FINDING A SIMPLIFIED CLINICAL SCORE FOR DIAGNOSIS AND TREATMENT OF ENDOMETRIOSIS WITHOUT CHOCOLATE CYST
Keywords:endometriosis, trans-vaginal , trans-abdominal, ultrasonography, clinical score, laparoscopy
Introduction: This study has been proposed to evaluate the feasibility of trans-vaginal and trans-abdominal ultrasound in screening of endometriosis.
Methods: This was a retrospective observational study in which women with clinical symptoms, features and family history of endometriosis were included. Women with diagnosed endometriosis on treatment, with chocolate cystor adenomyosis were excluded. The ultrasound features in patients with suspected endometriosis were correlated with the laparoscopy findings and a new scoring system has been introduced to facilitate the management of the disease. Results: 2080 patients were examined clinically either by per-vaginal or by per-rectal examination (in adolescents, unmarried patients) and the findings were noted and ultrasound was performed. 489 of these women had undergone laparoscopy. Combined clinical score of 1-3 is associated with USG score 1. The visualisation shows that combined clinical score of 7-9 is associated with laparoscopy score 4 and combined clinical score of 1-3 is associated with laparoscopy score 2.Combined clinical score 10-12 is highly differentiated statistically. Conclusion: Clinical symptoms, signs along with USG findings have been seen to be quite helpful to screen endometriotic cases and thereby they should be followed up closely to detect its presence. In extremely doubtful cases laparoscopy should be performed for detection of the foresaid disease. It is very important to note that the clinical score and USG score corresponds to a large extent to laparoscopy score as mentioned in the results.
Keywords: endometriosis, trans-vaginal, trans-abdominal, ultrasonography, clinical, score, laparoscopy
List of abbreviations
USG – Ultrasonography
MRI –Magnetic Resonance Imaging
POD- Pouch of Douglas
VAS- Visual Analogue Scale
TVS- Trans-vaginal ultrasonography
TRUS- Trans-rectal ultrasonography
USL- utero-sacral ligament