Suicidal thoughts and behaviours in Cape Town: A cross-sectional study of prevalence and social, contextual, and clinical correlates.

Endometriosis is a chronic inflammatory gynecological disease characterized by endometrial-like tissue located outside the uterus []. The condition affects approximately 10% of women, primarily of reproductive age, and leads to a sustained reduction in their quality of life [, ]. Endometriosis is usually located within the abdominal cavity and can be classified into three different forms: peritoneal, ovarian, and deeply infiltrating endometriosis []. Accurate preoperative diagnosis of endometriosis continues to be challenging, due to the heterogeneous presentation of the disease and the variable depth and localization of the lesions [, ]. Traditionally, laparoscopy with histological confirmation has been considered the gold standard for diagnosing the condition []. However, in recent years, noninvasive diagnostic approaches have become increasingly important. Symptomatic improvement during empirical treatment with oral contraceptives, when considered alongside imaging findings, may also further support a presumptive diagnosis of endometriosis []. A combination of clinical examination and imaging techniques is commonly used to improve diagnostic accuracy and facilitate preoperative surgical planning []. Digital rectal examination (DRE) may provide important information about posterior compartment involvement, particularly in patients with deeply infiltrating endometriosis []. Among imaging modalities, transvaginal ultrasonography (TVUS) is widely used as a first-line diagnostic tool due to its wide availability and high level of diagnostic accuracy for ovarian endometriomas and deeply infiltrating lesions []. Magnetic resonance imaging (MRI) may be used as an additional diagnostic modality, particularly when extensive disease is suspected or when detailed preoperative mapping of pelvic structures is required [].