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In case of suspicion of endometriosis, the gynecologist may recommend performing some tests to evaluate the uterine cavity and the endometrium, such as transvaginal ultrasound, magnetic resonance imaging and the measurement of the CA 125 marker in the blood, for example. However, in cases where the symptoms are very intense, the doctor can indicate the performance of tests that allow to evaluate other parts of the body and thus check the severity of endometriosis.
Endometriosis is characterized by the presence of endometrial tissue, which is the tissue that lines the uterus internally, in places outside the uterus, such as the peritoneum, ovaries, bladder or intestines, for example. Usually the gynecologist asks for these tests when the disease is suspected because there are symptoms such as very intense and progressive menstrual cramps, pain during intimate contact or difficulty getting pregnant.
Tests that are usually ordered to diagnose endometriosis include:
1. Gynecological examination
The gynecological examination can be performed in the investigation and diagnosis of endometriosis, and the gynecologist must observe the vagina and uterus with the speculum. In addition, according to the observed characteristics, the rectum can also be observed in order to search for cysts, which may be indicative of intestinal endometriosis.
2. Pelvic or transvaginal ultrasound
The ultrasound exam is one of the first exams performed in the investigation of endometriosis, and it can be pelvic or transvaginal. To do this exam it is recommended to completely empty the bladder, as it is possible to better visualize the organs.
The ultrasound exam is also very useful in the diagnosis of ovarian endometriosis, in which the endometrial tissue grows in the ovaries, but it can also identify endometriosis in the bladder, vagina and in the rectum wall.
3. CA 125 blood test
CA 125 is a marker that is present in the blood and a dirty dosage is usually requested to assess the person's risk of developing cancer or ovarian cyst and endometriosis, for example, since in these situations the levels of CA 125 in the blood are high. Thus, when the CA 125 result is greater than 35 IU / mL, it is important that the doctor orders other tests to confirm the diagnosis. See what the CA 125 exam is and how to understand the result.
4. Magnetic resonance
Magnetic resonance imaging is requested when there is suspicion of ovarian masses that need to be better evaluated, in addition to being also indicated with the aim of investigating deep endometriosis, which also affects the intestine. This examination can show the scattered fibrosis and changes in the pelvis, subcutaneous tissue, abdominal wall, and even the surface of the diaphragm.
5. Videolaparoscopy
Videolaparoscopy is the best exam to identify endometriosis because it leaves no doubt of the disease, however it is not the first exam to be performed, since it is a more invasive exam, and it is possible to conclude the diagnosis through the other tests.
In addition to being able to be indicated in the diagnosis of endometriosis, videolaparoscopy can also be requested to monitor the evolution of the disease and check if there is a response to treatment. Understand how videolaparoscopy is performed.
Complementary exams
There are other complementary tests that can also be ordered, such as a rectal resonance or echo endoscopy, for example, which help to better observe the places where the endometrial tissue is growing so that the best treatment can be started, which can be done with the continuous pill for 6 months. During this period, the doctor may repeat laparoscopy again to assess the evolution of the disease.
In the most severe cases, surgery may be necessary to remove the tissue that is growing outside the uterus, which can cause infertility if the pelvic organs are also removed. See how surgery for endometriosis is done.