The (Ideal) Path to Diagnosis
Reflections on the diagnostic journey
...and everything leads to laparoscopy
Current State (2026): Modern ultrasound techniques have improved significantly in recent years for detecting certain forms of endometriosis - such as ovarian endometriomas ("chocolate cysts") and deep infiltrating endometriosis - not least due to improved image resolution. However, the only definitive method for clinical diagnosis of all types of endometriosis remains expert laparoscopy. This minimally invasive surgical procedure allows direct visualization and, if necessary, removal of lesions, making it the gold standard for accurate diagnosis.
As you can see from the flowchart above, endo belongs in expert hands and can only achieve a quick diagnosis there, preventing unnecessary further suffering. More about endo categories and the ENZIAN score can be found on the What is Endo? page.
What is Endometriosis?
Understand categories and ENZIAN score
Appeal to Research: Enable Faster Diagnosis for Endometriosis
Endometriosis affects millions of people worldwide - yet it often takes years, sometimes even decades, to receive a diagnosis. I created this flowchart to visualize this complex diagnostic journey and would like to share some thoughts.
Key Insights:
- Clinical expertise remains crucial – especially in interpreting imaging, recognizing atypical presentations, and listening: The individual patient experience is central.
- One of the most challenging steps often lies at the very beginning: "Suspicious symptoms". This is where the challenge begins, as endometriosis often presents in different, often non-specific ways:
- Chronic pelvic pain (not necessarily cycle-dependent)
- Infertility or cycle-dependent pain in chest or shoulder
- Gastrointestinal complaints mistaken for irritable bowel syndrome
- Fatigue and elevated inflammation markers without clear cause
Here Lies Hope
Research and AI-powered tools are opening new perspectives:
- Non-invasive biomarkers for early detection (e.g., Diamens from Linz)
- AI-assisted imaging to make even subtle lesions visible (e.g., Scanvio Medical from Zurich)
Imagine a future where a simple biomarker test raises early alarms, or AI provides imaging insights that might escape even experienced specialists. These developments are not science fiction - they are happening NOW and could help finally break through the long diagnostic delay.
I share this flowchart not only as a visualization but also as an invitation to ponder: How can we best unite clinical experience and new technologies to optimize endo diagnosis?
More about current developments in endometriosis research can be found in the Blog or you can browse directly through the Studies.