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Diagnosis of Endometriosis
Laparoscopy is the gold standard for diagnosing endometriosis.The clinical diagnosis is based on the history and a pelvic exam.
A Clinical history of pain as described before should make one suspect the condition.
On vaginal examination there maybe uterus, tubes and ovaries being felt as one fixed mass that is tender.
A rectovaginal exam (one finger in the vagina and one finger in the rectum) is indicated to rule out tenderness and deeply infiltrating nodules that maybe present in the ligaments of the uterus (utero-sacral) or behind the uterus (pouch of Douglas) and/or maybe visible in the vagina or on the cervix
As the clinical presentation and physical findings can be variable; a review of history and physical exam is not sufficient for a confirmative diagnosis of endometriosis. A definitive diagnosis is often based on direct visualisation.
Laparoscopy is the gold standard for diagnosing endometriosis.
1.Ultrasonography - Is a non-invasive imaging technique which may provide supporting evidence by demonstrating the presence of ovarian endometriotic cysts and adenomyosis.
2. Magnetic resonance imaging (MRI) – This non-invasive technique is used to diagnose endometriosis and to monitor treatment response, once a diagnosis is firmly established.
3. Laparoscopy – This procedure helps in direct visualisation of the endometrial lesions and also is helpful in treating endometriosis surgically. Biopsies of the endometrial implants can be taken and sent for histo pathological examination.