2908 Ultrasound Findings in Patients Referred to an Endometriosis Unit in a Tertiary Centre: Does Previous Surgery Matter?

Abstract

Study Objective The objective of this study is to analyze the ultrasound findings in patients referred to an endometriosis unit with and without previous endometriosis surgeries over one-year period. Design Retrospective study including 430 patients who had a first visit and an ultrasound scan at an endometriosis referral unit from January to December 2018. Information about surgical history and ultrasound findings was collected. Setting Endometriosis referral unit in a tertiary hospital in Barcelona, Spain. Patients or Participants 430 patients referred to the endometriosis unit were included. Interventions Ultrasound scan was performed according to the protocol stablished in this unit. Measurements and Main Results 177 patients (41.2%) had a previous history of endometriosis surgery. 72.9% of them had one previous surgery and 14.7% had two whereas 12.4% had three or more. Laparoscopy was the main route, which was used in 74.6% of them. The main procedures were endometrioma decapsulation (45.6%) followed by adnexal surgery (19.8%) and deep infiltrating endometriosis nodule excision (16%). Only 2.7% of patients had a previous bowel resection. When comparing the ultrasound findings between patients who have a previous endometriosis surgery with those without, statistically significant differences were found in the presence of ovarian adhesions, ovarian endometriomas, presence of intestinal endometriotic nodules and Douglas-blockage. Conclusion More than 40% of patients referred to the endometriosis unit had had a previous surgery. They had a higher rate of presence of intestinal endometriotic nodules among other ultrasound findings. Thus, it reinforces the need of referral units in order to establish a precise treatment either medical or surgical with high-skilled surgeons.