A 24-months Follow-up Study of Individuals with Endometriosis using Transvaginal Ultrasound

Study Objective: To investigate the progression of deep infiltrating endometriosis using transvaginal ultrasound surveillance of patients undergoing conservative management. Design: Retrospective single cohort. Setting: Australian tertiary university hospital Patients: One hundred twenty two 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: A total of 122 patients fulfilled the inclusion criteria. All women had 2 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 <.001. Conclusion: Individuals with deep infiltrating endometriosis are unlikely to see significant disease progression over time. Both surgical and nonsurgical interventions are effective in managing endometriosis in terms of endometriotic nodule size and number, as measured by ultrasound.