EP24.23: Association between deep endometriosis and clinical symptoms

To determine if there is an association between deep endometriosis and clinical symptoms reported by patients. Ambispective observational study based on ultrasound data collected at a University Hospital with specialised gynecologic ultrasound unit between 2016 and 2023. Two level III sonographers performed the mapping for endometriosis with the International Deep Endometriosis Analysis (IDEA) group protocol. The main outcome was to determine whether clinical symptoms are associated with the finding of deep endometriosis including the parametrium (anterior and posterior). An analysis was performed according to the nature of the variables. A Chi-square test was used to determine a possible association, considering p < 0.05 as significant. A total of 630 patients were evaluated, and deep endometriosis was identified in 250 (40%) of them. 88% (220/250) presented involvement of the posterior compartment and 12% (30/250) of the anterior compartment. The symptoms reported were: pelvic pain (51.2%), dysmenorrhea (47.2%), dyspareunia (24.8%), heavy menstrual bleeding (20.8%), irregular cycles (12.4%), infertility (8.8%), tenesmus (8.4%), constipation (8%), abdominal distension (5.6%), cystitis (4.8%), diarrhoea (4%), lumbalgia (2.8%), anal pain (2%), spotting (2%), headache (1.6%), myalgia (1.6%), anemia (1.2%), nausea (1.2%), mastalgia (0.8%), rectal bleeding (0.8%), urinary incontinence (0.8%), hematuria (0.4%), and cyclic chest pain (0.4%). A statistically significant association was found between the presence of heavy menstrual bleeding, irregular cycles, infertility, and cystitis (p < 0.05). In our experience, the presence of heavy menstrual bleeding, irregular cycles, infertility, and cystitis are associated with ultrasound findings suggestive of deep endometriosis.