DIAGNOSIS

History

A careful and thorough history may highlight symptoms which could be due to endometriosis

Pelvic examination

A pelvic examination may identify ovarian cysts, endometriotic nodules or scarring on the ligaments supporting the uterus and between bowel and vagina (rectovaginal endometriosis).

Ultrasound scan

An ultrasound scan can help in assessing the severity of endometriosis. If cysts are present on the ovaries these can be identified and in addition, ultrasound also allows us to make an assessment of how stuck the ovaries and womb are. Ultrasound can also aid in identifying other areas of endometriosis within the pelvis. This information is useful when planning treatment.

Magnetic Resonance Imaging

MRI is particularly helpful in identification of endometriomas and extraperitoneal endometriotic lesions, especially in the rectovaginal septum. MRI is also helpful in the diagnosis of bladder and cul-de-sac endometriosis, but has unsatisfactory sensitivity in the detection of rectal lesions.

MRI is not sensitive in identifying superficial endometriotin implants; therefore, other modality, such as laparoscopy, should be relied on to rule out endometriosis.

Laparoscopy

The gold standard for the diagnosis of pelvic endometriosis. This is the most accurate and reliable way to check the degree and extent of endometriosis. It involves inserting a telescope through a small cut in the navel to look inside the abdomen and pelvis.

Rectovaginal endometriotic nodule Superficial endometriotic deposit