EP24.12: Prevalence of adenomyosis and endometriosis on ultrasound among symptomatic patients stratified by referring physician

To determine the prevalence rates of adenomyosis and endometriosis among symptomatic patients referred for ultrasounds according to referral sources: primary general practitioners, general gynecologists, and specialist gynecologists in minimally invasive surgery (MIGS). This is a retrospective cross-sectional study across a single community outpatient ultrasound centre. Each patient underwent a transvaginal ultrasound by a skilled gynecologist sonologist with systematic evaluation of the pelvis using the international Morphological Uterus Sonographic Assessment (MUSA) and International Deep Endometriosis Analysis (IDEA) standards for assessment of adenomyosis and endometriosis. A total of 151 patient underwent assessment, of which 32.9% and 66.2% were diagnosed with adenomyosis and endometriosis respectively. The prevalence of adenomyosis and overall endometriosis in those referred by general practitioners was 30.8% and 74.1%. In this group, 48.1% was diagnosed with superficial endometriosis, 30.0% with deep endometriosis, and 11.1% with ovarian endometriosis. Among patients referred by a general gynecologist, 40.4% had adenomyosis and 63.3% had endometriosis, of which superficial endometriosis was the most common at 38.8%. In those referred by a MIGS, 28.6% had findings of adenomyosis and 65.3% had endometriosis. Deep endometriosis was most prevalent among those referred by MIGS at 50.7%. Most symptomatic patients referred for endometriosis assessment were diagnosed with endometriosis with transvaginal ultrasound, irrespective of referring physician speciality. Among those referred by general practitioners and gynecologists, superficial endometriosis emerged as the predominate subtype diagnosed. This highlights the importance of non-invasive diagnostic methods while emphasising the role of general practitioners in guiding triage between referral to a general gynecologist or MIGS based on ultrasound findings.