Endometriosis Ultrasound in Auckland

Specialist pelvic ultrasound for the diagnosis and mapping of endometriosis

Many women with endometriosis are told their pelvic ultrasound is "normal" — sometimes for years — even when their symptoms persist. Standard pelvic ultrasound is not designed to detect endometriosis. Specialist endometriosis ultrasound is.

I provide advanced pelvic ultrasound for women with suspected or confirmed endometriosis, performed within specialist consultation, with the scan and findings interpreted by me directly. This means a working diagnosis, a clear explanation of what the imaging shows, and a treatment plan — all within a single appointment.

Endometriosis ultrasound forms part of my broader specialist pelvic ultrasound practice, which covers the full range of gynaecological imaging.

Why standard ultrasound misses endometriosis

Routine pelvic ultrasound is excellent for detecting large cysts or fibroids, but it is not designed to assess the structures most commonly affected by endometriosis. It does not routinely evaluate:

  • Deep infiltrating endometriosis affecting the bowel, bladder, or pelvic sidewalls

  • Pouch of Douglas obliteration

  • Pelvic organ mobility (the "sliding sign")

  • Adhesions affecting the uterus, ovaries, or bowel

  • Adenomyosis — which often accompanies endometriosis and is frequently missed

  • Soft markers such as thickening of the uterosacral ligaments

  • Features of superficial endometriosis like hyperechoic foci, small cystic lesions, and filmy adhesions

Endometriosis ultrasound, performed using the IDEA (International Deep Endometriosis Analysis) protocol, evaluates each of these systematically. It is a fundamentally different examination from a standard pelvic scan — both in technique and in what it can find.

What this means for your diagnosis

Specialist ultrasound has changed the diagnostic pathway for endometriosis. Historically, endometriosis was confirmed only by laparoscopy — surgery was performed not to treat the condition, but simply to identify it. For many women, this meant waiting years for a diagnosis, undergoing surgery to receive one, and only then beginning treatment.

When endometriosis can be confirmed through ultrasound, this changes completely. Diagnostic surgery becomes unnecessary. Surgery is reserved for its proper purpose — therapeutic treatment in patients for whom an operation is genuinely needed. Many patients can be managed effectively without ever requiring an operation, because an accurate diagnosis opens the door to effective non-surgical treatment.

For patients who do proceed to surgery, the ultrasound findings allow precise pre-operative planning — including identifying when bowel or urology specialists need to be involved.

Validation, not just diagnosis

For many women who come to see me, the specialist ultrasound consultation is the first time they have seen direct visual evidence of a condition that has been present and painful — sometimes for a decade or more. After years of being told their scans are normal, of being dismissed, or of being offered no clear answer, the moment of seeing endometriosis on the screen and having it explained in real time can be profoundly important.

That validation is itself part of the care. It changes the conversation, it changes the patient's relationship with their own body, and it changes the decisions that follow.

What an endometriosis ultrasound assessment involves

The scan is performed within your specialist consultation, typically taking 10–20 minutes of the appointment. It is performed transvaginally with consent, supplemented by abdominal scanning where indicated. I assess:

  • The uterus — including features of adenomyosis using validated MUSA criteria

  • Both ovaries — including endometriomas and mobility

  • The pouch of Douglas — for obliteration and deep disease

  • The pelvic sidewalls and ureters

  • The bladder and bowel for deep infiltrating endometriosis

  • Pelvic organ mobility — the "sliding sign"

  • Soft markers of disease

  • Evidence of superficial endometriosis

Findings are explained as the scan is performed, and a written report and treatment plan are provided in the same consultation.

A pre-appointment ultrasound is not required. I do not offer ultrasound as a standalone service — it is performed within specialist consultation as part of integrated clinical assessment.

My endometriosis ultrasound training and recognition

I am the only gynaecologist in New Zealand to hold both the AGES Advanced Endoscopic Surgery Training Program (AATP) — the highest laparoscopic surgical accreditation in Australasia — and the Diploma of Diagnostic Ultrasound (DDU). This combination of advanced ultrasound and surgical training means imaging findings translate directly into treatment planning by the same clinician who will perform any surgery required.

Training

  • Diploma of Diagnostic Ultrasound (DDU) — Australasian Society for Ultrasound in Medicine

  • Advanced Gynaecological and Early Pregnancy Ultrasound Fellowship — University College London Hospitals (UCLH), one of the world's leading centres for pelvic and endometriosis imaging

Speaking and teaching

Read more about these presentations — RANZCOG ASM plenary and endometriosis ultrasound workshop.

This combination of advanced ultrasound and surgical training means imaging findings translate directly into treatment planning by the same clinician who will perform any surgery required.

Second Opinion Consultations

If you have been told your scans are normal but your symptoms continue, or if your previous imaging has not provided clear answers, you are welcome to book a specialist consultation for reassessment. This includes specialist ultrasound performed within the consultation as part of integrated clinical evaluation.

I do not provide standalone second-opinion scans, but a full consultation with integrated ultrasound assessment is often what patients in this situation actually need: an expert reassessment of the symptoms, the previous findings, and the management plan as a whole.

Pelvic ultrasound for endometriosis assessment

Related services

Frequently Asked Questions

  • In most cases, yes. Specialist pelvic ultrasound performed by a clinician with advanced training can identify endometriosis — including deep disease — with a high degree of accuracy. International guidelines now recognise specialist ultrasound and MRI as first-line diagnostic tools, with laparoscopy reserved for patients who require treatment rather than diagnosis. Some superficial peritoneal endometriosis still cannot be seen on imaging, but this rarely changes the management plan when symptoms and imaging findings are otherwise consistent.

  • Routine pelvic ultrasound is not designed to evaluate the structures most commonly affected by endometriosis. The technique used is different, the time spent is different, and the operator's training is different. A "normal" routine ultrasound does not exclude endometriosis — it simply means deep disease wasn't actively looked for.

  • A GP referral is helpful but not required. Self-referrals are welcome.

  • No. I do not offer ultrasound as a standalone service. Endometriosis ultrasound is performed within specialist consultation, where findings can be interpreted in clinical context and translated directly into a management plan.

  • Yes — particularly for patients whose previous imaging has been normal or inconclusive but whose symptoms continue. These are booked as full specialist consultations with integrated ultrasound assessment, not as standalone scans.

  • In most cases, yes. International guidelines now recognise specialist ultrasound performed by a trained operator as equivalent to MRI for most endometriosis assessment, with MRI reserved for specific cases. This often means avoiding the cost, wait, and inconvenience of additional imaging.

Book a specialist consultation

If you have suspected or confirmed endometriosis, persistent pelvic pain, or have been told your scans are normal but your symptoms continue, you can book a specialist consultation directly. Endometriosis ultrasound assessment will be performed within the consultation as part of your care.

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