Diagnostic value of ultrasound

I was diagnosed with endometriosis 2003after lap and dye for investigations into infertility .HAd ovarian cyst and laser treatment performed in october 2003.Ihave never had any symptoms of the disease until march 2005 when i started getting increasing right sided abdominal pain especially at ovulation >Recently admitted with severe abdo pain and discharged with diagnosis of exacerbation of endometriosis after ultrasound .THE scan showed a solid mass in right adrexal area >My question is how can they diagnose a solid mass as endometriosis without biopsy?

Dear Kerry-
Thank you for your posting.
The disease Endometriosis cannot be diagnosed via ultrasound.These are microscopic and small implants throughout the pelvis which will not show up on radiologic testing.
Having said that, patients can develop a solid mass of endometrial tissue and blood..known as an endometrioma. This will appear on ultrasound and based on composition, and previous history, physicians will often render a diagnosis of endometriosis. Confirmation of that diagnosis can only be determined with a biopsy. Based on your email, and previous history..you may have an endometrioma.
Hope this has answered your question.

Dr. del Junco, i am writing you this message because three years ago my right ovary and its tube was removed due to an endometrioma. I just went to my obgyn today, he did an ultrasound and it turns out i have the same problem in my left ovary. I am interested in getting a second opinion because my doctor says that the only way to treat this problem is to undergo surgery, he said that most likely he was going to remove my left ovary as well, or part of it but he didnt give me much hope. Any suggestions?

Dear Nuryel-
Endometriomas need to be removed…they should not go untreated. Removing the cyst without removing the ovary is often dependent not only on the surgeon’s skill, but on the size of the cyst and how much it has encompassed the ovary. Even if a portion of the ovary can be saved..it can assist with hormone production. We would recommend that you do not completely remove the ovary. This is one of the reasons we use a laser…to minimize damage to surrounding healthy ovarian tissue, and then reconstruct the organ.