Which studies should be performed in the workup for endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Few laboratory tests prove to be valuable in the diagnosis of endometriosis, although some tests may be helpful in ruling out specific conditions in the differential diagnosis.

Routine radiographs are not recommended unless other disease entities requiring these studies are in the differential diagnosis.

Pelvic ultrasonography, computed tomography (CT) scanning, and magnetic resonance imaging (MRI) are only useful in the case of advanced disease with endometrial cyst formation or severe anatomic distortion. Intravenous pyelography and colonic studies are indicated if the clinical presentation suggests extragenital involvement of these organ systems.

Gross visualization of endometrial implants remains the definitive method of diagnosis. In this era of minimally invasive surgery, laparoscopy is the procedure of choice. Laparotomy can be another method of diagnosis. This is usually performed when another cause of patient pain is suspected.

Hysterosalpingography may reveal tubal occlusion or periadnexal adhesions.

Conscious pain mapping (ie, with the patient awake) has been used to locate the specific areas that cause pain. [42] Subsequently, the patient is placed under anesthesia and the deposits are ablated.


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