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How do health care providers diagnose endometriosis?

Surgery is currently the only way to confirm a diagnosis of endometriosis.

The most common surgery is called laparoscopy (pronounced lap-uh-ROS-kuh-pee). In this procedure:

  • The surgeon uses an instrument to inflate the abdomen slightly with a harmless gas.
  • After making a small cut in the abdomen, the surgeon uses a small viewing instrument with a light, called a laparoscope (pronounced LAP-er-uh-skohp), to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis.
  • He or she can make a diagnosis based on how the patches of endometriosis look.
  • In some cases, the surgeon will also do a biopsy, which involves taking a small tissue sample and studying it under a microscope, to confirm the diagnosis.1
  • While the most common surgery is a laparoscopy, sometimes a laparotomy—a surgical procedure involving a larger incision—is used to make a diagnosis.

Health care providers may also use imaging methods to produce a "picture" of the inside of the body to help detect endometriosis. Imaging allows them to locate larger endometriosis areas, such as nodules or cysts. The two most common imaging tests are ultrasound, which uses sound waves to make the picture, and magnetic resonance imaging (MRI), which uses magnets and radio waves to make the picture. These types of imaging will not aid in the diagnosis of small lesions or adhesions.1

Your health care provider will perform a laparoscopy only after learning your full medical history and giving you a complete physical and pelvic exam. This information, in addition to the results of an ultrasound or MRI, will help you and your health care provider make more informed decisions about treatment.

Researchers are also seeking less invasive ways to diagnose endometriosis and to determine how severe the disease is. NICHD-funded researchers in the National Centers for Translational Research in Reproduction and Infertility created a “diagnostic classifier” for endometriosis based on the presence of particular genes. The classifier was 90% to 100% accurate. Once the classifier is validated, a simple biopsy in the doctor’s office may be a non-surgical way to diagnose endometriosis in most women.2

Citations

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  1. American College of Obstetricians and Gynecologists. (2010). Management of Endometriosis. Practice Bulletin No. 114. Washington, DC. [top]
  2. Tamaresis, J. S., Irwin, J. C., Goldfien, G. A., Rabban, J. T., Burney, R. O., Nezhat, C., et al. (2014). Molecular classification of endometriosis and disease stage using high-dimensional genomic data. Endocrinology, 155(12), 4986–4999. PMID: 25243856 [top]

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