Quick, Safe, Accurate Endometriosis Diagnosis
Reported August 21, 2009
(Ivanhoe Newswire) Finally, there is a quick, accurate test for endometriosis that does not require hospitalization and surgery.
Researchers at the University of Sydney, Australia, and Mu’tah University in Karak, Jordan, have discovered they can take a small sample of the endometrium (the lining of the uterus) by inserting a device through the vagina to take a biopsy, which is then tested for the presence of nerve fibers. The test has identified the presence of endometriosis with nearly 100 percent accuracy.
Endometriosis, which affects and estimated 10 to 15 percent of women of reproductive age, is a chronic disease in which cells from the endometrium establish themselves outside the uterus in a woman’s pelvic area. Symptoms include infertility, painful periods, pelvic pain and pain during sexual intercourse.
Previously, the only way to accurately diagnose endometriosis was with laparoscopy an invasive exploratory surgical procedure requiring hospitalization and anesthetics.
In contrast, taking an endometrial biopsy is relatively quick and easy, and results are available within about three days.
In the study led by Professor Ian S. Fraser, head of the Queen Elizabeth II Research Institute for Mothers and Infants at the University of Sydney and Dr Moamar Al-Jefout, assistant professor in reproductive medicine at Mu’tah University, researchers took endometrial biopsies from 99 women who had consulted doctors about pelvic pain, infertility or both and who were undergoing laparoscopy for the condition. The results from the endometrial biopsies were compared with the results of the laparoscopies. Researchers found that in 64 women who had endometriosis confirmed by laparoscopy, all but one tested positive for the presence of nerve fibers in the endometrial biopsy. In the 35 women who were found by laparoscopy not to have endometriosis, no nerve fibers were found in 29 of the endometrial biopsies.
“This study has shown that testing for nerve fibers in endometrial biopsies is a valid and highly accurate diagnostic test for endometriosis, Dr Al-Jefout was quoted as saying. This test is probably as accurate as assessment via laparoscopy, the current gold standard . . . . 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.”
However, Dr Al-Jefout said, “It needs to be emphasized that this test requires a carefully collected endometrial biopsy and an experienced immunohistochemical pathology laboratory to confirm or exclude the presence of nerve fibers.”
Dr Al-Jefout said the procedure could be particularly useful in teenagers with spasmodic symptoms and a family history of endometriosis. “The usual diagnostic delay in this special group is greater than in older women. An endometrial biopsy to confirm or exclude the diagnosis of endometriosis will help initiating earlier treatment and possibly preventing the progress of endometriosis, thus improving life style and protecting their future fertility.”
SOURCE: Human Reproduction, August 19, 2009