[Paraclinical studies of endometriosis]

Investigations are performed in women with external endometriosis to confirm the diagnosis and to evaluate extension of the disease before treatment. Elevated serum CA 125 level is correlated with the severity of the disease. CA 125 may be a helpful to assess the efficacy of the treatment or to detect recurrences. Imaging diagnosis of endometriosis have a good sensitivity to detect cysts and nodes forms of the disease. Magnetic resonance imaging is more sensitive than ultrasonography to detect small nodular lesion and is able to made the diagnosis of deeply infiltrating endometriosis (sometimes not visualised by laparoscopy). Rectal endosonography, barium enema or excretion urography can be usefull if an involvement of the rectosigmoid or the bladder is suspected. Hysterosalpingography is an integral part of the initial fertility survey, but shows only indirect signs of endometriosis. Laparoscopy is the definitive diagnosis procedure for endometriosis, and permit to classify the lesions and to draw-up a therapeutic strategy.