OC19.06: Follow‐up of patients with symptoms suggesting endometriosis without initial ultrasound findings

The primary aim was to investigate what happened to the patients who had symptoms suggesting endometriosis but who initially had no signs of endometriosis on advanced transvaginal ultrasound examination. The secondary aim of this study was to learn whether laparoscopy helps to detect endometriotic lesions, confirming the disease. Patients having symptoms suggesting endometriosis but no findings on initial ultrasound examination were followed up for up to a 5-year period. All ultrasound examinations were done in accordance with IDEA consensus for terms and definitions. Severity of symptoms were assessed by patients using visual analogue scale. Laparoscopy was done at the discretion of treating gynecologist in agreement with the patient. Medical notes were studied to obtain the laparoscopy results. 98 patients were included in the study. In 22.4% (22/98) patients endometriotic lesions were found on consecutive ultrasound examinations; median time to findings was 4.0舁years. Additionally, in 31.6% (31/98) patients' superficial peritoneal endometriosis (SPE) was found by diagnostic laparoscopy. These patients had more severe symptoms according VAS score. Median time at observing endometriotic lesions by ultrasound examination was higher than by laparoscopy in case gynecologist and patient considered that. In summary, during the five-year period 54% (53/98) patients had endometriotic lesions confirmed by ultrasound or laparoscopy. It is impossible to know whether other patients would have SPE as they have not laparoscopy because of satisfactory hormonal treatment applied or evasion of operative exploration. Endometriotic lesions develop in a majority of patients with symptoms suggesting endometriosis, and most can be detected during a 5-year follow-up. For patients who have progressing clinical symptoms, laparoscopy helps quicker to discover SPE.