Meta-analysis and systematic review to determine the optimal imaging modality for the detection of bladder deep endometriosis

Gerges, B.; Li, Wentao; Leonardi, Mathew; Mol, Ben W.; Condous, G.

doi:10.1016/j.ejogrb.2021.04.030

Cited by 17 publications

(17 citation statements)

References 63 publications

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“…Similar to other classifications, the Enzian classification is based on the intraoperative assessment of endometriotic lesions utilizing radical resection to determine accurately the extent of DE. However, there is an increasing need for a classification system that may also be applied to non-invasive imaging techniques, such as sonography and magnetic resonance imaging, which have been shown to diagnose accurately DE lesions [9][10][11][12] . This need, as well as the addition of peritoneal and ovarian endometriosis and associated adhesions, led to the development of the updated #Enzian classification 13 , which is designed for use at non-invasive imaging evaluation as well as during surgical assessment.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of sonography for non‐invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study

Montanari

Bokor

Szabó

et al. 2022

Ultrasound in Obstet & Gyne

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The localization and severity of endometriotic lesions and adhesions, as described using the #Enzian classification for endometriosis, can be diagnosed accurately on preoperative ultrasound. What are the clinical implications of this work?The recently updated #Enzian classification can be applied accurately both at preoperative ultrasound examination and during surgical resection of endometriosis, thereby enabling the use of uniform terminology for describing endometriosis.

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Section: Introductionmentioning

confidence: 99%

Accuracy of sonography for non‐invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study

Montanari

Bokor

Szabó

et al. 2022

Ultrasound in Obstet & Gyne

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“…Today, ovarian endometriomas and DE can be detected by ultrasound or magnetic resonance imaging (MRI), ( Guerriero et al, 2015a ; Guerriero, et al, 2015b ; Guerriero, et al, 2016 ; Gerges et al, 2021 ). Adhesions can also be suspected on transvaginal ultrasound (TVS) ( Gerges et al, 2017 ; Holland et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

What to choose and why to use – a critical review on the clinical relevance of rASRM, EFI and Enzian classifications of endometriosis

Hudelist¹,

Valentin²,

Sarıdoğan³

et al. 2021

Facts Views Vis ObGyn

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Background: Endometriosis is a common benign gynaecological disease that affects pelvic structures and causes adhesions. Endometriosis outside the pelvis exists but is rarer. Deep endometriosis may affect organs such as the urinary bladder, ureters, bowel and sacral roots. Adenomyosis (growth of endometrium in the myometrium, sometimes explained by disruption of the uterine junctional zone) frequently co-exists with deep endometriosis. Over the past decades, multiple attempts have been made to describe the anatomical extent of endometriosis. Out of approximately 20 classification systems suggested and published so far, three have gained widespread acceptance. These are the rASRM (American Society of Reproductive Medicine) classification, the Endometriosis Fertility Index (EFI) and the Enzian classification. Ideally, a classification system should be useful both for describing disease extent based on surgical findings and results of imaging methods (ultrasound, magnetic resonance imaging). Objectives: To highlight the advantages and disadvantages of the three classification systems. Methods: This is a narrative review based on selected publications and experience of the authors. We discuss the current literature on the use of the rASRM, EFI and Enzian classification systems for describing disease extent with imaging methods and for prediction of fertility, surgical complexity, and risk of surgical complications. We underline the need for one universally acceptable terminology to describe the extent of endometriosis. Conclusions: A useful classification system for endometriosis should describe the sites and extent of the disease, be related to surgical complexity and to disease-associated symptoms, including subfertility and should satisfy needs of both, imaging specialists for pre-operative classification and surgeons. The need for such a system is obvious and is provided by the #Enzian classification. Future research is necessary to test its validity.

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“…The anatomical location of deep endometriosis is a key variable when considering its diagnostic accuracy. A series of three meta-analyses demonstrate this ( Gerges et al 2021 a , b , c ). Rectosigmoid disease has the highest sensitivity, followed by uterosacral ligament, vaginal, rectovaginal septum and then bladder deep endometriosis.…”

Section: Argument 4: Diagnostic Laparoscopy Remains the Best Methods ...mentioning

confidence: 95%

‘Seeing is believing’: arguing for diagnostic laparoscopy as a diagnostic test for endometriosis

Mak

Leonardi

Condous

2022

Reproduction and Fertility

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Diagnostic laparoscopy has traditionally been described as the gold standard for diagnosing endometriosis. However, advances in imaging and an increasingly risk-averse population has led many to question if diagnostic laparoscopy is now antiquated. In this paper, we will examine the risks and benefits of performing a diagnostic laparoscopy. We will argue that diagnostic laparoscopy is safe and both positive and negative laparoscopy are vitally important to the individual. Imaging and other non-surgical workup also has a vital role, but should complement rather than replace diagnostic laparoscopy. The available evidence supports this assertion. Diagnostic laparoscopy will not be antiquated any time in the near future.

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Meta-analysis and systematic review to determine the optimal imaging modality for the detection of bladder deep endometriosis

Cited by 17 publications

References 63 publications

Accuracy of sonography for non‐invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study

Accuracy of sonography for non‐invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study

What to choose and why to use – a critical review on the clinical relevance of rASRM, EFI and Enzian classifications of endometriosis

‘Seeing is believing’: arguing for diagnostic laparoscopy as a diagnostic test for endometriosis

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