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Gynecological appointment and consultationAn ultrasound is also performed during the consultation. We have the ability to perform cytology and all cultures in house.
PREGNANCYDIAGNOSTICS AND TREATMENT OF REPRODUCTIVE ORGAN DISEASESEndometriosis Gdańsk – symptoms, diagnosis and treatmentEndometriosis is a chronic condition that may cause severe period pain, persistent pelvic pain, pain during sexual intercourse and difficulties becoming pregnant. Symptoms vary considerably, and their severity does not always reflect the extent of the disease.
At Tartaczna 2 Medical Centre in Gdańsk, we provide consultations, diagnosis and treatment for patients with suspected or confirmed endometriosis. Patients are seen by Dr Marek Korożan and Dr Dominika Kozikowska.
Depending on the symptoms and previous results, the diagnostic process may include a gynaecological consultation, an expert endometriosis ultrasound scan in Gdańsk, pelvic magnetic resonance imaging (MRI) or additional diagnostic tests.
The endometrium is the lining of the uterine cavity, which changes throughout the menstrual cycle. Endometriosis is a condition in which tissue similar to the endometrium is found outside the uterine cavity.
Endometriotic lesions may cause chronic inflammation, fibrosis and adhesions. Endometriosis may affect:
The exact cause of endometriosis remains unknown. Hormonal, immunological, inflammatory, genetic and environmental factors are thought to contribute to its development.
Endometriosis and adenomyosis are related conditions, but they are not the same disease. In endometriosis, tissue similar to the endometrium is present outside the uterine cavity. In adenomyosis, similar tissue is found within the muscular wall of the uterus, known as the myometrium.
Both conditions may occur together and may cause painful or heavy periods. Features of adenomyosis can be assessed during a specialist ultrasound examination.
Endometriosis most commonly affects women of reproductive age, although symptoms may begin during adolescence. Symptoms may also persist after the menopause, particularly in patients with previously diagnosed endometriosis.
Endometriosis is estimated to affect approximately 10% of women of reproductive age. Some patients have no characteristic symptoms, and the condition may be identified during fertility investigations or imaging performed for another reason.
Symptoms that may suggest endometriosis include:
The severity of pain does not necessarily correspond to the extent of the disease. Small lesions may cause severe symptoms, while extensive endometriosis may sometimes cause relatively few symptoms.
A consultation is recommended if period pain interferes with everyday activities, causes absence from work or education, or requires the regular use of painkillers.
Diagnostic assessment should also be considered if you experience pain during intercourse, bowel movements or urination, bowel symptoms that become worse during menstruation, or difficulty becoming pregnant.
Severe period pain should not automatically be considered a normal part of the menstrual cycle. An early consultation allows the doctor to plan appropriate investigations and treatment.
The diagnostic pathway should be tailored to the individual patient. It may include:
Laparoscopy is no longer required in every patient before endometriosis can be diagnosed or treated. In many cases, clinical decisions can be based on the patient’s symptoms, examination and appropriately performed ultrasound or MRI.
A normal ultrasound result does not exclude every form of endometriosis. Small superficial peritoneal lesions may not be visible on imaging. The result must always be considered together with the patient’s symptoms and clinical findings.
An expert endometriosis ultrasound scan is more comprehensive than a standard gynaecological ultrasound examination. Its purpose is not only to assess the uterus and ovaries but also to systematically search for and map endometriotic lesions in different areas of the pelvis.
During the examination, the doctor may assess:
At Tartaczna 2 Medical Centre, expert endometriosis ultrasound scans are performed by Dr Dominika Kozikowska. The examination is specifically focused on endometriosis, and identified lesions may be mapped and described using the #Enzian classification.
Dr Marek Korożan provides consultations, diagnosis and treatment for patients with endometriosis. The dedicated expert endometriosis ultrasound scan with #Enzian mapping is a separate examination performed by Dr Dominika Kozikowska.
#Enzian is a system used to describe the location and extent of endometriosis in a structured manner. It can be applied to diagnostic imaging as well as surgical findings.
A #Enzian description helps identify the pelvic areas affected by endometriosis, estimate the size of the lesions and improve communication between the gynaecologist, radiologist and surgical team. It is particularly useful in deep endometriosis and when planning possible surgical treatment.
Pelvic magnetic resonance imaging can complement an endometriosis ultrasound scan, particularly when ultrasound findings are inconclusive, the disease appears extensive or more detailed mapping is required before planned surgery.
MRI may be useful when deep endometriosis involving the bowel, urinary bladder, ureters or other areas that are difficult to assess is suspected. It may also be recommended when a complete transvaginal ultrasound examination cannot be performed or its scope is limited.
The scan should be performed using an MRI protocol designed for endometriosis and assessed by a radiologist experienced in imaging this condition.
The choice between expert ultrasound and MRI is made by the doctor based on the symptoms, previous results and planned treatment. The two examinations may complement one another.
A normal ultrasound or MRI result does not exclude superficial peritoneal endometriosis, as small lesions may remain invisible on imaging.
CA-125 may be elevated in some patients with endometriosis, but it is a non-specific marker. A normal result does not exclude the condition, while an elevated result may occur for many other reasons. CA-125 should therefore not be used on its own to confirm or exclude endometriosis.
In selected situations, the doctor may discuss an additional test such as the EndoRNA test for endometriosis. This is an adjunctive test, and its result should be interpreted together with the patient’s symptoms, clinical examination and imaging findings.
The EndoRNA test does not replace expert ultrasound or MRI and cannot determine the location, extent or stage of endometriotic lesions. The decision to perform this test should be made by a doctor after reviewing the complete clinical picture.
Endometriosis treatment is individually tailored according to the severity of symptoms, location of the lesions, the patient’s age, previous treatment and plans for pregnancy.
Painkillers and anti-inflammatory medicines may be used to relieve symptoms. The type of medicine and the way it is taken should be adjusted to the patient’s medical history and individual needs.
Hormonal treatment may reduce disease activity and relieve pain. Depending on the clinical indications, the doctor may consider combined hormonal contraceptives, progestogens, a levonorgestrel-releasing intrauterine system, or medicines affecting the gonadotrophin-releasing hormone pathway.
Hormonal treatment is not used to improve the chances of natural conception while the medication is being taken. Treatment selection should take account of the patient’s reproductive plans, contraindications and possible adverse effects.
Surgery may involve removing endometriotic lesions, endometriomas and adhesions. The extent of surgery depends on the location of the disease, the severity of the symptoms and the patient’s fertility plans.
When deep endometriosis involving the bowel, urinary bladder or ureters is suspected, accurate pre-operative mapping and treatment planning by an appropriately experienced team are particularly important.
Removal of the uterus is not a routine treatment for endometriosis and does not always resolve all symptoms, as endometriotic lesions may be present outside the uterus.
Endometriosis may affect fertility through adhesions, changes in pelvic anatomy, ovarian involvement or inflammation. However, a diagnosis of endometriosis does not mean that pregnancy is impossible.
Management depends on the patient’s age, ovarian reserve, tubal patency, extent of the disease, semen analysis results and the length of time the couple has been trying to conceive. Depending on the individual situation, the doctor may recommend further attempts at natural conception, surgical treatment or referral to a fertility clinic.
Endometriosis is a chronic condition. Treatment can effectively reduce symptoms, improve quality of life and limit the effect of the disease on fertility. However, symptoms may return in some patients after hormonal treatment is stopped or following surgery.
An individual management plan, appropriate follow-up and adjustment of treatment to the patient’s current symptoms and plans are therefore important.
If you have symptoms suggesting endometriosis, have already been diagnosed with the condition or need to discuss further treatment, you can book a consultation with Dr Marek Korożan or Dr Dominika Kozikowska.
Expert endometriosis ultrasound scans with #Enzian mapping are performed by Dr Dominika Kozikowska. Due to the specialist nature of the examination and high demand, we recommend booking in advance. Our reception team can provide information about the earliest available appointment and the possibility of joining the waiting list.
Book an appointment through our contact form or telephone reception service, or call +48 58 719 10 25.
Online booking through ZnanyLekarz:
See also: gynaecologist in Gdańsk – gynaecology and obstetrics.
Endometriosis ultrasound Gdańsk – expert #Enzian assessmentAn expert endometriosis ultrasound is a detailed transvaginal examination used to detect and map changes associated with endometriosis, particularly endometriomas, pelvic adhesions, adenomyosis and deep endometriosis.
At Tartaczna 2 Medical Centre, the expert endometriosis ultrasound in Gdańsk is performed exclusively by Dr Dominika Kozikowska. The examination includes a systematic assessment of the pelvis, and any identified lesions may be mapped and described using the #Enzian classification.
This is a separate, more comprehensive service than a standard gynaecological ultrasound. When booking, please select “endometriosis ultrasound” rather than a standard gynaecological consultation or routine transvaginal ultrasound.
A standard transvaginal ultrasound primarily assesses the uterus, endometrium and ovaries. It may detect fibroids, polyps, ovarian cysts and other abnormalities of the reproductive organs.
An expert endometriosis ultrasound has a considerably broader scope. In addition to assessing the uterus and ovaries, it includes a systematic search for lesions in the anterior and posterior pelvic compartments, an assessment of organ mobility and adhesions, and an examination of structures that may be affected by deep endometriosis.
The examination also includes dynamic ultrasound assessment. The doctor evaluates the movement of the uterus, ovaries, bowel and other pelvic structures in relation to one another. Restricted mobility may indicate adhesions or deep endometriotic lesions.
The examination may be recommended if you experience symptoms or have previous findings that may suggest endometriosis, including:
The severity of pain does not always reflect the extent of endometriosis. Small lesions may cause severe symptoms, while more extensive disease may sometimes cause relatively few symptoms.
The scope of the examination is adapted to the patient’s symptoms and clinical situation. The assessment may include:
An expert ultrasound may help determine the location, size and extent of lesions and their relationship with adjacent organs. This information is important when planning conservative management, further assessment with MRI or possible surgical treatment.
The systematic ultrasound assessment of patients with suspected endometriosis is based on principles developed by the International Deep Endometriosis Analysis group, known as IDEA. It includes examination of the uterus and adnexa, a search for indirect signs of the disease, assessment of organ mobility and evaluation of the anterior and posterior pelvic compartments.
The results may be described using the #Enzian classification. This system provides a structured description of the location and extent of endometriosis, including ovarian involvement, adhesions, deep endometriosis and lesions involving the bowel, urinary bladder or ureters.
#Enzian is a classification used to map the disease rather than a separate type of ultrasound examination. It facilitates communication between the doctor performing the ultrasound, the treating gynaecologist, radiologist and surgical team.
Before the examination, Dr Dominika Kozikowska takes a medical history covering the patient’s symptoms, their relationship with the menstrual cycle, previous treatment, previous operations and plans for pregnancy.
The examination is primarily performed using a transvaginal ultrasound probe. When necessary, the assessment may be supplemented with an abdominal ultrasound.
During the examination, the doctor assesses not only the appearance of individual organs but also their mobility in relation to one another. Gentle probe movements and light pressure may be used in selected areas of the pelvis. This helps assess tenderness, adhesions and the ultrasound sliding sign.
The examination usually takes approximately 30 minutes, although its duration depends on the patient’s anatomy, the severity of symptoms and the extent of any identified lesions.
After the examination, the patient receives a report containing the most important findings. The doctor discusses any abnormalities and explains the possible next diagnostic or treatment steps.
Examples of areas assessed during an endometriosis ultrasound examination.
The examination does not require surgery, but it may cause temporary discomfort in patients with severe pelvic pain or deep endometriosis. Areas affected by the disease may be particularly sensitive during assessment.
The examination is performed with consideration for the patient’s comfort. You can report pain, ask the doctor to reduce the pressure or request that the examination be stopped at any time.
Preparation may depend on the planned scope of the examination. Detailed instructions are provided when the appointment is booked.
Please bring any relevant medical records, including:
Do not take laxatives or perform an enema unless this preparation has been specifically recommended by our reception team or doctor.
The examination can usually be performed on any day of the menstrual cycle. If you are experiencing heavy bleeding, think you may be pregnant or have any questions about preparation, please contact our reception team before the appointment.
A normal expert ultrasound result does not exclude every form of endometriosis. The examination can identify endometriomas and many forms of deep endometriosis with good accuracy, but small superficial peritoneal lesions may remain invisible on imaging.
The ultrasound result should always be interpreted together with the patient’s symptoms, medical history and gynaecological examination. If symptoms persist despite a normal ultrasound, the doctor may recommend monitoring, medical treatment, an MRI scan or another form of diagnostic assessment.
Detecting endometriosis on ultrasound does not automatically mean that surgery is required. The decision depends on the nature and severity of symptoms, the location of the lesions, the patient’s age, plans for pregnancy and the effectiveness of previous treatment.
Medical treatment and monitoring may be appropriate for some patients. Surgery may be considered in cases of severe symptoms, unsuccessful conservative treatment, selected fertility problems or lesions affecting the function of the bowel or urinary system.
Depending on the ultrasound findings and the patient’s clinical situation, the doctor may recommend additional investigations:
CA-125 and CA 19-9 are not sufficiently specific to confirm or exclude endometriosis on their own. They do not replace a medical consultation or appropriately performed diagnostic imaging.
Expert endometriosis ultrasound scans at Tartaczna 2 Medical Centre are performed exclusively by Dr Dominika Kozikowska. The examination includes a detailed assessment of the pelvis and mapping of identified lesions, which may be described using the #Enzian classification.
Due to the specialist nature of the examination and high demand, we recommend booking in advance. Our reception team can provide information about the earliest available appointment and the possibility of joining the waiting list.
Book the examination through our contact form or telephone reception service, call +48 58 719 10 25 or book through ZnanyLekarz: Dr Dominika Kozikowska.
For more information about symptoms and treatment, visit: endometriosis in Gdańsk – symptoms, diagnosis and treatment.
Testing for HPV (human papillomavirus) infectionAssessments of inflammatory conditions and diseases of the vulva, vagina and cervixHigh-quality gynecological and obstetrical care for women is a definite differentiator of our Center, compared to competing outpatient clinics. Our excellent staff consists of specialists who have gained professional experience over the years and work every day in gynecological and obstetrics departments in Poland and abroad. Constant participation in numerous symposia, conferences, courses and trainings allow us to offer gynecological and obstetric care based on the latest achievements in medicine – at the highest possible world level.
We will safely guide you through the entire process of preparing for pregnancy, expecting a baby, and giving birth. We have state-of-the-art equipment for non-invasive prenatal 3D and 4D ultrasound examinations, which you will be able to undergo quickly and conveniently in our Tartaczna 2 Medical Center, under the supervision of a dedicated team of specialists who will provide you with comprehensive care.
We offer a range of safe, effective, as well as reversible contraceptive methods that are appropriately tailored to each case and individual woman's needs. We also provide a full range of diagnostics, counseling and treatment of diseases of the genitals, as well as prevention and gynecological consultations verifying the current state of a woman's health.
Managing a high-risk pregnancy