in the clinic

Dr. Mathew Leonardi is an Assistant Professor at McMaster University. His primary research focus is improving the non-invasive diagnosis of gynaecological pathology, particularly those that cause pelvic pain, infertility, and reduced quality of life in women and those born with female pelvic organs*. Non-invasive diagnoses can be achieved by a single tool such as ultrasound or a combination of tools such as biomarkers and clinical history. The longterm goal is to reduce the necessity for diagnostic laparoscopy and reliance on a purely clinical diagnosis for gynaecological pathologies. Mathew firmly believes that patients and their families deserve to know what is causing the problem and use that information to best target therapies. Secondarily, improved diagnosis may allow for proper evaluation of disease progression, which remains a mystery in endometriosis since it has historically been diagnosed at the time of surgery and simultaneously surgically treated.

Specific to endometriosis, there are a great many unanswered questions. Areas Mathew has started to explore included the microbiome, general population and obstetrician/gynaecologist awareness of diagnostic techniques, machine learning models for diagnosis using ultrasound, diagnostic accuracy of advanced ultrasound techniques. Areas he is keen to explore are how the diagnosis of endometriosis impacts wellbeing and physical outcomes, how novel techniques can be disseminated outside of academic centres, how we can sample and test bodily fluids for biomarkers to assist in diagnosis and monitoring of disease state. Other possible considerations include the effect of complementary and alternative management strategies (e.g. physiotherapy, medical cannabis, psychotherapy) on endometriosis outcomes, optimizing evidence-based practices in endometriosis and infertility, and interventional trials on specific medical or surgical management options.

*We acknowledge individuals in the transgender community and people who are non-binary and living with endometriosis who may not identify as women.

  • Leonardi M, Condous G. Noninvasive diagnosis of endometriosis. Contemporary OB/GYN 2020.
  • Leonardi M, Espada M, Choi S, Chou D, Chang T, Smith C, Rowan K, Condous G. Transvaginal Ultrasound Can Accurately Predict the American Society of Reproductive Medicine Stage of Endometriosis Assigned at Laparoscopy. J Minim Invasive Gynecol 2020.
  • Leonardi M, Martin WP, Espada M, Georgousopoulou E, Condous G. Prevalence of negative sliding sign representing pouch of Douglas obliteration during pelvic transvaginal ultrasound for any indication. Ultrasound Obstet Gynecol 2020.
  • Leonardi M, Gibbons T, Armour M, Wang R, Glanville E, Hodgson R, Cave AE, Ong J, Tong YYF, Jacobson T, Mol B, Campbell N, Condous G. When to do surgery and when not to do surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol 2019.
  • Leonardi M, Hicks C, El-Assaad F, El-Omar E, Condous G. Endometriosis and the microbiome: a systematic review. BJOG An Int J Obstet Gynaecol 2019: