What is an endometriosis ultrasound mapping exam?

An endometriosis ultrasound mapping exam is a specialized pelvic ultrasound performed with the specific goal of “mapping” where endometriosis is suspected—not just checking whether a cyst or mass is present. In experienced hands, it looks for signs of deep endometriosis and evaluates key areas like the ovaries, uterosacral ligaments, the pouch of Douglas, and whether there are findings that suggest bowel involvement or reduced organ mobility from adhesions.

Mapping matters because endometriosis isn’t simply yes-or-no; surgical planning depends on location, size, and how deeply disease may involve surrounding structures. In some situations—especially when rectal endometriosis is suspected—your evaluation may include more than one ultrasound approach, such as transvaginal ultrasound and, when needed, an endorectal ultrasound to better assess the rectal wall layers.

We use imaging as one piece of a comprehensive evaluation that starts with your full symptom story and a careful exam, because imaging can miss disease or under-describe what’s driving your pain. If you’re considering surgery or have complex symptoms, our team can help you understand what a mapping exam can (and can’t) tell us and what information we still need to plan the safest, most effective next step.