Objectives: The primary end point of this study was to evaluate the image quality and reliability of a highly accelerated 3-dimensional T2 turbo spin echo (3D-T2-TSE) sequence with prototype iterative denoising (ID) reconstruction compared with conventional 2D T2 sequences for the diagnosis of deep infiltrating endometriosis (DIE). The secondary end point was to demonstrate the 3D-T2-TSE sequence image quality improvement using ID reconstruction. Material and Methods: Patients were prospectively enrolled to our institution for pelvis magnetic resonance imaging because of a suspicion of endometriosis over a 4-month period. Both conventional 2D-T2 (sagittal, axial, coronal T2 oblique to the cervix) and 3D-T2-TSE sequences were performed with a scan time of 7 minutes 43 seconds and 4 minutes 58 seconds, respectively. Reconstructions with prototype ID (3D-T2-denoised) and without prototype ID (3D-T2) were generated inline at the end of the acquisition. Two radiologists independently evaluated the image quality of 3D-T2, 3D-T2-denoised, and 2D-T2 sequences. Diagnosis confidence of DIE was evaluated for both 3D-T2-denoised and 2D-T2 sequences. Intraobserver and interobserver agreements were calculated using Cohen κ coefficient. Results: Ninety female patients were included. Both readers found that the ID algorithm significantly improved the image quality and decreased the artifacts of 3D-T2-denoised compared with 3D-T2 sequences (P < 0.001). A significant image quality improvement was found by 1 radiologist for 3D-T2-denoised compared with 2D-T2 sequences (P = 0.002), whereas the other reader evidenced no significant difference. The interobserver agreement of 3D-T2-denoised and 2D-T2 sequences was 0.84 (0.73–0.95) and 0.78 (0.65–0.9), respectively, for the diagnosis of DIE. Intraobserver agreement for readers 1 and 2 was 0.86 (0.79–1) and 0.83 (0.76–1), respectively. For all localization of DIE, interobserver and intraobserver agreements were either almost perfect or substantial for both 3D-T2-denoised and 2D-T2 sequences. Conclusions: Three-dimensional T2-denoised imaging is a promising tool to replace conventional 2D-T2 sequences, offering a significant scan time reduction without compromising image quality or diagnosis information for the assessment of DIE.

Recent decrees conditioning the placement of pelvic implants on a minimum annual activity threshold per institution have raised concerns. A survey was conducted among French urologists and gynecologists to assess their practices and perceptions of these measures. An online questionnaire was distributed via three scientific societies (AFU, CNGOF, SCGP) in May 2025. It covered four themes: respondent characteristics, experience in pelvi-perineology, impact of the new decrees, and opinions on surgical thresholds. The response collection period was 21 days, with a reminder after one week. A total of 431 practitioners responded (60% urologists, 40% gynecologists; 64% male; 34% aged 41-50). The majority worked in private practices (52%) and were trained in pelvi-perineology (61%). Regarding activity, 67% and 66% exceeded the thresholds for incontinence and pelvic organ prolapse (POP), respectively, but 18% and 18% did not meet them. Most incontinence procedures involved mid-urethral slings; 51% of respondents used only TVT, and 29% only TOT. For POP, sacrocolpopexy was the sole procedure performed by 9% of gynecologists and 61% of urologists. Among the latter, 59% did not perform Richter procedures (vs. 6% of gynecologists). The perceived impact of the decrees was significant: 53% of practitioners (including 67% of urologists) reported a desire to withdraw from the management of female incontinence, and 46% from POP (including 79% of urologists). If authorization were lost, 71% would stop implanting meshes and 60% would refer patients elsewhere. Only 32% believed the thresholds would improve patient care. For 61%, they did not guarantee individual experience, and for 51%, they did not reflect quality of care. Most respondents considered a threshold of 10 annual procedures more appropriate for POP and incontinence, and 78% believed that validation of specialized training would be more relevant than activity thresholds (78% among urologists). This survey highlights a real risk of practitioner disengagement, particularly among urologists, potentially detrimental to healthcare provision. Thresholds are perceived as inadequate, and recognition of individual competence appears preferable.