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Conclusions
 Always perform history + vaginal exam + vaginal US
 Consider MRI if deep endo (+ indication for surgery)
 There is no place for standard diagnostic laparoscopy if suspected endometriosis, on indication only
 We should increase awareness to avoid diagnostic delay
 In literature we should state: endometriosis was confirmed by ultrasound, MRI or diagnostic laparoscopy
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Al-Taher M et al. Intraoperative enhanced imaging for detection of endometriosis: A
systematic review of the literature. Eur J Obstet Gynecol Reprod Biol. 2018 May;224:108-116 Vercellini P et al. Reducing low-value care in endometriosis between limited evidence and
unresolved issues: a proposal. Hum Reprod 2015, 30 (9), 1996-2004
Menakaya U et al. Diagnostic laparoscopy in presurgical planning for higher stage endometriosis: is it still relevant? ANZJOG 2016, 56: 518-522
Bazot M, Darai E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, MRI, and other techniques. Fertil Steril 2017, 108, 6: 886-894
Graziano A et al. Diagnostic findings in adenomyosis: a pictorial review on the major concerns. Eur Rev Med Pharmacol Sci 2015, 19: 1146-1154
Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019 Mar 25:1-7
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