical expertise with fertility treatment through Fertility Associates.
This allows coordinated management from diagnosis through to treatment and pregnancy planning.
Advanced endometriosis ultrasound training
I completed a fellowship in advanced gynaecological ultrasound at University College London Hospitals (UCLH), a leading international centre for endometriosis imaging.
This training allows detailed assessment of:
Deep endometriosis involving ligaments and pelvic structures
Disease affecting the bowel or bladder
Ovarian endometriomas
Associated conditions such as adenomyosis
Accurate ultrasound assessment allows disease to be mapped before surgery, improving planning and outcomes.
Endometriosis treatment options
Treatment depends on your symptoms, goals, and stage of life.
Options may include:
Hormonal or medical therapy
Pain management strategies
Fertility planning
Laparoscopic (keyhole) surgery
The focus is on understanding your symptoms and developing a clear, individualised plan.
Advanced laparoscopic surgery for endometriosis
I completed the AGES Advanced Endoscopic Surgery Training Program (AATP) and am accredited to perform Level 6 laparoscopic procedures.
This includes management of complex and Stage IV endometriosis, including disease involving the bowel, bladder, and deep pelvic structures. Surgery is carefully planned and, when required, performed with a multidisciplinary team.
This approach reduces the risk of incomplete treatment and repeat procedures.
How I can help
I combine advanced pelvic ultrasound and fellowship-trained laparoscopic surgery to assess and treat endometriosis with precision — including complex and deep disease.
For many women, having a clear diagnosis and a well-planned treatment approach is the first step toward relief.
Related services
Book an assessment
If you have pelvic pain, pain with sex, or difficulty conceiving, you can book a comprehensive assessment with advanced ultrasound.
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Yes. Standard pelvic ultrasound often does not detect endometriosis.
However, advanced pelvic ultrasound performed by a specialist can identify features such as deep endometriosis, reduced organ mobility, and characteristic changes in pelvic structures. This allows many cases to be diagnosed or strongly suspected before surgery.
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Not always.
In many cases, a diagnosis can be made based on symptoms and specialist ultrasound findings. Surgery is usually considered when symptoms are severe, when fertility is affected, or when a clear diagnosis is needed to guide treatment.
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Symptoms vary, but commonly include:
Painful periods
Pelvic pain outside of your period
Pain during or after sex
Bowel or bladder pain
Fatigue
Difficulty falling pregnant
Symptoms do not always reflect the severity of disease.
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Yes.
Endometriosis can affect fertility through inflammation, distortion of pelvic anatomy, and effects on egg quality and implantation. Many women with endometriosis can still conceive, but specialist assessment can help guide the best approach.
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You should consider seeing a specialist if you have:
Ongoing pelvic pain
Painful periods affecting daily life
Pain during sex
Difficulty falling pregnant
Persistent symptoms despite normal scans
Early specialist assessment can reduce delays in diagnosis and treatment.
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Treatment depends on your symptoms and goals, and may include:
Hormonal or medical therapy
Pain management strategies
Fertility planning
Laparoscopic (keyhole) surgery
The aim is to develop a plan that fits your symptoms, priorities, and stage of life.
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Endometriosis can recur over time, particularly if not completely excised or if underlying drivers remain.
Careful surgical planning and ongoing management can reduce the risk of recurrence and help maintain long-term symptom control.
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Endometriosis occurs outside the uterus, while adenomyosis occurs within the muscle wall of the uterus.
The two conditions can occur together and may cause similar symptoms, including pain and heavy periods. Specialist assessment can help distinguish between them and guide treatment.