A 27-year-old woman referred to a gynecology office for evaluation, reporting dyspareunia for about 8 months, along with dyschezia and occasional rectorrhagia coinciding with menstruation for 3-4 months. She also reports dysmenorrhea for years, which she controls well with ibuprofen. She has been trying to get pregnant for 16 months without success. In the gynecological examination she only shows pain when pressing on the posterior vaginal fornix. Which test do you consider would allow you to reach a diagnosis of certainty of her pathology?
The clinical case presented is a woman of childbearing age (27 years) presenting dyspareunia + dysmenorrhea + infertility, which should lead us to think of endometriosis. The clinical history and ultrasound give a diagnosis of suspicion, but the diagnosis of certainty is given by direct observation (with or without associated biopsy) of ectopic endometrial tissue implants, either by laparotomy or laparoscopy.
Transvaginal ultrasound.
Diagnostic laparoscopy.
Magnetic resonance imaging.
Colonoscopy.
The clinical history and ultrasound give a diagnosis of suspicion, but the diagnosis of certainty is given by direct observation (with or without associated biopsy) of ectopic endometrial tissue implants, either by laparotomy or laparoscopy.