How to check for endometriosis? Three tests to know!

Endometriosis is a disease of the endometrium that occurs when the endometrium grows in other parts of the body. This disease is common in women around 40 years old. As for how to detect endometriosis, there are three main diagnostic methods, which can be detected through laparoscopy.

(1) Imaging examination: B-mode ultrasound examination

It is an important method for diagnosing ovarian ectopic cysts and bladder and rectal endometriosis. It can determine the location, size and shape of ectopic cysts. Its diagnostic sensitivity and specificity are both above 96%. The cyst is round or oval in shape, adhered to the surrounding area, especially the uterus, with thick and rough cyst walls and tiny floc-like light spots inside the cyst. Because the echo image of the cyst is non-specific, the diagnosis cannot be confirmed solely based on B-mode ultrasound images. Pelvic CT and MRI are valuable in diagnosing pelvic endometriosis, but they are expensive and are not used as the primary diagnostic method.

(2) Serum CA125 measurement

Serum CA125 levels may increase, which is more obvious in severe patients, but the range of variation is very large. It is mostly used clinically for patients with severe endometriosis and suspected deep ectopic lesions. In the diagnosis of early endometriosis, the CA125 value in peritoneal fluid is more meaningful than the serum value. However, CA125 may also be elevated in other diseases such as ovarian cancer and pelvic inflammatory disease. CA125 levels are more clinically valuable for monitoring the activity of ectopic endometrial lesions. Dynamic detection of CA125 helps evaluate efficacy and predict recurrence.

(3) Laparoscopy

It is currently internationally recognized as the best method for diagnosing endometriosis. In addition to lesions directly visible in the vagina or other parts of the body, laparoscopy is the standard method for diagnosing pelvic endometriosis. The diagnosis can be confirmed by observing typical lesions described in gross pathology under laparoscopy or by performing a biopsy of the lesions. Laparoscopic examination should be the first choice in the following situations: infertile patients suspected of endometriosis, patients with chronic abdominal pain and progressive dysmenorrhea without positive findings in gynecological examination and B-ultrasound examination, and patients with symptoms, especially elevated serum CA125 levels. The clinical stage of endometriosis can only be determined under laparoscopy or direct laparotomy.