Can imaging be negative and still help plan endometriosis surgery?

Yes—imaging can be “negative” and still be very useful for surgery planning. Small or superficial peritoneal endometriosis may not show up on ultrasound or MRI, so a normal report doesn’t rule out disease.

Even when it doesn’t visualize every lesion, imaging can help identify or map deeper disease, ovarian endometriomas, adhesions, and whether nearby organs may be involved. That information helps us plan the right surgical team, anticipate complexity, and have a clear, informed consent discussion before the procedure. When imaging and symptoms don’t match, our surgical assessment and intraoperative findings still guide what we treat, and we’re happy to review your images and history with you in a consultation.