Integrating the concept of advanced gynaecological imaging for endometriosis

Performance of ultrasound‐based endometriosis staging system (UBESS) for predicting level of complexity of laparoscopic surgery for endometriosis

“…Preoperative recognition of these phenotypes of endometriosis would facilitate triage of these women to centers of excellence for higher-stage endometriosis, consistent with the recommendation of the WES 3,7,21 . Integrating the use of TVS to identify women with bowel DIE and POD obliteration into the clinical work-up of women in whom surgery for endometriosis is planned would improve patient counseling, enhance theater-list management and potentially reduce women's exposure to multiple laparoscopies, with the attendant operative risks and healthcare costs 7,32,33 .…”

Diagnostic laparoscopy in pre‐surgical planning for higher stage endometriosis: Is it still relevant?

“…This approach reduces the risks of multiple surgical exposures, enhances theatre list planning and facilitates the referral of women with higher stage endometriosis to centres of excellence for endometriosis surgery at their primary clinical interface . In addition, it improves preoperative counselling and patient participation in medical decision‐making by enhancing an understanding of the severity of endometriosis and the treatment options available prior to surgery.…”

“…In addition, it improves preoperative counselling and patient participation in medical decision‐making by enhancing an understanding of the severity of endometriosis and the treatment options available prior to surgery. As such, it empowers women with endometriosis who may be planning surgery by giving them more control over where and by whom their surgery is managed . It also enables them to ask the right questions regarding their future fertility and the resolution of their pelvic pain after surgery …”

Capacity building in endometriosis ultrasound: are we there yet?

“…Unfortunately, despite this growing body of evidence on the clinical value of pre‐operative TVS in the work up and triage of women with higher stage endometriosis, there remains an apparent delay in the uptake of these advanced gynecological imaging techniques for the diagnosis and surgical management of women with higher stage endometriosis 11 , 19 . The reasons for this delay in utilising TVS in the pre operative work up of women with suspected higher stage endometriosis may be related to the current lack of practice guidelines for endometriosis ultrasound from the various governing bodies for ultrasound.…”

“…Although improving the uptake and practice of advanced gynecological imaging for endometriosis requires additional training and expertise beyond that available for performing routine gynecological imaging, 19 the introduction of an evidence based, structured capacity building program with a ‘protocolized’ approach to teaching these techniques can increase the pool of sonographers with expertise in advanced gynecology imaging for endometriosis. Such a program(s) should incorporate an objective system for assessing sonographer competency and also provide ongoing support for those sonographers who demonstrate the requisite proficiency in the assessment of women with suspected higher stage endometriosis with TVS.…”