VP62.30: Do ultrasound features of deep infiltrating bowel endometriosis affect patient's symptoms?

To investigate the association between the symptoms and number, size and location of bowel deep infiltrating endometriosis (DIE) as assessed at transvaginal ultrasound examination. Women of fertile age with diagnosed bowel DIE at transvaginal ultrasound examination by an experienced examiner in 2011–2018 were eligible for the study. All ultrasound examinations were performed at the Ultrasound Unit at the Department of Obstetrics and Gynecology, SkÅne University Hospital, Malmö, Sweden using GE E8 or E10 ultrasound equipment (Milwaukee, WI, USA) with vaginal transducer of 5-9 MHz according to standardised endometriosis protocol. Number, size and location of bowel DIE lesions were noted. Patients filled in questionnaires with visual analogue scales measuring the intensity of symptoms including dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia and dysuria with and without hormonal treatment before the ultrasound examination. In all, 151 women had bowel DIE at ultrasound and were eligible for the study. Eight women were excluded due to insufficient records. In total, 143 women were included, of which 29 had isolated bowel DIE. Only four women were asymptomatic. Dysmenorrhea was present in 91%, chronic pelvic pain in 76%, dyspareunia in 72%, dyschezia 71% and dysuria 42% women. Dyspareunia was more common in women with increased length of the largest bowel lesion (p = 0.033), and if bowel endometriosis in rectosigmoid location was present (p = 0.041). No significant differences were found in women with and without dyschezia, dysmenorrhea, chronic pelvic pain and dyspareunia for number, location and size of the bowel lesion (p = 0.072–0.931). In women that reported symptoms with and without hormonal treatment, the intensity (VAS score) of all symptoms was lower when women were on hormonal treatment than without (p = 0.000). Presence of dyspareunia was associated with the length of bowel DIE lesion and rectosigmoid location. Hormonal treatment was found to reduce intensity of all symptoms as assessed using VAS score.