Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

A new ultrasonographic mapping system for evaluating the extent of deep endometriosis may be useful for preoperative planning and intraoperative management of symptomatic patients.

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Authors

Caterina Exacoustos, M.D., Mario Malzoni, M.D., Alessandra Di Giovanni, M.D., Lucia Lazzeri, M.D., Claudia Tosti, M.D., Felice Petraglia, M.D., Errico Zupi, M.D.

Volume 102, Issue 1, Pages 143–150.e2

Abstract

Objective:

To assess the accuracy of transvaginal sonography (TVS) in defining size and location of deep infiltrating endometriosis (DIE) with laparoscopic/histologic confirmation.

Design:

Prospective observational study.

Setting:

University hospital.

Patient(s):

One hundred four women with suspected DIE on the basis of TVS.

Intervention(s):

Patients with DIE underwent TVS evaluation before laparoscopic surgery. An accurate mapping of the extent of the disease was recorded during TVS and at laparoscopy. This new mapping system was developed to assess the extent of endometriosis by measuring the size and depth of the lesions at the various pelvic locations.

Main Outcome Measure(s):

Surgical and histologic confirmation of the ultrasonographic data to evaluate the presence and location of DIE and creation of a new mapping methodology for detecting DIE by TVS.

Result(s):

Depending on the different location of the lesions, the accuracy of TVS ranged from 76%–97%. The lowest sensitivity (59%) and accuracy (76%) were obtained for TVS in the diagnosis of vaginal endometriosis, whereas the greatest accuracy (97%) was shown in detecting bladder lesions and Douglas obliteration.

Conclusion(s):

This new ultrasound mapping system is accurate for detecting the extent of DIE and may be useful for preoperative planning and intraoperative management of symptomatic patients with DIE.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00298-2/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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