Diagnostic evaluation

The most common symptoms associated with endometriosis are dysmenorrhea, chronic pelvic pain, and deep dyspareunia. Other symptoms include infertility and bowel or bladder symptoms. The three different presentations of endometriosis are superficial peritoneal lesions, ovarian endometriomas, and deep infiltrating lesions. A good clinical history can often help in making the presumptive diagnosis of endometriosis. The role of ultrasonography and MRI is imperative in identifying the possible endometriotic implants before proceeding to laparoscopy. They also help in differentiating ovarian endometriomas from hemorrhagic cysts or dermoid cysts. The role of CA-125 and other biomarkers are still being investigated.