VP62.15: The absence of endometrioma doesn't mean absence of deep endometriosis: a new challenge

The aim of this study was to evaluate the incidence of deep endometriosis in patients without suspicion of endometrioma using an imaging technique as ultrasonography (US). We included in this observational study all patients with less than 45 yrs old underwent diagnostic transvaginal US evaluation from January 2018 to December 2019 in one academic department as a part of SANABA (Sardinia-Navarra-Barcelona) collaborative. We evaluate the prevalence of deep endometriotic lesions (DE), endometrioma and absence of sign of endometriosis. Of 56.487 women underwent to US by expert, 2458 (4.3%) showed ultrasonographic findings of endometriosis. Of these, 1296 (53%) had an ultrasonographic diagnosis of presence of deep endometriosis not associated with presence of endometrioma, 742 (30%) of endometrioma only and 420 (17%) both. The presence of only deep endometriosis is the most frequent phenotypes of endometriosis. In contrast with previous published data, in this study, performed in a large population by US expert ultrasonographer, was demonstrated that the majority of patients showed the presence of deep endometriosis in absence of endometrioma. For these reasons in all women with clinical suspicion of endometriosis DE must be searched also in patients without endometrioma. This study was partly supported by Fondazione di Sardegna grant F74I19001010007.