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The definitive diagnosis of endometriosis (chocolate cyst) is made by surgically removing the lesions formed by the presence of endometrial tissue (belonging to the inner lining of the uterus) outside the uterus, followed by microscopic (pathological) examination.
During the preliminary diagnostic phase, the patient's detailed history and presented symptoms are of great importance. Symptoms such as severe, newly occurring menstrual pain (dysmenorrhea), chronic pelvic pain, pain during sexual intercourse (dyspareunia), infertility, pain during defecation (dyschezia), bloody urine (hematuria), or bloody stools (hematochezia) are indicative for the diagnosis of endometriosis.
During physical examination, vaginal endometriosis nodules can be detected, and chocolate cysts (endometriomas) may be palpable. Gynecological ultrasonography is particularly valuable in identifying endometriomas and nodules in areas such as the rectosigmoid. A clinical preliminary diagnosis can be made in approximately 70% of severe endometriosis cases through gynecological examination.
In some cases, additional diagnostic tests may be required. In patients with bloody urine, endometriosis foci in the urinary tract can be visualized with cystoureteroscopy, while in patients experiencing bloody stools, endometriosis nodules in the intestines can be seen with colonoscopy. Magnetic Resonance Imaging (MRI) plays an important role in the diagnosis of deep infiltrative endometriosis and surgical planning.
How is Endometriosis (Chocolate Cyst) Diagnosed?
During the preliminary diagnostic phase, the patient's detailed history and presented symptoms are of great importance. Symptoms such as severe, newly occurring menstrual pain (dysmenorrhea), chronic pelvic pain, pain during sexual intercourse (dyspareunia), infertility, pain during defecation (dyschezia), bloody urine (hematuria), or bloody stools (hematochezia) are indicative for the diagnosis of endometriosis.
During physical examination, vaginal endometriosis nodules can be detected, and chocolate cysts (endometriomas) may be palpable. Gynecological ultrasonography is particularly valuable in identifying endometriomas and nodules in areas such as the rectosigmoid. A clinical preliminary diagnosis can be made in approximately 70% of severe endometriosis cases through gynecological examination.
In some cases, additional diagnostic tests may be required. In patients with bloody urine, endometriosis foci in the urinary tract can be visualized with cystoureteroscopy, while in patients experiencing bloody stools, endometriosis nodules in the intestines can be seen with colonoscopy. Magnetic Resonance Imaging (MRI) plays an important role in the diagnosis of deep infiltrative endometriosis and surgical planning.