Diagnosis of endometriosis today conducted carefully, as a very important time to identify all foci of the disease, which may be located in different tissues and organs. Only after the establishment of the final diagnosis the doctor decides how to treat this disease.
Basic principles of diagnosis of endometriosis
The diagnosis of endometriosis gynecologist may suspect after detailed questioning (anamnesis) examination and woman. But this is not always possible, and sometimes endometriosis, as well as many other gynecological diseases are asymptomatic. Therefore, preventive examinations of women always spend ultrasonography (US) of the pelvic organs, including vaginal probe. Sometimes one of the study sufficiently to reveal endometriosis in the body of the uterus and the ovaries.
In addition, it conducted radiological, endoscopic and laboratory tests that help identify endometriosis.
Ultrasound with vaginal probe reveals the structural changes in the mucous membranes and muscle of the uterus. Such studies are the best reason in the second half of the menstrual cycle (25 Day), when all the violations are more pronounced.
On US clearly visible increase in uterine size, density of different parts of the body tissue of endometriosis uterus (endometriosis development areas in its muscular layer), the clarity of the contours, the presence or absence of capsules and identified education (when the capsule have uterine fibroids and endometriosis is absent).
It is the first ultrasound examination, which allows the doctor to make a plan for further diagnostic studies.
Informative method is hysterosalpingography
Hysterosalpingography - effective examination of the uterus
- X-ray examination of the uterus with appendages using a contrast agent for assessing the extent of endometriosis in the wall of the uterus and the fallopian tubes, as well as to assess the degree of tubal patency.
Sometimes, to clarify the extent of endometriosis held computer and magnetic resonance imaging (CT and MRI). Especially informative MRI technique that allows you to identify and diffuse and nodular endometriosis, uterine body.
By endoscopic methods of investigation include hysteroscopy - adherence to the internal state of the wall of the uterus using a special optical device - hysteroscope. This method can detect diffuse forms of endometriosis, uterine body. Furthermore, during research can well see the mouth of the fallopian tubes. Hysteroscopy allows you not only to identify certain changes in the uterine wall, and classify them according to the stage of proliferation process. This allows the physician to determine the future strategy of diagnosis and treatment.
But this method is not perfect: no signs of endometriosis
Symptoms of endometriosis - can be very different
does not rule out the presence of lesions in the deeper layers of the myometrium (muscular layer of the uterus).
Laparoscopy - the most informative method of research in endometriosis
Laparoscopy refers to endoscopic methods of investigation. But unlike hysteroscopy
Hysteroscopy - examination of the uterus inside
This study is being conducted in violation of the integrity of the skin. For laparoscopy on the anterior surface of the abdominal wall make a few small holes, through which under the control of the doctor (everything that happens can be seen on the monitor) are special tools to examine the state of the body and, if necessary, to take biopsies for histological examination.
That is the main diagnostic laparoscopy study of endometriosis, if the patient will have surgery. Moreover, operations with endometriosis also conducted using a laparoscope - it minimizes trauma to the tissues and the development of adhesions.
When taking biopsy during diagnostic hysteroscopy or laparoscopy tissue to be investigated in the histology laboratory. Under the microscope, examined thin slices of tissue and identify them typical of endometriosis changes. Furthermore, histological studies confirm or rule out malignancy.
Work is also a blood test for Ca - 125 - carbohydrate (carbohydrate) antigen 125, which is the main marker of ovarian cancer and its metastases. In addition, this figure increased and endometriosis
Endometriosis - a serious problem with serious consequences
But not so much as in cancer, - up to 35 IU / ml. The analysis allows to establish the severity of the disease and to assess the effectiveness of the treatment.