Speakers - 2026

Title: The Role of Ultrasound in the Early Diagnosis of Endometriosis

Abstract

Endometriosis is a chronic gynecological condition affecting women of reproductive age and is commonly associated with pelvic pain and infertility. Early diagnosis remains a challenge due to the variability of symptoms and the frequent delay in diagnosis. The aim of this study was to evaluate the role of transvaginal ultrasound in the early detection of endometriosis. A prospective observational study including 90 women aged 20–45 years presenting with symptoms suggestive of endometriosis was conducted. All patients underwent clinical examination and transvaginal ultrasound evaluation. Ultrasound findings suggestive of endometriosis were recorded and compared with laparoscopic findings in selected cases. Ovarian endometriomas were the most common lesions detected. Ultrasound demonstrated high sensitivity for ovarian endometriomas and moderate sensitivity for deep infiltrating endometriosis. The findings suggest that transvaginal ultrasound is an effective and non-invasive method for the early diagnosis of endometriosis.

Introduction:

Endometriosis is a chronic gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. It affects approximately 10–15% of women of reproductive age and represents a common cause of chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Despite its high prevalence, endometriosis is frequently underdiagnosed and the average delay between the onset of symptoms and diagnosis may reach 7–10 years. Traditionally, laparoscopy has been considered the gold standard for diagnosing endometriosis. However, in recent years, imaging techniques, particularly transvaginal ultrasound, have become increasingly important in the early detection of the disease. Ultrasound examination allows visualization of ovarian endometriomas, deep infiltrating endometriosis, and pelvic adhesions, making it a valuable non-invasive diagnostic method.

Aim of the Study:

The aim of this study was to evaluate the diagnostic value of transvaginal ultrasound in the early detection of endometriosis in women presenting with pelvic pain, dysmenorrhea, and infertility.

Materials and Methods:

This prospective observational study included 90 women aged between 20 and 45 years who presented to the gynecology outpatient clinic with symptoms suggestive of endometriosis. All patients underwent detailed clinical evaluation, gynecological examination, and transvaginal ultrasound. During the ultrasound examination, special attention was given to the presence of ovarian endometriomas, deep infiltrating nodules, adhesions, and the mobility of pelvic organs. Ultrasound findings suggestive of endometriosis were documented. In selected cases where surgery was indicated due to severe symptoms or infertility, laparoscopic procedures were performed and the diagnosis was confirmed through histopathological examination. Statistical analysis was conducted to determine the diagnostic accuracy of ultrasound in detecting endometriotic lesions.

Results:

Ultrasound examination detected signs suggestive of endometriosis in 43% of the examined patients. Ovarian endometriomas were the most frequently observed lesions, identified in 28% of cases. Deep infiltrating endometriosis involving the uterosacral ligaments and posterior compartment was detected in 10% of patients. Among the women who underwent laparoscopic surgery, ultrasound findings correlated with intraoperative findings in the majority of cases. Transvaginal ultrasound demonstrated high sensitivity in detecting ovarian endometriomas and moderate sensitivity in identifying deep infiltrating endometriosis. A significant association was observed between chronic pelvic pain and the presence of ultrasound-detected endometriotic lesions (p < 0.05).

Discussion:

Early diagnosis of endometriosis remains a clinical challenge because of the variability of symptoms and the lack of specific diagnostic markers. Traditionally, laparoscopy has been considered the definitive diagnostic tool; however, it is an invasive procedure and cannot be used as a routine screening method. Transvaginal ultrasound has emerged as an important non-invasive imaging technique for evaluating pelvic pathology. Numerous studies have demonstrated its high diagnostic accuracy in detecting ovarian endometriomas and its growing role in identifying deep infiltrating endometriosis. The use of ultrasound in routine gynecological practice can significantly reduce diagnostic delay and allow earlier therapeutic intervention, particularly in women with infertility and chronic pelvic pain.

Conclusion:

Transvaginal ultrasound represents a valuable, accessible, and non-invasive diagnostic tool in the early detection of endometriosis. Its routine use in women presenting with pelvic pain and infertility may contribute to earlier diagnosis, improved clinical management, and better reproductive outcomes