Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy

Manoel Orlando da C Goncalves, Manoel Orlando Gonçalves, Goncalves MO, Sérgio Podgaec, Sergio Podgaec, José Augusto de Carvalho Dias, Dias JA Jr, Joao Antonio Dias, M. Gonzalez, Midgley Gonzalez, Gonzalez M, Mauricio S Abrao, Maurício Simões Abrão, Abrao MS
Human Reproduction · 2009 · vol. 25(3) , pp. 665–671 · doi:10.1093/humrep/dep433 · PMID:20023291 · W2134589038
article OA: bronze CC0 ⤵ 167 in-corpus citations
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Transvaginal ultrasonography with bowel preparation accurately predicts the number of rectosigmoid nodules and affected bowel layers in deep endometriosis, aiding surgical strategy definition.

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Abstract

BACKGROUND: Successful surgical treatment of deep bowel endometriosis depends on obtaining detailed information about the lesions, prior to the procedure. The objective of this study was to determine the capability of transvaginal ultrasonography with bowel preparation (TVUS-BP) to predict the presence of one or more rectosigmoid nodules and the deepest bowel layer affected by the disease. METHODS: A prospective study of 194 patients with clinical and TVUS-BP suspected deep endometriosis submitted to videolaparoscopy. Image data were compared with surgical and histological results. RESULTS: With respect to bowel nodule detection and presence of at least two rectosigmoid lesions, TVUS-BP had a sensitivity of 97 and 81%, specificity 100 and 99%, positive predictive value (PPV) 100 and 93% and negative predictive value (NPV) 98 and 96%, respectively. Regarding diagnosis of infiltration of the submucosal/mucosal layer, TVUS-BP had a sensitivity of 83%, specificity 94%, PPV 77%, NPV 96%. CONCLUSIONS: These findings show that TVUS-BP is an adequate exam for evaluating the presence of one or more rectosigmoid nodules and the deepest layer affected in deep infiltrating bowel endometriosis, confirming the importance of this technique for defining the most appropriate surgical strategy to be implemented.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Colon, Sigmoid Endometriosis Rectum Adult Colon, Sigmoid Colon, Sigmoid Endometriosis Endometriosis Female Humans Predictive Value of Tests Preoperative Care Preoperative Care Prospective Studies Rectum Rectum Sensitivity and Specificity Ultrasonography

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