[Endometriosis: Assessment of the Ultrasound-Based Endometriosis Staging System score (UBESS) in predicting surgical difficulty]

Gynecol Obstet Fertil Senol. 2019 Mar;47(3):265-272. doi: 10.1016/j.gofs.2018.12.003. Epub 2019 Jan 26.
[Article in French]


Objectives: Surgical management of endometriosis may require different levels of surgical skill which influences the orientation of the patient. The Ultrasound-Based Endometriosis Staging System (UBESS) is a score developed in 2016 to predict the difficulty of surgery. To study the correlation between UBESS score and two main surgical classifications in the literature.

Methods: Study performed at the center of Poissy, France, between July 2016 and December 2017. Patients who underwent prospective UBESS staging then operated of their endometriosis were included. The patients were classified according to the levels of surgical difficulty of the Royal College of Obstetricians and Gynecologists (RCOG) and the classification created by Chi et al. The criterion of judgment was the correlation between the UBESS stages and RCOG and CHI levels. In a second analysis, we determined the predictive value of the operative plan for items included in the systematic sonographic evaluation described by Menakaya et al. RESULTS: Thirty-three patients were included in the study. Correlation was found to be low between UBESS and RCOG (θ=0.22) and between UBESS and CHI (θ=0.30). The prediction of the operative plan was good for endometrioma, sites specific tenderness, sliding sign, vaginal and digestive tract involvement; but modest for the anterior compartment and uterosacrals ligaments.

Conclusion: In our study on a small number of patients, the UBESS score does not adequately predict the surgical difficulty. Taken separately, the items of systematic sonographic evaluation based on 5 domains successfully predict the operative plan.

Keywords: Chirurgical; Classification; Difficulty; Difficulté; Endometriosis; Endométriose; Score; Severity; Surgical; Sévérité; Ultrasound; Échographie.

MeSH terms

  • Adult
  • Clinical Competence
  • Endometriosis / classification*
  • Endometriosis / diagnostic imaging
  • Endometriosis / surgery*
  • Female
  • France
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Retrospective Studies
  • Ultrasonography*