Transvaginal Ultrasound as a First-Line Approach in Deep Endometriosis: A Pictorial Essay

Abstract

Endometriosis (EMS) is a benign condition characterized by a systemic inflammation that affects fertile women at reproductive age. Ultrasound became, in recent years, the method of choice for both effective diagnostic and preoperative planning. Therefore, accurate characterization and mapping of endometriotic lesions is imperative in such circumstances to enable optimal approach of treatment, whether surgical or non-surgical based on the severity of the findings. This pictorial essay outlines a practical approach to evaluating patients with deep endometriosis by means of transvaginal ultrasound. The technical aspects are in conjunction with both consensus of the International Deep Endometriosis Analysis (IDEA) group and the hands-on experience acquired through daily clinical practice.

Risk factors for postoperative recurrence of cesarean scar endometriosis

“…Ultrasound is currently the main diagnostic method for endometriosis because of its noninvasiveness, simplicity, and high patient acceptance. 38 In most cases of CSE, ultrasound examination findings reveal abdominal masses that are hypoechoic masses with irregular size and depth. Compared with ultrasound, magnetic resonance imaging can better judge the depth and scope of lesion infiltration and easily detect smaller lesions.…”

The current and future state of surgery in reproductive endocrinology

“…Pelvic sonogram has long been established as a reliable tool to diagnose OMA. In addition, pelvic sonogram and MRI have both been demonstrated to have reasonable sensitivity and specificity in diagnosing DIE (TVS 52-60% sensitivity, 95-100% specificity; MRI 64-81% sensitivity, 83-98% specificity) [2,3]. In the future, laparoscopy to diagnose endometriosis is likely to be performed less often for all patients and not just in infertile women.…”

The role of peroxisome proliferator-activated receptors in endometriosis

“…Should endometriotic lesions invade the urinary tract, dys-/hematuria can occur, while dys-/hematochezia represent additional symptoms upon intestinal involvement ( 7 ). Initial diagnosis of endometriosis is mostly based on transvaginal ultrasound findings, in addition to a thorough physical examination and patient history ( 8 , 9 ). The uterus is typically not engorged, but the existence of ovarian cysts or nodules in the rectovaginal septum and/or the bladder necessitates additional examinations ( 10 ).…”