Transrectal ultrasound and the diagnosis of rectovaginal endometriosis: a prospective observational study

Anthony Griffiths, Griffiths A, A Griffiths, R. N. Koutsouridou, Koutsouridou R, Roxani Koutsouridou, Vaughan S, Sue Vaughan, Penketh R, R. Penketh, Richard Penketh, S Ashley Roberts, S.A. Roberts, Roberts SA, Torkington J, Jared Torkington
Acta obstetricia et gynecologica Scandinavica · 2008 · vol. 87(4) , pp. 445–448 · doi:10.1080/00016340801948318 · PMID:18382872 · W2158276820
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Transrectal ultrasound accurately predicted rectovaginal endometriosis and extensive laparoscopic dissection needs, with a positive predictive probability of 93% and negative predictive probability of 23%.

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Abstract

BACKGROUND: Rectovaginal endometriosis is a severe form of pelvic endometriosis in which pharmacological treatment is relatively ineffective (Vercellini et al., Fertil Steril. 2005;84:1375-87). Laparoscopic surgical treatment is effective, but has the potential risks of bowel perforation and colostomy formation (Darai et al., Am J Obstet Gynecol. 2005;192:394-400). Transrectal ultrasound scanning can be applied as a preoperative tool to predict the presence of rectovaginal endometriosis and bowel wall involvement (Abrao et al., J Am Assoc Gynecol Laparosc. 2004;11:50-4). METHODS: Thirty-two women underwent transrectal ultrasound followed by therapeutic laparoscopy. Likelihood ratios and post-test prevalences were calculated with Fagan's normogram. This was then extrapolated with the aid of a mathematical model to a low-risk population. RESULTS: A positive likelihood ratio was found to be 10.89 (95% confidence ratio (CI): 1.62-73.15) and a negative likelihood ratio was found to be 0.24 (95% CI: 0.1-0.57). The pre-test prevalence of rectovaginal endometriosis was 56%. The positive post-test prevalence probability was 93%, and the negative post-test prevalence probability was 23%. CONCLUSION: Preoperative transrectal ultrasound scanning for rectovaginal endometriosis is an extremely accurate predictive test, and strongly predicts the need for extensive laparoscopic dissection and potential bowel resection.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Vaginal Diseases Endometriosis Endometriosis Female Female Humans Humans Likelihood Functions Likelihood Functions Prospective Studies Prospective Studies Rectal Diseases Rectal Diseases Rectum Rectum Rectum Sensitivity and Specificity Sensitivity and Specificity

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 ]

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