1829 Current State of Pelvic Ultrasound for Endometriosis: Results of an International Survey

Abstract

Study Objective Compare how obstetrician/gynecologists (OBGYNs) in four English-speaking regions (Australia/New Zealand (ANZ), Canada (CAN), United Kingdom (UK), and United States of America (USA)) think of and use transvaginal ultrasound (TVS) in the diagnosis and management of endometriosis. Design An online survey. Setting Between May and November 2018, the online survey was distributed in ANZ, CAN, UK and USA. Patients or Participants Independently-practicing OBGYNs belonging to the Royal Australian New Zealand College of Obstetricians and Gynaecologists, Society of Obstetricians and Gynaecologists of Canada, American College of Obstetricians and Gynecologists and British Society for Gynaecological Endoscopy. Interventions Questions on the diagnosis and management of endometriosis, with particular emphasis on the utility of ultrasound. Measurements and Main Results Questions were designed by the study team and piloted. The formal invitation was distributed via email through the respective societies with a reminder at two weeks. Responses were analyzed quantitatively using descriptive and inferential statistics. Missing data were excluded from the analysis. 1140 OBGYNs responded. Regional respondent number and response rate are as follows: ANZ 449(20.4%), CAN 156(10.4%), UK: 95(14.2%), US: 440(1.4%). 65 respondents were disqualified based on practice composition. Differences in the utilization of the deep endometriosis (DE) TVS were noted, with ANZ members seemingly adopting the technology more readily. Similarly, ANZ respondents had the highest rates of expectation/belief in the utility of TVS for endometriosis. A high rate of disbelief of TVS utility exists broadly. Lastly, US members ranked endometriomas as the most important feature of endometriosis predict on imaging preoperatively, whereas UK members ranked rectovaginal septum and ANZ/CAN members ranked bowel DE as most important, respectively. Conclusion Regional differences were noted in the awareness of utility and adoption of TVS for diagnosis of endometriosis. This study should serve as an important stepping stone in raising awareness and introducing educational campaigns to improve the utility and adoption of this essential preoperative and diagnostic tool.