Diagnosing Endometriosis

Endometriosis associated with the classic symptoms of painful menstrual periods and/or painful sexual intercourse raise the suspicion of endometriosis. However, when the symptoms are less suggestive such as unexplained infertility, irregular periods, or spotting; identifying the disease would be more difficult. The only definitive diagnostic procedure for endometriosis, however, is a direct look inside the abdominal cavity and a biopsy of the tissue.

Diagnostic Laparoscopy

Laparoscopy is the only definitive way to diagnose endometriosis, and cannot be made from symptoms alone. However, all other male and female fertility factors should be evaluated before performing it. Depending on the woman's age, history, and findings from the workup, a rather global view would be undertaken to evaluate all the different options available to reach the goal of achieving pregnancy.

Viewed through the laparoscope, the endometrial lesions look like raised shaggy brown or blue-black areas ranging from 2 to 10 cm in diameter. If the disease has been present for a prolonged period of time, the tissue adjacent to the implants will pucker and burned-out areas will show fibrotic scars. Advanced endometriosis (stage III or IV) may invade, pucker, and erode the walls of affected organs, and adhesions may be so dense that they "freeze" the pelvic organs into distorted positions.

During laparoscopy, a thin, lighted telescope, called a laparoscope, is inserted into the abdominal cavity through a small incision in or near the navel. Looking through the laparoscope, the surgeon can see the surface of the uterus, fallopian tubes, ovaries, and other pelvic organs. The doctor can then visually confirm the presence of endometriosis and gauge its extent. A small piece of tissue can be removed for microscopic examination at this time. This is called a biopsy.

Conclusion

Endometriosis is a disease affecting millions of women throughout the world. For many, the condition goes unnoticed. But for others, it demands professional attention, especially when fertility is impaired or pain affects the lifestyle. Choosing a qualified physician who is familiar with the latest developments in endometriosis management is your best strategy. The physician you choose will recommend the most appropriate course of treatment based on your personal situation.