Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women
Abstract Introduction There is a gap in knowledge regarding development of endometriosis and adenomyosis lesions visible at transvaginal ultrasound. The objectives were to evaluate if women with symptoms suggestive of endometriosis or adenomyosis but normal ultrasound examination develop endometrios...
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Wiley
2024-08-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14865 |
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| author | Sofie Orlov Povilas Sladkevicius Ligita Jokubkiene |
| author_facet | Sofie Orlov Povilas Sladkevicius Ligita Jokubkiene |
| author_sort | Sofie Orlov |
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| description | Abstract Introduction There is a gap in knowledge regarding development of endometriosis and adenomyosis lesions visible at transvaginal ultrasound. The objectives were to evaluate if women with symptoms suggestive of endometriosis or adenomyosis but normal ultrasound examination develop endometriosis or adenomyosis lesions visible at ultrasound over time and if alterations of symptoms over time are associated with ultrasound findings at follow‐up. Material and Methods This was a prospective cohort study of 100 symptomatic women with normal initial ultrasound examination during 2014–2017 who underwent follow‐up ultrasound examination in 2022. Symptoms suggestive of endometriosis were assessed using visual analog scale at both examinations and minimal clinically important difference of 10 mm was considered as a significant alteration. An examiner with expertise in advanced ultrasound examination of endometriosis performed transvaginal ultrasound examinations in accordance with the consensus protocol by the International Deep Endometriosis Analysis group. Results At follow‐up ultrasound examination of 100 women, 13 (13% [95% CI 7.1–21.2]) had visible endometriosis or adenomyosis lesions, 8 (8% [95% CI 3.5–15.2]) had endometriosis lesions, and 6 (6% [95% CI 2.2–12.6]) had adenomyosis. At follow‐up, women with endometriosis or adenomyosis lesions reported lower intensity of dysmenorrhea and chronic pelvic pain compared to women without lesions (48 mm [IQR 16–79] vs. 73 mm [IQR 46–85] and 45 mm [IQR 26–57] vs. 57 mm [IQR 36–75], p = 0.087 and p = 0.026, respectively). None of the women with endometriosis or adenomyosis lesions reported increased intensity of dysmenorrhea at follow‐up, compared to 32/86 women (37%) without lesions (p = 0.008). Increased intensity of chronic pelvic pain tended to be less common in women with lesions compared to those without (3/13 [23%] vs. 35/86 [41%], p = 0.223). Conclusions Our findings suggest that in symptomatic women, endometriosis and adenomyosis lesions visible at ultrasound may develop over time. However, majority of women remain having normal ultrasound examinations despite symptoms. Exacerbation of dysmenorrhea or chronic pelvic pain during follow‐up was not associated with the development of endometriosis or adenomyosis lesions visible at ultrasound, suggesting that even women with less severe symptoms might benefit from a follow‐up ultrasound when indicated. |
| format | Article |
| id | doaj-art-ed58768f04a347c1a3d056d0da1d5bdf |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-ed58768f04a347c1a3d056d0da1d5bdf2025-08-20T03:30:53ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-08-0110381634164410.1111/aogs.14865Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic womenSofie Orlov0Povilas Sladkevicius1Ligita Jokubkiene2Obstetric, Gynecological and Prenatal Ultrasound Research, Department of Clinical Sciences Malmo Lund University Malmo SwedenObstetric, Gynecological and Prenatal Ultrasound Research, Department of Clinical Sciences Malmo Lund University Malmo SwedenObstetric, Gynecological and Prenatal Ultrasound Research, Department of Clinical Sciences Malmo Lund University Malmo SwedenAbstract Introduction There is a gap in knowledge regarding development of endometriosis and adenomyosis lesions visible at transvaginal ultrasound. The objectives were to evaluate if women with symptoms suggestive of endometriosis or adenomyosis but normal ultrasound examination develop endometriosis or adenomyosis lesions visible at ultrasound over time and if alterations of symptoms over time are associated with ultrasound findings at follow‐up. Material and Methods This was a prospective cohort study of 100 symptomatic women with normal initial ultrasound examination during 2014–2017 who underwent follow‐up ultrasound examination in 2022. Symptoms suggestive of endometriosis were assessed using visual analog scale at both examinations and minimal clinically important difference of 10 mm was considered as a significant alteration. An examiner with expertise in advanced ultrasound examination of endometriosis performed transvaginal ultrasound examinations in accordance with the consensus protocol by the International Deep Endometriosis Analysis group. Results At follow‐up ultrasound examination of 100 women, 13 (13% [95% CI 7.1–21.2]) had visible endometriosis or adenomyosis lesions, 8 (8% [95% CI 3.5–15.2]) had endometriosis lesions, and 6 (6% [95% CI 2.2–12.6]) had adenomyosis. At follow‐up, women with endometriosis or adenomyosis lesions reported lower intensity of dysmenorrhea and chronic pelvic pain compared to women without lesions (48 mm [IQR 16–79] vs. 73 mm [IQR 46–85] and 45 mm [IQR 26–57] vs. 57 mm [IQR 36–75], p = 0.087 and p = 0.026, respectively). None of the women with endometriosis or adenomyosis lesions reported increased intensity of dysmenorrhea at follow‐up, compared to 32/86 women (37%) without lesions (p = 0.008). Increased intensity of chronic pelvic pain tended to be less common in women with lesions compared to those without (3/13 [23%] vs. 35/86 [41%], p = 0.223). Conclusions Our findings suggest that in symptomatic women, endometriosis and adenomyosis lesions visible at ultrasound may develop over time. However, majority of women remain having normal ultrasound examinations despite symptoms. Exacerbation of dysmenorrhea or chronic pelvic pain during follow‐up was not associated with the development of endometriosis or adenomyosis lesions visible at ultrasound, suggesting that even women with less severe symptoms might benefit from a follow‐up ultrasound when indicated.https://doi.org/10.1111/aogs.14865adenomyosisdysmenorrheaendometriosisfollow‐upnatural historypelvic pain |
| spellingShingle | Sofie Orlov Povilas Sladkevicius Ligita Jokubkiene Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women Acta Obstetricia et Gynecologica Scandinavica adenomyosis dysmenorrhea endometriosis follow‐up natural history pelvic pain |
| title | Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women |
| title_full | Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women |
| title_fullStr | Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women |
| title_full_unstemmed | Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women |
| title_short | Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women |
| title_sort | evaluating the development of endometriosis and adenomyosis lesions over time an ultrasound study of symptomatic women |
| topic | adenomyosis dysmenorrhea endometriosis follow‐up natural history pelvic pain |
| url | https://doi.org/10.1111/aogs.14865 |
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