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Preoperative assessment of intestinal endometriosis: a comparison of Transvaginal Sonography with Water-Contrast in the Rectum, Transrectal Sonography, and Barium Enema

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Abstract

To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.

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References

  1. Bergqvist A (1993) Different types of extragenital endometriosis: a review. Gynecol Endocrinol 7:207–221

    Article  CAS  PubMed  Google Scholar 

  2. Weed JC, Ray JE (1987) Endometriosis of the bowel. Obstet Gynecol 69:727–730

    CAS  PubMed  Google Scholar 

  3. Prystowsky JB, Stryker SJ, Ujiki GT, Poticha SM (1988) Gastrointestinal endometriosis. Incidence and indications for resection. Arch Surg 123:855–858

    CAS  PubMed  Google Scholar 

  4. Coronado C, Franklin RR, Lotze EC, Bailey HR, Valdés CT (1990) Surgical treatment of symptomatic colorectal endometriosis. Fertil Steril 53:411–416

    CAS  PubMed  Google Scholar 

  5. Bailey HR, Ott MT, Hartendorp P (1994) Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum 37:747–753

    Article  CAS  PubMed  Google Scholar 

  6. Verspyck E, Lefranc JP, Guyard B, Blondon J (1997) Treatment of bowel endometriosis: a report of six cases of colorectal endometriosis and a survey of the literature. Eur J Obst Gynecol Repr Biol 71:81–84

    Article  CAS  Google Scholar 

  7. Itoga T, Matsumoto T, Takeuchi H, et al. (2003) Fibrosis and smooth muscle metaplasia in rectovaginal endometriosis. Pathol Int 53:371–375

    Article  PubMed  Google Scholar 

  8. Fedele L, Bianchi S, Portuese A, Borruto F, Dorta M (1998) Transrectal ultrasonography in the assessment of rectovaginal endometriosis. Obstet Gynecol 91:444–448

    Article  CAS  PubMed  Google Scholar 

  9. Chapron C, Dumontier I, Dousset B, et al. (1998) Results and role of rectal endoscopic ultrasonography for patients with deep pelvic endometriosis. Hum Reprod 13(8):2266–2270

    Article  CAS  PubMed  Google Scholar 

  10. Bazot M, Detchev R, Cortez A, et al. (2003) Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison. Hum Reprod 18(8):1686–1692

    Article  PubMed  Google Scholar 

  11. Valenzano Menada M, Remorgida V, Abbamonte LH, et al. (2008) Hum Reprod 23(5):1069–1075

    Article  CAS  PubMed  Google Scholar 

  12. Laufer I (1994) Barium studies. In: Gore RM, Levine MS (eds) Textbook of gastrointestinal radiology. Philadelphia: W.B. Saunders, pp 1028–1040

    Google Scholar 

  13. Koga K, Osuga Y, Yano T, et al. (2003) Characteristic images of deeply infiltrating rectosigmoid endometriosis on transvaginal and transrectal ultrasonography. Hum Reprod 18(6):1328–1333

    Article  PubMed  Google Scholar 

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Correspondence to Valentino Bergamini.

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Bergamini, V., Ghezzi, F., Scarperi, S. et al. Preoperative assessment of intestinal endometriosis: a comparison of Transvaginal Sonography with Water-Contrast in the Rectum, Transrectal Sonography, and Barium Enema. Abdom Imaging 35, 732–736 (2010). https://doi.org/10.1007/s00261-010-9610-z

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