Diagnosing Endometriosis at Virginia Mason - Seattle

Your doctor has a number of excellent tests and procedures to choose from to help diagnose this disease. First, he or she will take your complete medical history, during which you will be asked questions about your general health and about any symptoms you may be having.

Your doctor also will perform a physical exam and a pelvic exam to determine if a mass or tumor is causing any of your symptoms.

Next, your doctor may have you undergo several diagnostic tests to view your internal organs and tissues. These include a pelvic or vaginal ultrasound and, less commonly, computed tomography (CT) scan or magnetic resonance imaging (MRI). Each of these procedures is described below.

• Pelvic Ultrasound
  A pelvic ultrasound is a painless procedure in which, after first applying a clear gel on your stomach, an instrument called a transducer or wand is moved over it. The transducer transmits sound waves to a computer monitor, which allows images of your internal organs to be viewed on the screen.
• Vaginal Ultrasound
  A vaginal ultrasound procedure, a transducer is inserted into the vagina, which also sends sound waves to a computer screen and allows a technician and your physician to view images of your uterus and ovaries.
• Computed Tomography (CT)
  A CT scan uses x-rays and computer imaging to show three-dimensional images of your internal organs. During the CT scan, you will lie on a table that moves into a cylindrical scanner. The scanner takes pictures from several angles and these images are transmitted to a computer.
• Magnetic Resonance Imaging (MRI)
  A MRI procedure uses electromagnetic waves (instead of radiation) and computer imaging to show three-dimensional images of your organs, tissues and nerves. As with a CT scanner, you will lie on a table that moves into a chamber. The chamber contains a large magnet and a transmitter for radio waves. The magnetic field and radio waves produce signals that are picked up by the machine and sent to a computer, which records the signals as images.

Laparoscopy

If these tests suggest or show that excess tissue is present in your pelvic cavity, your doctor will have you undergo laparoscopy to view the area closely and to take a biopsy (sample) of the tissue.

During the laparoscopy procedure, a small incision is first made in your abdomen. The laparoscope, which is a thin tube with a light and a video camera in it, is inserted through the incision and into your pelvic cavity. The surgeon then moves the laparoscope around and views images of your internal organs on a screen.

Your surgeon also can take a tissue sample with another instrument inserted through the laparoscope. (Larger patches of endometrial tissue may be removed during this procedure and may require one or two additional incisions, and the insertion of several more instruments.)

Diagnostic laparoscopy is performed as an outpatient procedure. Recovery time is quick, about one or two days with only minor discomfort.