Transvaginal Ultrasound for Endometriosis: Learning From a Decade of Diagnostic Challenges Through a…

ObservationalThe Australian & New Zealand journal of obstetrics & gynaecology· Oct 2026

Transvaginal Ultrasound for Endometriosis: Learning From a Decade of Diagnostic Challenges Through a Retrospective Observational Cohort Study.

Candice Dry, Charlotte Moss, Elizabeth Nathan … Jan E Dickinson

Reproductive Medicine & FertilityObservationalDiagnosisQ2IF 1.6

Enhanced transvaginal ultrasound detected adnexal endometriomas with high sensitivity and specificity compared with laparoscopy

Transvaginal Ultrasound for Endometriosis: Learning From a Decade of Diagnostic Challenges Through a Retrospective Observational Cohort Study.

Candice Dry … Jan E Dickinson

The Australian & New Zealand journal of obstetrics & gynaecology · Oct 2026 · Q2 in General Medicine

Background

Endometriosis is a chronic, inflammatory condition associated with pelvic pain, subfertility, and reduced quality of life.

Purpose

To evaluate and critically reflect on the diagnostic performance of eTVUS during its implementation prior to the adoption of standardised scanning protocols.

Methods

A retrospective observational study of patients with suspected endometriosis who underwent preoperative eTVUS and subsequent laparoscopy between January 2015 and January 2024 at a single tertiary hospital.

n = 221 patients

Results

of surgically confirmed endometriomas were picked up on ultrasound, so about 1 in 5 were missed

81.4%

Sensitivity

84.1%

Specificity

More results

Tubo-ovarian complex disease demonstrated a sensitivity of 72.9% and specificity of 68.8%.

Sensitivity for deep endometriosis was lower, with specificity for detection depending on anatomical location varying from 83%-95%.

Bladder involvement had a PPV of 83.3% and NPV of 94.8%; ureteric disease had a PPV of 0% and NPV of ~100%.

More results

Peritoneal disease was rarely identified.

“

Conclusion

eTVUS demonstrated high diagnostic accuracy for ovarian endometriomas, moderate performance for bowel involvement, and low sensitivity for peritoneal disease.

Transvaginal Ultrasound for Endometriosis: Learning From a Decade of Diagnostic Challenges Through a Retrospective Observational Cohort Study.

Transvaginal Ultrasound for Endometriosis: Learning From a Decade of Diagnostic Challenges Through a Retrospective Observational Cohort Study.

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