OC024: Assessment of recto‐vaginal endometriosis using sonovaginography

Previously we showed that sonovaginography is an accurate ultrasonographic tool in the assessment of recto-vaginal endometriosis. The aim of this study was to compare the diagnostic accuracy of sonovaginography in the diagnosis of recto-vaginal endometriosis. A longitudinal prospective study in which 62 women with recto-vaginal endometriosis suspected with medical history and/or pelvic examination were enrolled. The study group underwent transvaginal ultrasonography and in the same session a sonovaginography was performed as follows: an assistant inserted a Foley into the vagina and an ultrasound probe covered with a specific ballon to shell the vagina. The ballon was filled with water with a mean of 40 ml, soon after an amount of 60–180 cc of saline solution was inserted trough the Foley catheter to fill the vagina with saline solution in order to create an acoustic window through the vagina to detect recto-vaginal lesions. The Bladder of women was not empty to obtain another acoustic window from the uterus and bladder. After the examination all the study group underwent laparoscopic surgery to enucleate the endometriosic lesion which was measured and sent for pathologic examination. Fifty-four (87%) patients showed recto-vaginal endome- triosic lesions. The sensitivity of sonovaginography was 92.1%, specificity 75.2%, PPV 96% and NPV 61.1%, The procedure was well tolerated with a median visual analogue scale of 2 (range 0–8). Sonovaginography is a well tolerated procedure, costless and with a high accuracy in the detection of recto-vaginal endometriosis.