Novel diagnostic strategies for endometriosis

Diagnosing endometriosis has been a challenging and controversial concept for years. When considering a patient with pelvic pain, endometriosis may be suspected based on the clinical history and physical examination. While a presumptive clinical diagnosis can be provided, more accurate and tangible diagnostic tests may be sought by patients and clinicians. Historically, surgery was thought to be the only way to accurately diagnose endometriosis. While surgery remains a useful and accurate tool, there are many disadvantages including but not limited to risk, cost, and accessibility. Novel diagnostic strategies in the noninvasive category have been researched and implemented into clinical practice, while others remain experimental. In this chapter, we discuss the current gold standard surgical diagnosis as well as the novel strategies including imaging (ultrasound and magnetic resonance imaging) and biomarkers, a body specimen that can be tested in a laboratory for signs of endometriosis. Ultimately, we envision that a combination of noninvasive diagnostic tools, in addition to clinical history and physical examination, will achieve a diagnostic accuracy similar to or better than surgery.