Clinical Symptoms and Ultrasound Findings in Patients with Histopathological Diagnosis of Endometrium

Abstract

Introduction: Ultrasound is performed to check the growth of endometrial cells outside the uterus and the pathology is performed to confirm endometriosis. A combination of diagnostic methods is important for summarizing and starting treatment of endometriosis. The present study was performed with aim to investigate and compare clinical and ultrasound diagnoses in patients with histopathological diagnoses of endometriosis. Methods: This retrospective study was conducted in 2010-2021 on 140 women aged 18-65 years old suffering from endometriosis referred to Ayatollah Rouhani Hospital in Babol city. Confirmation of endometriosis was done based on tissue pathology and then comparing clinical history with ultrasound findings. The data collection tools were the patients' files and the researcher made checklist. Collected data included clinical manifestations, presence or absence of pain during menstruation, abdominal pain, pain during intercourse, pelvic pain, abnormal menstrual bleeding, backache, pain during defecation, and dysuria. Data were analyzed by SPSS software (version 22) and chi-square and independent t-tests. P<0.05 was considered statistically significant. Results: Dysmenorrhea (55.63%), abdominal pain (48.59%), and dyspareunia (31.69%) were the most common clinical symptoms. The state of uterine echogenicity was reported to be homogeneous in 99 patients (69.7%) and heterogeneous in 43 (30.3%). Echogenic status had a significant relationship with abdominal pain (p=0.004) and abnormal menstrual bleeding (p=0.032), adenomyosis with abdominal pain (p=0.004), ovarian adhesion with complaints of pain during intercourse (p=0.002) and status of fallopian tubes with complaints of pain during intercourse (p=0.015) and dysuria (p=0.049). Conclusion: Dysmenorrhea, abdominal pain, dyspareunia, abnormal menstrual bleeding, and dysuria had significant difference with ultrasound findings. For definitive diagnosis and appropriate treatment, clinical manifestations, pathology, and ultrasound should be considered and treatment should be carried out based on that.

Keywords

• clinical findings
• histopathology
• ovarian endometriosis
• ultrasound