Accuracy of Transvaginal Ultrasonography for Diagnosis of Endometriosis Taking Laparoscopy as Gold Standard

<p><strong>Background and Objective:</strong> Endometriosis is a common gynaecological disease with a diverse clinical presentation. Laparoscopy has long been considered the gold standard diagnostic modality for endometriosis but with the evolution of non-invasive, high resolution transvaginal ultrasonography, it is frequently used as the first line diagnostic technique in making a preoperative diagnosis for endometriosis. This study was designed to determine the diagnostic accuracy of transvaginal ultrasonography (TVS) in diagnosis of endometriosis taking laparoscopy as gold standard.<br /><strong>Methods:</strong> A total of 118 women of child bearing age who presented with symptoms of pelvic endometriosis in the department of gynecology, Bakhtawar Amin Hospital Multan were included. The study duration was from June 01, 2018 to May 31, 2020. Patients were first investigated on TVS examination to diagnose endometriosis. Afterwards, diagnostic laparoscopy was performed in all patients to confirm the diagnosis of endometriosis. Accuracy of TVS was determined in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).<br /><strong>Results:</strong> Mean age of the patients was 31.7 &plusmn; 7.4 years. Most common presenting complaint was dysmenorrhea in 89 (75.4%) patients followed by dyspareunia in 36 (30.5%), chronic pelvic pain in 30 (25.4%) patients and subfertility in 18 (15.3%) patients. On TVS, endometriosis was diagnosed in 69 (58.5%) patients. While on diagnostic laparoscopy, endometriosis was diagnosed in 75 (63.6%) patients.The sensitivity of TVS in diagnosis of endometriosis was calculated as 82.7%, specificity as 83.7%, PPV as 89.9% and NPV as 73.5%.<br /><strong>Conclusion:</strong> TVS appears to be the alternative and safe modality for diagnosis of endometriosis. It can be used as an alternative to diagnostic laparoscopy for the early diagnosis of endometriosis. It has a good sensitivity and specificity for diagnosis of endometriosis.</p>