Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • dysmenorrhea
  • chronic or cyclic pelvic pain
  • dyspareunia
  • subfertility
  • uterosacral ligament nodularity
  • pelvic mass
  • fixed, retroverted uterus
  • depression

Other diagnostic factors

  • dysuria, flank pain, hematuria
  • dyschezia, hematochezia

Risk factors

  • reproductive age group
  • white ethnicity
  • positive FHx
  • nulliparity
  • low BMI
  • mullerian anomalies
  • autoimmune disease
  • late first sexual encounter
  • smoking
  • previous cesarean section

Diagnostic investigations

1st investigations to order

  • transvaginal ultrasound (TVUS)
Full details

Investigations to consider

  • rectal endoscopic ultrasound
  • 3D ultrasonography
  • hysterosalpingography
  • MRI pelvis
  • diagnostic laparoscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

M. Jonathon Solnik

Associate Professor of Obstetrics & Gynaecology

Head of Gynaecology & Minimally Invasive Surgery

Faculty of Medicine at the University of Toronto

Mt. Sinai Hospital

Toronto

Canada

Disclosures

MJS is an author of a number of references cited in this monograph. He acts as a consultant for AbbVie (manufacturers of depot leuprolide) and Medtronic.

Dr M. Jonathon Solnik would like to gratefully acknowledge Dr Sharon M. Jakus, a previous contributor to this monograph. SMJ declares that she has no competing interests.

Peer reviewers VIEW ALL

Professor

Department of Obstetrics, Gynecology, and Reproductive Sciences

Vice Chairman

Reproductive Sciences

Director

Division of Reproductive Endocrinology and Infertility

University of Pittsburgh

Pittsburgh

PA

Disclosures

JSS declares that he has no competing interests.

Professor of Obstetrics and Gynaecology

Leicester Royal Infirmary

Leicester

UK

Disclosures

JCK is an author of a reference cited in this monograph.

Use of this content is subject to our disclaimer