OC19.02: Changes in the intensity of symptoms suggestive of endometriosis over time in women without abnormal findings at initial ultrasound examination

Evaluate if changes in the intensity of dysmenorrhea and chronic pelvic pain at long-term follow-up in women without endometriosis findings at initial examination are associated with ultrasound findings of endometrioma, deep endometriosis (DE) or adenomyosis at follow-up. Long-term follow-up at five years was performed in 100 women without endometriosis findings at initial ultrasound examination. Women reported symptoms suggestive of endometriosis using a standardised questionnaire and underwent transvaginal ultrasound examinations at the Ultrasound Unit, Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden. Severity of symptoms was assessed using visual analogue scale (VAS) from 0 to 100 mm, 71-100 mm was considered severe. Alterations of 10 mm was used as cut-off for minimal clinical important difference to assess if intensity of the symptom reduced, increased or remained unchanged at follow-up. At follow-up, 13 women (13%) had signs of endometrioma, DE or adenomyosis, while 87 women (87%) had no ultrasound findings of endometrioma, DE or adenomyosis. Increased intensity of dysmenorrhea was less common in women with ultrasound findings endometriomas, DE or adenomyosis than in women without lesions (0% vs. 37%, p = 0.008). Hormonal treatment was equally frequent in both groups (50% vs. 54%, p = 0.766). Reduced intensity of dysmenorrhea was more common in women without ultrasound findings of endometrioma, DE or adenomyosis who began hormonal treatment compared to women who quit hormonal treatment during follow-up (75% vs. 38%, p = 0.041). Fewer women with ultrasound findings of endometrioma, deep endometriosis or adenomyosis reported severe chronic pelvic pain at follow-up compared to women without (0% vs. 24%, p = 0.046). Ultrasound findings of endometrioma, DE or adenomyosis were not associated with increased intensity of dysmenorrhea or chronic pelvic pain at long-term follow-up. Hormonal treatment reduced severity of dysmenorrhea, although not chronic pelvic pain.