The efficiency of transvaginal ultrasonography in the diagnosis of endometrioma

The ‘sliding sign’ in conjunction with sonovaginography: is this the optimal approach for the diagnosis of Pouch of Douglas obliteration and posterior compartment deep infiltrating endometriosis?

“…In a statement which delineated a consensus on the management of endometriosis, we believe that the omission of ultrasound in the diagnosis of both endometriomata and/or DIE was a serious oversight. Although there is a growing body of evidence for the routine use of pre‐operative TVS in the work up of women with chronic pelvic pain, 7 , 9 – 22 there seems to be a delay in the uptake of these approaches in day to day clinical practice as demonstrated by the recent consensus statement. High quality ultrasound is critical in the diagnosis and planning of surgical management of women with underlying endometriosis.…”

“…These studies have established the value of TVS as a first line pre‐operative imaging modality for endometriosis 7 . While traditional TVS evaluation of the pelvis is an excellent diagnostic tool for unilateral or bilateral endometriomata, 9 , 10 its role in the pre‐operative diagnosis of extra‐ovarian endometriosis has continued to evolve. This review aims to detail the progress made in the evolution of TVS as the primary imaging modality in the pre‐operative diagnosis of extra‐ovarian endometriosis.…”

Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis

“…Transvaginal sonography (TVS) is the first-line imaging technique recommended for the diagnosis of ovarian 3,4 and bladder endometriosis 5 . Using transrectal sonography (TRS), Ohba et al 6 found that normal uterosacral ligaments appeared as hypoechogenic, homogeneous arcs on each side of the uterine cervix, whereas they were thick and irregular when involved by endometriosis.…”

Sonographic diagnosis of a large and deep endometrioma of the uterine cervix

“…The sonographic appearance was consistent with an endometrioma. 3 TVUS-guided transvaginal needle aspiration with a 17-gauge, 35-cm-long needle (Cook, Spencer, IN) yielded a thick, chocolate-like fluid. Neither analgesic drugs nor prophylactic antibiotics were administered during or before the procedure.…”