More Chronicity

Step 1: View clinicals

A 25 year old lady presents with pelvic pain of 2 years duration, which worsens with menstruation. Her periods became heavier during the last 6 months, while she also experienced marked dyspareunia. Her medical and gynecological histories are otherwise unremarkable. She married 6 months ago, and is currently planning a pregnancy.

Step 2: Order all relevant investigations

Urine culture + ABST

No growth.

Pelvic ultrasound

Retroverted uterus of normal size. Ovaries attached to each other, behind uterus. No other abnormalities noted.


The CA-125 level is 50 IU/L (normal < 35)

Cervical swab + GC/CT NAAT

Negative for both gonorrhea and chlamydia.

Step 3: Select appropriate management

Oral Contraceptive Pills
Laparoscopic ablation

Score: ★★☆