How is endometrioma/endometriosis diagnosed?

Updated: Dec 14, 2018
  • Author: Shawn Daly, MD; Chief Editor: Eugene C Lin, MD  more...
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The initial workup begins with a history and physical examination. History and findings can be nonspecific, but occasionally, tender, nodular masses can be palpated on pelvic examination, representing fibrotic implants in the cul-de-sac. Elevations of CA-125 may be caused by endometriosis. [2]   [3]

Laparoscopy is the standard modality for the diagnosis of endometriosis. [4]  It is the most sensitive means of examination because only laparoscopy can identify superficial peritoneal implants; however, laparoscopy is an invasive surgical procedure. Laparoscopy can be incorporated into treatments in which endometriomas are cauterized or removed and adhesions are lysed. In addition, laparoscopy can be limited by the presence of dense pelvic adhesions, resulting in limited access to the cul-de-sac and adnexa.

For DIE, the modalities most commonly used are transvaginal ultrasound (TVUS) and MRI, which have comparable diagnostic accuracy. [1]

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