Right endometrioma is related with more extensive obliteration of the Douglas pouch

Abstract

Moreover, we also showed that in women with a right endometrioma, incidence of the pouch of Douglas obliteration is higher and the endometriosis tends to be more severe compared to women with a left endometrioma. Our most relevant observation is obliteration of Douglas pouch which was found to be more extensive in women with right ovarian endometrioma. Our results showing left lateral predisposition of endometriomas are in agreement with the previous reports and highlight the retrograde menstruation theory for the pathogenesis of this enigmatic disorder.

Sonographic evaluation of immobility of normal and endometriotic ovary in detection of deep endometriosis

“…In the absence of specialized ultrasound for prediction of obliteration of the pouch of Douglas (POD), TVS markers for endometriosis, such as ovarian fixation and ovarian endometrioma, may be useful in determining the risk of POD obliteration preoperatively. Ulukus et al . published a study including 340 women with benign ovarian cysts to determine whether laterality of endometriomas was related to severity of endometriosis, and found that women with right‐sided endometrioma had a significantly higher rate of POD obliteration than had women with left‐sided endometrioma (21% vs 6%).…”

Can we improve the prediction of pouch of Douglas obliteration in women with suspected endometriosis using ultrasound‐based models? A multicenter prospective observational study

“…Previous studies have demonstrated that endometriomata are significantly associated with both posterior compartment DIE and POD obliteration . In the study by Kondo et al ( n = 201), ovarian endometrioma was significantly associated with the presence of posterior compartment DIE (98.2%; p = 0.01) and intestinal DIE (57.1%, p = 0.01).…”

“…posterior compartment DIE nodule, right ovarian fixation, and negative TVS “sliding sign”) were selected, as these were the most significantly associated univariate preoperative features for POD obliteration prediction as determined by logistic regression analysis. The POD2 model differed from POD1 model in combining unilateral ovarian fixation and unilateral ovarian endometrioma with the negative “sliding sign.” These two ovarian features were chosen based on previously published research indicating that ovarian fixation is significantly associated with the presence of endometriosis , as is the presence of ovarian endometrioma with posterior compartment DIE and POD obliteration . Unilateral/bilateral ovarian fixation and ovarian endometrioma were also significantly associated with POD obliteration in the logistic regression analysis.…”

“…Ulukus et al found a significant difference between right‐sided endometrioma and left‐sided endometrioma (20.7% vs. 6.4%, p = 0.006) in relation to POD obliteration. In the current study, 69% of the women with right endometrioma had POD obliteration compared with 71% of women with a left endometrioma.…”

“…In the absence of specialized ultrasound for the prediction of POD obliteration, TVS markers for endometriosis, such as ovarian fixation and ovarian endometrioma, may be useful in determining the risk of POD obliteration pre‐operatively. Ulukus et al published a study including 340 women with benign ovarian cysts to determine whether laterality of endometriomata was related to endometriosis severity, and found that women with right‐sided endometrioma had a significantly higher rate of POD obliteration than women with left‐sided endometrioma (21% vs. 6%, respectively) . In addition, ovarian fixation has been significantly associated with the finding of endometriosis at laparoscopy .…”