Evaluation of endometriosis in uterosacral ligaments by transrectal ultrasonography

Uterosacral ligaments are one of the common targets of pelvic endometriosis, which is usually clinically rather than surgically diagnosed. This study was performed to determine if uterosacral ligaments infiltrated by endometriosis could be detected by transrectal ultrasonography. Uterosacral ligaments in non-endometriosis subjects (n = 64) were observed as low echoic homogeneous arcs in both sides of the uterine cervix. Patients who had endometriosis (n = 29) on the ligaments showed thick and irregularly-shaped uterosacral ligaments by the transrectal ultrasound examination. The results also suggested that the thickness of uterosacral ligaments was associated with the clinical symptoms. Transrectal ultrasonography may provide quantitative information to manage patients with infiltrating endometriosis.