Endometriosis Reccurence – is Ultrasound the Solution?

Nati ID, Ionel-Daniel Nati, Nati, Ionel-Daniel, Andrei Mihai Malutan, Andrei Mihai Măluţan, Malutan AM, Răzvan Ciortea, Razvan Ciortea, Ciortea R, Carmen Bucuri, Carmen Elena Bucuri, Bucuri C, Rada MP, Maria Patricia Rada, Cristina Mihaela Ormindean, Ormindean CM, Dan Mihu, Mihu D
Current medical imaging · 2023 · vol. 20 , pp. e050423215451 · doi:10.2174/1573405620666230405093304 · PMID:37038668 · W4364352574
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-12 ⓘ

This literature review identified a 17.26% recurrence rate of endometriosis in 2023 patients after surgery, highlighting ultrasound's importance for postoperative follow-up at six-month intervals.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-27 · read from full text ⓘ

This literature review analyzed nine studies involving 2,023 patients to evaluate the efficacy of transvaginal and transabdominal ultrasound in detecting endometriosis recurrence after surgical intervention. The analysis revealed an overall recurrence rate of 17.26%, highlighting significant variability in definitions and diagnostic criteria across different postoperative treatments such as progesterone administration or GnRH antagonists. The authors note that distorted anatomy and fibrosis present major challenges for imaging accuracy, proposing computer-aided textural analysis and a standardized follow-up algorithm to improve detection reliability. This paper is centrally about endometriosis — specifically focusing on the role of ultrasound imaging in monitoring disease recurrence following surgery.

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Abstract

BACKGROUND: Transvaginal and transabdominal ultrasonography has become a widely used investigative method in the diagnostic workup of endometriosis, as well as for the postoperative follow-up. The variety of lesions, the distorted anatomy caused by adhesions and the fibrosis process represent the main challenges of the ultrasound evaluation. Regarding the recurrence of endometriosis, the diagnostic criteria are being imprecise, being adjusted according to the development of ultrasound techniques. OBJECTIVE AND METHODS: To this study, extensive research has been performed interrogating PubMed, Embase and Web of Science databases to identify published research including patients with endometriosis who underwent surgery. Included patients had postoperative ultrasound investigations to detect evidence of endometriosis recurrence. The selected timeframe was 5 years. We conducted a literature review on ultrasound markers of endometriosis recurrence. RESULTS: In this analysis, 2023 patients from 9 studies were included. The recurrence rate detected was 17.26%. The postoperative treatment was different in the selected studies and they include the administration of progesterone, oral combined contraceptives, GnRh antagonists, aromatase inhibitors and intrauterine devices with prolonged release of progesterone. DISCUSSION: The recurrence rate is different in the selected studies as a result of the recurrence definition used by each author and the minimum dimension of the lesions, in case of the cystic pattern. Innovative techniques of differential diagnosis by ultrasound are proposed, one of them being the textural analysis performed by computer-aided diagnosis – CAD. In order to standardize the recommendations regarding imaging techniques, we propose an algorithm for following up with patients in the postoperative period. CONCLUSION: The transabdominal or endovaginal ultrasound performed regularly represents a key factor to determine the recurrence of endometriosis in the postoperative period and the imaging reassessment is recommended to be performed at a 6-month interval.
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Abstract

Background: Transvaginal and transabdominal ultrasonography has become a widely used investigative method in the diagnostic workup of endometriosis, as well as for the postoperative follow-up. The variety of lesions, the distorted anatomy caused by adhesions and the fibrosis process represent the main challenges of the ultrasound evaluation. Regarding the recurrence of endometriosis, the diagnostic criteria are being imprecise, being adjusted according to the development of ultrasound techniques.

Objective

and Methods: To this study, extensive research has been performed interrogating PubMed, Embase and Web of Science databases to identify published research including patients with endometriosis who underwent surgery. Included patients had postoperative ultrasound investigations to detect evidence of endometriosis recurrence. The selected timeframe was 5 years. We conducted a literature review on ultrasound markers of endometriosis recurrence.

Results

In this analysis, 2023 patients from 9 studies were included. The recurrence rate detected was 17.26%. The postoperative treatment was different in the selected studies and they include the administration of progesterone, oral combined contraceptives, GnRh antagonists, aromatase inhibitors and intrauterine devices with prolonged release of progesterone.

Discussion

The recurrence rate is different in the selected studies as a result of the recurrence definition used by each author and the minimum dimension of the lesions, in case of the cystic pattern. Innovative techniques of differential diagnosis by ultrasound are proposed, one of them being the textural analysis performed by computer-aided diagnosis – CAD. In order to standardize the recommendations regarding imaging techniques, we propose an algorithm for following up with patients in the postoperative period.

Conclusion

The transabdominal or endovaginal ultrasound performed regularly represents a key factor to determine the recurrence of endometriosis in the postoperative period and the imaging reassessment is recommended to be performed at a 6-month interval.

Keywords

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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