A 24-months follow up study of individuals with endometriosis using transvaginal ultrasound

Study Objective To investigate the progression of deep infiltrating endometriosis (DIE) using transvaginal ultrasound surveillance of patients undergoing conservative management. Design Retrospective single cohort. Setting Australian tertiary university hospital Patients 122 women with endometriosis proven on transvaginal ultrasound who had not undergone surgical management. Interventions The progression of endometriosis lesions demonstrated on transvaginal ultrasound in women receiving conservative management over the course of 24 months. Measurements and Main Results 122 patients fulfilled the inclusion criteria. All women had two ultrasounds that were performed at least 6 months apart. The median follow up time was 490.5 days (255.4 - 725.6). At second scan, 22% (95% CI: 15-30%) of cohort experienced an increase in the number of endometriosis nodules compared to first scan, with 51% (95% CI: 42-60%) remaining static while 27% (95% CI: 19-35%) experienced a decrease. While there was no statistically significant difference in the volumes of uterosacral ligament, retro cervical and bowel endometriosis, endometrioma volumes were significantly lower at second scan (Median = 3.24 mL, IQR = 0.6 - 16.87) as compared to the first scan (Median = 7.41 mL, IQR = 2.04 - 28.95), p<0.001. Conclusion Individuals with deep infiltrating endometriosis are unlikely to see significant disease progression over time. Both surgical and non-surgical interventions are effective in managing endometriosis in terms of endometriotic nodule size and number, as measured by ultrasound.