Consortium. Consensus on current management of endometriosis. Hum

of women to the appropriate network of expertise ’ described by Mana-kaya and Condous.We agree that transvaginal ultrasound might also be helpful, as suggested, tominimise under-diagnosis of the extent of endo-metriosis as can occur in some settings at laparoscopy. However, the problemwith transvaginal ultrasound is that its diagnos-tic accuracy is notoriously operator dependent. Vaginal examination and vaginal procedures must yield information that has the potential to changemanagement because, althoughmedical practitionersmight con-sider these ‘non-invasive ’ interventions, this is often not how they are perceived by women (for whom there may be a lengthy history of pelvic pain)whomust undergo the diagnostic procedure.While the diag-nostic accuracy of ultrasound in predicting ovarian endometriomas cannot be challenged, external validation is required of the studies that haveassessed theaccuracyofmoresophisticated transvaginal ultrasound markers in diagnosing deep endometriosis (such as the ‘sliding sign’