Does transvaginal ultrasonography combined with water-contrast in the rectum aid in the diagnosis of rectovaginal endometriosis infiltrating the bowel?

Mario Valenzano Menada, M Valenzano Menada, Valenzano Menada M, Valentino Remorgida, V. Remorgida, Abbamonte LH, L H Abbamonte, Luiza Helena Abbamonte, Nicoletti A, A Nicoletti, Amy Nicoletti, Nicola Ragni, N. Ragni, Ragni N, S Ferrero, Simone Ferrero
Human Reproduction · 2008 · vol. 23(5) , pp. 1069–1075 · doi:10.1093/humrep/den057 · PMID:18310049 · W2160572811
Non-randomised trial OA: bronze CC0 ⤵ 94 in-corpus citations
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Rectal water-contrast transvaginal ultrasonography improved diagnosis of deep rectovaginal endometriosis infiltration compared to standard transvaginal ultrasonography, especially for muscularis propria involvement.

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Abstract

BACKGROUND: The aim of this study was to determine whether adding water-contrast in the rectum during transvaginal ultrasonography (RWC-TVS) improves the diagnosis of rectal infiltration in women with rectovaginal endometriosis. METHODS: This prospective study included 90 women, with suspect rectovaginal endometriosis, who underwent operative laparoscopy. TVS and RWC-TVS were independently performed by different investigators. RWC-TVS was performed by injecting saline solution into the rectal lumen under ultrasonographic control through a 6-mm catheter. Presence of rectovaginal nodules, presence and degree of rectal infiltration, and the largest diameter of the bowel nodules were evaluated. Ultrasonographic results were compared to surgical and histological findings. RESULTS: Although RWC-TVS had higher accuracy than TVS in diagnosing rectovaginal endometriosis, the difference between the two techniques was not statistically significant. RWC-TVS was significantly more accurate than TVS in determining the presence of endometriotic infiltration reaching at least the muscular layer of the rectal wall. The sensitivity of RWC-TVS in identifying rectal lesions was 97%, the specificity 100%, the positive predictive value 100% and the negative predictive value 91.3%. RWC-TVS caused a higher intensity of pain than TVS. CONCLUSIONS: RWC-TVS determines the presence of rectovaginal nodules infiltrating the rectal muscularis propria more accurately than TVS; RWC-TVS could be used when TVS cannot exclude the presence of rectal infiltration.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Contrast Media Contrast Media Endometriosis Rectal Diseases Vaginal Diseases Water Water Adolescent Adolescent Adult Adult Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans Pain

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

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