OC12.07: Association between superficial endometriosis and clinical symptoms

To determine if there is an association between superficial endometriosis and clinical symptoms reported by patients. Ambispective observational study based on ultrasound data collected at a University Hospital with a specialised gynecological ultrasound unit in 2023. Two level III sonographers performed a transvaginal ultrasound to assess endometriosis using the International Deep Endometriosis Analysis (IDEA) consensus, with a detailed scanning of the peritoneum in the anterior, middle, posterior, and lateral compartments of the pelvis, a substantial magnification of the image, and presence of fluid in cul-de-sac. The main result was the identification of superficial endometriosis. An analysis was conducted 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 superficial endometriosis was identified in 39 (6.2%) of them. 92.3% (36/39) presented involvement of the posterior cul-de-sac and 7.7% (3/39) of the anterior cul-de-sac. The observed lesions presented a distribution of multiple separate lesions. Regarding the ultrasound features, 69.2% presented hyperechoic foci (“pearls”), 15.4% concave defect in the peritoneum (“pocket”), and 15.4% presence of velamentous adhesions (“veil”). The symptoms reported were: dysmenorrhea (69.2%), dyspareunia (46.2%), pelvic pain (41%), irregular cycles (33.3%), menorrhagia (30.7%), cystitis (18%), infertility (18%), constipation (15.4%), tenesmus (12.8%), and abdominal distension (10.3%). A statistically significant association was found between the presence of irregular cycles, cystitis, dysmenorrhea, dyspareunia, menorrhagia, and infertility (p < 0.05). In our experience, the presence of dysmenorrhea, dyspareunia, irregular cycles, cystitis, menorrhagia, and infertility are common symptoms that are associated with ultrasound findings suggestive of superficial endometriosis.