There is much talk circulating about a recent development of a non-surgical diagnostic test for endometriosis. Currently, the only definitively way to diagnosis endometriosis is to perform a laparoscopy, a surgery performed by keyhole incisions which allow the surgeon to insert various instrument into the pelvis and abdomen while the patient is under general anaesthesia. While considered invasive but still simple to most gynaecologist’s who perform these operations, this operation requires the patient to undergo an awful pre-surgical prep process, to fast before surgery, undergo the risks associated with anaesthetic and the risks associated with the carbon dioxide that is pumped into their system to inflate their abdomen. There is also the additional risk of having the surgical instruments inside their pelvic and abdominal cavities. Waivers for this procedure sound familiar to most other surgeries (loss of life, etc.), but include a clause such as puncture to an organ from an instrument.
So, with millions of women suffering from the pains of endometriosis and eventually undergoing a laparoscopy for diagnosis, one would like a non-surgical way to skip the O.R. completely, right? For years doctors have struggled to give “probable diagnoses” with techniques such as the MRI and ultrasound, but we know these things are inadequate as they are not a definitive diagnoses. They do not allow endometrisios patients access to specific endometriosis meds with some of their insurance providers, and most importantly, peace of mind knowing what is it they’ve been struggling with for X amount of years.
Now it appears that researchers in Belguim, Jordan and Australia were thinking along the same lines. They set out to find a simple way to identify women with endometriosis without having to perform a laparascopy. The women who have endometriosis can then be operated on and their endometriosis removed. For women without endometriosis, this means not getting adhesions from a needless surgery.
But, how does this simple non-surgical test work?
Now researchers at the University of Sydney and Mu’tah University in Karak, Jordan, have discovered that if they take a small sample of the endometrium (the lining of the uterus), which can be done by inserting the device for taking the biopsy via the vagina, and then test for the presence of nerve fibres in the sample, they can diagnose whether or not endometriosis is present with nearly 100% accuracy.
They enter via the vagina, as if doing a simple pap smear, take the biopsy and in a few days the results come in. According to Dr. Al-Jefout, one of the researchers, the results look very promising.
Dr Al-Jefout said: “This study has shown that testing for nerve fibres in endometrial biopsies is a valid and highly accurate diagnostic test for endometriosis. This test is probably as accurate as assessment via laparoscopy, the current gold standard, especially as it is unclear how often endometriosis is overlooked, even by experienced gynaecologists. Endometrial biopsy is clearly less invasive than laparoscopy, and this test could help to reduce the current lengthy delay in diagnosis of the condition, as well as allowing more effective planning for formal surgical or long-term medical management. It may be particularly helpful in cases of infertility.”
“It needs to be emphasised that this test requires a carefully collected endometrial biopsy and an experienced immunohistochemical pathology laboratory to confirm or exclude the presence of nerve fibres.”He continued: “Our results indicate that a negative endometrial biopsy result would miss endometriosis in only one percent of women. Performing a planned laparoscopy only on a woman with a positive endometrial biopsy result would result in endometriosis being confirmed in eighty to ninety percent of these women. Thus, using this diagnostic test in an infertility workup would significantly reduce the number of laparoscopies performed without reducing the number of women whose endometriosis is diagnosed and surgically treated.”
Currently, researchers are planning on doing a double-blind study in September 2009 (finally, researchers who know how to do researchers – I applaud you Dr Bokor and the team of Prof D’Hooghe). They will be performing this study to confirm their results. If these results are confirmed, this could mean a simpler and easier way to diagnose women with endometriosis and get them proper treatment.
You can read the full article here : At lat – a quick an accurate way of diagnosing endometriosis