What is the most conclusive way to diagnose endometriosis in a patient with relevant symptoms?

Laparoscopy with biopsy is recognized as the most conclusive method for diagnosing endometriosis. This surgical procedure allows direct visualization of the pelvic organs and the potential presence of endometrial-like tissue outside the uterus. During laparoscopy, the physician can identify lesions, adhesions, and endometriomas, which are characteristic findings associated with endometriosis.

Furthermore, a biopsy can be performed during the procedure to obtain tissue samples, which can then be examined histologically to confirm the diagnosis. This combination of visual confirmation and histological analysis makes laparoscopy the gold standard in diagnosing endometriosis.

In contrast, while pelvic ultrasound can be helpful in identifying ovarian endometriomas and assessing the pelvic anatomy, it does not provide a definitive diagnosis of endometriosis. CT scans are generally not useful for diagnosing endometriosis, as they may not clearly show the lesions or associated pelvic structures, and they are not typically utilized for this purpose. Blood tests, including markers like CA-125, may be elevated in patients with endometriosis but are not specific enough to confirm the diagnosis on their own. Thus, laparoscopy with biopsy stands out as the most reliable method for definitive diagnosis of endometriosis.