Cervical Anatomical Characteristics in Women with Endometriosis: A  Diagnostic Approach

Elahe  Afshari; Roya  Derakhshan; Shahla  Chaichian; Seyed Reza Saadat  Mostafavi; Shima Ghafourian   Noroozi; Samaneh  Rokhgireh; Abolfazl  Mehdizadehkashi; Babak  Sabet; Mohanna  Khandan

doi:10.18502/jri.v25i3.17016

Elahe Afshari Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Roya Derakhshan Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Shahla Chaichian Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Seyed Reza Saadat Mostafavi Department of Radiology, Iran University of Medical Sciences, Tehran, Iran
Shima Ghafourian Noroozi Department of Radiology, Iran University of Medical Sciences, Tehran, Iran
Samaneh Rokhgireh Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Abolfazl Mehdizadehkashi Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Babak Sabet Department of Artificial Intelligence, Smart University of Medical Sciences, Tehran, Iran
Mohanna Khandan Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

DOI: https://doi.org/10.18502/jri.v25i3.17016

Keywords: Cervical length measurement, Endometrial thickness, Endometriosis

Abstract

Background: Endometriosis is a gynecologic disorder which causes dysmenorrhea and infertility. Early diagnosis of endometriosis can help prevent the necessity for invasive diagnostic procedures. Medical imaging has been widely utilized to diagnose various diseases without the need for invasive procedures. The purpose of this study was to investigate the cervical length in women with endometriosis.

Methods: In this case-control study, the case group consisted of nulliparous women with endometriosis, while the control group comprised nulliparous women without endometriosis. A total of 42 individuals were included in each group. Cervical length was measured using transvaginal ultrasound from the external os to the internal os. The patients in the case group underwent laparoscopy to confirm the diagnosis. Pearson chi-square test and Fisher’s exact test were employed to compare categorical variables with a p<0.05 considered statistically significant.

Results: In both groups, there were no notable variations in any of the demographic characteristics. However, the severity of dysmenorrhea was significantly different between the two groups (p=0.01). The average diameter of the mediolateral cervix (29.48±6.2 and 27.14±3.8) was statistically significant between the patient group and control group, respectively (p=0.04). The mediolateral width may have a positive predictive effect on the presence of endometriosis, while cervical length appears to have a protective effect against endometriosis.

Conclusion: Demographic data do not predict endometriosis. This study suggests that mediolateral width in transvaginal sonography can serve as a minimally invasive diagnostic tool for endometriosis, showing correlation with endometriosis symptoms like dysmenorrhea and dyspareunia.