What is endometriosis mapping?
Endometriosis mapping is an imaging assessment used to investigate possible disease-related lesions and understand their location and extent when identified. It may be performed with specialized ultrasound and, in some situations, magnetic resonance imaging (MRI), according to medical indication.
The goal is not only to find changes. Imaging may help the team plan clinical follow-up, discuss treatment and organize a possible surgical approach when necessary.
When may endometriosis mapping be indicated?
- Severe menstrual cramps that affect daily activities, work or studies;
- Persistent pelvic pain;
- Pain during or after sexual intercourse;
- Pain when having a bowel movement or urinating, especially when cyclical;
- Bowel or urinary changes related to the menstrual cycle;
- Suspected deep endometriosis;
- Previous diagnosis requiring reassessment;
- Planning for surgical treatment;
- Infertility investigation with suggestive symptoms;
- Need for a second opinion.
These symptoms do not confirm endometriosis, and their absence does not replace medical assessment.
How is endometriosis mapping performed?
Specialized ultrasound
Specialized ultrasound can assess pelvic structures and identify findings that deserve investigation. The protocol, examination route and preparation vary according to the medical request, symptoms and clinical needs.
Magnetic resonance imaging
MRI may be considered in some contexts to complement imaging, particularly when more complex regions must be observed or specific findings need clarification.
Both exams are not required for every patient. The choice depends on individual assessment.
Ultrasound or MRI: which exam may be more appropriate?
The methods provide different information and may complement each other. This table is educational and does not determine which exam an individual patient should have.
| Criterion | Specialized ultrasound | Magnetic resonance imaging | How the decision is made |
|---|---|---|---|
| General purpose | Assess pelvic structures in real time and investigate findings related to the clinical question. | Produce detailed images of selected structures and regions. | Based on symptoms, history, clinical assessment and previous findings. |
| Information | May assess mobility, anatomy and suggestive changes in examined areas. | May complement anatomical characterization and clarify findings. | The purpose of the investigation guides the method. |
| Preparation | Varies by protocol, examination route and team instructions. | Varies by protocol and imaging service. | Official instructions are provided after scheduling. |
| Professional experience | Interpretation depends on the training and experience of the examiner. | Image acquisition and interpretation also require a qualified team. | The team considers availability and service quality. |
| Complementarity | May be sufficient in some contexts or indicate additional assessment. | May complement ultrasound in selected situations. | One method may complement the other when clinically justified. |
| When considered | Initial investigation, reassessment or planning, as requested. | When additional information or a specific context requires it. | No exam is universally superior for every patient. |
The choice depends on clinical history, symptoms, previous findings, the diagnostic question, exam availability and medical assessment.
What can mapping help assess?
Ovaries
Possible endometriomas and other findings that require clinical correlation.
Area behind the uterus
Suggestive findings in posterior pelvic regions when visible by the method.
Ligaments and pelvis
Pelvic structures and possible anatomical changes.
Bladder and urinary tract
Urinary regions when applicable to the indication and protocol.
Bowel and rectum
Selected bowel regions when applicable to the requested exam.
Adhesions and extent
Suggestive anatomical changes and possible lesion extent in selected cases.
Assessment capability varies by exam type, protocol, professional experience, preparation and individual characteristics. This list is not a guarantee of detection.
What does mapping not replace?
- Medical consultation and clinical assessment;
- Discussion of symptoms and history;
- Physical examination when indicated;
- Review of previous exams;
- Individualized treatment decisions;
- Follow-up after the result.
How should I prepare for the exam?
Preparation varies according to the requested exam, protocol and instructions from the responsible team.
- Confirm the type of exam scheduled;
- Request and follow the clinic’s official preparation instructions;
- Report regular medications;
- Bring the medical request when applicable;
- Bring relevant previous exams and reports;
- Report pregnancy, possible pregnancy, allergies or relevant conditions.
What happens after mapping?
1. Imaging exam
The assessment follows the protocol defined for your case.
2. Imaging report
The report describes observed findings and may guide discussion with the medical team.
3. Result discussion
The result is considered with symptoms, clinical history, previous exams and care goals.
Mapping integrated with endometriosis care
When indicated, mapping findings can support care across different areas. Not every patient needs multidisciplinary follow-up.
Endometriosis and surgery
Explore endometriosis care, gynecological surgery and robotic surgery.
Fertility and symptoms
Care may involve human reproduction, pain management and nutrition.
Urinary tract
Urogynecology may be involved when urinary symptoms or findings require specific assessment.
Prof. Dr. Mauricio Abrão
CRM-SP 52.842
Medical team
Meet the professionals and areas involved in care at Clínica Medicina da Mulher.
In-person care and teleconsultation
The exam is performed in person. Patients from other cities, provinces, states or countries may receive guidance by teleconsultation before or after the exam, depending on clinical needs and applicable medical practice rules.
Frequently asked questions about endometriosis mapping
It is an imaging assessment used to investigate possible endometriosis-related lesions and understand their location and extent when identified. It may involve specialized ultrasound and, in some situations, MRI. The most appropriate method depends on symptoms, medical history, previous findings and the clinical question being investigated.
The exam may identify findings compatible with endometriosis and support investigation, but it should not be interpreted alone as universal confirmation. Assessment also considers symptoms, medical history, physical examination when indicated and previous tests. The medical team discusses what the findings mean and recommends individualized next steps.
No. An exam without detected changes does not exclude every type or presentation of endometriosis. Some lesions may not be identified by the selected method or may require correlation with other clinical information. If symptoms persist, discuss the result with the medical team to determine whether follow-up or additional investigation is appropriate.
Ultrasound assesses structures in real time and may observe mobility and suggestive changes in examined areas. MRI provides detailed images and may complement assessment in selected contexts. Neither method is always superior. The choice depends on the clinical question, previous findings, availability and medical guidance.
The experience varies with the type and route of the exam, the areas assessed, existing pelvic pain and individual sensitivity. Tell the team about any discomfort during the procedure so they can provide guidance and adapt the assessment when possible. Specific questions can be discussed before scheduling.
Preparation depends on the exam type, protocol and responsible team’s instructions. Do not follow generic instructions found online. After scheduling, confirm the requested exam and follow only the clinic’s official preparation guidance, including any instructions about food, fasting or regular medications.
Duration varies according to the imaging method, protocol, structures assessed and individual case. Confirm the expected time with the team when scheduling. Also allow time for registration, instructions and care coordination rather than relying on a general estimate.
This depends on the exam type, protocol and service instructions. Before rescheduling or cancelling, tell the team that you are menstruating and ask whether there are restrictions for your scheduled exam. Instructions should be individualized by the responsible service.
Previous images, reports, surgical records and medical requests can provide useful context. Organize the available documents and confirm how to present them. Do not send detailed clinical information or images through channels that the clinic has not specifically recommended.
Mapping may be considered when symptoms, history or previous findings suggest bowel involvement. The ability to assess these regions depends on the method, protocol, preparation and professional experience. Indication and interpretation should be individualized, and a normal result does not exclude every clinical possibility.
When surgery is being considered, mapping findings may help the team understand potentially affected areas and plan an approach. Imaging does not determine the surgical indication or technique on its own. Decisions consider symptoms, goals, risks, alternatives, previous exams and clinical assessment.
Teleconsultation can help organize your history, review available exams and clarify the care journey, especially if you live outside São Paulo. Mapping remains an in-person exam, and some decisions may require an in-person consultation and physical examination. The team will advise on the appropriate format.
Scheduling can begin through the clinic’s WhatsApp. State whether you want mapping, a symptom assessment, a result review or teleconsultation information. The team will confirm the appointment type, documents and official preparation. You do not need to send a lengthy symptom history or imaging files before receiving instructions.