{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:35:49Z","timestamp":1778312149321,"version":"3.51.4"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether premenopausal women diagnosed with deep or ovarian endometriosis on transvaginal sonography (TVS) were more likely to suffer from dyspareunia and pelvic pain symptoms, and have a lower quality of life, compared to women without sonographically diagnosed deep or ovarian endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective, cross\u2010sectional study carried out between February 2019 and October 2020 at the general gynecology clinic at University College London Hospital, London, UK. All premenopausal women aged 18\u201350\u2009years, who were examined consecutively by a single experienced examiner and underwent a detailed TVS scan, were eligible for inclusion. Pregnant women and those who had received a previous diagnosis of endometriosis or who had experienced a hysterectomy or unilateral\/bilateral oophorectomy were excluded. Sonographic findings consistent with deep or ovarian endometriosis were noted. All women completed the British Society of Gynaecological Endoscopy pelvic pain questionnaire. The primary outcome was to determine whether women with sonographic evidence of endometriosis were more likely to experience moderate\u2010to\u2010severe levels of dyspareunia (score of \u2265\u20094 on an 11\u2010point numerical rating scale (NRS)). Secondary outcomes included assessing moderate\u2010to\u2010severe levels of other pelvic pain symptoms (NRS score of \u2265\u20094), bowel symptoms (score of \u2265\u20092 on a 5\u2010point Likert scale) and quality of life, which was measured using the EuroQol\u20105D\u20103L (EQ\u20105D) questionnaire. The number of women with pain scores \u2265\u20094 and bowel scores \u2265\u20092, as well as the mean EQ\u20105D scores, were compared between the group with and that without sonographic evidence of endometriosis using logistic regression analysis, and multivariable analysis was used to adjust for demographic and clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 514 women were included in the final study population, of whom 146 (28.4%) were diagnosed with deep or ovarian endometriosis on TVS. On multivariable analysis, the presence of moderate\u2010to\u2010severe dyspareunia was not found to be associated with endometriosis. Moderate\u2010to\u2010severe dyspareunia was significantly associated with lower age (odds ratio (OR), 0.70 (95%\u2009CI, 0.56\u20130.89);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) and a history of migraine (OR, 3.52 (95%\u2009CI, 1.42\u20138.77);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007), and it occurred significantly less frequently in women with non\u2010endometriotic ovarian cysts (OR, 0.47 (95%\u2009CI, 0.28\u20130.78);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). There was also a trend towards a positive association between anxiety\/depression and moderate\u2010to\u2010severe dyspareunia (OR, 1.94 (95%\u2009CI, 0.93\u20134.03);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.08). Following multivariable analysis, the only symptoms that were significantly more common in women with endometriosis compared to those without were menstrual dyschezia (OR, 2.44 (95%\u2009CI, 1.59\u20133.78);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and difficulty emptying the bladder (OR, 2.56 (95%\u2009CI, 1.52\u20134.31);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Although not reaching statistical significance on multivariable analysis, dysmenorrhea (OR, 1.72 (95%\u2009CI, 0.92\u20133.20);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.09) and lower EQ\u20105D score (mean\u2009\u00b1\u2009SD, 0.67\u2009\u00b1\u20090.33\n                      <jats:italic>vs<\/jats:italic>\n                      0.72\u2009\u00b1\u20090.28;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.06) also occurred more frequently in women with sonographic evidence of endometriosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The majority of pelvic pain symptoms did not differ significantly between women with and those without sonographic evidence of endometriosis, indicating that endometriosis may not always be the source of pelvic pain, even if present. This highlights the need to rule out other causes of pain in symptomatic endometriosis patients before considering surgical procedures, and to provide appropriate patient counseling. \u00a9 2024 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.29150","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:13:13Z","timestamp":1736899993000},"page":"372-383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of deep or ovarian endometriosis on pelvic pain and quality of life: prospective cross\u2010sectional ultrasound study"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-6117","authenticated-orcid":false,"given":"P.","family":"Chaggar","sequence":"first","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2635-4504","authenticated-orcid":false,"given":"T.","family":"Tellum","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"},{"name":"Department of Gynaecology Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Thanatsis","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-2605","authenticated-orcid":false,"given":"L. V.","family":"de Braud","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2560-1390","authenticated-orcid":false,"given":"T.","family":"Setty","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6487-5736","authenticated-orcid":false,"given":"D.","family":"Jurkovic","sequence":"additional","affiliation":[{"name":"EGA Institute for Women's Health, Faculty of Population Health Sciences University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.04.054"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt027"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14491"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.01.014"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des332"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24756"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26175"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2012.12.006"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05797-8"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1991.tb10370.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318223fed0"},{"key":"e_1_2_7_14_1","first-page":"767","article-title":"Pain symptoms associated with endometriosis","volume":"79","author":"Fedele L","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2004.07.973"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70438-6"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018924"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.52054\/FVVO.16.1.008"},{"issue":"1","key":"e_1_2_7_19_1","first-page":"79","article-title":"Minimum training recommendations for the practice of medical ultrasound","volume":"27","author":"Education and Practical Standards Committee, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB)","year":"2006","journal-title":"Ultraschall Med"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12666"},{"key":"e_1_2_7_21_1","unstructured":"Outcome measures.British Pain Society.2019Accessed April 21 2024.https:\/\/www.britishpainsociety.org\/mediacentre\/news\/bps\u2010launches\u2010joint\u2010outcome\u2010measures\u2010document\/"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890109002087"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15955"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19096"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7487"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew307"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.09.025"},{"issue":"5","key":"e_1_2_7_28_1","first-page":"1101","article-title":"Imaging in gynecological disease: clinical and ultrasound characteristics of accessory cavitated uterine malformations","volume":"57","author":"Naftalin J","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20254"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00500.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del339"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1089\/gyn.2015.0092"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2019.06.006"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452660"},{"issue":"7","key":"e_1_2_7_35_1","first-page":"513","article-title":"Prevalence of endometriosis in asymptomatic women","volume":"36","author":"Rawson JM","year":"1991","journal-title":"J Reprod Med"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(02)03331-9"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh627"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg152"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.8.1744"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26204"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2020.10.018"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70482-4"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1068755"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmi029"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14518"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2004.10.003"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2014.07.007"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sxmr.2018.12.007"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-008-0028-8"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijir.2016.22"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1159\/000007471"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1159\/000200951"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31821c98ec"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.01.767"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/302404"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/sm2.52"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27529"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T16:08:29Z","timestamp":1765642109000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.29150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,14]]},"references-count":56,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/uog.29150"],"URL":"https:\/\/doi.org\/10.1002\/uog.29150","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,14]]},"assertion":[{"value":"2024-05-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}