Endometriosis can be diagnosed and a variety of different ways all the surgery is really the most definitive an absolute way to secure the diagnosis. Your doctor might be able to diagnose you with it just by listening to your signs and symptoms like pain with your periods and other times of the month pain, with sex or maybe even some infertility problems. Other times we rely on surgical diagnoses where we actually are inside the abdomen looking either with the camera or with her eyes to be able to tell the endometriosis is there. Unfortunately you can't really diagnose. Is there unfortunately you can't really diagnose endometriosis by looking at an ultrasound for a CAT scan or an MRI or other types of imaging so we have to really listen to our patients and understand if they have symptoms that are suspicious and if needed surgery certainly can make the diagnosis 100 percent.