Gynaecological examination coupled with transvaginal ultrasound in the diagnosis of rectosigmoid endometriosis

Arrigo Fruscalzo, F Tuttlies, Olga Maria Schimidt Ritter, G Rauter, O Kandolf, KH Oberwinkler, Claudia Pasterk, J. Keckstein
In: Geburtshilfe und Frauenheilkunde · 2007 · vol. 67(09) · doi:10.1055/s-2007-989152 · W2730485724
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This study investigated the diagnostic accuracy of gynecological examination combined with transvaginal ultrasound for recto-sigmoid endometriosis to improve preoperative assessment.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-29 · read from full text ⓘ

This study evaluated the diagnostic accuracy of combining gynaecological examination with transvaginal ultrasound for identifying rectosigmoid endometriosis in 674 patients undergoing surgery. The researchers compared preoperative clinical and imaging findings against surgical and pathological results, which served as the gold standard. The combined approach demonstrated high sensitivity, specificity, and predictive values for detecting at least one deep infiltrating nodule, although it was less effective at identifying multiple distinct nodules. This paper is centrally about endometriosis — specifically the preoperative diagnosis of deep infiltrating lesions involving the rectosigmoid colon.

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Abstract

Aims: An accurate preoperative diagnosis of deep infiltrating endometriosis of recto-sigma is essential for an adequate counselling and surgical therapy.
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Objective

To assess the value of gynaecological examination and transvaginal ultrasound in the diagnosis of rectosigmoid endometriosis. Patients: 674 patients operated for clinical symptoms and/or signs of endometriosis between May 2005 and December 2006at the county hospital of Villach (Austria).

Methods

Prospectively, the preoperative gynaecological examination and transvaginal ultrasound findings were assessed and compared to the surgical/pathological findings of the same patients (gold standard).

Results

97 patients undergone segmental intestinal resection. All resulted affected by at least one deep infiltrating nodule of the recto-sigma and, among them, 40 by 2 or more, 5 by 3 or more and 2 by 4 distinct nodules. The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and phi correlation coefficient in the diagnosis of at least one nodule were respectively 86%, 99%, 94%, 98%, 0.88 and 97%, 99%, 92%, 99% 0.94 for the gynaecological examination and transvaginal ultrasound. No second nodules were preoperatively palpable and the above-mentioned parameters in the diagnosis of two or more nodules by US were 22%, 99%, 69%, 95% and 0.37 respectively.

Conclusion

Gynaecological examination coupled with transvaginal ultrasound is a very reliable approach in the preoperative assessment of rectosigmoid endometriosis.

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endometriosisdie_deep_infiltrating

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