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OC20.03: Prevalence of endometriosis at transvaginal ultrasound in women with dysmenorrhea

Objectives: To determine the prevalence of endometriosis detected at transvaginal ultrasound examination in different anatomical locations in women with dysmenorrhea and without previously known endometriosis. Methods: Women of fertile age with dysmenorrhea underwent transvaginal ultrasound examination by an experienced examiner in 2014-2017. All ultrasound examinations were performed at the Ultrasound Unit at the Department of Obstetrics and Gynaecology, Skane University Hospital, Malmö, Sweden using GE E8 or E10 ultrasound equipment (Milwaukee, WI, USA) with vaginal transducer of 5-9 MHz according to standardised endometriosis protocol. All abnormal findings in the uterus, ovaries, bowel, urinary bladder, sacrouterine ligaments and remaining pelvis were noted, and their size, location, tenderness and mobility described. Results: Out of 513 women with dysmenorrhea, 140 were excluded out of which 105 women had previously known endometriosis. Out of 373 women included, 178 (48%) women had normal ultrasound findings, 114 (31%) women had endometriosis and 81 (22%) women had other pathological findings. Endometrioma and adenomyosis had a prevalence of 20% and 12%, respectively. The prevalence of deep endometriosis in the bowel, sacrouterine ligaments, rectovaginal septum and urinary bladder was 8%, 3%, 3% and 0.5%, respectively. Obliteration of pouch of Douglas was found in 12% women. Endometriosis was found in only one anatomical location in 21 %, in two locations in 8% and in three locations in 2% of the examined women. Conclusions: One of three women with dysmenorrhea and not previously known endometriosis seeking for medical care had endometriosis at ultrasound examination performed by an experienced ultrasonographer. Most women had one location of endometriosis and the most common finding was endometrioma.