[Diagnosing endometriosis]

U Ulrich, J Keckstein
Zentralblatt fur Gynakologie · 2005 · doi:10.1055/s-2005-836869 · PMID:16195972
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Endometriosis diagnosis relies on pelvic exam, sonography, laparoscopy, and histology, with additional exams useful situationally, while MRI is nonessential and CA-125 is unhelpful.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

The paper reviews diagnostic approaches for endometriosis, emphasizing that clinical pelvic examination, vaginal sonography, and ultimately laparoscopy with histologic assessment serve as gold standards. It notes that additional procedures such as cysto- and rectoscopy, rectal endosonography, and intravenous pyelography may be useful depending on the individual case, while magnetic resonance imaging—despite yielding good results—is generally dispensable in routine practice. A major caveat is that CA-125 measurement is considered non-helpful for diagnosing endometriosis outside clinical studies. This paper is centrally about endometriosis — it specifically focuses on diagnostic methods and how their utility varies across routine and individual clinical scenarios.

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Abstract

Clinical pelvic exam, vaginal sonography, and, consequently, laparoscopic and histologic evaluation may be considered the gold standard for the diagnosis of endometriosis. Additional studies, such as cysto- and rectoscopy, rectal endosonography, and intravenous pyelogram may be useful in the individual situation. In the clinical routine, magnetic resonance imaging -- despite providing good results -- is inessential. The assessment of CA-125 -- outside clinical investigations -- is not helpful in making the diagnosis of endometriosis.
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Subscribe to RSS DOI: 10.1055/s-2005-836869 © Georg Thieme Verlag Stuttgart · New York Diagnostik der Endometriose Diagnosing EndometriosisPublication History Publication Date: 29 September 2005 (online) Zusammenfassung Klinische Untersuchung, Vaginalsonographie und letztlich die laparoskopische und histologische Abklärung können als Goldstandard für die Diagnostik der Endometriose gelten. Zusätzliche Untersuchungen wie Zysto- und Rektoskopie, rektale Endosonographie und intravenöses Pyelogramm sind im Einzelfall sinnvoll. Eine Magnetresonanztomographie - obwohl sie gute Resultate liefert - ist in der täglichen Routine in der Regel verzichtbar. Die Bestimmung des Tumormarkers CA-125 spielt außerhalb klinischer Studien bei der Diagnostik der Endometriose keine Rolle. Abstract Clinical pelvic exam, vaginal sonography, and, consequently, laparoscopic and histologic evaluation may be considered the gold standard for the diagnosis of endometriosis. Additional studies, such as cysto- and rectoscopy, rectal endosonography, and intravenous pyelogram may be useful in the individual situation. In the clinical routine, magnetic resonance imaging - despite providing good results - is inessential. The assessment of CA-125 - outside clinical investigations - is not helpful in making the diagnosis of endometriosis. Schlüsselwörter Endometriose - Laparoskopie - Sonographie Key words endometriosis - laparoscopy - sonography Literatur - 1 Abbott J, Hawe J, Hunter D, Halmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril. 2004; 82 878-884 - 2 Abrao M S, Neme R M, Averbach M, Petta C A, Aldrighi J M. Rectal ultrasound with a radial probe in the assessment of rectovaginal endometriosis. J Am Assoc Gynecol Laparosc. 2004; 11 50-54 - 3 Albrecht H. Die Endometriose. In: Seitz L, Amreich AI (Hrsg). Biologie und Pathologie des Weibes, Bd. IV. Urban & Schwarzenberg, Berlin, Innsbruck, München, Wien 1955; 190-288 - 4 American Society for Reproductive Medicine . Revised American Society for Reproductive Medicine classification of endometriosis. Fertil Steril. 1997; 67 817-822 - 5 Athey P A, Diment D D. The spectrum of sonographic findings in endometriomas. J Ultrasound Med. 1989; 8 487-491 - 6 Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, Buy J N. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004; 232 379-389 - 7 Chapron C, Dumontier I, Dousset B, Fritel X, Tardif D, Roseau G, Chaussade S, Couturier D, Dubuisson J B. Results of rectal endoscopic ultrasonography for patients with deep pelvic endometriosis. Hum Reprod. 1998; 13 2266-2270 - 8 Garry R. The effectiveness of laparoscopic excision of endometriosis. Curr Opin Obstet Gynecol. 2004; 16 299-303 - 9 Giudice L C, Kao L C. Endometriosis. Lancet. 2004; 364 1789-1799 - 10 Keckstein J, Ulrich U, Kandolf O, Wiesinger H, Wustlich M. Die laparoskopische Therapie der Darmendometriose und der Stellenwert der medikamentösen Therapie. Zentralbl Gynäkol. 2003; 125 259-266 - 11 Keckstein J, Ulrich U. Endokrine und operative Therapie der Adenomyose. Gynäkol Endokrinol. 2004; 2 11-18 - 12 Kupfer M, Schwimmer S, Lebonic J. Transvaginal sonographic appearance of endometrioma: Spectrum of findings. J Ultrasound Med. 1992; 11 129-133 - 13 Neis K. Leitlinie zur laparoskopischen Operation von Ovarialtumoren. http://www.dggg.de 2004 - 14 Ozaki T, Takahashi K, Okada M. Live birth after conservative surgery for severe adenomyosis following magnetic resonance imaging and gonadotropin-releasing hormone agonist therapy. Int J Fertil Womens Med. 1999; 44 260-264 - 15 Reinhold C, Tafazoli F, Mehio A, Wang L, Atri M, Siegelman E S, Rohoman L. Uterine adenomyosis: endovaginal US and MR features with histopathologic correlation. Radiographics. 1999; 19 S147-S160 - 16 Schollmeyer T, Pandit K, Schmutzler A, Mettler L. Correlation of endoscopic interpretation of endometriosis with histological verification. Clin Exp Obstet Gynecol. 2004; 32 107-109 - 17 Schweppe K -W. Endometriose - Eine Erkrankung ohne Lobby. Zentralbl Gynäkol. 2003; 125 233 - 18 Schweppe K -W. Endometriose: Aktueller Stand von Diagnose und Therapie. Frauenarzt. 2005; 46 373-381 - 19 Shaw R W. An Atlas of Endometriosis. Parthenon Publishing Group, Carnforth, Pearl River 1993 - 20 Sillem M, Teichmann A T. Patientinnenzentrierte Aspekte der Endometriose. Gynäkologe. 2003; 36 41-52 - 21 Ulrich U, Paulus W, Schneider A, Keckstein J. Laparoscopic surgery for complex ovarian masses. J Am Assoc Gynecol Laparosc. 2000; 7 373-380 - 22 Ulrich U, Possover M. Endometriose: Standards für problematische Krankheitsbilder. Frauenarzt. 2003; 44 857-859 - 23 Walter A J, Hentz J G, Magtibay P M, Cornella J L, Magrina J F. Endometriosis: correlation between histologic and visual findings at laparoscopy. Am J Obstet Gynecol. 2001; 184 1407-1411 - 24 Wykes C B, Clark J, Khan K S. Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic review. Br J Obstet Gynaecol. 2004; 111 1204-1212 Prof. Dr. U. Ulrich Klinik für Gynäkologie und Geburtshilfe · Kaiserswerther Diakonie · Florence-Nightingale-Krankenhaus Kreuzbergstr. 79 40489 Düsseldorf Email: [email protected]

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endometriosis

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Endometriosis Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Physical Examination

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