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Around the world, ultrasound in the specialty of obstetrics and gynecology (Ob/Gyn) has been performed and interpreted by a spectrum of healthcare providers: obstetrician-gynecologists, radiologists, sonographers, midwives and nurses. Depending on training and tradition, and practice differs not only between countries, but even within countries. [ABSTRACT FROM AUTHOR]

Purpose: The Canadian Association of Radiologists (CAR) Endometriosis Working Group developed a national survey to evaluate current practice patterns associated with imaging endometriosis using advanced pelvic ultrasound and MRI to inform forthcoming clinical practice guidelines for endometriosis imaging. Methods: The anonymous survey consisted of 36 questions and was distributed electronically to CAR members. The survey contained a mix of multiple choice, Likert scale and open-ended questions intended to collect information about training and certification, current practices and protocols associated with imaging endometriosis, opportunities for quality improvement and continuing professional development. Descriptive statistics were used to summarize the results. Results: Canadian radiologists were surveyed about their experience with imaging endometriosis. A total of 89 responses were obtained, mostly from Ontario and Quebec. Most respondents were community radiologists, and almost 33% were in their first five years of practice. Approximately 38% of respondents reported that they or their institution performed advanced pelvic ultrasound for endometriosis, with most having done so for less than 5 years, and most having received training during residency or fellowship. 70% of respondents stated they currently interpret pelvic endometriosis MRI, with most having 1-5 years of experience. Conclusion: Many radiologists in Canada do not perform dedicated imaging for endometriosis. This may be due to a lack of understanding of the benefits and limited access to training. However, dedicated imaging can improve patient outcomes and decrease repeated surgeries. The results highlight the importance of developing guidelines for these imaging techniques and promoting a multidisciplinary approach to endometriosis management. [ABSTRACT FROM AUTHOR]

Objective: To provide a contemporary approach to the understanding of the impact and methods for the diagnosis of endometriosis in Canada., Target Population: Individuals, families, communities, health care providers, and health care administrators who are affected by, care for patients with, or manage delivery of services for endometriosis., Options: The diagnosis of endometriosis is facilitated by a detailed history, examination, and imaging tests with providers who are experienced in endometriosis care. Surgical evaluation with pathology confirms a diagnosis of endometriosis; however, it is not required for those whose diagnosis was confirmed with imaging., Outcomes: There is a need to address earlier recognition of endometriosis to facilitate timely access to care and support. Education directed at the public, affected individuals and families, health care providers, and health care administrators are essential to reduce delays in diagnosis and treatment., Benefits, Harms, and Costs: Increased awareness and education about the impact and approach to diagnosis may support timely access to care for patients and families affected by endometriosis. Earlier and appropriate care may support a reduced health care system burden; however, improved clinical evaluation may require initial investments., Evidence: Each section was reviewed with a unique search strategy representative of the evidence available in the literature related to the area of focus. The literature searches for each section of this guideline are listed in Appendix A and include information from published systematic reviews described in the text., Validation Methods: The recommendations were developed following two rounds of review by a national expert panel through an iterative 2-year consensus process. Further details on the process are shared in Appendix B. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix C (Table C1 for definitions and Table C2 for interpretations of strong and conditional recommendations)., Intended Audience: This guideline is intended to support health care providers and policymakers involved in the care of those impacted by endometriosis and the systems required to support them., Tweetable Abstract: Endometriosis impact and diagnosis updated guidelines for Canadian health care providers and policymakers., Summary Statements: RECOMMENDATIONS., (Copyright © 2024. Published by Elsevier Inc.)

The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. This practice statement provides an overview of the state of the art of advanced pelvic ultrasound in the diagnosis and mapping of pelvic endometriosis. While acknowledging that advanced pelvic ultrasound in some practices falls within the scope of clinical colleagues rather than imaging departments, the statement seeks to guide radiologists interested in implementing these techniques into their practice for patients referred for evaluation and diagnosis of endometriosis. The statement covers indications, some components of the ultrasound assessment and technique, reporting, and recommendations for starting an ultrasound endometriosis evaluation program., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Unrelated to the recommendations contained herein, Dr. Leonardi is a member of the AbbVie advisory board; has delivered lectures for AbbVie, Hologic, and TerSera; has received research grants from Hyivy, AIMA, and AbbVie; and has participated in clinical trials within the past 36 months funded by Hyivy, and AIMA.

Objectives: To describe the use and perceived effectiveness of medical, surgical, and alternative therapies (e.g., diet, exercise, heat, cannabis, etc.) in managing endometriosis-associated pain in Canadians., Methods: A cross-sectional online survey was distributed via The Endometriosis Network Canada (TENC) from February to March 2021. Canadians aged 18-50 years with diagnosed or suspected endometriosis were eligible to participate., Results: A total of 434 survey responses were included, and 93.8% of respondents reported that they used at least 1 alternative therapy in the past 6 months for endometriosis-associated pain. Respondents used an array of medical (2.3/6 months), surgical (1.7/lifetime), and alternative therapies (6.9/6 months) to manage their pain, yet 61.9% of respondents did not feel it was adequately managed. The most common alternative therapies were heat, meditation/mindfulness/rest, and diet., Conclusion: Alternative therapies were commonly used by Canadians living with endometriosis to manage pain. Cannabis and heat were perceived as the most effective alternative therapies. Here, we gain a better understanding of alternative therapies that can provide an additional therapeutic avenue that clinicians and people living with endometriosis may wish to discuss and explore., (Copyright © 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.)

Objective: Ultrasonography in obstetrics and gynaecology (OB/GYN) is a vital component of patient assessment, diagnosis, and management. Standards for Canadian obstetrician-gynecologists' ultrasound skills are limited and vague. The primary objective was to audit the current curriculum administered to Canadian OB/GYN residents. The secondary objective was to understand self-perceived competency of final-year residents in performing OB/GYN ultrasound. We also sought to identify perceived barriers to incorporation of ultrasound into practice., Methods: A cross-sectional questionnaire, distributed to two cohorts of final-year Canadian OB/GYN residents, asked about ultrasound training they received and their perceived competency with respect to specific ultrasound skills. Respondents also answered questions on possible perceived obstacles to independently using ultrasound after graduation., Results: All Canadian residency programs were represented among the 81 respondents out of the possible 167 participants (49%). Ultrasound training varied in its delivery and quantity. The majority of training time was dedicated to obstetrics, with minimal focus on gynaecology. Self-reported competency for obstetric ultrasound was high, whereas that for gynaecologic ultrasound was variable. The main barrier to incorporating ultrasound into future practice was lack of adequate training., Conclusions: Canadian OB/GYN programs lack standardisation of ultrasound training. The imbalance in training between OB/GYN ultrasound may influence the low levels of self-reported competency in gynaecologic skills in residents. Standardization of ultrasound education and increasing gynaecologic ultrasound training in residency are the necessary first steps in preparing OB/GYN graduates to use ultrasound., (Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.)