EP13.50: Association between lesion location and pain symptoms in women with endometriosis detected by ultrasound at a single location

Objectives: The aim of this study was to assess the association between endometriosis findings at ultrasound described using #Enzian classification system and women symptoms.Methods: Women diagnosed with endometriosis at ultrasound between 2014-2024 were included.Presence and intensity of symptoms (dysmenorrhea, chronic pelvic pain (CPP), dyspareunia, dyschezia, dysuria) was reported using visual analogue scale 0-100.Findings at transvaginal ultrasound have been described using IDEA consensus and classified using the #Enzian classification system.Results: Out of 703 women included, 339 (48%) were on hormonal treatment at the time of ultrasound examination.Endometriosis findings in the #Enzian compartment O (Ovary) were associated with presence of CPP, dyspareunia, dysuria, and dyschezia, findings in the compartment A (Rectovaginal space/retrocervical area) were associated with dyspareunia and findings in the compartment C (Rectum) were associated with dysmenorrhea (p-values between 0.007 and 0.033).No association was found between endometriosis findings in the #Enzian compartments T (Tube), B (Sacrouterine ligaments) and F (Adenomyosis, urinary bladder, intestine) and any symptom.Compartment P (Peritoneum) has not been systematically evaluated.Women with endometriosis findings in compartment O had less intensity of dysmenorrhea, dyspareunia and dyschezia, compared to women without findings this compartment (p-values between 0.033 -0.052).Women with endometriosis findings in compartment T had less intensity of dysmenorrhea, CPP and dyspareunia compared to women without findings in the compartment (p-values between 0.001 and 0.031).Conclusions: Our results indicate an association between presence and intensity of symptoms suggestive of endometriosis and ultrasound findings classified using #Enzian classification system.Future studies are needed to assess the association between symptoms and lesion location in women with isolated endometriosis findings, particularly in women without hormonal treatment.