OC16.07: Is site‐specific tenderness at TVS associated with pouch of Douglas obliteration at laparoscopy in women with suspected endometriosis?

To determine whether there is an association between pouch of Douglas (POD) obliteration at laparoscopy and site specific tenderness during TVS. Multi-center prospective observational study undertaken from January 2009 to February 2013. All women included in this study were of reproductive age, had a history of chronic pelvic pain and/or endometriosis, and had a plan for laparoscopic endometriosis surgery. A detailed history and preoperative TVS was performed for all women prior to surgery. Site-specific tenderness was elicited by placing gentle pressure with the TV probe against each of the six locations: anterior fornix, right adnexa, left adnexa, right uterosacral ligament (USL), left USL, and posterior fornix. Women rated their pain score from 0 (no pain) to 10 (worst pain) for each of the six locations. All women then underwent laparoscopy +/- excision of endometriosis and determination of whether POD obliteration was present or absent. The relationship between site-specific tenderness at TVS and POD obliteration at laparoscopy were analysed for significance. 189 women were included in the study and 47/189 (25%) had POD obliteration at laparoscopy. None of the six locations assessed for site-specific tenderness were significantly associated with POD obliteration at laparoscopy. This study found that site-specific tenderness during TVS does not seem to be useful in the prediction of POD obliteration at laparoscopy.