women s health issues
Endometriosis
Diagnosis of Endometriosis
Laparoscopy to check for endometrial tissue Sometimes a biopsy during laparoscopy A doctor may suspect endometriosis in a woman who has typical symptoms or unexplained infertility. Occasionally, during a pelvic examination, a woman may feel pain or tenderness, or a doctor may feel a lump or mass of tissue behind the uterus or near the ovaries. Ultrasonography or magnetic resonance imaging (MRI) may help doctors evaluate endometriosis in a noninvasive way (that is, no incision is required). It may be done to check for an ovarian cyst caused by endometriosis (endometrioma). However, its usefulness for diagnosis is limited. MRI can sometimes detect unique signals that are characteristic of endometrial tissue. However, MRI cannot detect small patches of endometrial tissue. However, to diagnose endometriosis, a doctor examines the abdominal cavity with a thin viewing tube (called a laparoscope) to be able to directly see whether endometrial tissue is present. The laparoscope is inserted into the abdominal cavity (the space around the abdominal organs) through a small incision most often made just above or below the navel. The abdominal cavity is then inflated with carbon dioxide gas, which distends it and makes the organs easier to see. The entire abdominal cavity is examined. Laparoscopy is done in a hospital and usually requires a general anesthetic. An overnight stay in the hospital is usually not required. Laparoscopy causes mild to moderate abdominal discomfort, but normal activities can usually be resumed in a few days. If a doctor sees abnormal tissue during laparoscopy and is not sure whether it is endometrial tissue, a biopsy must be done. A sample of the tissue is removed, using instruments inserted through the laparoscope. The sample is then examined using a microscope. An overnight stay in the hospital is usually required only if a very large amount of abnormal tissue is removed. Depending on the location of the misplaced tissue, a biopsy may be done when the vagina is inspected during a pelvic examination or when a flexible viewing tube is inserted through the anus to examine the lower part of the large intestine, rectum, and anus ( Endoscopy ) or bladder ( If a woman is infertile, Diagnosis may be done to determine whether the cause is endometriosis or another disorder, such as problems with the fallopian tubes. Doctors classify endometriosis as minimal (stage I), mild (stage II), moderate (stage III), or severe (stage IV) based on the following: The amount of misplaced tissue Its location Its depth (whether it is on the surface of or deep within an organ) The presence and number of endometriomas and adhesions Doctors may use the following to estimate what the chances of becoming pregnant are for a woman with endometriosis: How severe the endometriosis is (its stage) How old the woman is How long she has been infertile Whether she has been pregnant before How well her reproductive organs are functioning 