P147Preoperative evaluation of endometriosis with transvaginal ultrasound

Objective To show the use of transvaginal ultrasound in the diagnosis of endometriosis, and based on that in the decision on the choice of treatment. Patients and methods Ultrasound finding of round shaped adnexal mass with thick wall and homogeneous, low level echo pattern was considered suspected for endometriosis. From 1995 to 1999 in women with chronic pelvic pain and palpable mass, transvaginal ultrasound confirmed the endometriosis, according to the above criteria in IS patients. Eleven patients were treated preoperatively with GnRH agonists (goserelin depot 3.6 mg) for 6 months. After the treatment operative laparoscopy was performed. In 7 patients laparoscopy was performed immediately, and patients received medicated treatment after the operations, also GnRH agonists for 6 months. Results During the preoperative treatment with GnRH most patients reported a reduction of pain after 3 months of treatment, and with patients operated immediately reduction of pain was reported 2 weeks following operation. Operation was shorter in patients with preoperative treatment with GnRH. Conclusion Disadvantages of preoperative treatment of endometriosis include changes in appearance of endometriosis, price of the medication, side‐effects, dilate of accurate diagnosis, and dilate in eventual pregnancy. For some patients it can be useful to start the preoperative medicated treatment to suppress ovulatory activity, so functional cysts would not be misdiagnosed for endometriosis. Patients with chronic pelvic pain should be evaluated laparoscopically to diagnose mild endometriosis adequately.