Purpose:
Endometriosis is one of the most common women’s diseases, which as a multiorgan condition and often painful disorder, Has drawn much attention to it. Hereby, we aim to test TVS accuracy for the diagnosis of deeply infiltrating endometriosis (DIE) in respect To the presence of ovarian endometrioma (OE).
Methods:
This was a prospective study with all enrolled patients undergoing transvaginal sonography (TVS) before undertaking gynecologic laparoscopy. Setting pathological confirmation as the standard reference, the accuracy of TVS for the diagnosis of DIE and pouch of douglas (POD) obliteration was compared with that of laparoscopy in anterior and posterior pelvic compartments, and with regard to the presence or absence of OE. The degree of agreement between TVS and laparoscopy was measured in each case and for each site of involvement, using cohen’s kappa statistic.
Results:
One hundred and ten patients were recruited with a mean age of 37.20 ±7.16 years. The accuracy, sensitivity, and negative predictive value of TVS to diagnose DIE and POD obliteration were calculated as 89.5%, 58.3%, and 88.9% in anterior pelvic compartment (APC), and 93.3%, 92%, and 70.6% in posterior pelvic compartment (PPC), respectively. Nevertheless, TVS had a lower sensitivity for detecting pelvic adhesion and peritoneal cyst comparing to laparoscopy. OE presence did not significantly increased TVS accuracy for the diagnosis of DIE or POD obliteration (P> 0.05).
Conclusions:
Current study has shown that TVS is an accurate and non-invasive tool for the detection and mapping of DIE and POD obliteration, regardless of the presence of OE. TVS May waive the need for exploratory laparoscopy in DIE, or at least it can offer a precise pre-procedural DIE mapping.