OC26.06: Meta‐analysis and systematic review to determine the optimum imaging modality for the detection of bladder deep infiltrative endometriosis

To review the accuracy and determine the optimum imaging modality for the detection of bladder deep infiltrative endometriosis (DIE) in women with a clinical history of endometriosis. A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of DIE, and specifically bladder DIE, which was then correlated with the laparoscopic gold standard. Bladder DIE included bladder, ureters and uterovesical pouch. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 2 study groups in the analyses and the main results are reported on table 1. The sensitivity of TVS for detecting bladder endometriosis seems to be slightly better than MRI, although the sensitivity of both methods is not very high. Specificity of both MRI and TVS was excellent. As TVS is the simpler, faster, more readily available, we believe it should be the first line diagnostic tool for the women with suspected DIE in this region.