자궁내막증 증상We ask when the symptoms occur and how severe they are, and if menstrual pain occurs, when it started and how severe it is. We also check overall information, including past medical history, medications (painkillers, contraceptives, hormones, etc.), and general health. Symptoms and symptoms due to endometriosis appear in many different ways depending on the location of the lesion, the involved organs, and the extent of the lesion, so it is difficult to diagnose just by taking the patient’s history. A temperamental abnormality may be suspected.
A gynecological examination alone cannot confirm the diagnosis of endometriosis, but during examination, the uterus or
Fallopian tube area, utero-sacral ligament (located behind the uterus)
Endometriosis may be suspected if there is localized pain in the ligaments, etc., if these organs are thickened (thickening), or if nodules (small lumps) are felt accompanied by tenderness. Periodic examinations are important as examination findings may vary depending on the menstrual cycle. However, because these clinical symptoms and examination findings are very diverse, they do not provide definitive clues to the diagnosis of endometriosis.
A blood test called CA-125 can be performed when endometriosis is suspected. If the level is higher than the normal range, endometriosis may be considered. However, CA-125 levels can be increased in other gynecological diseases such as pregnancy, inflammation of the uterus, menstrual period, uterine fibroids, etc. in addition to endometriosis, so it cannot be used specifically for the diagnosis of endometriosis. Therefore, endometriosis is diagnosed based on a comprehensive evaluation of each patient’s clinical symptoms, examination findings, and other test results. This blood test is widely used as an indicator to predict recurrence after treatment in patients diagnosed with endometriosis.
Transvaginal ultrasound is a test commonly performed in obstetrics and gynecology as it is painless and can be performed easily.
It is useful in checking for lumps in the ovaries. Although it is somewhat less useful in diagnosing endometriosis, it is relatively effective in observing endometriomas (endometriosis lumps) that have formed on the ovaries.
Magnetic resonance imaging (MRI) is a test that provides more information to observe endometriomas, ovarian adhesions, extraperitoneal endometriosis, and changes in the size of endometriosis lesions. However, the cost of the test is high and it is limited in detecting small lesions, that is, early lesions.
Currently, these two imaging methods are the most commonly used, and depending on the condition of the disease, they can provide useful information for establishing a treatment plan or diagnosing recurrence. However, in the case of early endometriosis that is not in the form of a lump, imaging tests are definitely not recommended. In many cases, it cannot be diagnosed.
The diagnostic methods presented above are insufficient to be used satisfactorily as a screening test for diagnosing endometriosis. Currently, the most certain methods for diagnosing endometriosis are direct confirmation through surgery and biopsy, and diagnostic laparoscopic surgery is most commonly used.
Endometriosis lesions vary greatly in appearance, and typical lesions are characteristic enough to be diagnosed by examination alone, but atypical cases require a biopsy.
Endometriosis is classified according to the severity of the disease from stage 1 to stage 4 depending on the extent of the lesion. For example, stage 1 endometriosis is not accompanied by adhesions and may show characteristic dark chocolate-colored lesions on the uterine wall, peritoneum, or ovaries. However, in the case of stage 3 endometriosis, lumps or adhesion of pelvic organs and intestines are commonly observed, which can cause chronic pain or infertility.
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