Transvaginal sonography (TVS) soft markers for the prediction of pelvic adhesions/endometriosis at laparoscopy include ovarian immobility and site-specific tenderness (SST). In a recent consensus statement by the ‘International Deep Endometriosis Analysis’ group, TVS soft markers are included as a component of the ultrasound evaluation of women with suspected pelvic deep infiltrating endometriosis (DIE). Studies have demonstrated a significant relationship between ovarian immobility and the presence endometrioma, pouch of Douglas (POD) obliteration and posterior compartment DIE, at both TVS and laparoscopy. SST also appears to be useful in the prediction of endometriotic disease at laparoscopy. The use of these TVS soft markers for women with pelvic pain may improve the ability to plan for complex endometriosis surgery and for patient counselling, thereby improving the overall management for these women.

Supplementary material

Video 6.1

Transvaginal ultrasound is used to demonstrate a mobile right ovary (RO) along the right pelvic sidewall (RPSW) in the transverse plane. EIV external iliac vessel (MP4 9977 kb)

Video 6.2

Transvaginal ultrasound is used to demonstrate ovarian (O) mobility along the lateral uterus (U), as well as the right pelvic sidewall (PSW), in the transverse plane (MP4 17,600 kb)

Video 6.3

Transvaginal ultrasound is used to demonstrate fixation of the left ovary (LO) to both the posterior uterus (U) and left pelvic sidewall (LPSW), in the sagittal plane (MP4 7486 kb)

Video 6.4

Transvaginal ultrasound is used to demonstrate fixation between the left ovary (O) and the posterior uterine cervix (C), in the sagittal plane (MP4 3290 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Shannon Reid
    • 1
  1. 1.Department of Obstetrics and GynaecologyLiverpool HospitalSydneyAustralia

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