Transvaginal ultrasound (USTV) for Deep Pelvic Endometriosis: How “To Do” do it

Endometriosis is characterized by the growth of endometrial tissue outside the uterine cavity. The standard gold diagnosis for endometriosis is the surgery. For surgical planning, the imaging diagnosis is fundamental to obtain complete excision and patient's treatment. The transvaginal ultrasounds after bowel preparation should be the first line in the diagnosis and endometriosis staging. The hiperechoic uterus serosa must be seen intact. Looking for pelvic adhesions, the ovary often is fixed to the uterus. Vaginal gel before the exam helps to detect small lesions. Intestinal Lesions: perform after bowel preparation, provide the lesions size, wall layers infiltration degree, circumference of bowel involvement and the distance from the anal verge to the inferior lesion margin. Bladder: minimal amount of urine in the bladder to study the vesical wall. The aim of this study is to describe and illustrate radiologic signs, surgery and pathologic correlations of deep endometriosis, from a reference Center, presenting a pre surgical protocol study using ultrasound technique.