How is endometriosis diagnosed?
First of all, the patient's complaints and personal history are taken. Here, it is definitely discussed with the patient whether there are any specific complaints regarding endometriosis. Then, ultrasonography is performed along with Gynecological Examination and examination. Tenderness, expression of pain, and limited movement of the uterus and ovaries during pelvic examination may suggest endometriosis. From time to time, during speculum examination, blue-purple nodular lesions can be seen behind the cervix. This simple finding indicates the presence of Deep Infiltrative Endometriosis in the deep tissues of the pelvis. It does. For this reason, pelvic examination with a speculum is very important in making the diagnosis.
Another helpful method is blood tests, the most frequently requested being Ca 125 and Ca 19-9. However, the sensitivity of these tests in detecting endometriosis is low and they are only requested as an additional examination.
The most informative of the auxiliary methods in diagnosis isUltrasonography. In ultrasonography, chocolate cysts in the ovary, which we call endometrioma, serious adhesions between the ovaries and the uterus, and occasionally endometriotic nodules in the intestine, rectum, bladder, and around the ureter (the tube that carries urine from the kidney to the bladder). can be seen.
Advanced imaging methods,Magnetic Resonance Imaging(MRI)are especially useful in cases where endometriosis, which we call deep endometriosis, involves deep pelvic tissues. Standard MRI is not sufficient here. This MRI must be able to take very sensitive images and special equipment must be used to increase the image quality in the relevant area during shooting. These features are available at a very limited number of imaging centers. It is also very important that the interpreting radiologist is experienced in these matters.
The definitive diagnosis of endometriosis is made by tissue biopsy with laparoscopy. During laparoscopy, endometriosis can be evaluated as mild (stage 1-2) and severe (stage 3-4).
In another classification, endometriosis is peritoneal endometriosis, ovary. It is evaluated in 3 groups: endometriosis and deep endometriosis. perito Although it is easy to detect endometriosis in the abdominal membrane and ovary during laparoscopy, deep endometriosis can be overlooked during the operation because it involves the deep pelvic tissues.
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