Staging of pelvic endometriosis: Role of sonographic appearance in determining extension of disease and modulating surgical approach

Study Objective. To estimate whether laparoscopic staging of endometriosis can be predicted by ultrasound findings. Design. Prospective study (Canadian Task Force classification II-2). Setting. Obstetrics and Gynecology Department, University of Rome Tor Vergata. Patients. One hundred twenty-one women with histologically confirmed sonographic diagnosis of endometriomas. Interventions. Ultrasonographic staging and laparoscopic assessment. Measurements and Main Results. All patients underwent transvaginal and/or transrectal sonographic evaluation of ovarian endometriomas and other sonographic markers (anatomic sites and their relation to abdominovaginal palpation, adhesions, deep or infiltrating nodules) to stage the disease before surgery. These results were compared with laparoscopic staging. Concordance between methods was 83.5%. Specificity and sensitivity of ultrasonographic staging of stages 3 and 4 disease were 86% and 82% and 76% and 91%, respectively. Conclusion. Ultrasonographic findings can predict pelvic extension and stage of endometriosis.